CRC TXTBK DIABET PREG PDF

Preface

The field of diabetes and pregnancy has come of age. From the conception of the terminology ‘gestational diabetes' and ‘diabetes in pregnancy' to the creation of an entire subspecialty, this textbook documents the ‘gestation' of the field.Now we have even subdivided the field and have created subspecialists in gestational diabetes, and pregestational or diabetes in pregnancy, Type 1 and Type 2. In fact we have created our own internal debating groups as to the correct terminology for each type of diabetes and its impact on pregnancy and the pregnancy's impact on the type of diabetes. It is a great honor to be on the team of editors who have sought out the most creative and progressive of scientists, and learned from them the latest techniques and opinions as to the optimal management of all types of diabetes in pregnancy.

This textbook not only documents the past 80 years of progress in the field of diabetes and pregnancy, but also presents the most up-to-date tools, techniques and management protocols to ensure the optimal outcome of pregnancies complicated by diabetes. In addition, the areas that remain controversial are discussed in detail to enable the reader to come to an opinion while waiting for the evidence to validate many of the expert opinions presented in this book. A scan of the table of contents shows that every area in the field of diabetes and pregnancy has been covered. After a retrospective and historical perspective this textbook covers both gestational diabetes and the Type 1 and Type 2 diabetic woman who becomes pregnant. There are four chapters devoted to the history written by giants in the field who have had the opportunity to sit at the feet of the pioneers in our field: the great Drs Priscilla White, Norbert Freinkel, John O'Sullivan and Jørgen Pedersen. The authors of each of the subsequent chapters are world renowned. Thus if there is not the highest level of evidence-based literature to substantiate an opinion, the expert presents the data upon which a decision can be made about optimal care.

The most controversial topic today in the field of diabetes and pregnancy is in the area of screening and diagnosis. Here the evidence to date is presented and the justification for a multi-national, multi-center clinical trial to elucidate the optimal methods for screening and diagnosis are presented. In addition, the pure physiology of normal metabolism in pregnancy and the pathophysiology of diabetes in pregnancy are discussed in detail. These chapters set the stage for deriving the optimal therapy for the pregnant diabetic women and creating the algorithms that most closely mimic the normal physiology and metabolism of pregnancy.

The chapters devoted to malformations, placental pathology and defects of growth and development of the fetus are the strongest discussions to date in our understanding of diabetic fetopathy and teratogenesis. Based on this literature the reader will be motivated to learn the difficult protocols to achieve and maintain normoglycemia before, during and in-between all pregnancies complicated by diabetes.