Skip to main content
SpringerLink
Log in

Typ-2-Diabetes und Schwangerschaft

Type 2 diabetes and pregnancy

  • CME Weiterbildung · Zertifizierte Fortbildung
  • Published:
Der Diabetologe Aims and scope

Zusammenfassung

Im Vergleich zu Schwangeren mit Typ-1-Diabetes sind Schwangere mit Typ-2-Diabetes älter, übergewichtiger, häufiger Immigrantinnen mit geringerer Schulbildung und niedrigerem Einkommen und leben öfter in Gegenden mit sozialer Deprivation. Trotz kürzerer Diabetesdauer und im Durchschnitt besseren HbA1c-Verläufen sind die Ergebnisse der Schwangerschaften nicht besser als bei Typ-1-Diabetes, die perinatale Mortalität ist sogar gesteigert. Sie planen ihre Konzeption seltener und sind insgesamt schlechter auf eine Schwangerschaft vorbereitet, z. B. nutzen sie seltener sichere Kontrazeptiva oder nehmen perikonzeptionell Folsäure ein, stellen sich erst nach Abschluss der Embryogenese erstmals vor, nehmen zu diesem Zeitpunkt oft noch orale Antidiabetika ein und befinden sich zu selten in diabetologischer Mitbetreuung.

Abstract

In comparison to pregnant women with type 1 diabetes, women with type 2 diabetes tend to be older, more obese, more often immigrants and live in areas of social deprivation. Despite a shorter duration of diabetes and better course of HbA1c, the outcomes are similar as in type 1 diabetic women and perinatal mortality is even increased. Those affected rarely plan the conception and therefore adequate preparation for pregnancy is often lacking, for example safe contraceptives or folic acid periconceptionally are rarely used and patients present for the first visit for pregnancy care often after completed embryogenesis. At this time they often take oral antidiabetic drugs and seldom have access to specialized diabetological care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1

Literatur

  1. Balsells M, García-Patterson A, Gich I, Corcoy R (2009) Maternal and fetal outcome in women with type 2 versus type 1 diabetes mellitus: a systematic review and metaanalysis. J Clin Endocrinol Metab 94:4284–4291

    Article  PubMed  CAS  Google Scholar 

  2. Bleich S, Cutler D, Murray C, Adams A (2007) Why is the developed world obese? http://www.nber.org/papers/w12954

  3. Catalano P (2007) Management of obesity in pregnancy. Obstet Gynecol 109:419–433

    Article  PubMed  Google Scholar 

  4. Clausen T, Matthiesen E, Ekbom P et al (2005) Poor pregnancy outcome in women with type 2 diabetes. Diabetes Care 28:323–328

    Article  PubMed  Google Scholar 

  5. Committee to Reexamine IOM Pregnancy Weight Guidelines, Food and Nutrition Board, Board on Children, Youth and Families (2009) Weight gain during pregnancy: reexaming the guidelines. Institute of Medicine, Washington DC

  6. Confidential Enquiry into Maternal and Child Health (2005) Pregnancy in women with type 1 and type 2 diabetes in 2002–2003. CEMACH, England Wales Northern Ireland London

  7. Coustan D (2008) A 40-year-old woman with diabetes contemplanting pregnancy after gastric bypass surgery. JAMA 299:2550–2557

    Article  PubMed  CAS  Google Scholar 

  8. Currie J, DellaVigna S, Mortelli E, Pathania V (2009) The effect of fast food restaurants on obesity. http://www.nber.org/papers/w14721

  9. Ekpebegh C, Coetzee E, Merwe L van der, Levitt N (2007) A 10-year retrospective analysis of pregnancy outcome in pregestational type 2 diabetes: a comparsion of insulin and oral glucose-lowering agents. Diabet Med 24:253–258

    Article  PubMed  CAS  Google Scholar 

  10. Feig D, Palda V (2002) Type 2 diabetes in pregnancy: a growing concern. Lancet 359:1690–1692

    Article  PubMed  Google Scholar 

  11. Hammes H (2005) Diabetische Retinopathie. In: Nauck M, Brabant G, Hauner H (Hrsg) Kursbuch Diabetologie. Kirchheim, Mainz, S 58–64

