Limited evidence supports the use of gabapentin or carbamazepine for the treatment of mild or moderate alcohol withdrawal as the sole treatment or as combination therapy with other medications; however, gabapentin does not appear to be effective for treatment of severe alcohol withdrawal and is therefore not recommended for use in this setting. A 2010 Cochrane review similarly reported that the evidence to support the role of anticonvulsants over benzodiazepines in the treatment of alcohol withdrawal is not supported. Paraldehyde combined with chloral hydrate showed superiority over chlordiazepoxide with regard to life-threatening side effects and carbamazepine may have advantages for certain symptoms. Long term anticonvulsant medications are not usually recommended in those who have had prior seizures due to withdrawal. Prevention of further drinking
There are three medications used to help prevent a return to drinking: naltrexone, acamprosate, and disulfiram. They are used after withdrawal has occurred. Other
Clonidine may be used in combination with benzodiazepines to help some of the symptoms. No conclusions can be drawn concerning the efficacy or safety of baclofen for alcohol withdrawal syndrome due to the insufficiency and low quality of the evidence.Antipsychotics, such as haloperidol, are sometimes used in addition to benzodiazepines to control agitation or psychosis. Antipsychotics may potentially worsen alcohol withdrawal as they lower the seizure threshold. Clozapine, olanzapine, or low-potency phenothiazines (such as chlorpromazine) are particularly risky; if used, extreme caution is required.While intravenous ethanol could theoretically be used, evidence to support this use, at least in those who are very sick, is insufficient.
The National Institute of Health and Clinical Excellence in the UK indicated that glycohemoglobin levels <6.1% are correlated with the lowest risk of malformations while the reproductive risks are higher in women above this threshold and prohibitive for glycohemoglobin levels >10%.Consumption of folic acid and antioxidant substances before fertilization result in a reduced rate of malformations in the offspring of mothers with diabetes. Antioxidants such as lipoic acid, vitamin C, and vitamin E, increase the probability of favorable prenatal outcomes in offspring of diabetic mothers because oxidative stress is a teratogenic mediator of hyperglycemia in mothers with diabetes. After fertilization
Optimal weight and glycemic management encourage good outcomes because diabetes has the potential to influence the mother and fetus during the entire pregnancy. The integrity of embryofetal development and placental function can be monitored by fetal echocardiography and ultrasound scanning. See also
Diabetic diet


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