Diabetes in Women (eBook)

Preface 7
Contents 8
Contributors 10
Sex Differences in Energy Balance, Body Composition, and Body Fat Distribution 12
Abstract 12
INTRODUCTION 13
SEX DIFFERENCES IN ENERGY BALANCE 14
SEX DIFFERENCES IN BODY COMPOSITION AND BODY FAT DISTRIBUTION 15
FAT DEPOT-SPECIFIC CHARACTERISTICS: A KEY TO THE LINK BETWEEN VISCERAL FAT ACCUMULATION AND DISEASE OUTCOME 17
TELEOLOGICAL SIGNIFICANCE 21
STEROID HORMONES AND BODY FAT DISTRIBUTION PATTERNS 23
CONCLUSION 27
REFERENCES 27
Menopause and Diabetes Mellitus 36
Abstract 36
CHANGES IN GONADAL HORMONES AT MENOPAUSE 36
SYMPTOMS OF MENOPAUSE 37
AGE OF MENOPAUSE 38
CHANGES IN BODY COMPOSITION AT MENOPAUSE 38
RISK OF DIABETES IN POSTMENOPAUSAL WOMEN 39
HORMONE REPLACEMENT THERAPY 39
CONCLUSION 42
REFERENCES 42
Cardiovascular Disease in Women with Diabetes 45
Abstract 45
INTRODUCTION 46
IMPACT AND BURDEN OF DIABETES ON CARDIOVASCULAR DISEASE IN WOMEN 46
PLATELET AND COAGULATION ABNORMALITIES IN DIABETES 48
ENDOTHELIAL DYSFUNCTION 54
SCREENING AND DIAGNOSIS OF CAD 61
TREATMENT OF CVD IN WOMEN WITH DIABETES 62
SUMMARY 62
REFERENCES 63
Insulin Resistance, Diabetes, and Cardiovascular Risk in Women and the Paradigm of the Polycystic Ovary Syndrome 67
Abstract 67
The Biology of Sex Difference in Health and Disease 68
Insulin Resistance in the General Female Population 68
The Metabolic Syndro me, Cardiovascular Risk Factors , and Cardiovascular Events in Women 70
How the Definition of the Metabolic Syndro me Overlaps that of Insulin Resistance 72
Diabetes and Cardiovascular Risk Factors in Women 73
The Paradigm of Pcos 76
Andro gens and Risk for Cvd and Diabetes in the Female Population: Lessons Fro m the Pcos Paradigm 83
Summary and Conclusions 84
References 85
Developmental Programming of Polycystic Ovary Syndrome: Role of Prenatal Androgen Excess 92
Abstract 92
Introduction 93
The Clinical and Molecular Phenotype of Pcos 93
Evidence for the Developmental Origins of Pcos 95
Potential Origin of Prenatal Andro gen Exces in Humans 98
Plausible Biological Mechanisms 105
Conclusions and Future Implications 107
References 107
An Anthropological View of the Impact of Poverty and Globalization on the Emerging Epidemic of Obesity 113
Abstract 113
The Big Three 115
The Food Production 119
Subsidies 120
EXPORT TAXES (OR “SLIDING SCALE DUTIES” OR “RETENTIONS”) 122
Globali zed Industry 123
Final Words 129
References 131
Eating Disorders and Depression in Women with Diabetes 134
Abstract 134
Eating Disorders and Depression: an Introduction 135
Diabetes and Eating Disorders: Epidemiology and Clinical Features 137
Depression and Diabetes 138
Eating Disorders and Depression: Screening and Treatment 141
Conclusion 144
References 144
Sexual Health in Women with Diabetes 151
Abstract 151
INTRODUCTION 152
FEMALE SEXUAL DYSFUNCTION: DEFINITIONS, CLINICAL CLASSIFICATION, AND EPIDEMIOLOGY 152
PREDICTORS OF SEXUAL DYSFUNCTION AMONG WOMEN WITH DIABETES 155
TREATMENT OF SEXUAL DISORDERS IN WOMEN WITH DIABETES 162
CONCLUSIONS 165
REFERENCES 165
Contraception for Women with Diabetes 172
Introduction 172
Counseling and Selecting A Method 173
Barrier Methods 174
Hormonal Contraception 174
Question: Can She Use Intrauterine Contraception? 180
Breastfeeding and Postpartum Contraception: Stepwise Questions 181
References 182
The Effect of PCOS on Fertility and Pregnancy 186
INTRODUCTION 186
PATHOGENESIS OF INFERTILITY 187
INFERTILITY TREATMENT IN PCOS 187
PREGNANCY 194
CONCLUSION 202
REFERENCES 202
The Effect of Pregnancy on Energy Metabolism, Body Composition, and Endothelial Function 211
Abstract 211
INTRODUCTION 212
ENERGY METABOLISM IN PREGNANCY 212
BODY COMPOSITION 214
INSULIN RESISTANCE IN PREGNANCY 216
LIPID METABOLISM IN PREGNANCY 217
ENDOTHELIAL FUNCTION 218
SUMMARY 220
References 222
The Epidemiology of Diabetes in Women and the Looming Epidemic of GDM in the Third World 227
The prevalence of diabetes in women in third world countries 228
The prevalence of gestational diabetes in women in third world countries 229
