The physiological changes which occur during pregnancy with diabetes are vast and involve every body system. In this chapter, we will review the metabolic changes that occur during normal pregnancies and those affected by pregestational diabetes. Due to the significant overlap in maternal and perinatal risks secondary to pregestational diabetes and obesity, we will review the risks of maternal obesity and hyperglycemia on maternal, fetal, and infant outcomes. The management of pregestational diabetes in pregnancy will be reviewed in detail including up-to-date medications and diabetes technologies. Postpartum issues including changes in insulin sensitivity, breastfeeding, and contraception for individuals with pregestational diabetes will be discussed. For complete coverage of all related areas of Endocrinology, please visit our on-line FREE web-text,
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