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Article About Gestational Diabetes

Diabetes Mellitus And Pregnancy

Diabetes Mellitus And Pregnancy

Initiate testing early enough to avoid significant stillbirth but not so early that a high rate of false-positive test results is encountered. In patients with poor glycemic control, intrauterine growth restriction, or significant hypertension, begin formal biophysical testing as early as 28 weeks. In patients who are at lower risk, most centers begin formal fetal testing by 34 weeks. Fetal movement counting is performed in all pregnancies from 28 weeks onward. There is no consensus regarding antenatal testing in patients with gestational diabetes that is well controlled with diet. Monitoring fetal growth continues to be a challenging and imprecise process. Although currently available tools (serial plotting of fetal growth parameters based on ultrasonographic measurement) are superior to those used previously for clinical estimations, accuracy is still only within 15%. [ 95 ] In the obese fetus, the inaccuracies are further magnified. In 1992, Bernstein and Catalano reported that significant correlation exists between the degree of error in the ultrasonogram-based estimation of fetal weight and the percentage of body fat on the fetus. [ 96 ] Perhaps this is the reason no single formula has proven to be adequate in identifying a macrosomic fetus with certainty. Despite problems with accuracy, ultrasonogram-based estimations of fetal size have become the standard of care. Estimate fetal size once or twice at least 3 weeks apart in order to establish a trend. Time the last examination to be at 36-37 weeks' gestation or as close to the planned delivery date as possible. Select the timing of delivery to minimize morbidity for the mother and fetus. Delaying delivery to as near as possible to the expected date of confinement helps maximize cervical maturity and improves the Continue reading >>

Gestational Diabetes

Gestational Diabetes

Gestational diabetes definition and facts Risk factors for gestational diabetes include a history of gestational diabetes in a previous pregnancy, There are typically no noticeable signs or symptoms associated with gestational diabetes. Gestational diabetes can cause the fetus to be larger than normal. Delivery of the baby may be more complicated as a result. The baby is also at risk for developing low blood glucose (hypoglycemia) immediately after birth. Following a nutrition plan is the typical treatment for gestational diabetes. Maintaining a healthy weight and following a healthy eating plan may be able to help prevent or minimize the risks of gestational diabetes. Women with gestational diabetes have an increased risk of developing type 2 diabetes after the pregnancy What is gestational diabetes? Gestational diabetes is diabetes, or high blood sugar levels, that develops during pregnancy. It occurs in about 4% of all pregnancies. It is usually diagnosed in the later stages of pregnancy and often occurs in women who have no prior history of diabetes. What causes gestational diabetes? Gestational diabetes is thought to arise because the many changes, hormonal and otherwise, that occur in the body during pregnancy predispose some women to become resistant to insulin. Insulin is a hormone made by specialized cells in the pancreas that allows the body to effectively metabolize glucose for later usage as fuel (energy). When levels of insulin are low, or the body cannot effectively use insulin (i.e., insulin resistance), blood glucose levels rise. What are the screening guidelines for gestational diabetes? All pregnant women should be screened for gestational diabetes during their pregnancy. Most pregnant women are tested between the 24th and 28th weeks of pregnancy (see Continue reading >>

