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Describe The Pathology Involved In Gestational Diabetes Mellitus

Gestational Diabetes Pathophysiology

Gestational Diabetes Pathophysiology

The exact pathophysiology of gestational diabetes is unknown. One main aspect of the underlying pathology is insulin resistance, where the bodys cells fail to respond to the hormone insulin in the usual way. Several pregnancy hormones are thought to disrupt the usual action of insulin as it binds to its receptor, most probably by interfering with cell signalling pathways. Insulin is the primary hormone produced in the beta cells of the islets of Langerhans in the pancreas. Insulin is key in the regulation of the bodys blood glucose level. Insulin stimulates cells in the skeletal muscle and fat tissue to absorb glucose from the bloodstream. In the presence of insulin resistance, this uptake of blood glucose is prevented and the blood sugar level remains high. The body then compensates by producing more insulin to overcome the resistance and in gestational diabetes, the insulin production can be up to 1.5 or 2 times that seen in a normal pregnancy. Western diet during pregnancy may increase obesity risk in offspring The glucose present in the blood crosses the placenta via the GLUT1 carrier to reach the fetus. If gestational diabetes is left untreated, the fetus is exposed to an excess of glucose, which leads to an increase in the amount of insulin produced by the fetus. As insulin stimulates growth, this means the baby then develops a larger body than is normal for their gestational age. Once the baby is born, the exposure to excess glucose is removed. However, the newborn still has increased insulin production, meaning they are susceptible to low blood glucose levels. Some of the symptoms of gestational diabetes include: Recurrent infections including thrush or yeast infection Gestational diabetes raises the risk of birth complications and future health conditions. Som Continue reading >>

The Pathogenesis And Pathophysiology Of Gestational Diabetes Mellitus: Deductions From A Three-part Longitudinal Metabolomics Study In China.

The Pathogenesis And Pathophysiology Of Gestational Diabetes Mellitus: Deductions From A Three-part Longitudinal Metabolomics Study In China.

Gestational diabetes mellitus (GDM) is a form of diabetes that is first recognised during pregnancy, with no evidence of pre-existing type 1 or type 2 diabetes. The prevalence of GDM has been rising steadily over the past few decades, coinciding with the ongoing epidemic of obesity and type 2 diabetes. Although GDM normally disappears after delivery, women who have been previously diagnosed with GDM are at a greater risk of developing gestational diabetes in subsequent pregnancies, and type 2 diabetes later in life. Infants born to mothers with GDM also have a higher risk of developing type 2 diabetes in their teens or early adulthood. There are many possible causes of insulin resistance, and multiple metabolic aberrants are known to be involved in the development of different forms of diabetes. Increasing evidence suggests that different forms of diabetes share common pathogenesis and pathophysiological dysregulation resulting from a progressive -cell demise or dysfunction. The outcome manifests clinically as hyperglycaemia. The development of GDM may represent a very early stage of the progression to type 2 diabetes that is being manifested under the stresses of pregnancy. However, the exact mechanisms of GDM development are not clearly understood. Based on the results of a three-part longitudinal metabolomics study of Chinese pregnant women, in combination with the current literature, a new model of GDM development is proposed to outline the biomolecular mechanisms underpinning GDM. A possible cause of GDM is obesity, which is an important clinical risk factor for the development of diabetes. Women who develop GDM generally have higher body mass indices when compared with healthy pregnant women, and obesity can induce low-grade inflammation. Chronic low-grade inflam Continue reading >>

The Role Of Oxidative Stress In The Pathophysiology Of Gestational Diabetes Mellitus

The Role Of Oxidative Stress In The Pathophysiology Of Gestational Diabetes Mellitus

