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Flow chart. OGTT: oral glucose tolerance test, G: glycaemia.

Flow chart. OGTT: oral glucose tolerance test, G: glycaemia.

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Abstract Early gestational diabetes mellitus (eGDM) is diagnosed when fasting plasma glucose before 24 weeks of gestation (WG) is ≥ 5.1 mmol/L, whilst standard GDM is diagnosed between 24 and 28 WG by oral glucose tolerance test (OGTT). eGDM seems to have worse obstetric outcomes than standard GDM. We compared the rates of postpartum glucose metabo...

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... However, some pregnant women have high blood sugar in the early stages of pregnancy due to a missed diagnosis of pregestational diabetes mellitus (PGDM), which has a high prevalence in China [7,8]. Early screening for GDM is recommended for pregnant women with risk factors to improve pregnancy outcomes [9][10][11][12][13][14]. ...
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Purpose To study the prediction of gestational diabetes mellitus (GDM) in high-risk pregnant women by testing fasting blood glucose, 1-h(1hPG) and 2-h plasma glucose (2hPG) after an oral glucose tolerance test, and glycated hemoglobin (HbA1c) in early pregnancy (6–14 weeks). Methods We recruited 1311 pregnant women at high risk for diabetes from the Obstetrics Clinic of Daxing District People’s Hospital between June 2017 and December 2019. The tests performed during the first trimester included fasting blood glucose (FPG), HbA1c, and 75-g oral glucose tolerance test (OGTT) with 1hPG and 2hPG. Seventy-three pregnant women diagnosed with pregestational diabetes mellitus (PGDM) early in pregnancy and 36 who were missed in the second trimester were excluded. A total of 1202 women were followed up until 24–28 weeks for GDM. The receiver operating characteristic (ROC) and area under the ROC curve (AUC) were calculated to determine the predictive values of FPG, 1hPG, 2hPG, and HbA1c for GDM in early pregnancy in high-risk pregnant women. Results The AUC for 1hPG for the prediction of GDM in high-risk pregnant women was greater than those for FPG, 2hPG, and HbA1c. All differences were significant. The AUCs for the predictive values of FPG, 1hPG, 2hPG, and HbA1c in high-risk pregnant women were 0.63, 0.76, 0.71, and 0.67, respectively. The prevalence of PGDM among pregnant women at high risk of diabetes was 5.6%. Conclusion First-trimester levels of FPG, 1hPG, 2hPG, and HbA1c in high-risk women are significant predictors of GDM, with 1hPG having the most significant predictive value.
... Cosma et al. did not report any difference in postpartum hyperglycemia between 192 women with eGDM (elevated FPG as per IADPSG criteria) and 81 women with cGDM diagnosed as per the one-step criterion. However, the eGDM group had less incidence of preterm labor, more induced deliveries, and reduced fetal problems [54]. More studies are required to analyze the association between postpartum dysglycemia and eGDM. ...
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Preexisting diabetes mellitus (DM) should be ruled out early in pregnancy in those at risk. During screening, a significant proportion of women do not reach the threshold for overt DM but fulfill the criteria used for diagnosing conventional gestational DM (cGDM). There is no consensus on the management of pregnancies with intermediate levels of hyperglycemia thus diagnosed. We have used the term early gestational DM (eGDM) for this condition and reviewed the currently available literature. Fasting plasma glucose (FPG), oral glucose tolerance test, and glycated hemoglobin (HbA1c) are the commonly employed screening tools in early pregnancy. Observational studies suggest that early pregnancy FPG and Hba1c correlate with the risk of cGDM and adverse perinatal outcomes. However, specific cut-offs, including those proposed by the International Association of the Diabetes and Pregnancy Study Group, do not reliably predict the development of cGDM. Emerging data, though indicate that FPG ≥ 92 mg/dL (5.1 mmol/L), even in the absence of cGDM, signals the risk for perinatal complication. Elevated HbA1c, especially a level ≥ 5.9%, also correlates with the risk of cGDM and worsened outcome. HbA1c as a diagnostic test is however besieged with the usual caveats that occur in pregnancy. The studies that explored the effects of intervention present conflicting results, including a possibility of fetal malnutrition and small-for-date baby in the early treatment group. Diagnostic thresholds and glycemic targets in eGDM may differ, and large multicenter randomized controlled trials are necessary to define the appropriate strategy.
... Regardless of GDM status, maternal triglyceride levels, particularly in the third trimester, were found to be strong predictors of birth weight [55]. GDM is characterized by resistance to insulin and tolerance to glucose, which may persist after delivery [61,62] results exhibit a high frequency of early postpartum glucose abnormalities, for both early and typical GDM. [48] illustrated that even brief exposure to maternal diabetes during early development is enough to induce permanent changes in DNA methylation and expression of genes that control insulin secretion, implying a methylation-mediated epigenetic mechanism for GDM-induced intergenerational glucose intolerance. ...
Article
