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Pregestational (type 1 and type 2) diabetes: care and complications during pregnancy 

Pregestational (type 1 and type 2) diabetes: care and complications during pregnancy
Chapter:
Pregestational (type 1 and type 2) diabetes: care and complications during pregnancy
Author(s):

Helen R Murphy

DOI:
10.1093/med/9780199593033.003.0017
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date: 23 October 2019

Fetal growth acceleration resulting in the delivery of a large for gestational age or macrosomic infant is the commonest complication of pregnancy affecting approximately 50% of diabetic pregnancies

Macrosomic infants are at increased risk both of immediate birth complications (shoulder dystocia, neonatal hypoglycaemia and neonatal care admission) and of longer term complications (insulin resistance, obesity and type 2 diabetes)

Pre-eclampsia complicates 13% or 1 in 7 diabetes pregnancies and is closely related to glycaemic control during the second trimester

Quick acting analogues (NovoRapid® and Humalog®) are the preferred prandial insulins. Basal insulin replacement is controversial with NICE recommending only Neutral Protamine Hagedorn (NPH) or pump therapy during pregnancy.

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