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Lemaitre M, Ternynck C, Bourry J, Baudoux F, Subtil D, Vambergue A. Association Between HbA1c Levels on Adverse Pregnancy Outcomes During Pregnancy in Patients With Type 1 Diabetes. J Clin Endocrinol Metab 2022; 107:e1117-e1125. [PMID: 34694409 PMCID: PMC8852207 DOI: 10.1210/clinem/dgab769] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Despite optimization of metabolic balance during pregnancy in type 1 diabetes (T1D), maternal-fetal complications remain higher than in the background population. OBJECTIVE We examined whether there is an association between glycated hemoglobin (HbA1c) levels and these complications. METHODS Retrospective study of pregnancies in 678 T1D subjects at Lille Hospital (1997-2019). The association between variations in HbA1c levels and complications was examined. The composite criterion (CC) was defined as having at least 1 of the following complications: prematurity, pre-eclampsia, large for gestational age (LGA), small for gestational age (SGA), or cesarean section. RESULTS Among the 678 births, median preconception HbA1c was 7.2% (55 mmol/mol), 361 were LGA (56%), 29 were SGA (4.5%), and 504 were births without preterm delivery (76.1%). The CC occurred in 81.8%. Higher HbA1c during the first trimester was associated with the CC (OR 1.04; 95% CI 1.02-1.06 per 0.1% increase; P < .001). Higher HbA1c during the third trimester was associated with the CC (OR 1.07; 95% CI 1.03-1.10 per 0.1% increase; P < .001). The group defined by a first trimester Hba1c >6.5% (48 mmol/mol) and a third trimester HbA1c <6% was associated with an increased rate of the CC (OR 2.81; 95% CI 1.01-7.86) and an increased rate of LGA (OR 2.20; 95% CI 1.01- 4.78). CONCLUSION Elevated HbA1c is associated with maternal-fetal complications. Despite optimization of metabolic balance during the third trimester, for patients with early glycemic imbalance the risk of LGA persists.
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Affiliation(s)
- Madleen Lemaitre
- Department of Diabetology, Endocrinology, Metabolism, and Nutrition, CHU Lille, Lille University Hospital, Lille, France
- Department of Medicine, University of Lille, France
| | - Camille Ternynck
- , ULR 2694-METRICS: évaluation des technologies de santé et des pratiques médicales, University of Lille, CHU Lille, Lille, France
- Department of Biostatistics, CHU Lille, Lille, France
| | - Julien Bourry
- Department of Diabetology, Endocrinology, Metabolism, and Nutrition, CHU Lille, Lille University Hospital, Lille, France
- Department of Medicine, University of Lille, France
| | - Florence Baudoux
- Department of Diabetology, Endocrinology, Metabolism, and Nutrition, CHU Lille, Lille University Hospital, Lille, France
| | - Damien Subtil
- Department of Medicine, University of Lille, France
- Department of Gynecology and Obstetrics, CHU Lille, Lille University Hospital, Lille, France
| | - Anne Vambergue
- Department of Diabetology, Endocrinology, Metabolism, and Nutrition, CHU Lille, Lille University Hospital, Lille, France
- Department of Medicine, University of Lille, France
- European Genomic Institute for Diabetes, University School of Medicine, Lille, France
- Correspondence: Anne Vambergue, Department of Diabetology, Endocrinology, Metabolism, and Nutrition Claude Huriez Hospital, Polonovski Street, 59037 Lille, cedex, France.
