Journal ArticleDOI
Preconception care of diabetes. Glycemic control prevents congenital anomalies.
John L. Kitzmiller,Laurence A. Gavin,Gary D. Gin,Lois Jovanovic-Peterson,Elliott K. Main,William D. Zigrang +5 more
TLDR
It is concluded that education and intensive management for glycemic control of diabetic women before and during early pregnancy will prevent excess rates of congenital anomalies in their infants.Abstract:
To test the value of intensive management of diabetes before and during early pregnancy, 84 women recruited prior to conception were compared with 110 women who were already pregnant referred at 6 to 30 weeks' gestation. All underwent daily measurement of fasting and postprandial capillary blood glucose levels. Mean blood glucose levels during embryogenesis and organogenesis were within 3.3 to 7.8 mmol/L in 50% of preconception subjects and exceeded 10 mmol/L in 6.5%. One major congenital anomaly occurred in 84 infants (1.2%) of women treated before conception compared with 12 anomalies in 110 infants (10.9%) of mothers in the postconception group. Transient symptomatic hypoglycemia occurred during embryogenesis in 60% of women in the preconception group, with a median frequency of 2.7 episodes per week, but was not associated with excess malformations. We conclude that education and intensive management for glycemic control of diabetic women before and during early pregnancy will prevent excess rates of congenital anomalies in their infants.read more
Citations
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Standards of Medical Care in Diabetes
TL;DR: These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care.
Journal ArticleDOI
Standards of Medical Care in Diabetes—2010
TL;DR: These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, general treatment goals, and tools to evaluate the quality of care.
Journal ArticleDOI
Standards of medical care in diabetes--2006: response to the American Diabetes Association.
TL;DR: In regard to the ADA’s recommendation to use statin therapy for diabetic patients without overt cardiovascular disease (CVD), the recommendation to treat “regardless of baseline LDL” might have extended beyond the evidence quoted.
References
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Journal ArticleDOI
Elevated maternal hemoglobin A1c in early pregnancy and major congenital anomalies in infants of diabetic mothers.
Edith Miller,John W. Hare,John P. Cloherty,P J Dunn,Ray E. Gleason,J. S. Soeldner,John L. Kitzmiller +6 more
TL;DR: Fetal malformations occur before eight weeks of gestation (postmenstrual dates), when most diabetic pregnant women have not yet come to medical attention, and there has been no objective method to assess control.
Journal ArticleDOI
Malformations in Infants of Diabetic Mothers Occur Before the Seventh Gestational Week: Implications for Treatment
TL;DR: Developmental morphologic dating shows that the significantly more common congenital malformations in infants of diabetic mothers occur before the seventh week of gestation, which suggests that any therapeutic intervention aimed at decreasing the incidence of congenital Malformations must be instituted during the critical early period.
Journal ArticleDOI
Prevention of Congenital Malformations in Infants of Insulin-dependent Diabetic Mothers
Kurt Fuhrmann,Horst Reiher,Klaus Semmler,Friedericke Fischer,Michael Fischer,Eberhard Glöckner +5 more
TL;DR: It is indicated that reasonable metabolic control started before conception and continued during the first weeks of pregnancy can prevent malformations in infants of diabetic mothers.
Journal ArticleDOI
The Pregnant Diabetic and Her Newborn
TL;DR: In this 2nd edition J0rgen Pedersen has performed a service in lucid English and in a handy book for those paediatricians both old and new to this subject, the old may look critically at their own work through his discerning eyes and the young will find all the information they need before starting work on a problem which, like diabetes itself, is in some ways as challenging now as it was 25 years ago.
Journal ArticleDOI
Incidence of Spontaneous Abortion among Normal Women and Insulin-Dependent Diabetic Women Whose Pregnancies Were Identified within 21 Days of Conception
James L. Mills,Simpson Jl,Driscoll Sg,Lois Jovanovic-Peterson,Van Allen M,J. H. Aarons,Boyd E. Metzger,Frederick R. Bieber,Robert H. Knopp,L. B. Holmes +9 more
TL;DR: It is concluded that diabeticWomen with good metabolic control are no more likely than nondiabetic women to lose a pregnancy, but that diabetic women with elevated blood glucose and glycosylated hemoglobin levels in the first trimester have a significantly increased risk of having a spontaneous abortion.