Sacks - Diabetes and pregnancy a guide to a healthy pregnancy for women with type 1, type 2, or gestational diabetes

Director, Book Publishing, Abe Ogden; Managing Editor, Greg Guthrie; Acquisitions Editor, Victor Van Beuren; Editor, Rebekah Renshaw; Production Manager, Melissa Sprott; Composition, ADA; Cover Design, pixiedesign, llc.; Printer, Victor Graphics.

2011 by the American Diabetes Association, Inc. All Rights Reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including duplication, recording, or any information storage and retrieval system, without the prior written permission of the American Diabetes Association.

Printed in the United States of America
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The suggestions and information contained in this publication are generally consistent with the Clinical Practice Recommendations and other policies of the American Diabetes Association, but they do not represent the policy or position of the Association or any of its boards or committees. Reasonable steps have been taken to ensure the accuracy of the information presented. However, the American Diabetes Association cannot ensure the safety or efficacy of any product or service described in this publication. Individuals are advised to consult a physician or other appropriate health care professional before undertaking any diet or exercise program or taking any medication referred to in this publication. Professionals must use and apply their own professional judgment, experience, and training and should not rely solely on the information contained in this publication before prescribing any diet, exercise, or medication. The American Diabetes Associationits officers, directors, employees, volunteers, and membersassumes no responsibility or liability for personal or other injury, loss, or damage that may result from the suggestions or information in this publication.

The paper in this publication meets the requirements of the ANSI Standard Z39.48-1992 (permanence of paper).

ADA titles may be purchased for business or promotional use or for special sales. To purchase more than 50 copies of this book at a discount, or for custom editions of this book with your logo, contact the American Diabetes Association at the address below, at booksales@diabetes.org, or by calling 703-299-2046.

American Diabetes Association
1701 North Beauregard Street
Alexandria, Virginia 22311

DOI: 10.2337/9781580404372

Library of Congress Cataloging-in-Publication Data
Diabetes and pregnancy : a guide to a healthy pregnancy for women with type 1, type 2, or gestational diabetes / [edited by] David A. Sacks.
p. cm.
Includes bibliographical references and index.
ISBN 978-1-58040-437-2 (pbk.)
1. Diabetes in pregnancy--Popular works. I. Sacks, David A.
RG580.D5D513 2011
618.3'64--dc22
2011014144
eISBN: 9781580403924

Dedication

This book is dedicated to all reproductive age women who have some form of diabetes, and to those who may develop diabetes. We hope that its contents will provide you with knowledge that will enable you to help you have the best outcome possible before, during, and after your pregnancy.

Table of Contents

Acknowledgments

This book is intended as an update and combining of two previous publications (Diabetes & Pregnancy: What to Expect, 4th ed., and Gestational Diabetes: What to Expect, 5th ed.). The reason for combining these books was that gestational diabetes in many instances will develop into permanent diabetes. This is important to know because it is now possible to decrease your risks of developing diabetes in the years following pregnancy. We are grateful to the authors, editors, and reviewers of the many editions of both these texts for having provided the template for the current book.

The editor wishes to personally express his gratitude to all the contributors to this book. Largely academic clinicians, they bravely undertook the task of taking some fairly sophisticated medical concepts and translating them into everyday language.

Recognition is also extended to the behind the scenes people without whom this publication would remain a sequence of ideas united by a sequence of bits and bytes on a computer. Special thanks go to Rebekah Renshaw, developmental editor; Victor Van Beuren, acquisitions; and Abe Ogden, director of book publishing, of the ADA for their support and counsel throughout the development of this book.

Thanks also to the reviewers of this book: Boyd Metzger, MD; Martha Funnell, MS, RN, CDE; Florence Brown, MD; Sue Kirkman, MD; and Stephanie Dunbar, RD.

David A. Sacks, MD

Contributors

Howard Berger, MD
Head, Maternal Fetal Medicine
St. Michaels Hospital
Assistant Professor
University of Toronto
Toronto, Canada

Kathleen M. Berkowitz, MD
Medical Director, Maternal Transport Program
MemorialCare Center for Women at Miller Childrens Hospital & Long Beach Memorial Medical Center

Denice Feig, MD, MSc
Associate Professor
Departments of Medicine, Obstetrics & Gynecology, Health Policy, Management & Evaluation
University of Toronto,
Mount Sinai Hospital
Toronto, Canada

T. Murphy Goodwin, MD
Professor of Obstetrics and Gynecology and Pediatrics
Chief, Maternal-Fetal Medicine
University of Southern California

Mandhir Gupta, MD
Director NICU and Assistant Chief Pediatrics
Kaiser Permanente

Susan Hales, RD, CDE
Perinatal Diabetes Center
Cabell Huntington Hospital
Huntington, West Virginia

Janet C. King, PhD
Senior Scientist
Childrens Hospital Oakland Research Institute
Oakland, California
Professor
University of California Berkeley & Davis

Martin Montoro, MD
Professor of Clinical Medicine & OB/GYN
Division of Maternal-Fetal Medicine
Keck School of Medicine
University of Southern California

Laura Mullarky, RN, CDE
Perinatal Diabetes Center
Cabell Huntington Hospital
Huntington, West Virginia

Robin Reeves, BSN
Coordinator Perinatal Center
Cabell Huntington Hospital
Huntington, West Virginia

Carolina Reyes, MD
Clinical Associate Professor
Maternal-Fetal Medicine
Keck School of Medicine
University of Southern California
Maternal-Fetal Medicine
Virginia Hospital Center
Arlington, Virginia

Barak M. Rosenn, MD
Professor of Clinical Obstetrics and Gynecology
Columbia University College of Physicians and Surgeons
Director of Obstetrics and Maternal-Fetal Medicine
St. Lukes Roosevelt
Hospital Center
New York, New York

Penina Segall-Gutierrez, MD, MSc
Assistant Professor of Clinical Obstetrics and Gynecology and Family Medicine
Keck School of Medicine
University of Southern California

Shailini Singh, MD
Clinical Professor of OB/GYN
University of Buffalo
Director of Fetal Diagnostic Center
Director of Metabolic Syndrome Center
Kaleida Health Care
Former Director of Perinatal Center and Perinatal Diabetes Center
Cabell Huntington Hospital
Huntington, West Virginia

Naomi E. Stotland, MD
Associate Professor
Department of Obstetrics, Gynecology, and Reproductive Sciences
University of California, San Francisco

Bonnie Trader, RN
Perinatal Diabetes Center
Cabell Huntington Hospital
Huntington, West Virginia

Terri Weiland, RN, CDE
Diabetes and Pregnancy
Case Manager
WCH High Risk Services

Introduction

T his book is for any woman who has diabetes and who is, or will soon be, of an age when she is capable of having babies. It started as a project to combine and update two earlier books published by the American Diabetes Association, one of which deals with pregnancy for women who had diabetes before they got pregnant, and the other for women whose diabetes first occurred or was first recognized during pregnancy. It subsequently took on a personal aspect, because as the chapters came in, I found myself wishing that my patients had access to this information before they became pregnant.