By Donald R. Coustan, Abbot R. Laptook, Carol J. Homko, Susan Biastre, Julie M. Daley
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Additional info for Medical Management of Pregnancy Complicated by Diabetes
Prepregnancy care incorporated into the plan of management for women with preexisting diabetes can result in improved pregnancy outcomes. This chapter provides the rationale behind and protocols for developing a prepregnancy program for women with diabetes or who have had previous gestational diabetes. PREEXISTING DIABETES Women with preexisting diabetes (type 1 diabetes [T1D] or type 2 diabetes [T2D]) who desire pregnancy present a broad array of challenging problems for the health-care team. In the preinsulin era, maternal mortality was as high as 44%, and perinatal mortality was 60% (Hare 1977).
Coustan, editor. -- 5th ed. p. ; cm. Includes bibliographical references and index. ISBN 978-1-58040-510-2 (alk. paper) I. Coustan, Donald R. II. American Diabetes Association. [DNLM: 1. Pregnancy in Diabetics--therapy. 2. Diabetes Mellitus. 3. Diabetes, Gestational--therapy. 4. Pregnancy Outcome. 3--dc23 2012049594 eISBN: 978-1-58040-536-2 This book is dedicated to the many mothers with diabetes who have allowed us to participate in their care over the years, being involved in the most important events in their families’ lives.
Htm. Accessed 5 September 2012 To achieve weight loss, a reduction in caloric intake or an increase in physical activity must occur. Carbohydrate management is a key factor in achieving glucose control and should be individualized. Carbohydrate from fruits, vegetables, whole grains, legumes, and low-fat milk are encouraged to meet nutrient recommendations. A pattern of three meals and some snacks can provide satiety, promote weight goals, and transition to the pregnancy meal plan. Additionally, women with diabetes should do the following: • Limit saturated fat to <7% of total kcals.
Medical Management of Pregnancy Complicated by Diabetes by Donald R. Coustan, Abbot R. Laptook, Carol J. Homko, Susan Biastre, Julie M. Daley