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Gestational Diabetes Mellitus

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Diabetes

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 771))

Abstract

Gestational diabetes mellitus is one of the most common medical problems that results from an increase in the insulin resistance as well as an impairment of the compensatory increase in insulin secretion from the β cells of the pancreas. It serves as a metabolic stress test that uncovers underlying insulin resistance and β-cell dysfunction. Gestational diabetes is associated with a variety of maternal and fetal complications, most notably macrosomia. Controversy surrounds the ideal approach for detecting gestational diabetes, and the approaches recommended for screening and diagnosis are largely based on expert opinion. Controlling maternal glycemia with Medical Nutrition therapy, close monitoring of blood glucose levels and treatment with insulin if blood glucose levels are not at goal has been shown to decrease fetal and maternal morbidities. Other treatment modalities, such as oral agents, need further study to validate their safety and efficacy. Finally, postpartum management of women with Gestational diabetes is critical because of their markedly increased risk of type 2 diabetes in the future. Efforts should be made to prevent gestational diabetes in subsequent pregnancies. Because body fat and diet contribute to the risk of gestational diabetes mellitus, patients who lose weight before pregnancy and follow an appropriate diet may lower their risk of gestational diabetes mellitus.

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References

  1. Metzger BE, Gabbe SG, Persson B et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care 2010; 33:676–682.

    Article  PubMed  Google Scholar 

  2. Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 2003; Suppl 1:S5–S20.

    Google Scholar 

  3. American Diabetes Association: Gestational diabetes mellitus (Position Statement). Diabetes care 2004; Suppl 1:S88–S90.

    Google Scholar 

  4. Catalano PM, Tyzbir ED, Wolfe RR et al. Carbohydrate metabolism during pregnancy in control subjects and women with gestational diabetes. Am J Physiol 1993; 264:E60–E67.

    CAS  PubMed  Google Scholar 

  5. Freinkel N. Pregnancy and progeny. Banting Lecture Diabetes 1980; 29:1023–1025.

    CAS  PubMed  Google Scholar 

  6. Metzger BE, Lowe LP, Dyer ar et al. hyperglycemia and adverse pregnancy outcomes. N Engl J Med 2008; 358:1991.

    Article  PubMed  Google Scholar 

  7. Baptiste-roberts k, Barone BB, Gary tl et al. risk factors for type 2 diabetes among women with gestational diabetes: a systematic review. am j Med 2009; 122:207–214.

    Article  PubMed  PubMed Central  Google Scholar 

  8. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2010; 33(Suppl 1):S62–S69.

    Article  PubMed Central  Google Scholar 

  9. hedderson MM, ferrara a. high blood pressure before and during early pregnancy is associated with an increased risk of gestational diabetes mellitus. Diabetes care 2008; 31:2362–2367.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Yogev Y, Xenakis EM, langer o. the association between preeclampsia and the severity of gestational diabetes: the impact of glycemic control. am j obstet Gynecol 2004; 191:1655–1660.

    Article  PubMed  Google Scholar 

  11. Hopp H, Vollert W, Ebert A et al. Diabetic retinopathy and nephropathy⇽omplications in pregnancy and labor. Geburtshilfe frauenheilkd 1995; 55:275–279.

    Article  CAS  PubMed  Google Scholar 

  12. Bellamy L, casas JP, Hingorani AD et al. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet 2009; 373:1773.

    Article  CAS  PubMed  Google Scholar 

  13. kim C, Newton KM, Knopp RH. Gestational diabetes and the incidence of type 2 diabetes. Diabetes care 2002; 25:1862–1868.

    Article  PubMed  Google Scholar 

  14. Metzger BE, Coustan DM, Organizing Committee. Summary and recommendations of the Fourth International Workshop-Conference on Gestational Diabetes Mellitus. Diabetes Care 1998; Suppl 2:B161–B167.

    Google Scholar 

  15. de Valk HW, van Nieuwaal NH, Visser GH. Pregnancy outcome in type 2 diabetes mellitus: a retrospective analysis from the Netherlands. Rev Diabet Stud 2006; 3:134–142.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Dunne F, Brydon P, Smith K et al. Pregnancy in women with type 2 diabetes: 12 years outcome data 1990–2002. Diabet Med 2003; 20:734–738.

    Article  CAS  PubMed  Google Scholar 

  17. Hillier TA, Pedula KL, Vesco KK et al. Excess gestational weight gain: modifying fetal macrosomia risk associated with maternal glucose. obstet Gynecol 2008; 112:1007.

    Article  PubMed  Google Scholar 

  18. Alam M, Raza SJ, Sherali AR et al. Neonatal complications in infants born to diabetic mothers. J Coll Physicians Surg Pak 2006; 16:212–215.

    PubMed  Google Scholar 

  19. Banerjee S, Ghosh US, Banerjee D. Effect of tight glycaemic control on fetal complications in diabetic pregnancies. J Assoc Physicians India 2004; 52:109–113.

    CAS  PubMed  Google Scholar 

  20. Carpenter MW, Coustan D: Criteria for screening tests for gestational diabetes. am J Obstet Gynecol 1982; 144:768–773.

