Perinatal Outcomes in Type 2 Diabetes
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Over the past decade the prevalence of type 2 diabetes in pregnancy has continued to increase. It is vital that health care professionals recognize that preconception care is just as important for mothers with type 2 diabetes as it is in type 1 diabetes. All women with type 2 diabetes should be advised regarding safe effective contraception and the benefits of optimal glycemic control, folic acid supplementation, and avoidance of potentially harmful mediations before attempting pregnancy. Glycemic control is the most important modifiable risk factor for congenital anomaly in women with type 2 diabetes, whereas maternal obesity and social disadvantage are associated with large for gestational age neonates. This review aims to bring the reader up to date with the burden of perinatal outcomes and clinical interventions to improve maternal and infant health. It warns that the consequences of type 2 diabetes pregnancy do not end at birth.
- Feig DS, Palda VA. Type 2 diabetes in pregnancy: a growing concern. Lancet. 2002;359:1690–2. CrossRef
- Temple R, Murphy H. Type 2 diabetes in pregnancy — an increasing problem. Best Pract Res. 2010;24:591–603. CrossRef
- Murphy HR, Roland JM, Skinner TC, Simmons D, Gurnell E, Morrish NJ, et al. Effectiveness of a regional prepregnancy care program in women with type 1 and type 2 diabetes: benefits beyond glycemic control. Diabetes Care. 2010;33:2514–20. CrossRef
- Dunne F. Type 2 diabetes and pregnancy. Semin Fetal Neonatal Med. 2005;10:333–9. CrossRef
- Dabelea D, Crume T. Maternal environment and the transgenerational cycle of obesity and diabetes. Diabetes. 2011;60:1849–55. CrossRef
- Nolan CJ, Damm P, Prentki M. Type 2 diabetes across generations: from pathophysiology to prevention and management. Lancet. 2011;378:169–81. CrossRef
- Poston L. Intergenerational transmission of insulin resistance and type 2 diabetes. Prog Biophys Molec Biol. 2010;106:315–22. CrossRef
- Clausen TD, Mathiesen E, Ekbom P, Hellmuth E, Mandrup-Poulsen T, Damm P. Poor pregnancy outcome in women with type 2 diabetes. Diabetes Care. 2005;28:323–8. CrossRef
- Dunne F, Brydon P, Smith K, Gee H. Pregnancy in women with Type 2 diabetes: 12 years outcome data 1990-2002. Diabetes Med. 2003;20:734–8. CrossRef
- Roland JM, Murphy HR, Ball V, Northcote-Wright J, Temple RC. The pregnancies of women with Type 2 diabetes: poor outcomes but opportunities for improvement. Diabetes Med. 2005;22:1774–7. CrossRef
- Macintosh MC, Fleming KM, Bailey JA, Doyle P, Modder J, Acolet D, et al. Perinatal mortality and congenital anomalies in babies of women with type 1 or type 2 diabetes in England, Wales, and Northern Ireland: population based study. BMJ (Clinical research ed). 2006;333:177. CrossRef
- Holman N, Lewis-Barned N, Bell R, Stephens H, Modder J, Gardosi J, et al. Development and evaluation of a standardized registry for diabetes in pregnancy using data from the Northern, North West, and East Anglia regional audits. Diabetes Med. 2011;28:797–804. CrossRef
- Balsells M, Garcia-Patterson A, Gich I, Corcoy R. Maternal and fetal outcome in women with type 2 vs type 1 diabetes mellitus: a systematic review and meta-analysis. J Clin Endocrinol Metabol. 2009;94:4284–91. A definitive review of the type 2 diabetes pregnancy literature before 2009. CrossRef
- Murphy HR, Steel SA, Roland JM, Morris D, Ball V, Campbell PJ, et al. Obstetric and perinatal outcomes in pregnancies complicated by Type 1 and Type 2 diabetes: influences of glycemic control, obesity and social disadvantage. Diabetes Med. 2011;28:1060–7. CrossRef
- Cundy T, Gamble G, Townend K, Henley PG, MacPherson P, Roberts AB. Perinatal mortality in Type 2 diabetes mellitus. Diabetes Med. 2000;17:33–9. CrossRef
- Beauharnais CC, Roberts DJ, Wexler DJ. High rate of placental infarcts in type 2 compared with type 1 diabetes. J Clin Endocrinol Metabol. 2012;97:E1160–4. CrossRef
- Reece EA. Diabetes-induced birth defects: what do we know? What can we do? Curr Diabetes Rep. 2012;12:24–32. A comprehensive review article summarizing causes and potential treatments for congenital malformations. CrossRef
- Bell R, Glinianaia SV, Tennant PW, Bilous RW, Rankin J. Peri-conception hyperglycaemia and nephropathy are associated with risk of congenital anomaly in women with pre-existing diabetes: a population-based cohort study. Diabetologia. 2012;55:936–947.
