Type 1 diabetes in pregnancy can result in significant short- and long-term morbidity to both mother and offspring if management is suboptimal. This morbidity imposes a considerable financial and health burden on the individual and society at large. There is currently a significant body of knowledge to offer guidance on optimal obstetric management of the woman with type 1 diabetes. Utilization of appropriate management guidelines preconception and during pregnancy is an effective strategy to limit complications of type 1 diabetes and should therefore become the standard of care.
Obstetricians & Gynecologists, Family Physicians
After completion of this article, the reader should be able to describe the features of a type I diabetic patient, to outline the goals of preconception care in this population of patients, to list the potential adverse effects of diabetes in pregnancy, and to summarize a potential strategy for the management of insulin administration in pregnancy.
Assistant Professor of Obstetrics and Gynecology, New York University School of Medicine, and Director, North Shore Center for Diabetes in Pregnancy, Division of Maternal–Fetal Medicine, North Shore-Long Island Jewish Health System, North Shore University Hospital, Manhasset, New York
CHIEF EDITOR'S NOTE: This article is part of a series of continuing education activities in this Journal through which a total of 36 AMA/PRA category 1 credit hours can be earned in 2004. Instructions for how CME credits can be earned appear on the last page of the Table of Contents.
Reprint requests to: James Bernasko, MD, Director, North Shore Center for Diabetes in Pregnancy, Division of Maternal–Fetal Medicine, North Shore-Long Island Jewish Health System, North Shore University Hospital, 300 Community Drive, Manhasset, NY 11030. E-mail: email@example.com
The author has disclosed no significant financial or other relationship with any commercial entity.
The author has disclosed that Insulin Aspart, Insulin Lispro, NPH insulin, and Insulin glargine are not approved ny the FDA for use in pregnancy.