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Gestational Diabetes Articles

Maternal Gestational Diabetes Mellitus Increases Placental And Foetal Lipoprotein-associated Phospholipase A2 Which Might Exert Protective Functions Against Oxidative Stress

Maternal Gestational Diabetes Mellitus Increases Placental And Foetal Lipoprotein-associated Phospholipase A2 Which Might Exert Protective Functions Against Oxidative Stress

Article | Open Maternal Gestational Diabetes Mellitus increases placental and foetal lipoprotein-associated Phospholipase A2 which might exert protective functions against oxidative stress Scientific Reportsvolume7, Articlenumber:12628 (2017) Increased Lipoprotein associated phospholipase A2 (LpPLA2) has been associated with inflammatory pathologies, including Type 2 Diabetes. Studies on LpPLA2 and Gestational Diabetes Mellitus (GDM) are rare, and have focused mostly on maternal outcome. In the present study, we investigated whether LpPLA2 activity on foetal lipoproteins is altered by maternal GDM and/or obesity (a major risk factor for GDM), thereby contributing to changes in lipoprotein functionality. We identified HDL as the major carrier of LpPLA2 activity in the foetus, which is in contrast to adults. We observed marked expression of LpPLA2 in placental macrophages (Hofbauer cells; HBCs) and found that LpPLA2 activity in these cells was increased by insulin, leptin, and pro-inflammatory cytokines. These regulators were also increased in plasma of children born from GDM pregnancies. Our results suggest that insulin, leptin, and pro-inflammatory cytokines are positive regulators of LpPLA2 activity in the foeto-placental unit. Of particular interest, functional assays using a specific LpPLA2 inhibitor suggest that high-density lipoprotein (HDL)-associated LpPLA2 exerts anti-oxidative, athero-protective functions on placental endothelium and foetus. Our results therefore raise the possibility that foetal HDL-associated LpPLA2 might act as an anti-inflammatory enzyme improving vascular barrier function. Although pathologies such as atherosclerosis and diabetes are generally associated with derangements in lipid and glucose metabolism, these conditions are also characte Continue reading >>

Screening Gestational Diabetes Mellitus: The Role Of Maternal Age

Screening Gestational Diabetes Mellitus: The Role Of Maternal Age

Abstract 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 consideration. We included 945 pregnant women without history of GDM who received 75g OGTT to diagnose GDM in 2011. Screening algorithms using FPG with or without age were developed. Another 362 pregnant women were recruited in 2013–2015 as the validation cohort. Using FPG criteria alone, more GDM diagnoses were missed in women ≥35 years than in women <35 years (13.2% vs. 5.8%, p <0.001). Among GDM women ≥35 years, 63.6% had FPG <92 mg/dL (5.1 mmol/L). Use of the algorithm with an “age plus FPG” cutoff could reduce the use of OGTT (OGTT%) from 77.6% to 62.9%, while maintaining good sensitivity (from 91.9% to 90.2%) and specificity (from 100% to 100%). Similar reduction in OGTT% was found in the validation cohort (from 86.4% to 76.8%). In the simulation, if the percentage of women ≥35 years were 40% or more, the screening algorithm with an “age plus FPG” cutoff could further reduce OGTT% by 11.0%-18.8%. Figures Citation: Kuo C-H, Chen S-C, Fang C-T, Nien F-J, Wu E-T, Lin S-Y, et al. (2017) Screening gestational diabetes mellitus: The role of maternal age. PLoS ONE 12(3): e0173049. Editor: Emilio Russo, University of Catanzaro, ITALY Received: August 23, 2016; Accepted: February 14, 2017; Published: March 15, 2017 Copyright: © 2017 Kuo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, 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 >>

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 >>

Effect Of Treatment Of Gestational Diabetes Mellitus: A Systematic Review And Meta-analysis

Effect Of Treatment Of Gestational Diabetes Mellitus: A Systematic Review And Meta-analysis