    Article  CAS  PubMed  Google Scholar 

  21. Franz MJ, Bantle JP, Beebe CA et al. Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care 2002; 25:148–198.

    Article  PubMed  Google Scholar 

  22. Jovanovic-Peterson L, Peterson CM. Nutritional management of the obese gestational diabetic pregnant woman. J Am Coll Nutr 1992; 11:246–250.

    Article  CAS  PubMed  Google Scholar 

  23. Knopp RH, Magee MS, raisys V et al. Metabolic effects of hypocaloric diets in management of gestational diabetes. Diabetes 1991; 40(Suppl 2):165–171.

    Article  PubMed  Google Scholar 

  24. Jovanovic L, Pettitt DJ. Treatment with insulin and its analogs in pregnancies complicated by diabetes. Diabetes Care 2007; 30(Suppl 2):S220.

    Article  CAS  PubMed  Google Scholar 

  25. Langer O, Conway DL, Berkus MD et al. A comparison of glyburide and insulin in women with gestational diabetes mellitus. N Engl J Med 2000; 19;343:1134–1138.

    Article  Google Scholar 

  26. Langer O, Yogev Y, Xenakis EM et al. Insulin and glyburide therapy: dosage, severity level of gestational diabetes and pregnancy outcome. am j obstet Gynecol 2005; 192:134–139.

    Article  CAS  PubMed  Google Scholar 

  27. Conway DL, Gonzales O, Skiver D. use of glyburide for the treatment of gestational diabetes: the San antonio experience. J Matern Fetal Neonatal Med 2004; 15:51.

    Article  CAS  PubMed  Google Scholar 

  28. Rochon M, Rand L, Roth L et al. Glyburide for the management of gestational diabetes: riskfactors predictive of failure and associated pregnancy outcomes. am J Obstet Gynecol 2006; 195:1090.

    Article  CAS  PubMed  Google Scholar 

  29. Moore LE, Clokey D, Rappaport VJ et al. Metformin compared with glyburide in gestational diabetes: a randomized controlled trial. obstet Gynecol 2010; 115:55.

    Article  CAS  PubMed  Google Scholar 

  30. Glueck CJ, Wang P, Kobayashi S et al. Metformin therapy throughout pregnancy reduces the development of gestational diabetes in women with polycystic ovary syndrome. fertil Steril 2002; 77:520–525.

    Article  CAS  PubMed  Google Scholar 

  31. hawkins JS, casey BM, Lo JY et al. Weekly compared with daily blood glucose monitoring in women with diet-treated gestational diabetes. Obstet Gynecol 2009; 113:1307–1312.

    Article  CAS  PubMed  Google Scholar 

  32. Griffiths RJ, Vinall PS, Stickland MH et al. Haemoglobin A1c levels in normal and diabetic pregnancies. Eur J obstet Gynecol reprod Biol 1987; 24:195–200.

    Article  CAS  PubMed  Google Scholar 

  33. Lurie S, Mamet Y. red blood cell survival and kinetics during pregnancy. Eur j obstet Gynecol reprod Biol 2000; 93:185–192.

    Article  CAS  PubMed  Google Scholar 

  34. American College of Obstetricians and Gynecologists. Gestational Diabetes. ACOG practice bulletin #30, american college of obstetricians and Gynecologists, Washington, DC 2001.

    Google Scholar 

  35. Kjos SL, Henry OA, Montoro M et al. Insulin-requiring diabetes in pregnancy: a randomized trial of active induction of labor and expectant management. am J Obstet Gynecol 1993; 169:611–615.

    Article  CAS  PubMed  Google Scholar 

  36. ACOG Practice Bulletin. Clinical management guidelines for obstetrician-gynecologists. fetal Macrosomia 2000; 22.

    Google Scholar 

  37. Webster J, Moore K, McMullan A. Breastfeeding outcomes for women with insulin dependent diabetes. J Hum Lact 1995; 11:195–200.

    Article  CAS  PubMed  Google Scholar 

  38. Taylor JS, Kacmar JE, Nothnagle M et al. A systematic review of the literature associating breastfeeding with type 2 diabetes and gestational diabetes. J Am Coll Nutr 2005; 24:320–326.

    Article  PubMed  Google Scholar 

  39. West Na, Crume TL, Maligie MA et al. cardiovascular risk factors in children exposed to maternal diabetes in utero. Diabetologia 2011; 54:504–507.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Diabetes and Endocrinology Section, Liaquat National Hospital and Medical College, Karachi, Pakistan

    Khalid Imam

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  1. Khalid Imam
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Editor information

Editors and Affiliations

  1. School of Science and Technology, Nottingham Trent University, Nottingham, UK

    Shamim I. Ahmad BSc, MSc, PhD

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© 2013 Landes Bioscience and Springer Science+Business Media

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Imam, K. (2013). Gestational Diabetes Mellitus. In: Ahmad, S.I. (eds) Diabetes. Advances in Experimental Medicine and Biology, vol 771. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5441-0_4

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