Quality Of Life In Women With Gestational Diabetes Mellitus: A Systematic Review

Quality Of Life In Women With Gestational Diabetes Mellitus: A Systematic Review

Copyright © 2017 Daniela Marchetti et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background and Objective. Diagnosis of Gestational Diabetes Mellitus (GDM) could significantly increase the likelihood of health problems concerning both potential risks for the mother, fetus, and child’s development and negative effects on maternal mental health above all in terms of a diminished Quality of Life (QoL). The current systematic review study is aimed at further contributing to an advancement of knowledge about the clinical link between GDM and QoL. Methods. According to PRISMA guidelines, PubMed, Web of Science, Scopus, and Cochrane databases were searched for studies aimed at evaluating and/or improving levels of QoL in women diagnosed with GDM. Results. Fifteen research studies were identified and qualitatively analyzed by summarizing results according to the following two topics: GDM and QoL and interventions on QoL in patients with GDM. Studies showed that, in women with GDM, QoL is significantly worse in both the short term and long term. However, improvements on QoL can be achieved through different intervention programs by enhancing positive diabetes-related self-management behaviors. Conclusion. Future studies are strongly recommended to further examine the impact of integrative programs, including telemedicine and educational interventions, on QoL of GDM patients by promoting their illness acceptance and healthy lifestyle behaviors. 1. Introduction Gestational Diabetes Mellitus (GDM) is defined as “diabetes diagnosed in the second or third trimester of pregnancy that was not clearly overt d Continue reading >>

All Gestational Diabetes Articles

All Gestational Diabetes Articles

A new study shows that regular exercise can reduce a woman's risk of developing type 2 diabetes after she has had gestational diabetes. Gestational diabetes can have long-term effects Gestational diabetes is generally thought of as a serious pregnancy complication, but is believed to cause few long-term health consequences. African Americans who experience gestational diabetes are at risk for metabolic problems later in life Developing gestational diabetes can be a scary experience for a woman. Many wonder if it will mean they will have metabolic problems later in life. New legislation seeks to address diabetes epidemic among minority populations Gestational diabetes and type 2 diabetes are significantly more common among racial minorities, but new legislation introduced into Congress seeks to address these issues by making educational and other health resources more available to those affected by the problem. With more women delaying maternity, gestational diabetes becomes a bigger risk The age at which many women are becoming pregnant for the first time is being pushed back. This may have a number of important health consequences, not the least of which is an increased risk of developing gestational diabetes. A diabetic diet may limit negative impact of gestational diabetes on maternal and fetal health A growing body of evidence suggests that the types of food that women consume during pregnancy can have an impact on their baby's health. Mother with gestational diabetes delivers 16-pound baby The birth of a 16-pound child delivered by a woman with gestational diabetes in Texas sparked nationwide attention. Odds of developing gestational diabetes may be predicted up to seven years before pregnancy Some women wish that they could foresee the future. However, a recent s Continue reading >>

Gestational Diabetes Mellitus

Gestational Diabetes Mellitus

We are experimenting with display styles that make it easier to read articles in PMC. The ePub format uses eBook readers, which have several "ease of reading" features already built in. The ePub format is best viewed in the iBooks reader. You may notice problems with the display of certain parts of an article in other eReaders. Generating an ePub file may take a long time, please be patient. Gestational diabetes mellitus (GDM) affects between 2% and 5% of pregnant women. Data show that increasing levels of plasma glucose are associated with birth weight above the 90th percentile, cord blood serum C-peptide level above the 90th percentile, and, to a lesser degree, primary cesarean deliveries and neonatal hypoglycemia. Risk factors for GDM include history of macrosomia, strong family history of diabetes, and obesity. Screening protocol for GDM is controversial; some recommend a universal approach, whereas others exempt low-risk patients. The cornerstone of management is glycemic control. Quality nutritional intake is essential. Patients with GDM who cannot control their glucose levels with diet alone will require insulin. There is no consensus as to when to initiate insulin therapy, but more conservative guidelines are in place to help minimize macrosomia and its associated risks to the infant. It is generally recommended that pregnancies complicated by GDM do not go beyond term. Key words: Gestational diabetes mellitus, Plasma glucose, Hyperglycemia, Glycemic control, Insulin Pregnancy confers a state of insulin resistance and hyperinsulinemia that may predispose some women to develop diabetes. Gestational diabetes mellitus (GDM) occurs when a womans pancreatic function is not sufficient to overcome the diabetogenic environment of pregnancy. GDM is defined as glucose in Continue reading >>

