糖尿病と妊娠

Introduction

About one in 100 women of childbearing age have diabetes before pregnancy (pre-existing diabetes). Another 3-5% develop diabetes during pregnancy (gestational diabetes). While diabetes poses some risks in pregnancy, advances in healthcare have greatly improved the outlook for these pregnancies. However, untreated or poorly controlled gestational diabetes can seriously harm the fetus.

Scope of this report

• Review of therapeutic approaches to gestational diabetes mellitus and pre-existing diabetes during pregnancy to protect the health of mother & baby
• Overview of screening and diagnosis guidelines

Research and analysis highlights

The prevalence of congenital anomalies among children of diabetic women is much higher compared to non-diabetic women. The frequency of malformations correlates with the degree of maternal glycemic control. Their prevalence may be reduced by normalization of blood glucose and the maintenance of normal glycemic control throughout the pregnancy.

Key reasons to read this report

• Get insight in the current therapeutic approaches used to treat women with gestational and pre-existing diabetes during pregnancy
• Understand the effect of diabetes in pregnancy outcomes and gauge the impact of diabetic complications in the treatment of pregnant women

ABOUT DATAMONITOR HEALTHCARE

About the Cardiovascular pharmaceutical analysis team

EXECUTIVE SUMMARY

Introduction

Scope and coverage of the Brief

Key findings about the topic

GESTATIONAL DIABETES MELLITUS

Definition

Screening and diagnosis

Prevalence

Pathophysiology

The mother

The fetus

Management of GDM

Antepartum management

Nutrition therapy

Monitoring effectiveness of therapy

Intensification of treatment

Obstetric management

Assessment of fetal wellbeing

Timing and mode of delivery

Management after pregnancy

The mother

The child

MANAGEMENT OF PREGNANT DIABETICS

Preconceptional metabolic control and congenital malformations

Management of pregnant diabetic women without complications

Nutrition recommendations

Exercise

Insulin

Hypoglycemia

Ketosis

Management of pregnant diabetic women with vascular complications

Coronary artery disease

Diabetic nephropathy

Retinopathy

APPENDIX

Bibliography

Disclaimer

List of Tables

Table 1: Diagnostic criteria for GDM

Table 2: Glucose targets for antepartum management of GDM

Table 3: Estimated prevalence of CAD in diabetics in the seven major markets, 2003

Table 4: Estimated prevalence of diabetic nephropathy in the seven major markets, 2003

Table 5: Changes in kidney structure and function in diabetic nephropathy

Table 6: Perinatal outcome of patients with diabetic nephropathy

Table 7: Estimated prevalence of diabetic retinopathy in the seven major markets, 2003

List of Figures

Figure 1: Classification of patients at risk of developing GDM

Figure 2: Recommended screening for patients at risk of developing GDM

Figure 3: White's classification of diabetes in pregnancy