糖尿病と妊娠(<シリーズ>「糖尿病の治療」(13))

概要

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Maternal hyperglycemia is associated with high risks for maternal and neonatal complications. During early pregnancy, maternal hyperglycemia can cause fetal malformation. Maternal hyperglycemia induces fetal hyperglycemia and consequently fetal hyperinsulinemia. Fetal hyperinsulinemia causes neonatal complications such as macrosomia and hypoglycemia. To prevent complications of the mother and fetus, the goal of treatment is to achieve normal metabolism of the mother, before and during pregnancy. Metabolic changes occur in a mother during pregnancy. Insulin resistance falls in the first trimester and increases progressively from 20th gestational week and onwards. Treatment includes large and increasing dose of insulin as the pregnancy progresses. To achieve a strict control of hyperglycemia, diet therapy and insulin therapy are both required.