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Mourou L, Vallone V, Vania E, Galasso S, Brunet C, Fuchs F, Boscari F, Cavallin F, Bruttomesso D, Renard E. Assessment of the effect of pregnancy planning in women with type 1 diabetes treated by insulin pump. Acta Diabetol 2021; 58:355-362. [PMID: 33098473 DOI: 10.1007/s00592-020-01620-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/09/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Pregnant women with type 1 diabetes (T1D) have high risk of complications despite improved care based on technology advancements. OBJECTIVE To assess the effects of pregnancy planning on fetal and maternal outcomes in T1D women treated with continuous subcutaneous insulin infusion (CSII). STUDY DESIGN We retrospectively assessed maternal and neonatal outcomes in T1D women using CSII who had planned or unplanned pregnancies between 2002 and 2018. The study was done in two European countries with similar sustained programs for pregnancy planning over the study period. RESULTS Data from 107 pregnancies and newborn babies were collected. Seventy-nine pregnancies (73.8%) had been planned. HbA1c was lower in planned versus unplanned pregnancy before and during all three trimesters of pregnancy (p < 0.0001). Pregnancy planning was associated with a reduction in the occurrence of iatrogenic preterm delivery (RR 0.44, 95% CI 0.23-0.95; p = 0.01). Risk reduction persisted after adjustments for mother's age above 40 years and preeclampsia. High HbA1c before or during pregnancy was associated with an increased risk of iatrogenic preterm delivery (RR 3.05, 95% CI 1.78-5.22, p < 0.0001). Premature newborns needed intensive care more often than those at term (RR 3.10, 95% CI 1.53-4.31; p = 0.002). CONCLUSIONS Pregnancy planning in T1D women using CSII was associated with better glucose control and decreased risk of iatrogenic preterm delivery. Hence preconception care also improves pregnancy outcome in patients using an advanced mode of insulin delivery. Planned pregnancies could further benefit from the use of new metrics of glucose control.
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Affiliation(s)
- Lucie Mourou
- Department of Endocrinology, Diabetes and Nutrition, Montpellier University Hospital, Montpellier, France
- Institute of Functional Genomics, CNRS, INSERM, University of Montpellier, Montpellier, France
| | - Valeria Vallone
- Division of Metabolic Diseases, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Eleonora Vania
- Department of Endocrinology, Diabetes and Nutrition, Montpellier University Hospital, Montpellier, France
- Institute of Functional Genomics, CNRS, INSERM, University of Montpellier, Montpellier, France
| | - Silvia Galasso
- Division of Metabolic Diseases, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Cécile Brunet
- Department of Endocrinology, Diabetes and Nutrition, Montpellier University Hospital, Montpellier, France
- Institute of Functional Genomics, CNRS, INSERM, University of Montpellier, Montpellier, France
- Department of Gynecology and Obstetrics, Montpellier University Hospital, University of Montpellier, Montpellier, France
| | - Florent Fuchs
- Department of Gynecology and Obstetrics, Montpellier University Hospital, University of Montpellier, Montpellier, France
| | - Federico Boscari
- Division of Metabolic Diseases, Department of Medicine DIMED, University of Padova, Padova, Italy
| | | | - Daniela Bruttomesso
- Division of Metabolic Diseases, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Eric Renard
- Department of Endocrinology, Diabetes and Nutrition, Montpellier University Hospital, Montpellier, France.
- Institute of Functional Genomics, CNRS, INSERM, University of Montpellier, Montpellier, France.
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Risk stratification and screening for coronary artery disease in asymptomatic patients with diabetes mellitus: Position paper of the French Society of Cardiology and the French-speaking Society of Diabetology. Arch Cardiovasc Dis 2020; 114:150-172. [PMID: 33309203 DOI: 10.1016/j.acvd.2020.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 01/09/2023]
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Valensi P, Henry P, Boccara F, Cosson E, Prevost G, Emmerich J, Ernande L, Marcadet D, Mousseaux E, Rouzet F, Sultan A, Ferrières J, Vergès B, Van Belle E. Risk stratification and screening for coronary artery disease in asymptomatic patients with diabetes mellitus: Position paper of the French Society of Cardiology and the French-speaking Society of Diabetology. DIABETES & METABOLISM 2020; 47:101185. [PMID: 32846201 DOI: 10.1016/j.diabet.2020.08.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Key Words] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 01/09/2023]
Affiliation(s)
- Paul Valensi
- Unit of Endocrinology Diabetology Nutrition, AP-HP, Jean Verdier hospital, CINFO, CRNH-IdF, Paris 13 University, Sorbonne Paris Cité, Bondy, France
| | - Patrick Henry
- Department of Cardiology, Inserm U942, Lariboisiere Hospital, Assistance Publique - Hôpitaux de Paris, University of Paris, Paris, France.
