Pregnancy and diabetes:
Fertility in those with well controlled diabetes does not appear to be affected, unless significant complication present.
Insulin resistance increases during pregnancy due to diabetogenic effects of placental hormones and progesterone glycaemic control before and during pregnancy important.
Metabolic control decreases most in 2nd and 3rd trimester; pre-existing microvascular complications often progress (especially retinopathy); increased risk of urinary tract infections
High incidence of large babies, due to accelerated foetal growth; increased risk for congenital malformation (related to glycaemic control at time of conception), stillbirth, neonatal complications and perinatal mortality obstetric and diabetologist management
Increased risk of offspring developing diabetes.
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