PMID- 24937039
OWN - NLM
STAT- MEDLINE
DCOM- 20150401
LR  - 20211021
IS  - 1752-2978 (Electronic)
IS  - 1752-296X (Linking)
VI  - 21
IP  - 4
DP  - 2014 Aug
TI  - Changing perspectives in pre-existing diabetes and obesity in pregnancy: maternal 
      and infant short- and long-term outcomes.
PG  - 257-63
LID - 10.1097/MED.0000000000000079 [doi]
AB  - PURPOSE OF REVIEW: Climbing obesity rates in women have propelled the increasing 
      prevalence of type 2 diabetes mellitus (T2DM) in pregnancy, and an increasing 
      number of women with type 1 diabetes mellitus (T1DM) are also affected by 
      obesity. Increasing recognition that an intrauterine environment characterized by 
      obesity, insulin resistance, nutrient excess, and diabetes may be fueling the 
      obesity epidemic in children has created enormous pressure to re-examine the 
      conventional wisdom of our current approaches. RECENT FINDINGS: Compelling data 
      in pregnancies complicated by diabetes, in particular those accompanied by 
      insulin resistance and obesity, support a fetal programming effect resulting in 
      increased susceptibility to metabolic disease for the offspring later in life. 
      Recent data also underscore the contribution of obesity, lipids, and lesser 
      degrees of hyperglycemia on fetal fat accretion, challenging the wisdom of 
      current gestational weight gain recommendations with and without diabetes. The 
      risks of adverse pregnancy outcomes in T2DM are at least as high as in T1DM and 
      there remains controversy about the ideal glucose treatment targets, the benefit 
      of different insulin analogues, and the role of continuous glucose monitoring in 
      T1DM and T2DM. SUMMARY: It has become unmistakably evident that achieving optimal 
      outcomes in mothers with diabetes is clearly impacted by ideal glycemic control 
      but goes far beyond it. The intrauterine metabolic environment seems to have 
      long-term implications on the future health of the offspring so that the 
      effectiveness of our current approaches can no longer be simply measured by 
      whether or not maternal glucose values are at goal.
FAU - Barbour, Linda A
AU  - Barbour LA
AD  - Divisions of Endocrinology, Metabolism and Diabetes and Maternal-Fetal Medicine, 
      University of Colorado School of Medicine, Aurora, Colorado, USA.
LA  - eng
GR  - R21 DK088324/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Review
PL  - England
TA  - Curr Opin Endocrinol Diabetes Obes
JT  - Current opinion in endocrinology, diabetes, and obesity
JID - 101308636
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
SB  - IM
MH  - Adult
MH  - Blood Glucose
MH  - Blood Glucose Self-Monitoring
MH  - Diabetes Mellitus, Type 1/blood/*complications/drug therapy
MH  - Diabetes Mellitus, Type 2/blood/*complications/drug therapy
MH  - Female
MH  - Humans
MH  - Hyperglycemia/blood/*complications/prevention & control
MH  - Hypoglycemic Agents/therapeutic use
MH  - Infant, Newborn
MH  - Insulin/therapeutic use
MH  - *Insulin Resistance
MH  - Mothers
MH  - Obesity/blood/*complications/prevention & control
MH  - Pregnancy
MH  - Pregnancy Complications
MH  - Pregnancy Outcome
MH  - Pregnancy in Diabetics/blood/*prevention & control
MH  - Prenatal Exposure Delayed Effects/blood/*physiopathology
MH  - Prevalence
EDAT- 2014/06/18 06:00
MHDA- 2015/04/02 06:00
CRDT- 2014/06/18 06:00
PHST- 2014/06/18 06:00 [entrez]
PHST- 2014/06/18 06:00 [pubmed]
PHST- 2015/04/02 06:00 [medline]
AID - 10.1097/MED.0000000000000079 [doi]
PST - ppublish
SO  - Curr Opin Endocrinol Diabetes Obes. 2014 Aug;21(4):257-63. doi: 
      10.1097/MED.0000000000000079.