Medicine an Surgery notes

Apr 24th, 2015
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DIABETES MELLITUS & PREGNANCYDefinitionsGestational diabetes mellitus (GDM) is defined as glucose intolerance of variable degree with onset or first recognition during pregnancy.The above definition applies regardless of whether insulin or only diet modification is used for treatment or whether the condition continues after pregnancyEpidemiologyAbnormal maternal glucose regulation occurs in 3-10% of pregnanciesStudies suggest that the prevalence of diabetes mellitus (DM) among women of childbearing age is increasing in the United States.This increase is believed to be attributable to more sedentary lifestyles, changes in diet, continued immigration from high-risk populations, and the virtual epidemic of childhood and adolescent obesity that is presently evolving in United States.Gestational diabetes mellitus accounts for 90% of cases of diabetes mellitus in pregnancy.Type II diabetes mellitus accounts for 8% of cases of diabetes mellitus in pregnancy, and given its increasing incidence, preexisting diabetes mellitus now affects 1% of pregnanciesPreexisting diabetes (i.e. diabetes diagnosed prior to pregnancy) affects approximately 1-3 pregnancies per 1000 births.GDM complicates approximately 4% of pregnanciesInfants of mothers with preexisting diabetes experience double the risk of serious injury at birth, triple the likelihood of cesarean delivery, and quadruple the incidence of newborn intensive care unit admission. Studies indicate that the risk of the

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