- Fraser RB, Waite SL, Wood KA, Martin KL. Impact of hyperglycemia on early embryo development and embryopathy: in vitro experiments using a mouse model. Hum Reproduction. 2007;22:3059–68. CrossRef
- Cooper WO, Hernandez-Diaz S, Arbogast PG, Dudley JA, Dyer S, Gideon PS, et al. Major congenital malformations after first-trimester exposure to ACE inhibitors. N Engl J Med. 2006;354:2443–51. CrossRef
- Edison RJ, Muenke M. Central nervous system and limb anomalies in case reports of first-trimester statin exposure. N Engl J Med. 2004;350:1579–82. CrossRef
- Lupo PJ, Canfield MA, Chapa C, Lu W, Agopian AJ, Mitchell LE, et al. Diabetes and obesity-related genes and the risk of neural tube defects in the national birth defects prevention study. Am J Epidemiol. 2012;176:1101–9. CrossRef
- Cyganek K, Hebda-Szydlo A, Skupien J, Katra B, Janas I, Borodako A, et al. Glycemic control and pregnancy outcomes in women with type 2 diabetes from Poland. The impact of pregnancy planning and a comparison with type 1 diabetes subjects. Endocrine. 2011;40:243–9. CrossRef
- Knight KM, Thornburg LL, Pressman EK. Pregnancy outcomes in type 2 diabetic patients as compared with type 1 diabetic patients and nondiabetic controls. J Reprod Med. 2012;57:397–404.
- Knight KM, Pressman EK, Hackney DN, Thornburg LL. Perinatal outcomes in type 2 diabetic patients compared with non-diabetic patients matched by body mass index. J Matern Fetal Neonatal Med. 2012;25:611–5. CrossRef
- Hammoud NM, Visser GH, Peters SA, Graatsma EM, Pistorius L, de Valk HW. Fetal growth profiles of macrosomic and non-macrosomic infants of women with pregestational or gestational diabetes. Ultrasound Obstet Gynecol. 2013;41:390–7. CrossRef
- Higgins MF, Russell NM, Brazil DP, Firth RG, McAuliffe FM. Fetal and maternal leptin in pre-gestational diabetic pregnancy. Int J Gynaecol Obstet. 2012;120:169–72. CrossRef
- Nohr EA, Vaeth M, Baker JL, Sorensen T, Olsen J, Rasmussen KM. Combined associations of prepregnancy body mass index and gestational weight gain with the outcome of pregnancy. Am J Clin Nutrit. 2008;87:1750–9.
- Institute of Medicine. Weight gain during pregnancy: re-examining the guidelines. Washington, DC: National Academies Press; 2009.
- Yee LM, Cheng YW, Inturrisi M, Caughey AB. Effect of gestational weight gain on perinatal outcomes in women with type 2 diabetes mellitus using the 2009 Institute of Medicine guidelines. Am J Obstet Gynecol. 2011;205(257):e1–6.
- Asbjornsdottir B, Rasmussen SS, Kelstrup L, Damm P, Mathiesen ER. Impact of restricted maternal weight gain on fetal growth and perinatal morbidity in obese women with type 2 diabetes. Diabetes Care. 2013;36:1102–6. Preliminary data suggesting that moderate gestational weight loss <5 kg may be beneficial.
