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- January 6, 2009 |
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"Diabetes in Indigenous Communities: Diabetes & Pregnancy" David Simmons (biography)
English - 2006-11-13 - 41 minutes
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Summary :
The diabetes epidemic among indigenous people includes an increasing number of women with diabetes during their child-bearing years. Type 2 diabetes (known or previously undiagnosed) is associated with high rates of congenital abnormalities and fetal loss rates, yet few studies among diabetic indigenous women have reported pre-conceptual counselling or folate therapy rates. While the prevalence of diabetes in pregnancy in indigenous populations, including gestational diabetes (GDM), has been studied. and previously ranged between 3% and 15% (depending on diagnostic criteria), up to date data are scarce. In different indigenous populations, communities and health systems, reduced access to antenatal care, screening, diagnosis and management from the majority populations continue to occur for indigenous women and these are associated with varying perinatal outcomes. Rurality can be a contributing factor. Breastfeeding rates are often lower among indigenous women, and this is lowered further by the need for medical intervention after pregnancies complicated by diabetes (eg Caesarean section or neonatal intensive care unit admission). Follow up rates for the future development of Type 2 diabetes among those with GDM, where known, suggest high progression rates. The substantial role of exposure of the
unborn child to maternal diabetes in utero, for future diabetes and obesity in the offspring has been suggested, particularly from studies among Pima Indians. Few reports of primary prevention programmes have been undertaken and are clearly urgently required.
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- The prevalence of diabetes and obesity in women of childbearing age
- The prevalence of diabetes in pregnancy in indigenous communities
- Outcomes of diabetes in pregnancy and postnatally
- What can be done in the management of diabetes in pregnancy?
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