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Diabetes aktuell 2016; 14(04): 176-180
DOI: 10.1055/s-0042-110235
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© Georg Thieme Verlag Stuttgart · New York

Diabetes und Schwangerschaft – Insulin, Pumpe und CGMS – Wann ist was notwendig und sinnvoll?

Diabetes and pregnancy – insulin, pump therapy and CGM
Thorsten Siegmund
1   Klinik für Endokrinologie, Diabetologie und Stoffwechsel am Isar Klinikum, Isar Klinikum, München
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Publication History

Publication Date:
29 June 2016 (online)

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Eine optimale glykämische Stoffwechselkontrolle ist von größter Bedeutung, um ein bestmögliches Outcome für Mutter und Kind bei Schwangeren mit einer Glukosestoffwechselstörung zu erzielen, egal ob es sich um einen Gestationsdiabetes, Typ-1- oder Typ-2-Diabetes handelt. Bei der Optimierung der Glukose spielt neben der Ernährung häufig die Insulintherapie eine relevante Rolle. Während beim Gestations- und Typ-2-Diabetes die Insulinisierung bedarfsgerecht in Richtung ICT erfolgen kann ist bei Typ-1-Diabetes die ICT oder die Pumpentherapie das Mittel der Wahl. Unterstützt beim Streben nach optimaler Glukosekontrolle werden die Schwangeren zunehmend auch die neuen Glukosesensormesssysteme, die neben dem aktuellen Glukosewert auch den Glukose-Trend anzeigen, eine Option, die die Therapieentscheidungen für die Betroffenen unterstützt, einfacher macht und die Einstellungsqualität verbessert.

An optimal glycemic control is of utmost importance to achieve the best possible outcome for mother and child in pregnant women with elevated glucose levels, irrespective of the type of diabetes - gestational, type 1 or type 2 diabetes. When optimizing glucose metabolism, beside a personalized diet, insulin therapy plays a relevant role for an increasing number of patients. For women with gestational diabetes or type 2 diabetes the insulin strategy is chosen depending on the individual need and will often develop towards a basal bolus regimen. In type 1 diabetes, a MDI or a pump therapy is the treatment of choice. To seek for an optimal glucose control pregnant women are increasingly using glucosesensors which shows both, the current glucose value and the glucose trend, an option that not only simplifies therapeutic decisions, it usually further improves the quality of glucose control.

Key words

pregnancy - type 1 diabetes - type 2 diabetes - gestational diabetes - insulin therapy - MDI - CSII - CGM - FGM
 

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