The Role of Oxidative Stress in the Pathophysiology of Gestational Diabetes Mellitus Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia. Mercy Perinatal Research Centre, Mercy Hospital for Women, Victoria, Australia. Normal human pregnancy is considered a state of enhanced oxidative stress. In pregnancy, it plays important roles in embryo development, implantation, placental development and function, fetal development, and labor. However, pathologic pregnancies, including gestational diabetes mellitus (GDM), are associated with a heightened level of oxidative stress, owing to both overproduction of free radicals and/or a defect in the antioxidant defenses. This has important implications on the mother, placental function, and fetal well-being. Animal models of diabetes have confirmed the important role of oxidative stress in the etiology of congenital malformations; the relative immaturity of the antioxidant system facilitates the exposure of embryos and fetuses to the damaging effects of oxidative stress. Of note, there are only a few clinical studies evaluating the potential beneficial effects of antioxidants in GDM. Thus, whether or not increased antioxidant intake can reduce the complications of GDM in both mother and fetus needs to be explored. This review provides an overview and updated data on our current understanding of the complications associated with oxidative changes in GDM. Antioxid. Redox Signal. 15, 30613100. Continue reading >>

Pathogenesis Of Gestational Dm

Pathogenesis Of Gestational Dm

Gestational diabetes (GDM) describes a heterogeneous group of hyperglycemic metabolic disorders detected in pregnancy. The majority of women with GDM are overweight or obese, and many have latent metabolic syndrome, a genetic predisposition to type 2 diabetes, a physically inactive lifestyle and unhealthy eating habits prior to pregnancy. The risk factors for GDM are similar to those of type 2 diabetes: increased waist circumference, dyslipidemia, hypertension, polycystic ovary syndrome, increasing age, family history of diabetes and ethnicity (Asian, Hispanic). Prenatal programming may also contribute to GDM whereby nutritional stress induced by both maternal undernutrition and overnutrition or maternal hyperglycemia during pregnancy persistently alter metabolism of the offspring. A minority of women develop type 1 diabetes in pregnancy, and clinicians should be alert to this possibility, but GDM may in general be regarded as pre-type 2 diabetes. Gestational diabetes is diabetes first detected in pregnancy [1] [2] . Although type 1 diabetes is more likely to develop in pregnancy, the great majority of women have pre-type 2 diabetes, and many will go on to develop permanent diabetes later in life. If type 1 diabetes is suspected during pregnancy or after delivery, autoimmunity should be confirmed by measurement of antibodies against islet cell antigens (antibodies directed against glutamic acid decarboxylase [GADA], islet antigen-2 [IA-2A]). MODY may also present in pregnancy, and genetic testing is recommended when family history suggests that this phenotype may be present. However, in general GDM can be regarded as pre-Type 2 diabetes. Pregnancy is a state of physiological insulin resistance, and thereforerepresents a physiological model of beta-cell stress [3] [4] . Continue reading >>

Gestational Diabetes

Gestational Diabetes

Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy.[2] Gestational diabetes generally results in few symptoms;[2] however, it does increase the risk of pre-eclampsia, depression, and requiring a Caesarean section.[2] Babies born to mothers with poorly treated gestational diabetes are at increased risk of being too large, having low blood sugar after birth, and jaundice.[2] If untreated, it can also result in a stillbirth.[2] Long term, children are at higher risk of being overweight and developing type 2 diabetes.[2] Gestational diabetes is caused by not enough insulin in the setting of insulin resistance.[2] Risk factors include being overweight, previously having gestational diabetes, a family history of type 2 diabetes, and having polycystic ovarian syndrome.[2] Diagnosis is by blood tests.[2] For those at normal risk screening is recommended between 24 and 28 weeks gestation.[2][3] For those at high risk testing may occur at the first prenatal visit.[2] Prevention is by maintaining a healthy weight and exercising before pregnancy.[2] Gestational diabetes is a treated with a diabetic diet, exercise, and possibly insulin injections.[2] Most women are able to manage their blood sugar with a diet and exercise.[3] Blood sugar testing among those who are affected is often recommended four times a day.[3] Breastfeeding is recommended as soon as possible after birth.[2] Gestational diabetes affects 3–9% of pregnancies, depending on the population studied.[3] It is especially common during the last three months of pregnancy.[2] It affects 1% of those under the age of 20 and 13% of those over the age of 44.[3] A number of ethnic groups including Asians, American Indians, Indigenous Australians, and Pacific Continue reading >>