| | - Franck Boccara
- AP-HP, Hôpitaux de l'Est Parisien, Hôpital Saint-Antoine, Department of Cardiology, Sorbonne Université-Inserm UMR S_938, Centre de Recherche Saint-Antoine, Paris, France
| | - Emmanuel Cosson
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France; Paris 13 University, Sorbonne Paris Cité, UMR U557 Inserm/U11125 INRAE/CNAM/Université Paris13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France
| | - Gaetan Prevost
- Department of Endocrinology, Diabetes and Metabolic Diseases, Normandie Univ, UNIROUEN, Rouen University Hospital, Centre d'Investigation Clinique (CIC-CRB)-Inserm 1404, Rouen University Hospital, 76000 Rouen, France
| | - Joseph Emmerich
- Service de Médecine Vasculaire, Groupe Hospitalier Paris Saint-Joseph, Université de Paris, Inserm UMR1153-CRESS, 75674 Paris cedex 14, France
| | - Laura Ernande
- Service des explorations fonctionnelles, Hôpital Henri Mondor, AP-HP et Inserm U955, Université Paris-Est Créteil, France
| | - Dany Marcadet
- Centre Coeur et Santé Bernoulli - Cardiologie du sport et Réadaptation Cardiaque, 3, rue Bernoulli, 75008 Paris, France
| | - Elie Mousseaux
- Radiology Department, Hôpital Européen Georges Pompidou & Inserm U 970; Assistance Publique - Hôpitaux de Paris, University of Paris, French Society of Cardiovascular Imaging (SFICV), Paris, France
| | - François Rouzet
- Nuclear Medicine Department, Bichat Hospital, AP-HP Paris - Université de Paris, Laboratory for Vascular Translational Science, Inserm, UMR 1148, 75018 Paris, France
| | - Ariane Sultan
- Physiologie et Médecine Expérimentale du Coeur et des Muscles (PHYMEDEX), U1046 Inserm, UMR9214 CNRS, Université de Montpellier, 34295 Montpellier; Département Endocrinologie, Nutrition, Diabète, Equipe Nutrition, Diabète, CHRU Montpellier, 34090 Montpellier, France
| | - Jean Ferrières
- Department of Cardiology and UMR Inserm 1027, Toulouse Rangueil University Hospital, Toulouse University School of Medicine, Toulouse, France
| | - Bruno Vergès
- Service Endocrinologie-Diabétologie, CHU Dijon - Inserm LNC-UMR 1231, Dijon, France
| | - Eric Van Belle
- Department of Interventional Cardiology for Coronary, Valves and Structural Heart Diseases, Institut Coeur Poumon, Centre Hospitalier Universitaire de Lille, Lille, France; Inserm, U1011, Institut Pasteur de Lille, EGID, Lille, France; Department of Medicine, Université de Lille, Lille, France
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McCarthy EA, Williamson R, Shub A. Pregnancy outcomes for women with pre‐pregnancy diabetes mellitus in Australian populations, rural and metropolitan: A review. Aust N Z J Obstet Gynaecol 2018; 59:183-194. [DOI: 10.1111/ajo.12913] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 09/22/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Elizabeth A. McCarthy
- Department of Obstetrics and GynaecologyUniversity of Melbourne Melbourne Victoria Australia
- Department of Perinatal MedicineMercy Hospital for Women Melbourne Victoria Australia
| | - Rebecca Williamson
- Department of Obstetrics and GynaecologyUniversity of Melbourne Melbourne Victoria Australia
| | - Alexis Shub
- Department of Obstetrics and GynaecologyUniversity of Melbourne Melbourne Victoria Australia
- Mercy Hospital for Women Melbourne Victoria Australia
