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Prognosen

Ved svangerskapsdiabetes kan som oftest svangerskapet gå til termin, det er vanligvis ikke nødvendig å sette i gang fødsel tidlig. Svangerskapsdiabetes forsvinner vanligvis etter fødsel, men kvinner med svangerskapsdiabetes har betydelig økt risiko for å få diabetes type 2 senere i livet. Risiko for hjerte- og karsykdom er også økt. Det anbefales derfor at du følger opp med måling av langtidsblodsukker regelmessig, måler blodtrykk og eventuelt kolesterol. Fastlegen din kan gjøre en helhetlig vurdering av din risiko for hjerte- og karsykdom og sammen med deg bestemme videre kontrollopplegg. 

Annonse

Kvinner med diabetes type 1 eller type 2, og i mindre grad kvinner med svangerskapsdiabetes, har noe økt risiko for komplikasjoner som for tidlig fødsel og fosterskader. Med god behandling er imidlertid denne risikoen blitt betydelig redusert, og bare beskjedent høyere enn hos kvinner uten diabetes. 

 

Dette dokumentet er basert på det profesjonelle dokumentet Svangerskapsdiabetes . Referanselisten for dette dokumentet vises nedenfor

  1. Helsedirektoratet. Nasjonal faglig retningslinje for svangerskapsdiabetes. Oslo 2018. Sist faglige endring 06.06.2023. Siden besøkt 26.06.2024 helsedirektoratet.no
  2. Folkehelseinstituttet, Medisinsk fødselsregister. Diabetes hos mor. Folkehelseinstituttet 2021. Siden besøkt 24.10.2022 statistikkbank.fhi.no
  3. Kjerpeseth LJ, Hjellvik V, Gulseth HL, et al. Prevalence and treatment of gestational diabetes in Norway 2010–2020. Diabetes Res Clin Pract 2023; 207: 111025. pmid:38000666 PubMed
  4. Sweeting A, Hannah W, Backman H, et al. Epidemiology and management of gestational diabetes. Lancet 2024. pmid:38909620 PubMed
  5. Behboudi-Gandevani S, Parajuli R, Vaismoradi M. A Systematic Review of the Prevalence of Gestational Diabetes in Norway. Int J Environ Res Public Health. 2021 Feb 3;18(4):1423. PMID: 33546492 PubMed
  6. Folkehelseinstituttet, Mors kroppsmasseindeks før svangerskapet. Medisinsk fødselsregister. Folkehelseinstituttet 2021. Siden besøkt 24.10.2022 statistikkbank.fhi.no
  7. Plows JF, Stanley JL, Baker PN et al. The Pathophysiology of Gestational Diabetes Mellitus. Int J Mol Sci. 2018 Oct 26;19(11):3342. dPMID: 30373146 PubMed
  8. Chawla A, Amundsen ÅL, Hanssen KF, Iversen PO. Svangerskapsdiabetes hos kvinner fra Sør-Asia. Tidsskr Nor Lægeforen 2006; 126: 1041-3. PubMed
  9. Glukosebelastning – analysering på pasientnært instrument Oral glukosetoleransetest (OGTT). NOKLUS 2021. Siden lest 13.10.22. www.noklus.no
  10. Helsedirektoratet. Nasjonal faglig retningslinje for svangerskapsomsorgen. Oslo, 2018 www.helsedirektoratet.no
  11. Magnussen EB. et al. Adipositas i svangerskap og fødsel. Norsk gynekologisk forening Veileder i fødselshjelp (2020). ePub. ISBN 978-82-692382-0-4. [hentet 03. juni 2022]. www.legeforeningen.no
  12. Middleton P, Crowther CA, Simmonds L. Different intensities of glycaemic control for pregnant women with pre‐existing diabetes. Cochrane Database of Systematic Reviews 2016, Issue 5. Art. No.: CD008540. DOI: 10.1002/14651858.CD008540.pub4. Accessed 05 January 2024. The Cochrane Library
  13. Sanusi AA, Xue Y, McIlwraith C, et al. Association of Continuous Glucose Monitoring Metrics With Pregnancy Outcomes in Patients With Preexisting Diabetes. Diabetes Care 2024; 47: 89-96. pmid:37782847 PubMed
