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Chapter-05 Preconceptional Counseling for Women with Diabetes

BOOK TITLE: Clinical Guidelines for Management of Diabetes in Pregnancy

Author
1. Rathore Asmita Muthal
2. Shahanaz Gazala
ISBN
9789352703951
DOI
10.5005/jp/books/18049_6
Edition
1/e
Publishing Year
2018
Pages
8
Author Affiliations
1. Maulana Azad Medical College, New Delhi, India, Maulana Azad Medical College and LN Hospital, New Delhi, MAMC and LNH, New Delhi, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India, Maulana Azad Medical College, New Delhi, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi
2. Maulana Azad Medical, College and Hospital, New Delhi, India
Chapter keywords
Preconceptional counseling, diabetes, type 1 diabetes, type 2 diabetes, gestational diabetes mellitus, GDM, placental hormone, cytokines, diabetic pregnancy

Abstract

This chapter focuses on preconceptional counseling for women with diabetes. Diabetes is a state of glucose intolerance either due to insulin deficiency and/or insulin resistance. The American Diabetes Association (ADA) describes three classes of glucose intolerance in pregnancy following as type 1 diabetes, type 2 diabetes, and gestational diabetes mellitus (GDM). This chapter covers the effect of diabetes in pregnancy, preconceptional counseling, effect of preconception counseling, component of preconceptional counseling, barriers to preconceptional care, and improving uptake of preconception care. The knowledge of effects of diabetes in pregnancy is important for optimal preconceptional counseling. Normal pregnancy itself is a diabetogenic state associated with increased postprandial glucose levels and reduced insulin sensitivity due to the effects of various placental hormones, growth factors, and cytokines.

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