Master Class

The Diabetes Pandemic


 

The world is experiencing a diabetes pandemic, with the incidence projected to double worldwide over current levels by 2030. This extraordinary rise in the rate of diabetes worldwide has been paralleled by a similarly rapid rate of increase in the incidence of obesity. Most of the rise in diabetes rate is occurring in the type 2 category.

As a result of this pandemic in the general population, pregnant women also have a high rate of diabetes. Indeed, some clinics report that as many as 20% or more of their pregnant patients have diabetes. This presents an increasing challenge to the practitioner, especially because these patients present not only with diabetes but its associated complications for the mother and for fetal development and fetal outcome.

If there was ever a time when educating practitioners regarding contemporary methods of managing pregnant patients with diabetes is needed, it is now. Thus, we have decided to dedicate two issues of our Master Class series to the management of diabetes in pregnancy. The first installment, below, addresses how diabetes affects perinatal outcomes and how we can work to detect diabetes early and provide intensive treatment. The second installment, scheduled for the December issue, will delve into the use of oral antidiabetic agents in pregnancy.

Between the two parts of this series will be another Master Class that addresses another very challenging public health problem: the novel influenza A(H1N1) pandemic.

Both topics—diabetes in pregnancy, and influenza in pregnancy—are extremely high priority and highly contemporary, and are worthy of significant attention.

For this Master Class, I have invited Oded Langer, M.D, Ph.D., an internationally recognized expert on diabetes in pregnancy who has written and lectured extensively on this subject. Dr. Langer is the Babcock Professor and chairman of the department of obstetrics and gynecology at St. Luke's-Roosevelt Hospital Center, a university hospital of Columbia University in New York.

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