Controversies in Diabetes and Pregnancy (Endocrinology and Metabolism, 2)

As I read this unique volume on diabetes and pregnancy edited by Lois Jovanovic, I was struck by two themes that run throughout these collected chapters. First, this volume provides an excellent assessment of past problems, present management, and future challenges presented by dia­ betes in pregnancy. Orury's unique, longitudinal experience with diabetes iIi pregnancy provides the reader with an important overview, as does Coetzee's discussion of gestational diabetes. Current problems-deter­ mining the etiology and prevention of congenital malformations in infants of diabetic mothers (10M), assessment of antepartum fetal condition, management of pregnant patients with diabetic retinopathy, recognition of thyroid dysfunction in the pregnant diabetic woman, and understanding the multitude of metabolic sequelae observed in the 10M-are thoroughly reviewed. Finally, important considerations for future treatment and ther­ apy such as the adaptation of the fetal pancreas to the disordered intra­ uterine environment often seen in maternal diabetes, the use of fetal pan­ creatic tissue for transplantation, the application of exercise in the management of the pregnant woman with diabetes, and the long-term con­ sequences for the 10M provide an exciting glimpse into the future. The second important theme that emerges is the critical role the problem of diabetes in pregnancy has played in our understanding of maternal and fetal physiology. Clinical observations supported by basic research have emphasized the role of fetal fuels in teratogenesis. Front Matter....Pages N1-xiv Front Matter....Pages 1-1 Experimental Studies of Congenital Malformations in Diabetic Pregnancy....Pages 3-29 Front Matter....Pages 31-31 Adaptation of the Fetal Pancreas to Maternal Diabetes....Pages 33-42 The Use of Human Fetal Pancreatic Tissue for Transplantation....Pages 43-53 Front Matter....Pages 55-55 Oral Hypoglycemic Agents in the Treatment of Gestational Diabetes....Pages 57-76 Diabetic Retinopathy During Pregnancy....Pages 77-89 Thyroid Disorders in Pregnant Women With Type I Diabetes....Pages 90-100 Exercise in Gestational Diabetes....Pages 101-111 Front Matter....Pages 113-113 Methods of Fetal Surveillance in Pregnancies Complicated by Diabetes....Pages 115-128 Diabetes in Pregnancy: Considerations for the Management of Delivery....Pages 129-145 Front Matter....Pages 147-147 The Metabolic Sequelae in the Infant of the Diabetic Mother....Pages 149-171 Long-Term Outlook for the Offspring of the Diabetic Woman....Pages 172-189 Back Matter....Pages 191-205 This volume is both a comprehensive assessment of current approaches to management of diabetic pregnancy and a forum for discussion of alternative treatment protocols. Thyroid dysfunction and diabetic retinopathy during pregnancy, prevention of congenital malformations in infants of diabetic mothers, and the metabolic sequelae in these infants are explored, as are such controversial matters as the use of fetal pancreatic tissue for transplantation, of exercise during pregnancy, and of the oral hypoglycemic agents. The contributions significantly enhance our understanding of maternal, fetal and neonatal physiology under normal conditions and in pregnancies complicated by diabetes