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Rys PM, Ludwig-Slomczynska AH, Cyganek K, Malecki MT. Continuous subcutaneous insulin infusion vs multiple daily injections in pregnant women with type 1 diabetes mellitus: a systematic review and meta-analysis of randomised controlled trials and observational studies. Eur J Endocrinol 2018; 178:545-563. [PMID: 29545258 DOI: 10.1530/eje-17-0804] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 03/13/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Randomised controlled trials (RCTs) have shown an advantage of continuous subcutaneous insulin infusion (CSII) over multiple daily injections (MDI) in the general type 1 diabetes mellitus (T1DM) population. RCT data on T1DM management in pregnancy remain limited. OBJECTIVE We performed a systematic review of both RCTs and non-RCTs evaluating CSII vs MDI in T1DM-complicated pregnancy. STUDY DESIGN Electronic databases were searched for studies comparing CSII with MDI in T1DM-complicated pregnancy. METHODS A meta-analysis provided point estimates with 95% confidence intervals (CI). Continuous outcomes were reported as weighted mean differences (WMD) or standardised mean differences (SMD), and dichotomous data as relative risk (RR). RESULTS The search identified 47 studies, including 43 non-RCTs, reporting on 7824 pregnancies. The meta-analysis showed a lower HbA1c level with CSII vs MDI in the first trimester (WMD: -0.45%; 95%CI: -0.62, -0.27). This difference decreased in subsequent trimesters. Compared to MDI, therapy with CSII resulted in higher gestational weight gain (GWG) (WMD: 1.02 kg; 95%CI: 0.41, 1.62), and lower daily insulin dose requirements in the first (SMD: -0.46; 95%CI: -0.68, -0.24) and subsequent trimesters. Moreover, infants from the CSII group were more likely to be large for gestational age (LGA) (RR: 1.16; 95%CI: 1.07, 1.24) and less likely to be small for gestational age (SGA) (RR: 0.66; 95%CI: 0.45; 0.97). CONCLUSIONS In T1DM-complicated pregnancy, CSII compared to MDI therapy resulted in better first trimester glycaemic control; this difference decreased in subsequent trimesters. CSII therapy was associated with lower insulin requirements, higher GWG and altered risk for infants being LGA and SGA.
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Affiliation(s)
| | | | | | - Maciej T Malecki
- University HospitalKrakow, Poland
- Department of Metabolic DiseasesJagiellonian University Medical College, Krakow, Poland
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Perioperative management of adult diabetic patients. Specific situations. Anaesth Crit Care Pain Med 2018; 37 Suppl 1:S31-S35. [PMID: 29555546 DOI: 10.1016/j.accpm.2018.02.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 02/17/2018] [Accepted: 02/26/2018] [Indexed: 12/16/2022]
Abstract
Ambulatory surgery can be carried out in diabetic patients. By using a strict organisational and technical approach, the risk of glycaemic imbalance is minimised, allowing the patients to return to their previous way of life more quickly. Taking into account the context of ambulatory surgery, with a same day discharge, the aims are to minimise the changes to antidiabetic treatment, to maintain adequate blood sugar control and to resume oral feeding as quickly as possible. The preoperative evaluation is the same as for a hospitalised patient and recent glycaemic control (HbA1c) is necessary. Perioperative management and the administration of treatment depend on the number of meals missed. The patient can return home after taking up usual feeding and treatment again. Hospitalisation is necessary if significant glycaemic imbalance occurs. In pregnancy, it is necessary to distinguish between known pre-existing diabetes (T1D or T2D) and gestational diabetes, defined as glucose intolerance discovered during pregnancy. During labour, blood sugar levels should be maintained between 0.8 and 1.4g/L (4.4-8.25mmol/L). Control of blood sugar levels is obtained by using a continuous administration of insulin using an electronic syringe (IVES) together with a glucose infusion. Post-partum, management depends on the type of diabetes: in T1D and T2D patients a basal-bolus scheme is restarted with decreased doses while in gestational diabetes insulin therapy is stopped after delivery. Antidiabetic treatment is again necessary if blood sugar levels remain>1.26g/L (7mmol/L).
