Gestational Diabetes: A Survey and the Graz Approach to Diagnosis and Therapy

Abstract

Gestational diabetes mellitus is a heterogenous clinical entity with substantial phenotypic and genotypic diversity in the mother (Freinkel etal., 1985). It is most common in obese women and in those over 30 years old. Typically, the insulin response to glucose intake is delayed, while the basal plasma insulin level is normal or even elevated (Kühl etal., 1985; Persson and Lunell, 1975). The increase of maternal plasma insulin response to an increase in blood glucose, however, is diminished (Freinkel etal., 1985), leading to a relative insulin deficiency in the gravida and consequently to fetopathy. HLA antigens DR 3 and DR 4 are often associated with gestational diabetes mellitus as are cytoplasmic islet-cell antibodies (Freinkel etal., 1985).