endocrinology, diabetes & metabolism

Doctor : Dr. Chang Chee Siu

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05 Jul 2010

Dr. Chang Chee Siu

1. Type 1 patients can sometimes be controlled by twice daily mixed insulin--a combination of short and intermediate acting insulin. But for optimal control a regime with a once daily long acting insulin with 3 short or ultrashort acting insulins before 3 meals is the most suitable (ie, 4 injections a day). 2. The risk of DM in offspring is quoted as 6 %, for sibling it is 5 %, the risk is highest with identical twins, at 33 %. 3. The risk to the fetus is increased with uncontrolled diabetes in pregnancy. Congenital anomaly can occur if daibetes is poorly controlled at conception up to 7 weeks of pregnancy. The risk of premature labour is higher. The baby can be born as large baby (larger than 4 kg) with possible accompanying birth difficulty. Metabolic problems in infant (eg hypoglycaemia) may occur soon after birth and there is higher risk of diabetes and obesity at adulthood. It is therefore very important for mother with diabetes to achieve good control before conception and also frequent monitoring by diabetologist, obstetrician and paediatrician throughout and after pregnancy.

05 Jul 2010