- Hawthorne G. Metformin use and diabetic pregnancy-has its time come? Diabetes Med. 2006;23:223–7. CrossRef
- Hughes RC, Rowan JA. Pregnancy in women with Type 2 diabetes: who takes metformin and what is the outcome? Diabetes Med. 2006;23:318–22. CrossRef
- NICE guideline 63: Diabetes in Pregnancy. Management of diabetes and its complications in pregnancy from the pre-conception to the postnatal period. www.nice.org.uk. 2008. Last accessed 25 Jan 2013.
- Lawrence JM, Andrade SE, Avalos LA, Beaton SJ, Chiu VY, Davis RL, et al. Prevalence, trends, and patterns of use of antidiabetic medications among pregnant women, 2001-2007. Obstet Gynecol. 2013;121:106–14.
- Zhou G, Myers R, Li Y, Chen Y, Shen X, Fenyk-Melody J, et al. Role of AMP-activated protein kinase in mechanism of metformin action. J Clin Invest. 2001;108:1167–74.
- Foretz M, Hebrard S, Leclerc J, Zarrinpashneh E, Soty M, Mithieux G, et al. Metformin inhibits hepatic gluconeogenesis in mice independently of the LKB1/AMPK pathway via a decrease in hepatic energy state. J Clin Invest. 2010;120:2355–69. CrossRef
- Maida A, Lamont BJ, Cao X, Drucker DJ. Metformin regulates the incretin receptor axis via a pathway dependent on peroxisome proliferator-activated receptor-alpha in mice. Diabetologia. 2011;54:339–49. CrossRef
- Mulherin AJ, Oh AH, Kim H, Grieco A, Lauffer LM, Brubaker PL. Mechanisms underlying metformin-induced secretion of glucagon-like peptide-1 from the intestinal L cell. Endocrinology. 2011;152:4610–9.
- Gatford KL, Houda CM, Lu ZX, Coat S, Baghurst PA, Owens JA, et al. Vitamin B12 and homocysteine status during pregnancy in the metformin in gestational diabetes trial: responses to maternal metformin compared with insulin treatment. Diabetes Obes Metab. 2013;15:660–7.
- Barrett HL, Nitert MD, Jones L, O'Rourke P, Lust K, Gatford KL, et al. Determinants of maternal triglycerides in women with gestational diabetes mellitus in the metformin in gestational diabetes (MiG) study. Diabetes Care. 2013;36:1941–6.
- Salomaki H, Vahatalo LH, Laurila K, Jappinen NT, Penttinen AM, Ailanen L, et al. Prenatal metformin exposure in mice programs the metabolic phenotype of the offspring during a high fat diet at adulthood. PloS One. 2013;8:e56594. CrossRef
- Wu CS, Nohr EA, Bech BH, Vestergaard M, Olsen J. Long-term health outcomes in children born to mothers with diabetes: a population-based cohort study. PloS One. 2012;7:e36727. CrossRef
- Tanne JH. Maternal obesity and diabetes are linked to children's autism and similar disorders. BMJ (Clinical research ed). 2012;344:e2768.
- Krakowiak P, Walker CK, Bremer AA, Baker AS, Ozonoff S, Hansen RL, et al. Maternal metabolic conditions and risk for autism and other neurodevelopmental disorders. Pediatrics. 2012;129:e1121–8. A reminder that the consequences of type 2 diabetes do not end at birth. CrossRef
- Perinatal Outcomes in Type 2 Diabetes
Current Diabetes Reports
- Online Date
- January 2014
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Congenital malformation (CM)
- Large for gestational age (LGA)
- Perinatal mortality (PNM)
- Stillbirth (SB)
- Neonatal mortality (NM)
- Type 2 diabetes
- Industry Sectors
- Author Affiliations
- 1. MRCP, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK
- 2. University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Center, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 0QQ, UK
- 3. Level 4 Metabolic Research Laboratories, Institute of Metabolic Science, Box 289, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, UK