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Rougerie M, Czuzoj-Shulman N, Abenhaim HA. Diabetic ketoacidosis among pregnant and non-pregnant women: a comparison of morbidity and mortality. J Matern Fetal Neonatal Med 2018; 32:2649-2652. [PMID: 29486630 DOI: 10.1080/14767058.2018.1443071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE Diabetic ketoacidosis (DKA) is a critical diagnosis that can cause severe morbidity and mortality in the diabetic population. Although it is rare in pregnancy, the aim of this study is to compare DKA in pregnant women with age-matched non-pregnant women to determine if outcomes are influenced by pregnancy. MATERIALS AND METHODS A population-based age-matched retrospective cohort was carried out using data from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from 1999 to 2013. Pregnant patients with DKA were age-matched with non-pregnant controls also admitted with DKA at a ratio of 1:10. Severe morbidities and mortality were compared among the two groups. Logistic regression was used to adjust for baseline characteristics and comorbidities. RESULTS We identified 4661 cases of DKA in pregnancy during our study period, which were age-matched to 46,610 non-pregnant controls. Pregnant women with DKA were more likely to stay in hospital for >3 d (odds ratios (OR) 2.15, 95% CI 2.06-2.25) and had more associated renal failure (OR 2.86, 95% CI 1.76-4.55); however, they were less likely to require ventilation (OR 0.70, 95% CI 0.62-0.79), experience systemic inflammatory response syndrome (OR 0.53, 95% CI 0.38-0.73), or seizures (OR 0.49, 95% CI 0.42-0.57). Among pregnant women, rates of coma (0.04%) and death (0.17%, OR 0.23, 95% CI 0.14-0.39) were lower than previously reported and lower than non-pregnant women. CONCLUSION Pregnant women with DKA are admitted to hospital for longer periods than non-pregnant controls and are at higher risk for renal failure but otherwise have better outcomes and less mortality than non-pregnant controls.
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Affiliation(s)
- Michelle Rougerie
- a Department of Obstetrics and Gynecology , Jewish General Hospital, McGill University , Montreal , Canada
| | - Nicholas Czuzoj-Shulman
- b Center for Clinical Epidemiology and Community Studies , Lady Davis Institute, Jewish General Hospital , Montreal , Canada
| | - Haim A Abenhaim
- a Department of Obstetrics and Gynecology , Jewish General Hospital, McGill University , Montreal , Canada.,b Center for Clinical Epidemiology and Community Studies , Lady Davis Institute, Jewish General Hospital , Montreal , Canada
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Peterson-Burch F, Abujaradeh H, Charache N, Fischl A, Charron-Prochownik D. Preconception Counseling for Adolescents and Young Adults with Diabetes: a Literature Review of the Past 10 Years. Curr Diab Rep 2018; 18:11. [PMID: 29450662 DOI: 10.1007/s11892-018-0983-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Women with diabetes who have unplanned pregnancies and uncontrolled blood sugars are at a higher risk for maternal and fetal morbidities and mortalities. Preconception counseling (PC) has been shown to decrease the risks and improve health outcomes. From 2009 to 2017, the American Diabetes Association has recommended that preconception counseling be given at each clinic visit for all women with diabetes of childbearing age starting at puberty (prior to sexual debut). RECENT FINDINGS This article reports both national and international progress in PC efforts for adolescents and young adults (12-34 years) with diabetes over the past decade. Twenty-eight publications were identified and included in this article (11 were research, 12 clinical guidelines, and 5 reviews). Despite recommendations to start PC at puberty, only four studies had interventions that targeted the adolescent and young adult age group. Three of them were associated with the same PC awareness program. Positive outcomes were reported in all of these studies. Greater family vigilance was observed in a long-term follow-up of a cohort of women who received PC as teens. Adolescents should receive awareness PC. More early PC interventions and cohort follow-up studies are needed among adolescents and young adults, using technology that appeals to this age group. Programs should be expanded to include other populations like males with diabetes and females from other cultures and religions that would require program modification.