  14. Hartling L, Dryden DM, Guthrie A, et al. Benefits and harms of treating gestational diabetes mellitus: a systematic review and meta-analysis for the U.S. Preventive Services Task Force and the National Institutes of Health Office of Medical Applications of Research. . Ann Intern Med 2013 May 28 . doi:10.7326/0003-4819-159-2-201307160-00661 DOI
  15. Garrison A. Screening, Diagnosis, and Management of Gestational Diabetes Mellitus. Am Fam Phys 2015; 91: 460-7. pmid:25884746 PubMed
  16. Martis R, Crowther CA, Shepherd E, Alsweiler J, Downie MR, Brown J. Treatments for women with gestational diabetes mellitus: an overview of Cochrane systematic reviews. Cochrane Database of Systematic Reviews 2018, Issue 8. Art. No.: CD012327. DOI: 10.1002/14651858.CD012327.pub2. Accessed 26 June 2024. The Cochrane Library
  17. Boggess KA, Valint A, Refuerzo JS, et al. Metformin Plus Insulin for Preexisting Diabetes or Gestational Diabetes in Early Pregnancy The MOMPOD Randomized Clinical Trial. JAMA 2023; 330: 2182-2190. pmid:38085312 PubMed
  18. Socialstyrelsen. Nationella riktlinjer för diabetesvård – Stöd för styrning och ledning. 2018. (Hämtad 2018-09-27) www.socialstyrelsen.se
  19. Rowan JA, Rush EC, Plank LD, et al. Metformin in gestational diabetes: the offspring follow-up (MiG TOFU): body composition and metabolic outcomes at 7–9 years of age. BMJ Open Diabetes Res Care 2018; 6: e000456. pmid:29682291 PubMed
  20. Landi SN, Radke S, Engel SM et al. Association of Long-term Child Growth and Developmental Outcomes With Metformin vs Insulin Treatment for Gestational Diabetes. JAMA Pediatr 2018. PMID: 30508164 PubMed
  21. Sénat M-V, Affres H, Letourneau A, et al. Effect of Glyburide vs Subcutaneous Insulin on Perinatal Complications Among Women With Gestational Diabetes A Randomized Clinical Trial. JAMA 2018; 319: 1773-80. pmid:29715355 PubMed
  22. Balsells M, García-Patterson A, Solà I, et al. Glibenclamide, metfomin, and insulin for the treatment of gestational diabetes: a systematic review and meta-analysis. BMJ 2015; 350: h102. doi:10.1136/bmj.h102 DOI
  23. Cesta CE, Rotem R, Bateman BT, et al. Safety of GLP-1 Receptor Agonists and Other Second-Line Antidiabetics in Early Pregnancy. JAMA Intern Med 2024; 184: 144-152. pmid:38079178 PubMed
  24. Tieu J, Shepherd E, Middleton P, Crowther CA. Dietary advice interventions in pregnancy for preventing gestational diabetes mellitus. Cochrane Database of Systematic Reviews 2017, Issue 1. Art. No.: CD006674. DOI: 10.1002/14651858.CD006674.pub3. Accessed 03 November 2022. The Cochrane Library
  25. Shepherd E, Gomersall JC, Tieu J, Han S, Crowther CA, Middleton P. Combined diet and exercise interventions for preventing gestational diabetes mellitus. Cochrane Database of Systematic Reviews 2017, Issue 11. Art. No.: CD010443. DOI: 10.1002/14651858.CD010443.pub3. Accessed 03 November 2022. The Cochrane Library
  26. Vounzoulaki E, Khunti K, Abner SC, et al. Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysis. BMJ 2020; 369: m1361. www.bmj.com
  27. Koivusalo S, Rönö K, Klemetti M, et al. Gestational diabetes mellitus can be prevented by lifestyle intervention: The Finnish Gestational Diabetes Prevention Study (RADIEL): A randomized controlled trial. Diabetes Care 2015. PMID: 26223239 PubMed
  28. Claesson R, Ignell C, Shaat N, et al. HbA1c as a predictor of diabetes after gestational diabetes mellitus. Prim Care Diabetes 2017; 11(1): 46-51. pmid:27692850 PubMed
