Diabetes Mellitus Complicating Pregnancy

Landon, Mark B.; Catalano, Patrick M.; Gabbe, Steven G.

doi:10.1016/b978-0-323-32108-2.00040-8

Cited by 8 publications

(6 citation statements)

References 282 publications

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“…5 In pregnancy, however, a condition of ''accelerated starvation'' might be developed in an effort for adequate amounts of glucose and amino acids to be provided to the fetus for its growth and development with an exaggeration of such a process taking place especially in the third trimester. 6 This process was underlined by Metzger et al 2 by revealing increased levels of free fatty acids and ketone bodies after fasting for 12 hours in pregnant women compared to control non pregnant women with the already discussed hormone alterations of pregnancy further intensified during periods of stress such as vomiting. Such cases of starvation ketoacidosis are rarely reported and are mostly sequelae of diabetes mellitus.…”

Section: Discussionmentioning

confidence: 93%

Euglycaemic ketoacidosis during pregnancy: More common than you think

Sapantzoglou¹,

Psarris²,

Perros³

et al. 2023

HJOG

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Background: Euglycaemic ketoacidosis is a rare type of metabolic acidosis, with increased production of ketonic bodies and normal serum glucose. When it occurs during pregnancy, it might lead to adverse maternal and fetal outcomes. Pregnancy itself is a diabetogenic state that might predispose the patient to develop ketoacidosis following even relatively short periods of starvation and as such, a high index of suspicion is required for the diagnosis to be made and for the management plan to be established. Case presentation: We present a case of euglycaemic ketoacidosis in a twin pregnancy, which occurred in the second trimester, necessitating prompt and aggressive management, that eventually required early delivery due to the development of preeclampsia. Discussion/Conclusion: The physiology and pathology of euglycaemic ketoacidosis during pregnancy and the management required to avoid the potential maternal and fetal risks that such a condition might be complicated with.

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Section: Discussionmentioning

confidence: 93%

Euglycaemic ketoacidosis during pregnancy: More common than you think

Sapantzoglou¹,

Psarris²,

Perros³

et al. 2023

HJOG

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“…Table (3) shows no statistically significant difference between type 2DM and GDM groups regarding neonatal weight and gestational age (p > 0.05).…”

Section: Table (mentioning

confidence: 90%

“…The most prevalent metabolic condition that develops during pregnancy is diabetes mellitus. It has two clinical patterns: Pregestational diabetes mellitus (PGDM) and gestational diabetes mellitus (GDM) [3] .…”

Section: Introductionmentioning

confidence: 99%

Association Between Maternal Lipid Profile and Fetal Birth Weight in Type 2 Diabetes Mellitus and Gestational Diabetes Mellitus Pregnancies

Abd ELsamie,

ElBaradie,

Abd El Wahab

et al. 2024

Evidence Based Women's Health Journal

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Background: Diabetes raises the risk of maternal and neonatal morbidity and mortality. Fetal macrosomia is one of the most common perinatal problems in diabetes pregnancy, particularly in women with poor glycemic control. Aim: Determine the association between maternal serum lipid levels, particularly TG and TC levels, and newborn BW. Also, the ability of TG and TC levels was tested to predict macrosomia. Materials and Methods: This observational cohort study was conducted on 150 pregnant women divided into two groups 75 pregnant women with type2 DM and 75 pregnant women with GDM at 3 rd trimester GA of 29-40 week. The following lipid parameters were measured. Results: There is no statistically significant difference between the type 2DM group compared to GDM group regarding age, height, weight, BMI, F.B.G, 2HPP.BG, HbA1c, parity LDL, neonatal weight and gestational age (p > 0.05). On the other hand, there was a statistically significant difference between the type 2DM and GDM groups regarding TC, TG, and HDL. By applying Spearman's correlation test, there was a statistically significant positive correlation between neonatal weight and age, TC, TG, and parity in the type 2DM group. Regression analysis defined Neonatal weight development among the type 2DM group as the persistently significant positive predictor for TG. Conclusion:This research demonstrated the utility of measuring fasting serum TG and TC levels measured at thirdtrimester pregnancy correlated positively with neonatal BW and may be considered an independent predictor of fetal macrosomia at term in type 2DM and GDM.

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“…Patients also underwent self-monitoring of blood glucose (SMBG) four times daily (at fasting (before breakfast) and 2 h after each meal) using the same SMBG equipment (OneTouchVerioVue®; LifeScan Japan). We used a target glucose levels < 5.27 mmol/L (95 mg/dL) at fasting and <6.66 mmol/L (120 mg/dL) at 2 h after each meal [ 9 , 10 ]. Because postprandial capillary glucose values are known to be 20%-25% higher than the venous glucose values [ 11 ], we accepted <130 mg/dL as the postprandial target on the SMBG profile in the clinical setting.…”

Section: Methodsmentioning

confidence: 99%

Achievement of Target Glycemic Goal with Simple Basal Insulin Regimen in Women with Gestational Diabetes: A Prospective Cohort Study

Fukuoka,

Yasuhi,

Yamashita

et al. 2023

Journal of Diabetes Research

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There is little evidence concerning the need to treat gestational diabetes (GDM) in the same way as pregestational diabetes. We evaluated the efficacy of the simple insulin injection (SII) regimen for achieving the target glucose goal without increasing adverse perinatal outcomes in singleton pregnant women with GDM. All subjects underwent self-monitoring of blood glucose (SMBG), and insulin therapy was indicated according to the SMBG profile. Insulin was initially started with the SII regimen, in which one daily injection of NPH insulin before breakfast was used, and another NPH injection was added at bedtime, if necessary. We used the target glucose as <95 mg/dL at fasting and <120 mg/dL postprandial and accepted <130 mg/dL for the latter. If the target glucose did not reach with the regimen, we switched to the multiple daily injection (MDI) with additional prandial insulin aspart. We compared the SMBG profile before delivery as well as the perinatal outcomes between the SII and MDI groups. Among 361 women (age 33.7 years, nullipara 41%, prepregnancy body mass index 23.2 kg/m2) with GDM, 59%, 18%, and 23% were in the diet-alone, SII, and MDI groups, respectively. Consequently, regarding women requiring insulin therapy, 43% were treated with the SII regimen throughout pregnancy. The severity of baseline hyperglycemia according to the SMBG data at baseline was the MDI>the SII>the diet group. The rate of achieving target glucose levels before delivery in the SII group at fasting, postprandial < 120 mg/dL and <130 mg/dL were 93%, 54% and 87%, respectively, which were similar to that in the MDI group (93%, 57%, and 93%, respectively), with no significant differences in perinatal outcomes. In conclusion, more than 40% of women with GDM requiring insulin therapy achieved the target glucose goal with this simple insulin regimen without any increase in adverse effects.

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Diabetes Mellitus Complicating Pregnancy

Cited by 8 publications

References 282 publications

Euglycaemic ketoacidosis during pregnancy: More common than you think

Euglycaemic ketoacidosis during pregnancy: More common than you think

Association Between Maternal Lipid Profile and Fetal Birth Weight in Type 2 Diabetes Mellitus and Gestational Diabetes Mellitus Pregnancies

Achievement of Target Glycemic Goal with Simple Basal Insulin Regimen in Women with Gestational Diabetes: A Prospective Cohort Study

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