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Chapter-14 Diabetic Retinopathy in Pregnancy

BOOK TITLE: Clinical Guidelines for Management of Diabetes in Pregnancy

Author
1. Chawla Rohan
2. Venkatesh Pradeep
3. Makwana Tarjani
ISBN
9789352703951
DOI
10.5005/jp/books/18049_15
Edition
1/e
Publishing Year
2018
Pages
9
Author Affiliations
1. Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India, Dr RP Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India, RP Centre for Ophthalmic Sciences, AIIMS, New Delhi, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medial Sciences, New Delhi, India, Dr Rajendra Prasad Centre, All India Institute of Medical Sciences, New Delhi, India
2. Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India, Dr RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India, Dr RP Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India, Dr RP Centre, AIIMS, New Delhi, Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, ansari Nagar, New Delhi, India, All India Institute of Medical Sciences New Delhi, India, Dr. R.P. Centre for Ophthalmic Sciences, AIIMS, Ansari Nagar, New Delhi, India, All India Institute of Medical Sciences, New Delhi, Dr RP Centre for Ophthalmic Sciences, AIIMS, New Delhi, India, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, AIIMS, Delhi, India, Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Vitreo-retina
3. Dr Rajendra Prasad Centre, All India Institute of Medical Sciences, New Delhi, India
Chapter keywords
Diabetic retinopathy, DR, pregnancy, vascular endothelial growth factor, VEGF, gestational diabetes mellitus, GDM, type 2 diabetes, type 1 diabetes, microangiopathy, chronic hyperglycemia

Abstract

Diabetic retinopathy (DR) is the most common microvascular complication of diabetes mellitus (DM). It also accounts for the largest cause of blindness amongst middle-aged individuals in the industrialized world. Chronic hyperglycemia is the most important risk factor leading to retinopathy and other complications of diabetes. The risk of developing DR is higher in type 1 diabetes than type 2 diabetes. Microangiopathy in patients with diabetes retinopathy results in capillary occlusion on one hand and vascular leakage causing diabetic macular edema on the other. Capillary occlusion causes retinal ischemia, which increases the level of vascular endothelial growth factor (VEGF). This chapter covers the effect of diabetic retinopathy on pregnancy, management of diabetic retinopathy during pregnancy, and gestational diabetes mellitus. Gestational diabetes mellitus (GDM) is defined as glucose intolerance which was not present or recognized prior to pregnancy. Insulin resistance during pregnancy might develop from a variety of factors such as alterations in growth hormone and cortisol secretion, human placental lactogen secretion, and insulinase secretion by placenta.

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