Gestational Diabetes: A Clinical Update

Gestational Diabetes: A Clinical Update

Ulla Kampmann , Lene Ring Madsen , Gitte Oeskov Skajaa , Ditte Smed Iversen , Niels Moeller , and Per Ovesen Ulla Kampmann, Lene Ring Madsen, Niels Moeller, Department of Endocrinology and Internal Medicine, Aarhus University Hospital, 8000 Aarhus, Denmark Gitte Oeskov Skajaa, Ditte Smed Iversen, Per Ovesen, Department of Obstetrics and Gynecology, Aarhus University Hospital, 8000 Aarhus, Denmark Author contributions: Kampmann U designed and wrote the manuscript; Madsen LR, Skajaa GO, Iversen DS and Moeller N wrote the manuscript; Ovesen P wrote the manuscript and generated the table. Correspondence to: Ulla Kampmann, MD, PhD, Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Nrrebrogade 44, 8000 Aarhus, Denmark. [email protected] Telephone: +45-2-2370857 Fax: +45-8-9492072 Received 2014 Aug 28; Revised 2015 Feb 14; Accepted 2015 Apr 16. Copyright The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved. This article has been cited by other articles in PMC. Gestational diabetes mellitus (GDM) is increasing in prevalence in tandem with the dramatic increase in the prevalence of overweight and obesity in women of childbearing age. Much controversy surrounds the diagnosis and management of gestational diabetes, emphasizing the importance and relevance of clarity and consensus. If newly proposed criteria are adopted universally a significantly growing number of women will be diagnosed as having GDM, implying new therapeutic challenges to avoid foetal and maternal complications related to the hyperglycemia of gestational diabetes. This review provides an overview of clinical issues related to GDM, including the challenges of screening and diagnosis, the pathophysiology behind GDM, the treatment and prevention of GDM an Continue reading >>

Screening Gestational Diabetes Mellitus: The Role Of Maternal Age

Screening Gestational Diabetes Mellitus: The Role Of Maternal Age

Screening gestational diabetes mellitus: The role of maternal age Affiliation Department of Internal Medicine, New Taipei City Hospital, New Taipei City, Taiwan Affiliation Department of Internal Medicine, New Taipei City Hospital, New Taipei City, Taiwan Affiliations Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan Affiliation Department of Internal Medicine, National Taiwan University Hospital, Yun-lin branch, Yun-lin, Taiwan Affiliation Department of Obstetrics and Gynecology, Dianthus MFM Clinic, Taiwan Affiliation Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan Affiliations Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan * E-mail: [email protected] (HYL); [email protected] (CNL) Affiliation Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan * E-mail: [email protected] (HYL); [email protected] (CNL) Affiliation Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan Screening gestational diabetes mellitus: The role of maternal age Using a specific cutoff of fasting plasma glucose (FPG) to screen gestational diabetes mellitus (GDM) can reduce the use of oral glucose tolerance tests (OGTT). Since the prevalence of GDM increases with age, this screening method may not be appropriate in healthcare systems where women become pregnant at older ages. Therefore, we aimed to develop a screening algorithm for GDM that takes maternal age into considerat Continue reading >>

