Wiener klinische Wochenschrift
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Gestational diabetes (GDM) is defined as any degree of glucose intolerance with onset during pregnancy and is associated with increased feto-maternal morbidity as well as long-term complications in mothers and the offspring. Women detected to have diabetes early in pregnancy receive the diagnosis of overt, non-gestational, diabetes (glucose: fasting ≥ 126 mg/dl, spontaneous ≥ 200 mg/dl or HbA1c ≥ 6.5% before 20 weeks of gestation). GDM is diagnosed by an oral glucose tolerance test (oGTT) or increased fasting glucose (≥ 92 mg/dl). ⋯ Assessment of glucose parameters (fasting glucose, random glucose, HbA1c or optimally oGTT) are recommended every 2-3 years in case of normal glucose tolerance. All women have to be instructed about their increased risk of type 2 diabetes and cardiovascular disease at follow-up. Possible preventive meassures, in particular lifestyle changes as weight management and maintenance/increase of physical activity should be discussed (evidence level A).
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Wien. Klin. Wochenschr. · Jan 2023
[Diabetes mellitus and road traffic-a position paper of the Austrian Diabetes Association (update 2023)].
Public safety (prevention of accidents) is the primary objective in assessing fitness to drive a motor vehicle. However, general access to mobility should not be restricted if there is no particular risk to public safety. For people with diabetes mellitus, the Führerscheingesetz (Driving Licence Legislation) and the Führerscheingesetz-Gesundheitsverordnung (Driving Licence Legislation Health enactment) regulate important aspects of driving safety in connection with acute and chronic complications of the disease. ⋯ Other antihyperglycemic drugs without potential for hypoglycemia such as Metformin, SGLT‑2 inhibitors (Sodium-dependent-glucose-transporter‑2 inhibitors, gliflozins), DPP-4-inhibitors (Dipeptidyl-Peptidase inhibitors, gliptins), and GLP‑1 analogues (GLP‑1 rezeptor agonists) are not associated with such a time limitation. The relevant laws which regulate driving safety give room for interpretation, so that specific topics on driving safety for people with diabetes mellitus are elaborated from a medical and traffic-relevant point of view. This position paper is intended to support people involved in this challenging matter.
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Wien. Klin. Wochenschr. · Jan 2023
[Lifestyle: physical activity and training as prevention and therapy of type 2 diabetes mellitus (Update 2023)].
Lifestyle, in general and particularly regular physical activity, is known to be an important component in the prevention and therapy of type 2 diabetes. To gain substantial health benefits, a minimum of 150 min of moderate or vigorous intense aerobic physical activity and muscle strengthening activities per week should be performed. Additionally, inactivity should be recognized as health hazard and prolonged episodes of sitting should be avoided. ⋯ Standardized, regional and supervised exercise classes are well known to be attractive for adults to reach a sufficient level of health enhancing physical activity. Additionally, based on the large evidence of exercise referral and prescription, the Austrian Diabetes Associations aims to implement the position of a "physical activity adviser" in multi-professional diabetes care. Unfortunately, the implementation of booth-local exercise classes and advisers is missing so far.