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Affiliation(s)
- Frances Peterson-Burch
- University of Pittsburgh School of Nursing, 440 Victoria Building, Pittsburgh, PA, 15261, USA
| | - Hiba Abujaradeh
- University of Pittsburgh School of Nursing, 440 Victoria Building, Pittsburgh, PA, 15261, USA
| | - Nicole Charache
- University of Pittsburgh School of Nursing, 440 Victoria Building, Pittsburgh, PA, 15261, USA
| | - Andrea Fischl
- University of Pittsburgh School of Nursing, 440 Victoria Building, Pittsburgh, PA, 15261, USA
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Cosson E, Catargi B, Cheisson G, Jacqueminet S, Ichai C, Leguerrier AM, Ouattara A, Tauveron I, Bismuth E, Benhamou D, Valensi P. Practical management of diabetes patients before, during and after surgery: A joint French diabetology and anaesthesiology position statement. DIABETES & METABOLISM 2018; 44:200-216. [PMID: 29496345 DOI: 10.1016/j.diabet.2018.01.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 01/08/2018] [Accepted: 01/15/2018] [Indexed: 12/12/2022]
Affiliation(s)
- E Cosson
- Département d'endocrinologie-diabétologie-nutrition, CRNH-IdF, CINFO, hôpital Jean-Verdier, université Paris 13, Sorbonne Paris Cité, AP-HP, 93140 Bondy, France; UMR U1153 Inserm, U1125 Inra, CNAM, université Paris 13, Sorbonne Paris Cité, 93000 Bobigny, France
| | - B Catargi
- Service d'endocrinologie-maladies métaboliques, hôpital Saint-André, CHU de Bordeaux, 1, rue Jean-Burguet, 33000 Bordeaux, France.
| | - G Cheisson
- Service d'anesthésie-réanimation chirurgicale, hôpitaux universitaires Paris-Sud, hôpital de Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France
| | - S Jacqueminet
- Institut de cardio-métabolisme et nutrition, hôpital de la Pitié-Salpêtrière, AP-HP, 75013 Paris, France; Département du diabète et des maladies métaboliques, hôpital de la Pitié-Salpêtrière, 75013 Paris, France
| | - C Ichai
- Service de la réanimation polyvalente, hôpital Pasteur 2, CHU de Nice, 30, voie Romaine, 06001 Nice cedex 1, France; IRCAN, Inserm U1081, CNRS UMR 7284, university hospital of Nice, 06000 Nice, France
| | - A-M Leguerrier
- Service de diabétologie-endocrinologie, CHU hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, 35056 Rennes, France
| | - A Ouattara
- Department of anaesthesia and critical care II, Magellan medico-surgical center, CHU de Bordeaux, 33000 Bordeaux, France; Inserm, UMR 1034, biology of cardiovascular diseases, université Bordeaux, 33600 Pessac, France
| | - I Tauveron
- Service d'endocrinologie-diabétologie, CHU de Clermont-Ferrand, 58, rue Montalembert, 63000 Clermont-Ferrand, France; UFR médecine, université Clermont-Auvergne, 28, place Henri-Dunant, 63000 Clermont-Ferrand, France; UMR CNRS 6293, Inserm U1103, génétique reproduction et développement, université Clermont-Auvergne, 63170 Aubière, France; Endocrinologie-diabétologie, CHU G.-Montpied, BP 69, 63003 Clermont-Ferrand, France
| | - E Bismuth
- Service d'endocrinologie-pédiatrie-diabète, hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | - D Benhamou
- Service d'anesthésie-réanimation chirurgicale, hôpitaux universitaires Paris-Sud, hôpital de Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France
| | - P Valensi
- Département d'endocrinologie-diabétologie-nutrition, CRNH-IdF, CINFO, hôpital Jean-Verdier, université Paris 13, Sorbonne Paris Cité, AP-HP, 93140 Bondy, France
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Bartolo S, Goffinet F, Blondel B, Deneux-Tharaux C. Why women with previous caesarean and eligible for a trial of labour have an elective repeat caesarean delivery? A national study in France. BJOG 2016; 123:1664-73. [DOI: 10.1111/1471-0528.14056] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2016] [Indexed: 12/23/2022]
Affiliation(s)
- S Bartolo
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé); Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS); DHU Risks in pregnancy; Inserm UMR 1153; Paris Descartes University; Paris France