Effect of Treatment of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis Affiliation Department of Pharmacy, Faculty of Pharmacy, Silpakorn University, Nakhon-Pathom, Thailand Affiliation Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand Affiliation Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand Effect of Treatment of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis To assess the efficacy and safety of treating pregnant women with gestational diabetes mellitus in comparison to usual antenatal care. A systematic review and meta-analysis was conducted by including randomized controlled trials comparing any form of therapeutic intervention in comparison to usual antenatal care. A literature search was conducted using electronic databases together with a hand search of relevant journals and conference proceedings. Ten studies involving 3,881 patients contributed to meta-analysis. Our results indicated that gestational diabetes mellitus treatment significantly reduced the risk for macrosomia (RR, 0.47; 95% CI, 0.380.57), large for gestational age births (RR, 0.55; 95% CI, 0.450.67), shoulder dystocia (RR, 0.42; 95% CI, 0.230.77) and gestational hypertension (RR, 0.68; 95% CI, 0.530.87) without causing any significant increase in the risk for small for gestational age babies. However, no significant difference was observed between the two groups regarding perinatal/neonatal mortality, neonatal hypoglycemia, birth trauma, preterm births, pre-eclampsia, caesarean section and labor induction. Treating GDM reduces risk for many important adverse pregnancy outcomes and its association with any harm seems unlikely. Citation: Poolsup N, Suksomboon N, Amin M (2014) Effect of T 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 >>

Treatments For Gestational Diabetes: A Systematic Review And Meta-analysis

Treatments For Gestational Diabetes: A Systematic Review And Meta-analysis

Abstract Objective To investigate the effectiveness of different treatments for gestational diabetes mellitus (GDM). Methods Data sources were searched up to July 2016 and included MEDLINE and Embase. Randomised trials comparing treatments for GDM (packages of care (dietary and lifestyle interventions with pharmacological treatments as required), insulin, metformin, glibenclamide (glyburide)) were selected by two authors and double checked for accuracy. Outcomes included large for gestational age, shoulder dystocia, neonatal hypoglycaemia, caesarean section and pre-eclampsia. We pooled data using random-effects meta-analyses and used Bayesian network meta-analysis to compare pharmacological treatments (ie, including treatments not directly compared within a trial). Results Forty-two trials were included, the reporting of which was generally poor with unclear or high risk of bias. Packages of care varied in their composition and reduced the risk of most adverse perinatal outcomes compared with routine care (eg, large for gestational age: relative risk0.58 (95% CI 0.49 to 0.68; I2=0%; trials 8; participants 3462). Network meta-analyses suggest that metformin had the highest probability of being the most effective treatment in reducing the risk of most outcomes compared with insulin or glibenclamide. Conclusions Evidence shows that packages of care are effective in reducing the risk of most adverse perinatal outcomes. However, trials often include few women, are poorly reported with unclear or high risk of bias and report few outcomes. The contribution of each treatment within the packages of care remains unclear. Large well-designed and well-conducted trials are urgently needed. This is an Open Access article distributed in accordance with the terms of the Creative Common 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 >>

Prevention Of Diabetes In Women With A History Of Gestational Diabetes: Effects Of Metformin And Lifestyle Interventions

Prevention Of Diabetes In Women With A History Of Gestational Diabetes: Effects Of Metformin And Lifestyle Interventions

Prevention of Diabetes in Women with a History of Gestational Diabetes: Effects of Metformin and Lifestyle Interventions The Diabetes Prevention Program Research Group Search for other works by this author on: The Journal of Clinical Endocrinology & Metabolism, Volume 93, Issue 12, 1 December 2008, Pages 47744779, Robert E. Ratner, Costas A. Christophi, Boyd E. Metzger, Dana Dabelea, Peter H. Bennett, Xavier Pi-Sunyer, Sarah Fowler, Steven E. Kahn, The Diabetes Prevention Program Research Group; Prevention of Diabetes in Women with a History of Gestational Diabetes: Effects of Metformin and Lifestyle Interventions, The Journal of Clinical Endocrinology & Metabolism, Volume 93, Issue 12, 1 December 2008, Pages 47744779, Context: A past history of gestational diabetes mellitus (GDM) confers a very high risk of postpartum development of diabetes, particularly type 2 diabetes. Objective: The Diabetes Prevention Program (DPP) sought to identify individuals with impaired glucose tolerance (IGT) and intervene in an effort to prevent or delay their progression to diabetes. This analysis examined the differences between women enrolled in DPP with and without a reported history of GDM. Design: The DPP was a randomized, controlled clinical trial. Setting: The study was a multicenter, National Institutes of Health-sponsored trial carried out at 27 centers including academic and Indian Health Services sites. Patients: A total of 2190 women were randomized into the DPP and provided information for past history of GDM. This analysis addressed the differences between those 350 women providing a past history of GDM and those 1416 women with a previous live birth but no history of GDM. Interventions: Subjects were randomized to either standard lifestyle and placebo or metformin therapy Continue reading >>

