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- September 9, 2010 |
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CME on Diabetes is a website built to transmit top-level CME conferences given by international experts in endocrinology, insulin resistance, prediabetes, metabolic syndrome and type 2 diabetes. More than 2.6 million slides have been viewed since the website launch. Thank you for your continued support and commitment!
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"Glucose Targets in and Around Pregnancy: How Low Can You Go? Part II"Dr. David McIntyre (biography)
English - 2005-06-15 - 32 minutes
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Summary :
In this presentation Dr. McIntyre talks about diabetes care in pre-pregnancy and early pregnancy, with a focus on action to improve pre-pregnancy glycaemic control.
Studies have shown a reduced frequency of malformed infants born to mothers who received pre-conception diabetes care. Even with widespread knowledge of the value of pre-conception care, less than half the diabetic women in a study by Holing et al. had planned pregnancies, and factors associated with planned pregnancies included higher income and education and a positive relationship with doctors (1).
Intensive treatment options in type 1 diabetes are the classical DCCT style care (multiple daily injections or continuous subcutaneous insulin infusion (CSII); or the DTTP style care developed in Germany, which has been adapted as the DAFNE (Dose Adjustment for Normal Eating) program in the UK. Dr. McIntyre compares the 2 programs including outcome data, and the pros and cons of CSIIs. As important as controlling diabetes itself are other points in general management such as folic acid supplementation, complications screening and treatment, thyroid function tests, and others.
With regards to the role of insulin analogs, cohort studies suggest safety of short-acting insulin lispro in pregnancy, though more studies are needed on the long-acting analogs such as glargine and detemir. Dr. McIntyre presents several papers on the efficacy and safety of insulin analogs in pregnancy, and ends with some thoughts on what are the barriers to improved glycaemic control.
Copyright © 2005 E-MedHosting.com Inc.
Learning objectives :
After viewing this presentation the participant will be able to discuss:
Action to improve pre pregnancy glycaemic control
- Pre conception care
- Intensive therapy options
- Factors other than glycaemia
- Insulin analogs
Bibliographic references :
1. EV Holing, CS Beyer, ZA Brown and FA Connell.Why don't women with diabetes plan their pregnancies? Diabetes Care 1998;Vol 21, Issue 6 889-895.
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