Understanding the Diabetes-Pregnancy Nexus
Diabetes, a condition that has been long associated with numerous complications, presents unique challenges when it intersects with pregnancy. The article from Lancet delves deep into this topic, shedding light on the multifaceted implications of this condition.
The Source Article Details
Trends in incidence of diabetes in pregnancy and serious perinatal outcomes: a large, population-based study in Ontario, Canada, 1996-2010. by DS Feig et al. in 2017.
Cited By: 410 (Updated: November 27, 2023)
The Source Article's Abstract
Objective: Women with diabetes in pregnancy have high rates of pregnancy complications. Our aims were to explore trends in the incidence of diabetes in pregnancy and examine whether the risk of serious perinatal outcomes has changed.
Research design and methods: We performed a population-based cohort study of 1,109,605 women who delivered in Ontario, Canada, between 1 April 1996 and 31 March 2010. We categorized women as gestational diabetes (GDM) (n = 45,384), pregestational diabetes (pre-GDM) (n = 13,278), or no diabetes (n = 1,050,943). The annual age-adjusted rates of diabetes in pregnancy were calculated, and rates of serious perinatal outcomes were compared between groups and by year using Poisson regression.
Results: The age-adjusted rate of both GDM (2.7-5.6%, P < 0.001) and pre-GDM (0.7-1.5%, P < 0.001) doubled from 1996 to 2010. The rate of congenital anomalies declined by 23%, whereas the rate of perinatal mortality did not change significantly. However, compared with women with no diabetes, women with pre-GDM and GDM faced an increased risk of congenital anomalies (relative risk 1.86 [95% CI 1.49-2.33] and 1.26 [1.09-1.45], respectively), and perinatal mortality remained elevated in women with pre-GDM (2.33 [1.59-3.43]).
Conclusions: The incidence of both GDM and pre-GDM in pregnancy has doubled over the last 14 years, and the overall burden of diabetes in pregnancy on society is growing. Although congenital anomaly rates have declined in women with diabetes, perinatal mortality rates remain unchanged, and the risk of both remains significantly elevated compared with nondiabetic women. Increased efforts are needed to reduce these adverse outcomes.
The Source Article References
- Trends in incidence of diabetes in pregnancy and serious perinatal outcomes: a large, population-based study in Ontario, Canada, 1996–2010 by Feig, 2014 in Diabetes Care
- Obstetric and perinatal outcomes in type 1 diabetic pregnancies: a large, population-based study by Persson, 2009 in Diabetes Care
- Perinatal mortality and congenital anomalies in babies of women with type 1 or type 2 diabetes in England, Wales, and Northern Ireland: population based study by Macintosh, 2006 in BMJ
- Risk of complications of pregnancy in women with type 1 diabetes: nationwide prospective study in the Netherlands by Evers, 2004 in BMJ
- Pre-pregnancy care for women with pre-gestational diabetes mellitus: a systematic review and meta-analysis by Wahabi, 2012 in BMC Public Health
- Effectiveness of a regional prepregnancy care program in women with type 1 and type 2 diabetes: benefits beyond glycemic control by Murphy, 2010 in Diabetes Care
- Glycemic targets in the second and third trimester of pregnancy for women with type 1 diabetes by Maresh, 2015 in Diabetes Care
- Optimal glycemic control, pre-eclampsia, and gestational hypertension in women with type 1 diabetes in the diabetes and pre-eclampsia intervention trial by Holmes, 2011 in Diabetes Care
- Improved pregnancy outcomes in women with type 1 and type 2 diabetes but substantial clinic-to-clinic variations: a prospective nationwide study by Murphy, 2017 in Diabetologia
- Pharmacokinetics of insulin aspart in pregnant women with type 1 diabetes: every day is different by Goudie, 2014 in Diabetes Care
- Pathophysiology of postprandial hyperglycaemia in women with type 1 diabetes during pregnancy by Murphy, 2012 in Diabetologia
- Insulin requirements throughout pregnancy in women with type 1 diabetes mellitus: three changes of direction by Garcia-Patterson, 2010 in Diabetologia
- Hypoglycaemia during pregnancy in women with type 1 diabetes by Ringholm, 2012 in Diabet Med
- Changes in the glycemic profiles of women with type 1 and type 2 diabetes during pregnancy by Murphy, 2007 in Diabetes Care
- Glycaemic control in type 1 diabetes during real time continuous glucose monitoring compared with self monitoring of blood glucose: meta-analysis of randomised controlled trials using individual patient data by Pickup, 2011 in BMJ
- Continuous glucose monitoring and intensive treatment of type 1 diabetes by Tamborlane, 2008 in N Engl J Med
- Effectiveness of continuous glucose monitoring in pregnant women with diabetes: randomised clinical trial by Murphy, 2008 in BMJ
- The effect of real-time continuous glucose monitoring in pregnant women with diabetes: a randomized controlled trial by Secher, 2013 in Diabetes Care
- CONCEPTt: continuous glucose monitoring in women with type 1 diabetes in pregnancy trial: a multi-center, multi-national, randomized controlled trial—study protocol by Feig, 2016 in BMC Pregnancy Childbirth
- Anthropometric estimation of neonatal body composition by Catalano, 1995 in Am J Obstet Gynecol
Citing the Source Article (APA)
Feig, D. (2017). Trends in incidence of diabetes in pregnancy and serious perinatal outcomes: a large, population-based study in Ontario, Canada, 1996-2010.. Lancet, 390(10110), 2347-2359. 10.1016/S0140-6736(17)32400-5
The Medical Implications
Diabetes during pregnancy can lead to a plethora of complications, both for the mother and the child. From increased risks of gestational diabetes to potential birth complications, the stakes are high.
Moreover, the article emphasizes the importance of monitoring and managing blood glucose levels, highlighting the role of insulin in ensuring a healthy pregnancy outcome.
Key Takeaways for Medical Professionals
- Early diagnosis and management of diabetes during pregnancy are crucial.
- Regular monitoring of blood glucose levels can prevent potential complications.
- Insulin therapy plays a pivotal role in managing diabetes in pregnant women.
Looking Ahead: The Future of Diabetes Research
With advancements in medical research, there’s hope for better management strategies for diabetes during pregnancy. The article underscores the need for continuous research and innovation in this domain.
For medical professionals, staying abreast of the latest research findings is imperative. It not only equips them with the knowledge to provide optimal care but also paves the way for improved patient outcomes.
What are your thoughts on the findings of this article? How do you think it will shape the future of diabetes research and treatment? Share your insights below.