The IRELAnD study—investigating the role of early low-dose aspirin in diabetes mellitus: a double-blinded, placebo-controlled, randomized trial

Finnegan, Catherine; Dicker, Patrick; Asandei, Denisa; Higgins, Mary; O'Gorman, Neil; O’ Riordan, Mairead; Dunne, Fidelma; Gaffney, Geraldine; Newman, Christine; McAuliffe, Fionnuala; Ciprike, Vineta; Fernandez, Elena; Malone, Fergal D.; Breathnach, Fionnuala M.

doi:10.1016/j.ajogmf.2024.101297

American Journal of Obstetrics & Gynecology MFM

2024

DOI: 10.1016/j.ajogmf.2024.101297

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The IRELAnD study—investigating the role of early low-dose aspirin in diabetes mellitus: a double-blinded, placebo-controlled, randomized trial

Catherine Finnegan,

Patrick Dicker,

Denisa Asandei

et al.

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2024

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Cited by 3 publications

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Managing diabetic chronic kidney disease in pregnancy: Current clinical practice and uncertainties

Banerjee,

Brackenridge

2024

Diabet Med

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BackgroundPre‐gestational diabetes occurs in approximately 1% of pregnancies in the UK and increases the risk of adverse maternal and fetal outcomes. More women with type 2 than type 1 diabetes are now becoming pregnant and tend to have higher rates of obesity and other multi‐morbidities. Chronic kidney disease (CKD) affects approximately 5%–10% of pregnant women with type 1 diabetes and about 2%–3% with type 2 diabetes. Diabetic chronic kidney disease (DCKD) increases the risk of preeclampsia, preterm birth, Caesarean section, small for gestational age (SGA) infant and infant admission to neonatal intensive care unit (NICU), and risks are higher compared to those with diabetes without CKD and those with CKD from other causes. Definitions of CKD in pregnancy are not standardised, and studies are generally small, observational, heterogenous, mainly include women with type 1 diabetes and often predate modern diabetes management such as continuous glucose monitoring and insulin pumps. Therefore, there is a lack of robust data to guide practice and clinical guidelines offer conflicting advice, without precise detail.AimsWe present our approach to caring for women with diabetes and CKD in pregnancy based on available guidelines and clinical experience.Discussion and ConclusionOur practice is to aim for intensive targets for blood pressure and glycaemic control pre and during pregnancy, lower than suggested in many guidelines. The importance of multidisciplinary team work and patient centred care is emphasised. Using standardised prospective data collection to better understand the prevalence and outcomes of diabetes and CKD in contemporary pregnancy populations, is recommended to drive future improvements in care.

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Managing diabetic chronic kidney disease in pregnancy: Current clinical practice and uncertainties

Banerjee,

Brackenridge

2024

Diabet Med

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The Latest Trends in the Management of Type 1 and Type 2 Diabetes Mellitus

DeClue,

Gonzalez,

Bradley

et al. 2024

Endocrines

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Over the past few years, we have witnessed many advances in the understanding of diabetes and its management. Greater insight into pathogenesis has led to the approval of the first immunopreventative therapy for T1DM. We are using non-insulin agents more for nephro- and cardioprotection than glucose-lowering effects while leaning on advancing technology to use insulin more safely. We now recognize that over half of T1DM is diagnosed in adulthood, the prevalence of obesity in patients with T1DM matches that of the general population, and rates of pediatric T2DM have dramatically risen amongst marginalized youths in recent years. Diabetes is now considered more of a heterogenous disease state than ever before, and practitioners will need to be familiar with these endotypes as personalized medicine replaces standardized treatment approaches. To this end, this article aims to summarize recent findings in an easily digestible manner so that providers may be more familiar with this ever-growing complex disease state.

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Controversies and Clarifications Regarding the Role of Aspirin in Preeclampsia Prevention: A Focused Review

Rottenstreich

2024

JCM

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Preeclampsia is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. In recent decades, many studies have evaluated different interventions in order to prevent the occurrence of preeclampsia. Among these, administration of low-dose aspirin from early pregnancy showed consistent evidence of its prophylactic role. In this article, we review the scientific literature on this topic, highlighting the rationale for aspirin use, who should be treated, the timing of initiation and cessation of therapy, the importance of proper dosing, and its role in the prevention of other adverse outcomes.

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The IRELAnD study—investigating the role of early low-dose aspirin in diabetes mellitus: a double-blinded, placebo-controlled, randomized trial

Cited by 3 publications

References 38 publications

Managing diabetic chronic kidney disease in pregnancy: Current clinical practice and uncertainties

Managing diabetic chronic kidney disease in pregnancy: Current clinical practice and uncertainties

The Latest Trends in the Management of Type 1 and Type 2 Diabetes Mellitus

Controversies and Clarifications Regarding the Role of Aspirin in Preeclampsia Prevention: A Focused Review

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