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Research
Outcomes for Diabetes in Pregnancy
The current standard of care has produced excellent outcomes. We published the first normal outcome series for gestational diabetes (Thompson et al, 1994). We have recently been the first to report a perinatal mortality rate for women with type 1 diabetes that is the same as that of the general population (Wylie et al, 2002). There was an increased incidence of asymmetrical macrosomia, respiratory distress, neonatal hypoglycemia, and jaundice, as reported in other centres.
This study also gave us some information about maternal complications, including retinopathy. We found that rapid improvement of blood glucose control did not cause progression of eye disease in type 1 pregnancies. This new information was also presented at the 2003 ADA meeting.
We continue to see an increase in the amount of type 2 diabetes in pregnancy. We are evaluating our outcomes, and have presented our preliminary results at the 2003 American Diabetes Association (ADA) annual meeting. Further data was presented at the 2003 Canadian Diabetes Association (CDA) annual meeting. We are currently conducting some studies which will give us more information in this area.
Trial to Reduce IDDM in the Genetically at Risk (TRIGR)
Recent diabetes research has pointed to a possible link between infant nutrition and the development of type 1 (insulin-dependent) diabetes mellitus in childhood. TRIGR (Trial to Reduce IDDM in the Genetically at Risk) is an international study looking at infant nutrition to determine whether the number of children who develop type 1 diabetes can be reduced. In this multi-centred trial, parents are asked to eliminate all beef and cow's milk proteins from their infant's diet for the first six to eight months of life. Breastfeeding is encouraged, and a special study formula will be provided if needed. During this time, the infant will be followed closely by a registered nurse and dietitian. Children are followed up to the age of 10 years. To be eligible for this study:
- you or your partner must be pregnant
- your expected baby must be at increased genetic risk (i.e. you, your partner or one of your children has type 1 diabetes)
For more information call Cheryl Taylor, RD at (604) 875-2345, local 6658 or visit the TRIGR website at http://www.trigrnorthamerica.org.
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