Gestational Diabetes: Risks, Management, And Treatment Options

Gestational Diabetes: Risks, Management, And Treatment Options

Gestational diabetes: risks, management, and treatment options Departments of Medicine and Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA Abstract: Gestational diabetes mellitus (GDM) is commonly defined as glucose intolerance first recognized during pregnancy. Diagnostic criteria for GDM have changed over the decades, and several definitions are currently used; recent recommendations may increase the prevalence of GDM to as high as one of five pregnancies. Perinatal complications associated with GDM include hypertensive disorders, preterm delivery, shoulder dystocia, stillbirths, clinical neonatal hypoglycemia, hyperbilirubinemia, and cesarean deliveries. Postpartum complications include obesity and impaired glucose tolerance in the offspring and diabetes and cardiovascular disease in the mothers. Management strategies increasingly emphasize optimal management of fetal growth and weight. Monitoring of glucose, fetal stress, and fetal weight through ultrasound combined with maternal weight management, medical nutritional therapy, physical activity, and pharmacotherapy can decrease comorbidities associated with GDM. Consensus is lacking on ideal glucose targets, degree of caloric restriction and content, algorithms for pharmacotherapy, and in particular, the use of oral medications and insulin analogs in lieu of human insulin. Postpartum glucose screening and initiation of healthy lifestyle behaviors, including exercise, adequate fruit and vegetable intake, breastfeeding, and contraception, are encouraged to decrease rates of future glucose intolerance in mothers and offspring. Keywords: glucose intolerance, pregnancy, perinatal complications This work is published and licensed by Dove Medical Press Limited. The full terms of this license are avai Continue reading >>

Prevalence Of Gestational Diabetes Mellitus And Pregnancy Outcomes In Iranian Women - Sciencedirect

Prevalence Of Gestational Diabetes Mellitus And Pregnancy Outcomes In Iranian Women - Sciencedirect

Volume 46, Issue 3 , September 2007, Pages 236-241 Author links open overlay panel ArashHossein-Nezhad ZhilaMaghbooli Ali-RezaVassigh BagherLarijani Open Access funded by Taiwan Association of Obstetrics & Gynecology We investigated the prevalence and outcome of gestational diabetes mellitus (GDM) in pregnant Iranian women. A total of 2,416 women, who were consecutive referrals for antenatal care to five university teaching hospitals in Tehran, were recruited. Patients with known diabetes were excluded. All 2,416 women were screened with a 50-g 1-hour glucose challenge test, and any woman with a plasma glucose concentration more than or equal to 130 mg/dL was given a 100-g 3-hour glucose tolerance test. Diagnosis of GDM was according to Carpenter and Coustan's criteria. The remainder served as controls for the study. There were 114 women (4.7%; 95% confidence interval [CI], 3.95.6%) who had GDM. Women with GDM had a significantly higher parity and body mass index than non-diabetic women. Women with GDM were also more likely to have a family history of diabetes and a history of poor obstetric outcome. Of the 114 women, 27 (23.6%) were younger than 25 years old, and 16 (14.0%) had no recognizable risk factor for diabetes. The odds ratio (OR) for cesarean section (OR, 2.28; p = 0.0002), macrosomia (OR, 1.93; p = 0.0374), neonatal hypoglycemia (OR, 3.2; p = 0.011) and hypocalcemia (OR, 3.045; p = 0.0195), and still birth (OR, 4.8; p = 0.003) were all significantly higher in women with GDM than non-GDM controls. One out of every 20 pregnant Iranian women will develop GDM, with significantly increased odds of adverse maternal and fetal outcome. The significant proportion of young and/or risk factor-free women in our sample means that there seems to be a case for universal GD Continue reading >>

Gestational Diabetes

Gestational Diabetes

Diabetes mellitus is a disease characterized by levels of glucose (sugar) in the bloodstream that are higher than normal. Glucose is produced in the body from the foods that you eat. The pancreas, an organ located just behind the stomach, produces insulin. Insulin is a hormone that takes the glucose from the bloodstream and carries it inside your body?s cells where it is used for energy. Diabetes occurs when sugar builds up in the blood. Gestational diabetes mellitus (GDM) is a form of diabetes that can develop during pregnancy, usually during the second trimester. During pregnancy the placenta produces hormones that help the baby develop. These hormones also block the effects of insulin in the woman?s body increasing her blood sugar levels. GDM affects about 4% to 8% (4 to 8 in 100) of all pregnant women. In the United States there are about 135,000 cases of GDM each year. Any pregnant woman can develop the condition, but some women are at greater risk than others. Known risk factors for GDM include: Age (older than 25 years; the risk is even greater after age 35) Race (occurs more often in African Americans, Hispanics, American Indians, and Asian Americans) Personal medical history of gestational diabetes, prediabetes, or previously delivering a baby weighing more than 9 pounds. Family history of type 2 diabetes (in parents or siblings) Among women with these risk factors, as many as 14% (14 in 100) develop GDM. How do you know if you have gestational diabetes? The majority of women with GDM have no warning signs or symptoms. Because of the lack of symptoms, however, it is recommended that all pregnant women be tested for GDM during the 24th and 28th weeks of pregnancy. However, for minority women who are obese and who have had a previous history of GDM or a family h Continue reading >>

