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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 29 (1986), S. 13-16 
    ISSN: 1432-0428
    Keywords: Diabetic pregnancy ; fetal monitoring ; obstetrical management ; Caesarean section
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The outcome of 223 pregnancies in Type 1 (insulin-dependent) diabetic women managed from 1981 to 1985 in the Centre for Pregnant Diabetics in Copenhagen is presented. There were 17 spontaneous and 9 induced abortions. The latter were all done on medical indications. Among the 201 infants weighing 1000 g or more (including 4 pairs of twins), three died perinatally, 2 with lethal congenital malformations and one was stillborn in the 32nd gestational week. This represents a perinatal mortality rate of 2 percent. Timing and mode of delivery is individualized, but the general scheme is to induce labour around the 38th week of pregnancy. It is emphasized that an increased risk of sudden intrauterine death still exists in late diabetic pregnancy.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 40 (1997), S. 40-44 
    ISSN: 1432-0428
    Keywords: Keywords Gestational diabetes mellitus ; cholecalciferols.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effect of 1,25-dihydroxyvitamin D supplement on glucose metabolism was evaluated in 12 women with gestational diabetes mellitus (GDM). All women had an oral glucose tolerance test (OGTT) performed at inclusion in the study. Thereafter, each patient was instructed to continue their normal diet during the following 2 days, after which they received 2 μg/m2 Etalpha i. v. 2 h prior to the second OGTT. During the next 14 days each patient received 0.25 μg Etalpha orally, after which a third OGTT was performed. On average the level of 1,25-dihydroxyvitamin D3 at inclusion at baseline significantly increased after i. v. 1,25-dihydroxyvitamin D3 (from 92 to 138 ng/l [p 〈 0.001]), but returned to the baseline level after 2 weeks of oral Etalpha (85 ng/l). Simultaneously, the glucose level decreased from 5.6 to 4.8 mmol/l (p 〈 0.01) after i. v. treatment with 1,25-dihydroxyvitamin D3, but did not differ significantly from inclusion following 2 weeks of oral Etalpha. There was no difference between the glucose concentrations during OGTT prior to and after i. v. or oral 1,25-dihydroxyvitamin D3, in contrast to the insulin levels which tended to be lower after both i. v. and oral supplementation. In a multiple regression model including 1,25-dihydroxyvitamin D3, insulin , weight and height against glucose, only 1,25-dihydroxyvitamin D3 and insulin were selected for the final model (r 2 = 0.73, p 〈 0.0001). Our results suggest that supplements of 1,25-dihydroxyvitamin D3 influence glucose metabolism in patients with GDM probably by increasing the insulin sensitivity. [Diabetologia (1997) 40: 40–44]
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0428
    Keywords: Keywords GAD65 ; IAA ; ICA ; HLA ; gestational diabetes ; pregnancy.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We have studied the presence of GAD65 autoantibodies in women with insulin-dependent diabetes mellitus (IDDM) (n = 28) or gestational diabetes (GDM) (n = 139) diagnosed during pregnancy and investigated the temporal relationship between these autoantibodies and the subsequent recurrence or development of IDDM. Among the GDM patients, 4.3 % (6 of 139) developed true IDDM during a median follow-up period of 6.3 years (range 4.0–11.0). Of these, 2.2 % (3 of 139) were positive for GAD65 autoantibodies at diagnosis of GDM compared to 0 % (0 of 27) of healthy pregnant women. All 3 GAD65 autoantibody positive GDM patients subsequently developed IDDM after a median of 14 months (range 4–34). GAD65 autoantibodies were present in 50 % (14 of 28) of sera from women with IDDM diagnosed during pregnancy. The non-insulin-requiring remission period was significantly shorter in GAD65 autoantibody positive patients (median 0.5 years [range 0–6.0 years]) than in GAD65 antibody negative patients (median 2.6 years; range 0–9.7 years; p 〈 0.05). The results suggest that screening for GAD65 autoantibodies in women with GDM or IDDM diagnosed during pregnancy may be useful for predicting the clinical course of the disease. [Diabetologia (1996) 39: 1329–1333]
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-0428
