Type 2 diabetes (T2D) is associated with maternal and offspring complications (eFigure in the Supplement). Although the prevalence of type 1 diabetes during pregnancy has remained stable, the prevalence of T2D has increased from 1.8 to 7.3 per 1000 deliveries in the past 10 years.1 The pathogenesis of T2D leads to progressive insulin resistance, defective pancreatic beta cell insulin secretion, and inappropriate glucagon secretion by the alpha cells. The multiorgan metabolic dysregulation of T2D complicates the dynamic physiologic and metabolic changes necessary during pregnancy to grow and develop a healthy fetus. Therefore, addressing the factors that affect the metabolic complexity of T2D optimizes glycemia and promotes a healthier intrauterine environment.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Amy M. Valent, DO, MCR, Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Oregon Health & Science University, 3181 SW Sam Jackson Rd, L466, Portland, OR 97239 (firstname.lastname@example.org).
Published Online: March 10, 2023. doi:10.1001/jama.2023.0929
Conflict of Interest Disclosures: Dr Valent reported providing unpaid consulting for Dexcom outside the submitted work. No other disclosures were reported.
Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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