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Diabetes in Pregnancy

Diabetes in Pregnancy

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Diabetes in Pregnancy

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  1. Diabetes in Pregnancy Burden of Disease

  2. Diabetes in Pregnancy: Epidemiology • 2%-10% of pregnancies currently are complicated by gestational diabetes mellitus (GDM) • New diagnostic criteria estimated to increase rate to 18%2,3,4 • The prevalence of both GDM and type 2 diabetes mellitus have increased as obesity and sedentary lifestyle have increased in the United States5 • Pregnancies complicated by preexisting diabetes have increased substantially; most likely due to increased prevalence of T2DM in younger patients6,7 1. Engelgau, MM, et al. Diabetes Care. 1995;18(7):1029-33. 2. CDC. National Diabetes Fact Sheet 2011. CDC. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf. 2011. Accessed: April 26, 2012. 3. ADA. What is Gestational Diabetes? ADA. http://www.diabetes.org/diabetes-basics/gestational/what-is-gestational-diabetes.html. 2010. Accessed: April 26, 2012. 4. ADA. Diabetes Care. 2013;36(suppl1):S11-S66. 5. Chitayat L, et al. Diabetes TechnolTher. 2009;11:S105-111. 6. Pinhas-HamielO, Zeitler P. Pediatric Diabetes. 2007;8(9):16-27. 7. National Diabetes Education Program. Overview of Diabetes in Children and Adolescents. NIH. http://ndep.nih.gov/media/Youth_factsheet.pdf. June 2011. Accessed: April 26, 2012.

  3. Morbidity and Mortality 1. Committee on Obstetric Practice. ACOG. 2011;504:1-3. 2. Jovanovic L. Insulin therapy in pregnancy. In: Leahy JL, Cefalu WT, eds. Insulin Therapy. New York, NY: Marcel Dekker Inc; 2002:139-151. 3. Jovanovic L, Peterson CM. Diabetes Care. 1982;5(1):24-37. 4. AACE. Endocr Pract. 2011;17(2):1-53. 5. Metzger BE, et al. Diabetes Care, 2007;30(2):S251- 60.6. Jovanovic L, et al. Mt Sinai J Med. 2009;76(3):269-80. 7. Castorino K et al. Curr Diab Rep, 2012;12:53-59.8. ADA. Diabetes Care. 2013;36(suppl1):S11-S66. 9. Inness KE, et al. JAMA. 2002;287(19):2534-41.

  4. GDM: Pathophysiology • Inturrisi M, et al. Endocrinol Metab Clin N Am. 2011;40:703-26. • 2. Metzger BE, et al. Diabetes Care. 2007;30(2):S251- 60.

  5. GDM: Etiology and Risk Factors 1. American Diabetes Association. Diabetes Care. 2004;27(1):S88-S90. 2. ADA. Diabetes Care. 2013;36(suppl1):S11-S66. 3. Inturrisi M, et al. Endocrinol Metab Clin N Am. 2011;40:703-26. 4. Metzger BE, et al. Diabetes Care. 2007;30(2):S251- 60. 5. Committee on Obstetric Practice. ACOG. 2011;504:1-3. 6. CDC. National Diabetes Fact Sheet 2011. CDC. Http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf. 2011. Accessed: April 26, 2012 .

  6. Cost-Effectiveness of New Screening Criteria • International Association of the Diabetes and Pregnancy Study Groups (IADPSG) has proposed new screening criteria for gestational diabetes mellitus (GDM) • For every 100,000 women screened under the updated criteria, 6,178 quality-adjusted life-years (QALYs) will be gained at a cost of approximately $126 million • Compared with current GDM screening practices, the new IADPSG strategy has an incremental cost-effectiveness ratio (ICER) of $20,336 per QALY gained 1. Werner EF, et al. Diabetes Care. 2012;35:529-35.