Types Of Diabetes Mellitus

Types Of Diabetes Mellitus

Diabetes mellitus (or diabetes) is a chronic, lifelong condition that affects your body's ability to use the energy found in food. There are three major types of diabetes: type 1 diabetes, type 2 diabetes, and gestational diabetes. All types of diabetes mellitus have something in common. Normally, your body breaks down the sugars and carbohydrates you eat into a special sugar called glucose. Glucose fuels the cells in your body. But the cells need insulin, a hormone, in your bloodstream in order to take in the glucose and use it for energy. With diabetes mellitus, either your body doesn't make enough insulin, it can't use the insulin it does produce, or a combination of both. Since the cells can't take in the glucose, it builds up in your blood. High levels of blood glucose can damage the tiny blood vessels in your kidneys, heart, eyes, or nervous system. That's why diabetes -- especially if left untreated -- can eventually cause heart disease, stroke, kidney disease, blindness, and nerve damage to nerves in the feet. Type 1 diabetes is also called insulin-dependent diabetes. It used to be called juvenile-onset diabetes, because it often begins in childhood. Type 1 diabetes is an autoimmune condition. It's caused by the body attacking its own pancreas with antibodies. In people with type 1 diabetes, the damaged pancreas doesn't make insulin. This type of diabetes may be caused by a genetic predisposition. It could also be the result of faulty beta cells in the pancreas that normally produce insulin. A number of medical risks are associated with type 1 diabetes. Many of them stem from damage to the tiny blood vessels in your eyes (called diabetic retinopathy), nerves (diabetic neuropathy), and kidneys (diabetic nephropathy). Even more serious is the increased risk of hea Continue reading >>

Symptoms

Symptoms

Print Overview Diabetes mellitus refers to a group of diseases that affect how your body uses blood sugar (glucose). Glucose is vital to your health because it's an important source of energy for the cells that make up your muscles and tissues. It's also your brain's main source of fuel. If you have diabetes, no matter what type, it means you have too much glucose in your blood, although the causes may differ. Too much glucose can lead to serious health problems. Chronic diabetes conditions include type 1 diabetes and type 2 diabetes. Potentially reversible diabetes conditions include prediabetes — when your blood sugar levels are higher than normal, but not high enough to be classified as diabetes — and gestational diabetes, which occurs during pregnancy but may resolve after the baby is delivered. Diabetes symptoms vary depending on how much your blood sugar is elevated. Some people, especially those with prediabetes or type 2 diabetes, may not experience symptoms initially. In type 1 diabetes, symptoms tend to come on quickly and be more severe. Some of the signs and symptoms of type 1 and type 2 diabetes are: Increased thirst Frequent urination Extreme hunger Unexplained weight loss Presence of ketones in the urine (ketones are a byproduct of the breakdown of muscle and fat that happens when there's not enough available insulin) Fatigue Irritability Blurred vision Slow-healing sores Frequent infections, such as gums or skin infections and vaginal infections Although type 1 diabetes can develop at any age, it typically appears during childhood or adolescence. Type 2 diabetes, the more common type, can develop at any age, though it's more common in people older than 40. When to see a doctor If you suspect you or your child may have diabetes. If you notice any poss Continue reading >>

