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[IP] Diabetic management in high risk patients (pregnancy, insulin pumps).



Acta Clin Belg. 2004 Jul-Aug;59(4):173-81.Related Articles, Links 


Diabetic management in high risk patients (pregnancy, insulin pumps).

Vanhaverbeke G, Mertens A, Mathieu C.

Laboratory and Clinic of Experimental Medicine and Endocrinology, Leuven, 
Belgium.

During the past decades our understanding about the clinical impact of 
diabetes has changed. We now know for certain that a good (read : near normal) 
 glycemic control is necessary to prevent chronic complications of this disease
in
women regardless of the type of diabetes. Pregnancy is a specific situation 
 whereby a "near normal" control is wanted not only for the patient but also for
 the fetus. Several studies have shown a correlation beween glycemic control and
complications of pregnancy. Reaching optimal glycemic control is mandatory 
even before the pregnancy starts, considering the time window of occurance of 
 the severe foetal congenital malformations (first weeks of pregnancy). The role
of pre-conception care is emphasized. Optimal control in type 1 and type 2 
diabetic patients can best be reached through intensive insulin therapy, but 
reaching normoglycemia is mainly limited by the occurence of hypoglycemia. The 
 introduction of the new insulin analogues is an important step in our arsenal
to
achieve control using multiple daily insulin injections, but Novorapid and 
 Lantus have not yet been approved for use in pregnancy. Insulin pumps are often
used in pregnant patients, allowing an even better glycemic control with less 
hypoglycemia. An absolute requirement for CSII therapy to be successful is 
patient education and motivation by an experienced team.

PMID: 15597723 [PubMed - in process] 



Very sincerely yours,
Ellen H. Ullman 

Mom, Advocate for children who have diabetes and their parents, Friend, 
Webmaster..  www.kidsrpumping.com
Please support funding a cure for diabetes: Diabetes Research Institute in 
Miami, Florida:  http://www.drinet.org

"I realized that resignation to suffering from diabetes substitutes poorly 
 for the courage to manage it appropriately." Melissa P. Ford, doctoral student
in early modern British history at Oxford University; founding coordinator of 
the Oxford University Student Union Diabetes Network; member of Balliol College
.
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