Diabetes Mellitus And Pregnancy

Diabetes Mellitus And Pregnancy

Practice Essentials Gestational diabetes mellitus (GDM) is defined as glucose intolerance of variable degree with onset or first recognition during pregnancy. A study by Stuebe et al found this condition to be associated with persistent metabolic dysfunction in women at 3 years after delivery, separate from other clinical risk factors. [1] Infants of mothers with preexisting diabetes mellitus experience double the risk of serious injury at birth, triple the likelihood of cesarean delivery, and quadruple the incidence of newborn intensive care unit (NICU) admission. Gestational diabetes mellitus accounts for 90% of cases of diabetes mellitus in pregnancy, while preexisting type 2 diabetes accounts for 8% of such cases. Screening for diabetes mellitus during pregnancy Gestational diabetes The following 2-step screening system for gestational diabetes is currently recommended in the United States: Alternatively, for high-risk women or in areas in which the prevalence of insulin resistance is 5% or higher (eg, the southwestern and southeastern United States), a 1-step approach can be used by proceeding directly to the 100-g, 3-hour OGTT. The US Preventive Services Task Force (USPSTF) recommends screening for gestational diabetes mellitus after 24 weeks of pregnancy. The recommendation applies to asymptomatic women with no previous diagnosis of type 1 or type 2 diabetes mellitus. [2, 3] The recommendation does not specify whether the 1-step or 2-step screening approach would be preferable. Type 1 diabetes The disease is typically diagnosed during an episode of hyperglycemia, ketosis, and dehydration It is most commonly diagnosed in childhood or adolescence; the disease is rarely diagnosed during pregnancy Patients diagnosed during pregnancy most often present with unexpected 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 >>

Gestational Diabetes Mellitus Update And Review Of Literature

Gestational Diabetes Mellitus Update And Review Of Literature

Received date: May 09, 2011; Accepted date: June 18, 2012; Published date: June 20, 2012 Citation: Cheung KW, Wong SF (2012) Gestational Diabetes Mellitus Update and Review of Literature. Reproductive Sys Sexual Disord S2:002. doi: 10.4172/2161-038X.S2-002 Copyright: 2012 Cheung KW, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Gestational diabetes mellitus has been associated with various maternal and perinatal adverse outcomes. Screening and subsequent treatment are associated with short term benefit. With the recent recommended diagnostic criteria by the International Association of Diabetes and Pregnancy Study Groups and increasing rate of obesity, the prevalence will continue to rise. It remains uncertain whether this new diagnostic criteria is cost effective or beneficial. Interventions include lifestyle modification, oral hypoglycaemic agents and insulin. The encouraging result and safety profile with oral hypoglycaemic agents may provide a safe alterative to insulin in patients who fail lifestyle modification. Gestational diabetes mellitus (GDM) is defined by glucose intolerance of variable severity with onset of first recognition during pregnancy [ 1 ]. Hyperglycaemia during pregnancy is found to be associated with various maternal and perinatal adverse outcomes [ 2 , 3 ]. Their offsprings will have a life-long increase risk of glucose intolerance, obesity and metabolic syndrome whereas the mothers will have a higher risk of metabolic syndrome and diabetes in the future [ 4 ]. The detection of GDM during pregnancy provides an opportunity to identify women at risk of 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 >>

Gestational Diabetes

Gestational Diabetes

What is gestational diabetes? Gestational diabetes is a condition marked by high blood glucose (sugar) levels that are discovered during pregnancy. It is defined as carbohydrate intolerance. About two to 10 percent of all pregnant women in the U.S. are diagnosed with gestational diabetes. Am I at risk for gestational diabetes? These factors increase your risk of developing diabetes during pregnancy: Being overweight before becoming pregnant (if you are 20% or more over your ideal body weight) Family history of diabetes (if your parents or siblings have diabetes) Being over age 25 Previously giving birth to a baby that weighed more than 9 pounds Previously giving birth to a stillborn baby Having gestational diabetes with an earlier pregnancy Being diagnosed with pre-diabetes Having polycystic ovary syndrome Being African-American, Hispanic/Latino, Asian-American, American Indian, or Pacific Islander American Keep in mind that half of women who develop gestational diabetes have no known risk factors. What causes gestational diabetes? Gestational diabetes is caused by some hormonal changes that occur in all women during pregnancy. The placenta is the organ that connects the baby (by the umbilical cord) to the uterus and transfers nutrients from the mother to the baby. Increased levels of certain hormones made in the placenta can prevent insulin—a hormone that controls blood sugar—from managing glucose properly. This condition is called "insulin resistance." As the placenta grows larger during pregnancy, it produces more hormones and increases this insulin resistance. Usually, the mother’s pancreas is able to produce more insulin (about three times the normal amount) to overcome the insulin resistance. If it cannot, sugar levels will rise, resulting in gestational dia 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 >>

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