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Maternal health associated with Gestational Diabetes Mellitus (GDM) has been gaining significant research attention due to its severe risk and adverse health effects. GDM is the leading health disease in pregnant women. It is the most common metabolic disease and it can affect up to 25% of women during pregnancy. Pregnancy is a sensitive period that impacts both pregnant women and their unborn children's long-term health. It is a well-known fact that the leading causes of disease and mortality worldwide are diabetes mellitus and cancer, and specifically, women with diabetes mellitus are at a higher risk of developing breast cancer (BC). Women who have diabetes are equally vulnerable to reproductive diseases. Reproductive dysfunctions with diabetes are mainly attributed to coexisting polycystic ovarian syndrome (PCOS), obesity, and hyperinsulinemia, etc. Moreover, India has long been recognized as the world's diabetic capital, and it is widely acknowledged that particularly pregnant and lactating women are among the most affected by diabetes. In India, one-third (33%) of women with GDM had a history of maternal diabetes. Nevertheless, the latest research suggests that gestational diabetes is also a risk factor for cardiometabolic diseases of the mother and offspring. Therefore, in the 21st century, GDM imposes a major challenge for healthcare professionals. We intend to explore the role of diabetes on female reproductive function throughout various stages of life in the perspective of the changing prognosis, prevalence, and prevention of GDM.
... Regardless of GDM status, maternal triglyceride levels, particularly in the third trimester, were found to be strong predictors of birth weight [55]. GDM is characterized by resistance to insulin and tolerance to glucose, which may persist after delivery [61,62] results exhibit a high frequency of early postpartum glucose abnormalities, for both early and typical GDM. [48] illustrated that even brief exposure to maternal diabetes during early development is enough to induce permanent changes in DNA methylation and expression of genes that control insulin secretion, implying a methylation-mediated epigenetic mechanism for GDM-induced intergenerational glucose intolerance. ...
Article
Maternal health associated with Gestational Diabetes Mellitus (GDM) has been gaining significant research attention due to its severe risk and adverse health effects. GDM is the leading health disease in pregnant women. It is the most common metabolic disease and it can affect up to 25% of women during pregnancy. Pregnancy is a sensitive period that impacts both pregnant women and their unborn children's long-term health. It is a well-known fact that the leading causes of disease and mortality worldwide are diabetes mellitus and cancer, and specifically, women with diabetes mellitus are at a higher risk of developing breast cancer (BC). Women who have diabetes are equally vulnerable to reproductive diseases. Reproductive dysfunctions with diabetes are mainly attributed to coexisting polycystic ovarian syndrome (PCOS), obesity, and hyperinsulinemia, etc. Moreover, India has long been recognized as the world's diabetic capital, and it is widely acknowledged that particularly pregnant and lactating women are among the most affected by diabetes. In India, one-third (33%) of women with GDM had a history of maternal diabetes. Nevertheless, the latest research suggests that gestational diabetes is also a risk factor for cardiometabolic diseases of the mother and offspring. Therefore, in the 21st century, GDM imposes a major challenge for healthcare professionals. We intend to explore the role of diabetes on female reproductive function throughout various stages of life in the perspective of the changing prognosis, prevalence, and prevention of GDM.
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Objective:To study the prediction of gestational diabetes mellitus (GDM) in high-risk pregnant women by testing the 1-hour (1hPG) and 2-hour plasma glucose (2hPG) after an oral glucose tolerance test and the glycated hemoglobin (HbA1c) in early pregnancy (6-14 weeks). Methodology:We recruited 1311 pregnant women at high risk for diabetes from the Obstetrics Clinic of Daxing District People's Hospital between June 2017 and December 2019. Fasting blood glucose (FPG) and HbA1c were tested and a 75 g oral glucose tolerance test (OGTT) with 1-hour blood glucose (1hPG) and 2-hour blood glucose (2hPG) was performed during the first trimester of pregnancy. The women were seen at 24-28 weeks to follow-up for GDM. We calculated the receiver operating characteristic (ROC) and the area under the ROC curve (AUC) to determine the predictive values for early pregnancy FPG, 1hPG, 2hPG, and HbA1c for GDM in high-risk pregnant women. Results:The prevalence of pregestational diabetes mellitus among pregnant women at high risk of diabetes was 5.6%, and GDM was 24.7%. The AUCs for the predictive value of FPG, 1hPG, 2hPG, and HbA1c in high-risk pregnant women were 0.64, 0.76, 0.71, and 0.67, respectively. The AUC for 1hPG prediction of GDM in high-risk pregnant women is greater than FPG, 2hPG, and HbA1c. All differences were statistically significant. Conclusion:FPG, 1hPG, 2hPG, and HbA1c measured in the first trimester pregnancy of high-risk women are significant predictors of GDM. 1hPG was the most significant predictive value for GDM in high-risk pregnant women.