Preeclampsia: A Risk Factor For Gestational Diabetes Mellitus In Subsequent Pregnancy

Preeclampsia: A Risk Factor For Gestational Diabetes Mellitus In Subsequent Pregnancy

Preeclampsia: A risk factor for gestational diabetes mellitus in subsequent pregnancy Affiliation Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea Affiliation Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea Affiliation Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea Affiliation Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea Affiliation Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea Affiliation Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea Affiliation Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea Preeclampsia: A risk factor for gestational diabetes mellitus in subsequent pregnancy Preeclampsia and gestational diabetes (GDM) have several mechanisms in common. The aim of this study was to determine whether women with preeclampsia have an increased risk of GDM in a subsequent pregnancy. Study data were collected from the Korea National Health Insurance Claims Database of the Health Insurance Review and Assessment Service for 20072012. Patients who had their first delivery in 2007 and a subsequent delivery between 2008 and 2012 in Korea were enrolled. A model of multivariate logistic regression analysis was performed with GDM as the final outcome to evaluate the risk of GDM in the second pregnancy. Among the 252,276 women who had their first delivery in 2007, 150,794 women had their second delivery between 2008 and 2012. On the multivariate regression analysis, women with preeclampsia alone in the first pregnancy had an increased risk of GDM in the second pregnancy w Continue reading >>

Diabetes And Pregnancy

Diabetes And Pregnancy

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. When you are pregnant, high blood sugar levels are not good for your baby. About seven out of every 100 pregnant women in the United States get gestational diabetes. Gestational diabetes is diabetes that happens for the first time when a woman is pregnant. Most of the time, it goes away after you have your baby. But it does increase your risk for developing type 2 diabetes later on. Your child is also at risk for obesity and type 2 diabetes. Most women get a test to check for diabetes during their second trimester of pregnancy. Women at higher risk may get a test earlier. If you already have diabetes, the best time to control your blood sugar is before you get pregnant. High blood sugar levels can be harmful to your baby during the first weeks of pregnancy - even before you know you are pregnant. To keep you and your baby healthy, it is important to keep your blood sugar as close to normal as possible before and during pregnancy. Either type of diabetes during pregnancy increases the chances of problems for you and your baby. To help lower the chances talk to your health care team about A meal plan for your pregnancy A safe exercise plan How often to test your blood sugar Taking your medicine as prescribed. Your medicine plan may need to change during pregnancy. NIH: National Institute of Diabetes and Digestive and Kidney Diseases Continue reading >>