Diabetes Mellitus: An Overview

Diabetes Mellitus: An Overview

Diabetes mellitus is a disease that prevents your body from properly using the energy from the food you eat. Diabetes occurs in one of the following situations: The pancreas (an organ behind your stomach) produces little insulin or no insulin at all. (Insulin is a naturally occurring hormone, produced by the beta cells of the pancreas, which helps the body use sugar for energy.) -Or- The pancreas makes insulin, but the insulin made does not work as it should. This condition is called insulin resistance. To better understand diabetes, it helps to know more about how the body uses food for energy (a process called metabolism). Your body is made up of millions of cells. To make energy, the cells need food in a very simple form. When you eat or drink, much of your food is broken down into a simple sugar called glucose. Glucose provides the energy your body needs for daily activities. The blood vessels and blood are the highways that transport sugar from where it is either taken in (the stomach) or manufactured (in the liver) to the cells where it is used (muscles) or where it is stored (fat). Sugar cannot go into the cells by itself. The pancreas releases insulin into the blood, which serves as the helper, or the "key," that lets sugar into the cells for use as energy. When sugar leaves the bloodstream and enters the cells, the blood sugar level is lowered. Without insulin, or the "key," sugar cannot get into the body's cells for use as energy. This causes sugar to rise. Too much sugar in the blood is called "hyperglycemia" (high blood sugar) or diabetes. What are the types of diabetes? There are two main types of diabetes: Type 1 and Type 2: Type 1 diabetes occurs because the insulin-producing cells of the pancreas (beta cells) are damaged. In Type 1 diabetes, the pancreas Continue reading >>

Gestational Diabetes: Pathogenesis And Consequences To Mother And Offspring

Gestational Diabetes: Pathogenesis And Consequences To Mother And Offspring

Gestational Diabetes: Pathogenesis and Consequences to Mother and Offspring 1Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Satakunta Central Hospital, Pori, Finland 2Department of Medicine, University of Turku and Turku University Hospital, Turku, Finland 1Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Satakunta Central Hospital, Pori, Finland 2Department of Medicine, University of Turku and Turku University Hospital, Turku, Finland Address correspondence to: Risto Kaaja, e-mail: [email protected] Received 2009 Feb 1; Revised 2009 Feb 27; Accepted 2009 Feb 28. Copyright 2008, SBDR - Society for Biomedical Diabetes Research This article has been cited by other articles in PMC. Gestational diabetes mellitus (GDM) is defined as glucose intolerance with onset or first recognition during pregnancy. Data from Western countries suggest that the prevalence of GDM is increasing, being almost 10% of pregnancies and probably reflecting the global obesity epidemic. The majority of women with GDM seem to have -cell dysfunction that appears on a background of chronic insulin resistance already present before pregnancy. In less than 10% of GDM patients, defects of -cell function can be due to autoimmune destruction of pancreatic -cells, as in type 1 diabetes, or caused by monogenic mutations, as in several MODY subtypes. Diagnostic criteria for GDM vary worldwide and there are no clear-cut plasma glucose cut-off values for identifying women at a higher risk of developing macrosomia or other fetal complications. Because the oral glucose tolerance test (OGTT) is restricted to high risk individuals, 40% of GDM cases are left undiagnosed. Therefore, in high risk populations almost universal screening is recommended; on Continue reading >>

What Is Diabetes Mellitus?

What Is Diabetes Mellitus?

Diabetes mellitus is a common disease where there is too much sugar (glucose) floating around in your blood. This occurs because either the pancreas can’t produce enough insulin or the cells in your body have become resistant to insulin. When you eat food, the amount of glucose in your blood skyrockets. That’s because the food you eat is converted into glucose (usable energy for your cells) and enters your blood to be transported to your cells around the body. Special cells in your pancreas sense the increase of glucose and release insulin into your blood. Insulin has a lot of different jobs, but one of its main tasks is to help decrease blood glucose levels. It does this by activating a system which transports glucose from your blood into your cells. It also decreases blood glucose by stimulating an enzyme called glycogen synthase in the liver. This molecule is responsible for making glycogen, a long string of glucose, which is then stored in the liver and used in the future when there is a period of low blood glucose. As insulin works on your body, the amount of glucose in the blood slowly returns to the same level it was before you ate.. This glucose level when you haven’t eaten recently (called fasting glucose) sits around 3.5-6 mmol/L (70-110 mg/dL). Just after a meal, your blood glucose can jump as high as 7.8mmol/L (140 mg/dL) depending on how much and what you ate. There are two types of diabetes mellitus, type 1 and type 2. In both types, your body has trouble transporting sugar from your blood into your cells. This leads to high levels of glucose in your blood and a deficiency of glucose in your cells. The main difference between type 1 and type 2 diabetes mellitus is the underlying mechanisms that cause your blood sugar to stray from the normal range. T Continue reading >>