  12. Hughes E, Rowan J (2006) Pregnancy in women with type 2 diabetes: who takes metformin and what is the outcome? Diabet Med 23:318–322

    Article  PubMed  CAS  Google Scholar 

  13. Hughes E, Gardiner S, Begg E, Zhang M (2006) Effect of pregnancy on the pharmacokinetics of metformin. Diabet Med 23:323–326

    Article  PubMed  CAS  Google Scholar 

  14. Kleinwechter H, Bührer C, Hösli I et al (2010) Diabetes und Schwangerschaft (Praxisleitlinie). Diabetologie 5 (Suppl 2):S176–S182

    Article  Google Scholar 

  15. Kleinwechter H, Schäfer-Graf U (2006) Diabetes und Schwangerschaft. Diabetologe 2:351–366

    Article  Google Scholar 

  16. Kleinwechter H, Schäfer-Graf U (2008) Diabetes mellitus und Schwangerschaft. Diabetologie 3:R69–R93

    Article  Google Scholar 

  17. Kohner E, Aldington S, Stratton I et al for the United Kingdom Prospective Diabetes Study (1998) United Kingdom Prospective Diabetes Study 30: diabetic retinopathy at diagnosis of non-insulin-dependent diabetes mellitus and associated risk factors. Arch Ophthalmol 116:297–303

    PubMed  CAS  Google Scholar 

  18. Krebs C, Stahl R (2010) Schwangerschaftshypertonie. internist prax 50:705–710

    Google Scholar 

  19. Kuntz B, Lampert (2010) Sozioökonomische Faktoren und Verbreitung von Adipositas. Dtsch Arztebl Int 107:517–522

    PubMed  Google Scholar 

  20. Löbner K, Knopff A, Baumgarten A et al (2006) Predictors of postpartum diabetes in women with gestational diabetes mellitus. Diabetes 55:792–797

    Article  PubMed  Google Scholar 

  21. McElduff A, Ross G, Lagström J et al (2005) Pregestational diabetes and pregnancy. An Australian experience. Diabetes Care 28:1260–1261

    Article  PubMed  Google Scholar 

  22. Peters A, Langemann D (2009) Build-ups in the supply chain of the brain: on the neuroenergetic cause of obesity and type 2 diabetes mellitus. Front Neuroenergetics 1:2 [Epub adhead of print Apr 28]

    PubMed  Google Scholar 

  23. Peters A (2010) Stau in der Lieferkette. Die Ursache von Adipositas aus heutiger Sicht. internist prax 50:759–767

    Google Scholar 

  24. Phelan S (2010) Pregnancy: a „teachable moment“ for weight control and obesity prevention. Am J Obstet Gynecol 202:135.e1–e8

    Article  PubMed  Google Scholar 

  25. Simmons D, Thompson C, Conroy C, Scott D (2001) Use of insulin pumps in pregnancies complicated by type 2 diabetes and gestational diabetes in a multiethnic community. Diabetes Care 24:2078–2082

    Article  PubMed  CAS  Google Scholar 

  26. Rasmussen K, Laugesen C, Ringholm L et al (2010) Progression of diabetic retinopathy during pregnancy in women with type 2 diabetes. Diabetologia 53:1076–1083

    Article  PubMed  CAS  Google Scholar 

  27. Wiznitzer A, Mayer A, Novack V et al (2009) Association of lipid levels during gestation with preeclampsia and gestational diabetes mellitus: a population-based study. Am J Obstet Gynecol 201:1.e1–1.e8

    Article  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Diabetologikum Kiel, Diabetesschwerpunktpraxis u. Schulungszentrum, Alter Markt 11 u.14, 24103, Kiel, Deutschland

    H. Kleinwechter

  2. Berliner Diabeteszentrum für Schwangere, Klinik für Gynäkologie und Geburtshilfe, St. Joseph Krankenhaus, Berlin, Deutschland

    U. Schäfer-Graf

Authors
  1. H. Kleinwechter
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. U. Schäfer-Graf
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to H. Kleinwechter.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kleinwechter, H., Schäfer-Graf, U. Typ-2-Diabetes und Schwangerschaft. Diabetologe 7, 39–50 (2011). https://doi.org/10.1007/s11428-010-0654-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11428-010-0654-z

Schlüsselwörter

Keywords

Search

Navigation