Wiener klinische Wochenschrift
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Gestational diabetes mellitus (GDM) is defined as a glucose tolerance disorder with onset during pregnancy and is associated with increased feto-maternal morbidity as well as long-term complications in mother and child. Women who fulfil the criteria of a manifest diabetes in early pregnancy (fasting plasma glucose >126 mg/dl, spontaneous glucose level >200 mg/dl or HbA1c > 6.5% before 20 weeks of gestation) should be classified as having manifest diabetes in pregnancy and treated as such. Screening for undiagnosed type 2 diabetes at the first prenatal visit (evidence level B) is particularly recommended in women at increased risk (history of GDM or prediabetes, malformation, stillbirth, successive abortions or birth weight >4500 g in previous pregnancies, obesity, metabolic syndrome, age >35 years, vascular disease, clinical symptoms of diabetes, e. g. glucosuria, or ethnic groups with increased risk for GDM/T2DM, e.g. ⋯ Monitoring of the development of children and recommendations for a healthy lifestyle are necessary for the whole family. Regular obstetric examinations including ultrasound examinations are recommended. Within the framework of neonatal care, neonates of GDM mothers should undergo blood glucose measurements and if necessary appropriate measures should be initiated.
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Wien. Klin. Wochenschr. · May 2019
Review[Insulin therapy of type 2 diabetes mellitus (Update 2019)].
The present article is a recommendation of the Austrian Diabetes Association for the practical use of insulin in type 2 diabetes, including the various insulin regimens.
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Wien. Klin. Wochenschr. · May 2019
Review[Diabetes mellitus-Definition, classification, diagnosis, screening and prevention (Update 2019)].
Diabetes mellitus comprises a group of heterogeneous disorders, which have an increase in blood glucose concentrations in common. The current classification for diabetes mellitus is presented and the main features of type 1 and type 2 diabetes are compared. ⋯ The increasing prevalence of diabetes requires targeted screening for detecting diabetes and prediabetes in risk groups. This forms the basis for the early initiation of measures to prevent the onset of diabetes in these risk groups and to delay the progression of diabetes.
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Wien. Klin. Wochenschr. · May 2019
Review[Position statement: surgery and diabetes mellitus (Update 2019)].
This position statement reflects the opinion of the Austrian Diabetes Association concerning the perioperative management of patients with diabetes mellitus based on the available scientific evidence. The paper covers necessary preoperative examinations from an internal/diabetological point of view as well as the perioperative metabolic control by means of oral antidiabetics and/or insulin therapy.
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Wien. Klin. Wochenschr. · May 2019
Review[Diagnosis and management of patients with diabetes and co-existing osteoporosis (Update 2019) : Common guideline of the Autrian Society for Bone and Mineral Research and the Austrian Diabetes Society].
Fragility fractures are increasingly recognized as a complication of both type 1 and type 2 diabetes, with fracture risk that increases with disease duration and poor glycemic control. The identification and management of fracture risk in these patients remains challenging. ⋯ It further reviews the impact of diabetes drugs on bone tissue as well as the efficacy of osteoporosis treatments in this population. An algorithm for the identification and management of diabetic patients at increased fracture risk is proposed.