Jci -gestational Diabetes Mellitus

Jci -gestational Diabetes Mellitus

1Departments of Medicine, Obstetrics and Gynecology, and Physiology and Biophysics, and 2Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, California, USA. Address correspondence to: Thomas A. Buchanan, Room 6602 GNH, 1200 North State Street, Los Angeles, California 90089-9317, USA. Phone: (323) 226-4632; Fax: (323) 226-2796; E-mail: [email protected] . Find articles by Buchanan, T. in: JCI | PubMed | Google Scholar 1Departments of Medicine, Obstetrics and Gynecology, and Physiology and Biophysics, and 2Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, California, USA. Address correspondence to: Thomas A. Buchanan, Room 6602 GNH, 1200 North State Street, Los Angeles, California 90089-9317, USA. Phone: (323) 226-4632; Fax: (323) 226-2796; E-mail: [email protected] . Find articles by Xiang, A. in: JCI | PubMed | Google Scholar Published in Volume 115, Issue 3 (March 1, 2005) J Clin Invest.2005;115(3):485491.doi:10.1172/JCI24531. Copyright 2005, The American Society for Clinical Investigation. Gestational diabetes mellitus (GDM) is defined as glucose intolerance of various degrees that is first detected during pregnancy. GDM is detected through the screening of pregnant women for clinical risk factors and, among at-risk women, testing for abnormal glucose tolerance that is usually, but not invariably, mild and asymptomatic. GDM appears to result from the same broad spectrum of physiological and genetic abnormalities that characterize diabetes outside of pregnancy. Indeed, women with GDM are at high risk for having or developing diabetes when they are not pregnant. Thus, GDM provides a unique opportunity to study the early pathogenesis of diabetes and to develop Continue reading >>

All Gestational Diabetes Articles

All Gestational Diabetes Articles

Researchers find new indicators of gestational diabetes risk It may be possible for doctors to predict a woman's risk of developing gestational diabetes up to seven years before she becomes pregnant through blood sugar testing and body weight assessments, according to a new study out of the Kaiser Permanente Division of Research. Intervention Programs Help Women with Gestational Diabetes Lose More Weight Lifestyle intervention programs that target diet and exercise habits may help women who experience gestational diabetes retain less weight during pregnancy and reduce their future risk of developing type 2 diabetes, according to a new study from the Kaiser Permanente Foundation. Waistline and cholesterol linked to gestational diabetes Gestational diabetes poses significant risk to women and their babies. However, tests for the condition have traditionally been invasive and unreliable. Results from standard tests may not be available until six months into the pregnancy, which may be too late for women to seek adequate treatment. Insulin Therapy and Neuropathy in Type 1 Diabetes Send me updates for the following endocrine topics to my inbox. Ask questions. Share your opinions. Get advice. This information is not designed to replace a physician's independent judgment about the appropriateness or risks of a procedure for a given patient. Always consult your doctor about your medical conditions. Vertical Health & EndocrineWeb do not provide medical advice, diagnosis or treatment. Use of this website is conditional upon your acceptance of our user agreement. Continue reading >>

Gestational Diabetes Mellitus: Challenges In Diagnosis And Management

Gestational Diabetes Mellitus: Challenges In Diagnosis And Management

Abstract Gestational diabetes mellitus (GDM) is a well-characterized disease affecting a significant population of pregnant women worldwide. It has been widely linked to undue weight gain associated with factors such as diet, obesity, family history, and ethnicity. Poorly controlled GDM results in maternal and fetal morbidity and mortality. Improved outcomes therefore rely on early diagnosis and tight glycaemic control. While straightforward protocols exist for screening and management of diabetes mellitus in the general population, management of GDM remains controversial with conflicting guidelines and treatment protocols. This review highlights the diagnostic and management options for GDM in light of recent advances in care. Introduction Gestational diabetes mellitus (GDM), by definition, is any degree of glucose intolerance with onset or first recognition during pregnancy [1, 2]. This definition applies regardless of whether treatment involves insulin or diet modification alone; it may also apply to conditions that persist after pregnancy. GDM affects roughly 7 % of pregnancies with an incidence of more than 200,000 cases per year [2]. The prevalence, however, varies from 1–14 %, depending on the population and the diagnostic criteria that have been used [2]. GDM is the most common cause of diabetes during pregnancy, accounting for up to 90 % of pregnancies complicated by diabetes [2]. Women with GDM have a 40–60 % chance of developing diabetes mellitus over the 5–10 years after pregnancy [3]. Although GDM has been recognized as a disease for some time, it remains a controversial entity with conflicting guidelines and treatment protocols. Review Screening The first screening test for GDM, proposed in 1973, consisted of the 1-h 50 gm oral glucose tolerance test Continue reading >>

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