  29. Köhler M, Ziegler AG, Beyerlein A. Development of a simple tool to predict the risk of postpartum diabetes in women with gestational diabetes mellitus. Acta Diabetologica 2015. doi:10.1007/s00592-015-0814-0 DOI
  30. Ignell C, Ekelund M, Anderberg E, et al. Model for individual prediction of diabetes up to 5 years after gestational diabetes mellitus. Springerplus 2016; 5: 318. pmid:27065426 PubMed
  31. Persson M, Norman M, Hanson U. Obstetric and perinatal outcomes in type 1 diabetic pregnancies: A large, population-based study. Diabetes Care 2009; 32(11): 2005-9. pmid:19675195 PubMed
  32. Farrar D, Simmonds M, Bryant M et al. Treatments for gestational diabetes: a systematic review and meta.analysis. BMJ Open 2017; 7: e015557. pmid:28647726 PubMed
  33. Feghali MN, Scifres CM. Novel therapies for diabetes mellitus in pregnancy. BMJ 2018; 362: k2034. pmid:30012851 PubMed
  34. Billionet C, Mitanchez D, Weill A et al. Gestational diabetes and adverse perinatal outcomes from 716,152 births in France in 2012. Diabetologia 2017; 60: 636-44. pmid:28197657 PubMed
  35. Lai FY, Johnson JA, Dover D, Kaul P. Outcomes of singleton and twin pregnancies complicated by pre-existing diabetes and gestational diabetes: A population-based study in Alberta, Canada, 2005-11. J Diabetes 2016; 8: 45-55. pmid:25496644 PubMed
  36. Yang J, Qian F, Chavarro JE, et al. Modifiable risk factors and long term risk of type 2 diabetes among individuals with a history of gestational diabetes mellitus: prospective cohort study. BMJ 2022; 378: 070312. pmid:36130782 PubMed
  37. Persson M, Shah PS, Rusconi F et al. Association of Maternal Diabetes With Neonatal Outcomes of Very Preterm and Very Low-Birth-Weight Infants: An International Cohort Study. JAMA Pediatr 2018; 172: 867-75. pmid:29971428 PubMed
  38. Xie W, Wang Y, Xiao S, et al. Association of gestational diabetes mellitus with overall and type specific cardiovascular and cerebrovascular diseases: systematic review and meta-analysis. BMJ 2022; 378: e070244. pmid:36130740 PubMed
  39. Wang Y-X, Mitsunami M, Manson JE, et al. Association of gestational diabetes with subsequent long-term risk of mortality. JAMA Intern Med 2023. pmid:37695588 PubMed
  40. Eidem I, Vangen S, Hanssen KF, et al. Perinatal and infant mortality in term and preterm births among women with type 1 diabetes. Diabetologia 2011; 54: 2771-8. www.ncbi.nlm.nih.gov
  41. Eletri L, Mitanchez D. How Do the Different Types of Maternal Diabetes during Pregnancy Influence Offspring Outcomes? Nutrients. 2022 Sep 19;14(18):3870. PMID: 36145247 PubMed
  42. Poolsup N, Suksomboon N,Amin M. Effect of treatment of gestational diabetes mellitus: a systematic review and meta-analysis. PLoS One. 2014;9(3):e92485. PMID: 24658089. PubMed
  43. Alwan N, Tuffnell DJ, West J. Treatments for gestational diabetes. Cochrane Database of Systematic Reviews 2009, Issue 3. Art. No.: CD003395. DOI: 10.1002/14651858.CD003395.pub2. DOI
  44. Retnakaran R, Shah BR. Glucose screening in pregnancy and future risk of cardiovascular disease in women: a retrospective, population-based cohort study. Lancet Diabet Endocrinol 2019; 7: 378-84. pmid:30928459 PubMed
  45. Friis CM, Roum EMS, Holm HO, et al. Svangerskapsdiabetes. Norsk gynekologisk forening. Veileder i fødselshjelp. Sist oppdatert 16.02.2020. Siden lest 26.06.2024. www.legeforeningen.no
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