| | - F Goffinet
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé); Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS); DHU Risks in pregnancy; Inserm UMR 1153; Paris Descartes University; Paris France
- Port-Royal Maternity Unit; Cochin Hospital APHP; DHU Risks in pregnancy; Paris Descartes University; Paris France
| | - B Blondel
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé); Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS); DHU Risks in pregnancy; Inserm UMR 1153; Paris Descartes University; Paris France
| | - C Deneux-Tharaux
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé); Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS); DHU Risks in pregnancy; Inserm UMR 1153; Paris Descartes University; Paris France
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12
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Dong D, Reece EA, Lin X, Wu Y, AriasVillela N, Yang P. New development of the yolk sac theory in diabetic embryopathy: molecular mechanism and link to structural birth defects. Am J Obstet Gynecol 2016; 214:192-202. [PMID: 26432466 PMCID: PMC4744545 DOI: 10.1016/j.ajog.2015.09.082] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 09/18/2015] [Accepted: 09/22/2015] [Indexed: 12/12/2022]
Abstract
Maternal diabetes mellitus is a significant risk factor for structural birth defects, including congenital heart defects and neural tube defects. With the rising prevalence of type 2 diabetes mellitus and obesity in women of childbearing age, diabetes mellitus-induced birth defects have become an increasingly significant public health problem. Maternal diabetes mellitus in vivo and high glucose in vitro induce yolk sac injuries by damaging the morphologic condition of cells and altering the dynamics of organelles. The yolk sac vascular system is the first system to develop during embryogenesis; therefore, it is the most sensitive to hyperglycemia. The consequences of yolk sac injuries include impairment of nutrient transportation because of vasculopathy. Although the functional relationship between yolk sac vasculopathy and structural birth defects has not yet been established, a recent study reveals that the quality of yolk sac vasculature is related inversely to embryonic malformation rates. Studies in animal models have uncovered key molecular intermediates of diabetic yolk sac vasculopathy, which include hypoxia-inducible factor-1α, apoptosis signal-regulating kinase 1, and its inhibitor thioredoxin-1, c-Jun-N-terminal kinases, nitric oxide, and nitric oxide synthase. Yolk sac vasculopathy is also associated with abnormalities in arachidonic acid and myo-inositol. Dietary supplementation with fatty acids that restore lipid levels in the yolk sac lead to a reduction in diabetes mellitus-induced malformations. Although the role of the human yolk in embryogenesis is less extensive than in rodents, nevertheless, human embryonic vasculogenesis is affected negatively by maternal diabetes mellitus. Mechanistic studies have identified potential therapeutic targets for future intervention against yolk sac vasculopathy, birth defects, and other complications associated with diabetic pregnancies.
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Affiliation(s)
- Daoyin Dong
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD
| | - E Albert Reece
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD; Department of Biochemistry and Molecular Biology, University of Maryland School of Medicine, Baltimore, MD
| | - Xue Lin
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD
| | - Yanqing Wu
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD
| | - Natalia AriasVillela
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD
| | - Peixin Yang
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD; Department of Biochemistry and Molecular Biology, University of Maryland School of Medicine, Baltimore, MD.