Classification, Pathophysiology, Diagnosis And Management Of Diabetes Mellitus

Classification, Pathophysiology, Diagnosis And Management Of Diabetes Mellitus

University of Gondar, Ethopia *Corresponding Author: Habtamu Wondifraw Baynes Lecturer Clinical Chemistry University of Gondar, Gondar Amhara 196, Ethiopia Tel: +251910818289 E-mail: [email protected] Citation: Baynes HW (2015) Classification, Pathophysiology, Diagnosis and Management of Diabetes Mellitus. J Diabetes Metab 6:541. doi:10.4172/2155-6156.1000541 Copyright: © 2015 Baynes HW. 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. Visit for more related articles at Journal of Diabetes & Metabolism Abstract Diabetes Mellitus (DM) is a metabolic disorder characterized by the presence of chronic hyperglycemia either immune-mediated (Type 1 diabetes), insulin resistance (Type 2), gestational or others (environment, genetic defects, infections, and certain drugs). According to International Diabetes Federation Report of 2011 an estimated 366 million people had DM, by 2030 this number is estimated to almost around 552 million. There are different approaches to diagnose diabetes among individuals, The 1997 ADA recommendations for diagnosis of DM focus on fasting Plasma Glucose (FPG), while WHO focuses on Oral Glucose Tolerance Test (OGTT). This is importance for regular follow-up of diabetic patients with the health care provider is of great significance in averting any long term complications. Keywords Diabetes mellitus; Epidemiology; Diagnosis; Glycemic management Abbreviations DM: Diabetes Mellitus; FPG: Fasting Plasma Glucose; GAD: Glutamic Acid Decarboxylase; GDM: Gestational Diabetes Mellitus; HDL-cholesterol: High Density Lipoprotein cholesterol; HLA: Human Leucoid Antigen; IDD Continue reading >>

Gestational Diabetes

Gestational Diabetes

Gestational diabetes mellitus (sometimes referred to as GDM) is a form of diabetes that occurs during pregnancy and usually goes away after the baby is born. It is diagnosed when higher than normal blood glucose levels first appear during pregnancy. Gestational diabetes is the fastest growing type of diabetes in Australia, affecting thousands of pregnant women. Between 5% and 10% of pregnant women will develop gestational diabetes and this usually occurs around the 24th to 28th week of pregnancy. All women are tested for gestational diabetes as part of the 24-28 week routine examination with their GP. Women who have one or more of the risk factors are advised to have a diabetes test when pregnancy is confirmed then again at 24 weeks if diabetes was not detected in early pregnancy. While there is no one reason for why women develop gestational diabetes, you are at risk of developing gestational diabetes if you: Are over 25 years of age Have a family history of type 2 diabetes Are overweight Are from an Indigenous Australian or Torres Strait Islander background Are from a Vietnamese, Chinese, middle eastern, Polynesian or Melanesian background Have had gestational diabetes during previous pregnancies Have previously had Polycystic Ovary Syndrome Have previously given birth to a large baby Have a family history of gestational diabetes Most women are diagnosed after special blood tests. A Glucose Challenge Test (GCT) is a screening test where blood is taken for a glucose measurement one hour after a glucose drink. If this test is abnormal then an Oral Glucose Tolerance Test (OGTT) is done. For an OGTT a blood sample is taken before and two hours after the drink. For many people, being diagnosed with gestational diabetes can be upsetting. However, it is important to remember Continue reading >>

[pathophysiology Of Gestational Diabetes].

[pathophysiology Of Gestational Diabetes].

