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Feature Article

Type 2 diabetes in pregnancy: what are the risks?

CHRISTOPHER J. NOLAN

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Abstract

Type 2 diabetes in pregnancy is common and associated with increased rates of serious adverse pregnancy outcomes. Increased awareness that this is a serious condition of pregnancy is of paramount importance. Preconception care and a multidisciplinary team approach throughout pregnancy are key to improving outcomes.

Key Points

  • Type 2 diabetes in pregnancy is an increasingly common condition, often undiagnosed prior to pregnancy.
  • It is associated with increased rates of serious adverse pregnancy outcomes, including congenital anomalies and perinatal death.
  • Women considering pregnancy and with risk factors for type 2 diabetes should be screened for diabetes prepregnancy and, if negative, be screened again in the rst trimester.
  • Preconceptive care with optimisation of metabolic control, assessment and management of diabetes complications, changing of medications to those safe for use in pregnancy and folic acid supplementation will have the greatest impact on improving outcomes.
  • A multidisciplinary team approach is required, with clinicians experienced in managing diabetes in pregnancy, for optimal results for both mother and baby.

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