Diabetes In Pregnancy Ecab

Gestational diabetes mellitus (GDM) is classically seen in about 5–8% of the pregnant women. The condition appears to be caused by the same broad spectrum of physiological and genetic peculiarities that characterize diabetes outside of pregnancy. These women with GDM are also otherwise at high risk of having or developing diabetes even when not pregnant. The controversies regarding the diagnosis, management, and prevention of diabetes in pregnancy pose specific problems in clinical practice such as how to clinch the diagnosis, when to introduce therapy, what therapy to introduce, and how to predict the future course of the condition. This book is designed to address such questions with supportive typical clinical scenarios, with which all readers will be able to identify. Thus it provides an excellent opportunity to widen one’s perspective in this area.

The management of medical disorders in pregnancy has undergone significant changes in the recent years. The pattern of disease has changed with improvements in socio-economic conditions. For example, the incidence of antenatal anemia has decreased progressively in the past few decades, and pulmonary tuberculosis (which used to be prevalent) is now seen only rarely. Chronic rheumatic heart disease has also become less common. On the other hand, gestational diabetes has become more common. This may be due partly to the setting up of screening services for gestational diabetes in many hospitals. The four most common medical disorders complicating pregnancy are anemia, diabetes mellitus, cardiac disease, and thyroid disorders. In addition, because of the improvements in the medical, obstetric, and anesthetic management of pregnancy, many women with medical disorders can go through a pregnancy without major problems. There has also been a progressive decrease in the perinatal mortality associated with some medical disorders, such as diabetes. It is important for all healthcare professionals involved in the management of pregnant women with medical disorders to be conversant with the latest developments in order to provide the best care to these women. The chapters in this issue are certainly helpful in this respect. The eminent authors for the various chapters have discussed the various options available describing in detail their experiences regarding the various aspects of the condition.

Babies of women with diabetes are nearly five times more likely to be stillborn and almost three times more likely to die in the first three months. The incidence of gestational diabetes mellitus in the U.S. is high—between 3 and 7 percent—and rising. The condition is often complicated by other risk factors such as obesity and heart disease. The Textbook of Diabetes and Pregnancy presents a comprehensive review of the science, clinical management, and medical implications of gestational diabetes mellitus, a condition with serious consequences that is on the increase in all developed societies. This new edition supports the latest initiatives and strategies of the International Federation of Gynecology and Obstetrics (FIGO) and adds chapters on noncommunicable diseases, obesity, bariatric surgery, and epidemiology outside Western cultures. Written by a cadre of experts, the book provides a comprehensive, authoritative, and international view of gestational diabetes mellitus and will be invaluable to maternal-fetal medicine specialists, diabetologists, neonatologists, and a growing number of gynecologists and general physicians concerned with the management of noncommunicable diseases in pregnancy.

The most trusted reference on treating pregnancy with diabetes is back in a new edition Pregnancy complicated by diabetes is a medical challenge that can be minimized through a program of expert protocols and patient partnerships. This book presents a complete package of these protocols that when followed, can help produce healthy infants in pregnancies complicated by type 1, type 2, and gestational diabetes. Based on an ADA Technical Review, this fourth edition provides up-to-date information that includes: new guidelines for treatment using the new insulin analogues; a discussion on the use of oral hypoglycemic agents in pregnancy; and the latest in obstetrical surveillance of pregnant women with diabetes.

Abstract: This book is designed to cover all aspects of pregnancies in women with diabetes mellitus. It includes information concerning preconception counseling, the metabolic alterations of normal and diabetic pregnancies, management of women with both types (I and II) of diabetes, and gestational diabetes. Although more risks are involved in pregnancies of diabetic women, proper care and careful monitoring by a health care team throughout the pregnancy can reduce complications and help to insure the birth of a healthy baby.

Includes articles and FAQs on managing and living with gestational diabetes.

There are certain structural and functional changes that develop in the urinary tract during normal regnancy, which are significantly different than non-pregnant normal females. During pregnancy in women with underlying chronic kidney disease (CKD), the adaptation to these changes may not be optimal. Under these circumstances, the pregnancy outcome as well as maternal CKD may be affected. The issue focuses on the physiological changes in the kidney and assessment of proteinuria and GFR during pregnancy. The current update also details the cases of pregnancy in the setting of CKD describing the effect of CKD on pregnancy as well as effect of pregnancy on CKD. The chapter on pregnancy-induced hypertension―Pre-eclampsia focuses on the prevention and management of complications in the patient. The authors also give an insight into the pregnancy in cases after kidney transplantation.

Decision making in instituting insulin therapy is an important aspect of diabetes management. The appropriate insulin regimen for an individual patient should take into account the patient’s lifestyle, age, motivation, general health, self-management skills, and treatment goals. In addition, a discussion of the newer insulins versus older insulin is a much desired topic in the Indian context. Another area of interest is the insulin delivery mechanism in the intensive care units in hospital settings. This CME module is designed to address such questions with supportive typical clinical scenarios, with which all readers will be able to identify. Thus it provides an excellent opportunity to widen one’s perspective in this area.

Diet plays an important role in the treatment of diabetes, alone or in combination with insulin or oral hypoglycemic drugs. The diabetic nutrition plan of an individual necessitates to be based upon, excepting the usual parameters, his/her socioeconomic status, ethnicity/religion, and local food habits. It is important that diet plan is individualized and also region based. Since there are a number of artificial sweeteners available now, it is necessary that physicians should take in account scientific data while prescribing any artificial sweetener. This issue in the ECAB Update Series: Diabetology reviews these issues in accordance with the Indian Dietary habits and available evidence to support the clinical decisions.

Diabetes management, outcomes and prognosis are majorly affected by the lifestyle exercised by the diabetics. Diabetes has significant impact on the different facets of life. These facets tend to get overlooked in the management. The inter-relation of diabetes and marriage, sleep, travel, commute and uneven working hours seem to be trivial part of managing diabetes but are extremely important for a perfect recovery and management of the patient. Patients travelling with diabetes need to consider how to adapt their treatment programs to unfamiliar foods, irregular schedules, and varying amounts of exercise. Diabetes will be involved at every step of married life including vacations, outings, going to the movies, as well as intimate moments. Sleep and diabetes are interconnected. Sleep disorders have a slight but significant impact on diabetes management and it should be focused while attending a diabetic with sleep disorders. Shift workers make a special segment of diabetics, whose glucose monitoring and control need to be tailored in a special manner. With change in circadian rhythm and sleep pattern, diabetes management needs to be adjudged and adjusted. The main risks that arise in driving from having diabetes are hypoglycemia and the long term complications. All these aspects are being thoroughly covered in this book so as to facilitate better management of diabetes.