Type 2 Diabetes in Pregnancy

Anil Kapur; Harold David McIntyre; Moshe Hod

doi:10.1016/j.ecl.2019.05.009

Type 2 Diabetes in Pregnancy

Endocrinol Metab Clin North Am. 2019 Sep;48(3):511-531. doi: 10.1016/j.ecl.2019.05.009. Epub 2019 Jun 26.

Authors

Anil Kapur¹, Harold David McIntyre², Moshe Hod³

Affiliations

¹ World Diabetes Foundation, 30 A, Krogshoejvej, Bagsverd 2880, Denmark; FIGO Pregnancy and NCD Committee, Jabotinski Street, Petah Tiqwa 49100, Israel. Electronic address: dr.anilkapur@gmail.com.
² FIGO Pregnancy and NCD Committee, Jabotinski Street, Petah Tiqwa 49100, Israel; UQ Mater Clinical Unit, Faculty of Medicine, Mater Health Services, University of Queensland, Raymond Terrace, South Brisbane, Brisbane, Qld 4101, Australia.
³ FIGO Pregnancy and NCD Committee, Jabotinski Street, Petah Tiqwa 49100, Israel; Department of Obstetrics and Gynecology, Clalit Health Services, Mor Women's Health Center, Rabin Medical Center, Tel Aviv University, 18 Aba Ahimeir St., Tel Aviv 6949204, Israel.

PMID: 31345520
DOI: 10.1016/j.ecl.2019.05.009

Abstract

Hyperglycemia is common during pregnancy, involving multisystem adaptations. Pregnancy-induced metabolic changes increase insulin resistance. Pregnancy-induced insulin resistance adds to preexisting insulin resistance. Preexisting pancreatic β-cell defect compromises the ability to enhance insulin secretion, leading to hyperglycemia. Women with type 2 DM have similar rates of major congenital malformations, stillbirth, and neonatal mortality, but an even higher risk of perinatal mortality. In utero type 2 DM exposure confers greater risk and reduces time to development of type 2 DM in offspring. Preconception care to improve metabolic control in women with type 2 diabetes is critical.

Keywords: Management; Pregnancy hyperglycemia; Type 2 diabetes.

Publication types

Review

MeSH terms

Congenital Abnormalities / blood
Congenital Abnormalities / epidemiology
Congenital Abnormalities / etiology
Congenital Abnormalities / prevention & control
Diabetes Mellitus, Type 2* / blood
Diabetes Mellitus, Type 2* / epidemiology
Diabetes Mellitus, Type 2* / therapy
Female
Glycated Hemoglobin / analysis
Humans
Preconception Care / methods
Pregnancy
Pregnancy Outcome / epidemiology
Pregnancy in Diabetics* / blood
Pregnancy in Diabetics* / epidemiology
Pregnancy in Diabetics* / therapy
Prenatal Exposure Delayed Effects / blood
Prenatal Exposure Delayed Effects / diagnosis
Prenatal Exposure Delayed Effects / prevention & control

Substances

Glycated Hemoglobin A