Screening for gestational diabetes in third world countries: do we need ethnic and national specific criteria? 233
Challenges to heath care delivery in third world countries 235
Medical impact of gdm in the third world 237
Postpartum consequences of gestational diabetes on the prevalence of subsequent diabetes 238
Can we reduce the future risk of diabetes in women with gestational diabetes? 239
Conclusion 239
References 239
Gestational Diabetes Mellitus: Diagnosis, Maternal and Fetal Outcomes, and Management 243
Diagnostic Criteria and Screening Procedures for Gestational Diabetes Mellitus 244
Management of Gestational Diabetes 247
Postpartum Care: Postpartum Diabetes Screening and Diabetes Risk 250
Conclusions 253
References 254
Nutrition and Pregnancy 258
Introduction 259
Preconception Counseling 259
Nutrition Requirements and Meal Planning with Pregnancy and Preexisting Diabetes 259
Calories for Pregnancy 260
Weight Gain 260
Meal Plan Recommendations 261
Physical Activity 261
Cautions During Physical Activity 261
Carbohydrates 261
Dietary Fiber 262
Carbohydrate Counting 263
Glycemic Response to Foods 264
Protein 265
Fat 265
Heart Healthy Fats 265
Seafood Recommendations During Pregnancy 266
Food-borne Illness 266
Sweeteners 266
Micronutrients 267
Record Keepin g 269
Alcohol 269
Caffeine 269
Breastfeeding 269
Nutrition and Meal Planning in Gestational Diabetes 270
Follow-up 270
Postpartum Care/clinical Implications 270
Celiac Disease 271
Gluten-free Diet 272
Resources for Celiac Disease and the Gluten-free Diet 273
References 274
Preconception Care for Women with Diabetes Mellitus 276
Abstract 276
Introduction: What is Preconception Care? 276
Efficacy of Preconception Care at Reducing Pregnancy Complications: Why Do I Need Preconception Care? 277
The Three Cs: Contraception, Counseling and Care 280
Adoption of Preconception Care Programs: Why Did I Not Know About this with My Last Pregnancy? 289
Summary 290
References 290
Obstetric Care of the Woman with Diabetes 293
Abstract 293
First Trimester (0–12 Weeks) 294
Second Trimester (13–24 Weeks) 296
Third Trimester (25–40 Weeks) 297
Labor and Delivery 301
Postpartum 303
Summary 303
References 303
Medical Management of Preexisting Diabetes in Pregnancy 308
Nutrition 309
Exercise 310
Insulin Therapy 310
Glucose Monitoring 312
Continuous Glucose Monitoring 313
Hemoglobin A1C 317
Medical Management of Complications During Diabetic Pregnancy 318
Nephropathy 320
Neuropathy 321
Lipid Changes During Pregnancy and Preexisting Diabetes 322
Thyroid Disease in Preexisting Diabetic Pregnancy 323
Management of Diabetic Ketoacidosis During Pregnancy 323
Summary 323
References 324
Use of Ultrasound in the Metabolic Management of Gestational Diabetes and Preexisting Diabetes Mellitus in Pregnancy 329
Introduction 330
Management of Gdm Based on Maternal Glucose Control Combined with Fetal Growth 331
References 337
Preeclampsia 340
Abstract 340
Epidemiology of Preeclampsia 341
Pathophysiology of Preeclampsia 344
Prediction and Diagnosis of Preeclampsia 349
Complications of Preeclampsia 350
Summary 351
References 351
The Infant of the Diabetic Mother: Metabolic Imprinting 357
Abstract 357
Diabetes in Pregnancy 358
Epid emiological Studies 359
Mechanisms 366
Public Health and Clinical Implications 369
References 370
The Genetic Basis of Diabetes 374
Abstract 374
Introduction 376
Type 1 Diabetes 378
Type 2 Diabetes 387
Monogenic Diabetes 390
Special Issues in Women Related to the Genetics of Diabetes 398
Conclusion 398
References 398
Breastfeeding and Diabetes 411
Abstract 411
Introduction 412
Breastfeeding and Maternal Health 413
Breastfeeding and Pediatric Health 416
Pharmacologic Treatment Options for Breastfeeding Women with Diabetes 419
Future Research 425
References 426
Management of Disease in Women with Diabetes 430
Abstract 430
Introduction 430
Macrovascular or cardiovascular disease 431
Microvascular complications 438
Other disease management recommendations 441
Healthcare delivery for diabetes 441
References 442
Index 448