    Keywords: Keywords Urinary albumin excretion, ambulatory blood pressure monitoring, blood pressure, pregnancy, pre-eclampsia, pregnancy-induced hypertension, haemoglobin A1C, Type I diabetes.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Aims/hypothesis. To evaluate the value of 24-h blood pressure monitoring compared to office blood pressure and urinary albumin excretion in predicting pre-eclampsia in Type I (insulin-dependent) diabetes mellitus.¶Methods. The study included 136 consecutive pregnancies in Caucasian women with Type I diabetes before gestation without diabetic nephropathy, anamnestic hypertension or early abortion. Values of urinary albumin excretion and office blood pressure before pregnancy and the HbA1C value at the time of conception were obtained. Microalbuminuria was defined as urinary albumin excretion of 30–300 mg/24 h in two out of three consecutive urine samples. Single measurements of 24-h urinary albumin excretion, office blood pressure and HbA1C were done five 5 times during pregnancy. In a subgroup of 74 women 24-h blood pressure measurements were done at 10 and 28 weeks of gestation. Pre-eclampsia was defined as office blood pressure higher than 140/90 mm Hg accompanied by proteinuria above 0.3 g/24 h later than 20 weeks of gestation.¶Results. Urinary albumin excretion and systolic blood pressure were higher before and throughout pregnancy in 14 women developing pre-eclampsia compared with women remaining normotensive (p 〈 0.001; p 〈 0.05, respectively). By logistic regression analysis the best predictor for pre-eclampsia was microalbuminuria before pregnancy (p 〈 0.05) with no additive predictive effect of 24-h blood pressure or office blood pressure measurement. The night:day ratio of blood pressure was similar in the two groups.¶Conclusion/interpretation. Microalbuminuria before pregnancy is the strongest predictor of pre-eclampsia in Type I diabetes. Measuring 24-h blood pressure early in pregnancy did not improve the ability to identify women at risk. [Diabetologia (2000) 43: 927–931]
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 99 (1992), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To investigate whether fetal weight estimation by ultrasound in diabetic pregnancy might be based upon fetal abdominal circumference (AC) alone.Design A retrospective study.Setting Diabetes Center, Rigshospitalet and Ultrasound Laboratory, Glostrup Hospital, Copenhagen.Subjects Eighty-six diabetic pregnant women who had an ultrasound study within 2 days before delivery.Results We assessed in 73 fetuses various formulas based upon biparietal diameter and AC against formulas based upon AC alone, and these were only marginally less effective than the more complex ones. In 86 fetuses an AC was available. These fetuses were divided into a study population and a test population. The linear model was customized for the study population. Evaluation on the test population showed that the relative error (error as a percentage of birthweight) in predicting birthweight had a Standard deviation of 7–8%. The efficacy of AC in detecting fetuses 〉4000 g was examined in the test population; If AC〉36–0 cm was chosen as riterion for macrosomia the positive and negative predictive values were 80% (8/10) and 91% (30/33), respectively.Conclusion Formulas for estimating fetal weight in diabetic pregnancy based on AC alone are almost as effective as more complex ones. We recommend a simple linear formula of fetal weight as a function of AC.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-0428
    Keywords: Type 1 (insulin-dependent) diabetes mellitus ; pregnancy ; prognostic parameters
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The study concerns the clinical outcome and later prognosis (regarding permanent insulin treatment) of patients who develop insulin-dependent diabetes mellitus during pregnancy (which is different from gestational diabetes). Sixty-three such patients (27±1 (SEM) years old) were delivered at the Copenhagen Centre for Diabetes and Pregnancy during the years 1966–1980. Obstetric complications such as toxaemia were seen in 9.5% of these study patients and the perinatal mortality was 6.3%, both percentages being higher than in the general population (1.1%,p〈10−7 and 1.0%,p〈10−3, respectively), but similar to those observed in patients with Type 1 diabetes diagnosed before pregnancy. In contrast, the frequency of malformations was 1.6%, the same as in the general population (1.4%), but lowerthan that seen in patients with long-standing diabetes (8.3%,p〈0.05). At follow-up examination 8±1 years after diagnosis all patients were diabetic; 77% were insulin treated, having no or virtually no residual B-cell function, and were clearly Type 1 diabetic patients. After delivery 80% of the patients had a remission period (median 256 days) without insulin treatment. This remission period was absent or shortest in patients with the following characteristics (p≤0.03): low age, first parity, not overweight, and high blood glucose level at diagnosis. These prognostic parameters should be considered in obligatory, clinical follow-up plans for such patients.
    Type of Medium: Electronic Resource
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