[Pathophysiology of gestational diabetes]. Service d'Endocrinologie et Diabtologie, Clinique Marc-Linquette, CHRU, Lille, France. During pregnancy, a number of maternal metabolic changes occur early and continue throughout pregnancy which help optimize the transfer of nutrients to the fetus. During normal pregnancy, there are a decrease in insulin sensibility which is physiological, progressive and reverse. For glucose tolerance to be maintained in pregnancy it is necessary for maternal insulin secretion to increase sufficiently to counteract the fall in insulin sensitivity. The metabolic characteristic of women with gestational diabetes is insufficient insulin secretion to counteract the pregnancy related fall in insulin sensitivity. There are a lot of factors that could explain the mechanism of insulin secretion and insulin sensitivity during normal pregnancy and gestational diabetes mellitus. Although glucose tolerance normalizes shortly after pregnancy with gestational diabetes in the majority of women, the risk of developing overt diabetes, especially type 2 diabetes is markedly increased. The mechanisms which could explain gestational diabetes are the same as type 2 diabetes mellitus. We could speculate that these two diseases are identical for alterations in carbohydrate metabolism, but at different stages. Continue reading >>

Gestational Diabetes

Gestational Diabetes

Gestational diabetes is high blood sugar that develops during pregnancy and usually disappears after giving birth. It can occur at any stage of pregnancy, but is more common in the second half. It occurs if your body cannot produce enough insulin – a hormone that helps control blood sugar levels – to meet the extra needs in pregnancy. Gestational diabetes can cause problems for you and your baby during and after birth. But the risk of these problems happening can be reduced if it's detected and well managed. Who's at risk of gestational diabetes Any woman can develop gestational diabetes during pregnancy, but you're at an increased risk if: your body mass index (BMI) is above 30 – use the healthy weight calculator to work out your BMI you previously had a baby who weighed 4.5kg (10lbs) or more at birth you had gestational diabetes in a previous pregnancy one of your parents or siblings has diabetes your family origins are south Asian, Chinese, African-Caribbean or Middle Eastern If any of these apply to you, you should be offered screening for gestational diabetes during your pregnancy. Symptoms of gestational diabetes Gestational diabetes doesn't usually cause any symptoms. Most cases are only picked up when your blood sugar level is tested during screening for gestational diabetes. Some women may develop symptoms if their blood sugar level gets too high (hyperglycaemia), such as: But some of these symptoms are common during pregnancy anyway and aren't necessarily a sign of a problem. Speak to your midwife or doctor if you're worried about any symptoms you're experiencing. How gestational diabetes can affect your pregnancy Most women with gestational diabetes have otherwise normal pregnancies with healthy babies. However, gestational diabetes can cause problems s Continue reading >>

Gestational Diabetes Mellitus

Gestational Diabetes Mellitus

Table 1. Plasma Glucose Values for Screening and Diagnosis of Gestational Diabetes Mellitus [ 1 ] Appendix A. Appendix A. American Diabetes Association recommendations for medical nutritional therapy in gestational diabetes mellitus [ 17 ] Appendix B. Appendix B. Curriculum for education about diabetes self-management [ 27 ] Defining the Diabetes Disease Process and Treatment Options Insulin resistance and its role in gestational diabetes mellitus (GDM) should be defined for the patient. GDM should be differentiated from types 1 and 2 diabetes mellitus. Treatment options should be discussed. Incorporating Nutritional Management Into Lifestyle An individualized meal plan should be devised by a licensed dietitian or another qualified health care professional. Energy needs, the composition of meals, and meal patterns should be discussed. Incorporating Physical Activity Into Lifestyle The importance of exercise should be stressed, but patients should be reminded to start slowly and work up to a personalized goal. Monitoring Blood Glucose and Using the Findings to Improve Blood Glucose Control Patients should be taught to monitor blood glucose four times daily (while fasting and two hours after meals) and when they have symptoms of hyperglycemia or hypoglycemia. The goal fasting blood glucose concentration is 70-105 mg/dL and the two-hour postprandial goal is 80-120 mg/dL.[ 1 ] Preventing, Detecting, and Treating Acute and Chronic Complications All potential complications to mother and fetus, present and future, should be discussed with the patient, and the importance of compliance with medical nutritional therapy, exercise, and prescribed medications should be stressed. Goal Setting for Health and Problem Solving for Daily Living The patient's support system and ability to Continue reading >>

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