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Ayed S, Bouguerba A, Ahmed P, Barchazs J, Boukari M, Goldgran-Toledano D, Bornstain C, Vincent F. Les pièges de l’acidocétose diabétique. MEDECINE INTENSIVE REANIMATION 2015. [DOI: 10.1007/s13546-015-1113-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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14
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Abstract
The primary goal of type 1 diabetes treatment is attaining near-normal glucose values. This currently remains out of reach for most people with type 1 diabetes despite intensified insulin treatment in the form of insulin analogues, educational interventions, continuous glucose monitoring, and sensor augmented insulin pump. The main remaining problem is risk of hypoglycaemia, which cannot be sufficiently reduced in all patient groups. Additionally, patients' burn-out often develops with years of tedious day-to-day diabetes management, rendering available diabetes-related technology less efficient. Over the past 40 years, several attempts have been made towards computer-programmed insulin delivery in the form of closed loop, with faster developments especially in the past decade. Automated insulin delivery has reduced human error in glycaemic control and considerably lessened the burden of routine self-management. In this chapter, data from randomized controlled trials with closed-loop insulin delivery that included type 1 diabetes population are summarized, and an evidence-based vision for possible routine utilization of closed loop is provided.
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Affiliation(s)
- Tadej Battelino
- Department of Endocrinology, Diabetes and Metabolism, UMC - University Children's Hospital, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Slovenia.
| | - Jasna Šuput Omladič
- Department of Endocrinology, Diabetes and Metabolism, UMC - University Children's Hospital, Ljubljana, Slovenia
| | - Moshe Phillip
- Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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15
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Pathologies maternelles chroniques et pertes de grossesse. Recommandations françaises. ACTA ACUST UNITED AC 2014; 43:865-82. [PMID: 25447366 DOI: 10.1016/j.jgyn.2014.09.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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16
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Cameron FJ, Amin R, de Beaufort C, Codner E, Acerini CL. ISPAD Clinical Practice Consensus Guidelines 2014. Diabetes in adolescence. Pediatr Diabetes 2014; 15 Suppl 20:245-56. [PMID: 25039664 DOI: 10.1111/pedi.12169] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 06/05/2014] [Indexed: 01/16/2023] Open
Affiliation(s)
- Fergus J Cameron
- Royal Children's Hospital, Murdoch Children's Research Institute, University of Melbourne, Melbourne, Australia
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Garabedian C, Vambergue A, Salleron J, Deruelle P. Prediction of macrosomia by serial sonographic measurements of fetal soft-tissues and the liver in women with pregestational diabetes. DIABETES & METABOLISM 2013; 39:511-8. [DOI: 10.1016/j.diabet.2013.03.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 03/03/2013] [Accepted: 03/12/2013] [Indexed: 12/27/2022]
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18
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Khoo CM, Lee KO. Endocrine emergencies in pregnancy. Best Pract Res Clin Obstet Gynaecol 2013; 27:885-91. [PMID: 24016619 DOI: 10.1016/j.bpobgyn.2013.08.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 08/08/2013] [Accepted: 08/09/2013] [Indexed: 12/20/2022]
Abstract
Endocrine emergencies in pregnancy are rare and are more likely to occur in the absence of good obstetric care. Serious thyroid and diabetes related events in pregnancy are more common because of their higher prevalence in the normal population. Pituitary complications in pregnancy are now relatively rare. A high index of suspicion is needed for early diagnosis, and medical treatment is directed primarily at maintaining maternal hemodynamic stability. A close liaison between an endocrinologist, maternal-fetal specialist and intensivist is critical in optimising both maternal and fetal outcomes.
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Affiliation(s)
- Chin Meng Khoo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Rd NUHS Tower Blk L10, Singapore 119228, Singapore
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