Metabolic alterations in pregnant women: Gestational diabetes

Journal of pediatric endocrinology & metabolism: JPEM (Impact Factor: 1). 10/2012; 25(9-10):835-42. DOI: 10.1515/jpem-2012-0175
Source: PubMed


Abstract Gestational diabetes mellitus (GDM) and controversy are old friends. The impact of GDM on maternal and fetal health has been increasingly recognized. Nevertheless, universal consensus on the diagnostic methods and thresholds has long been lacking. Published guidelines from major societies differ significantly from one another, with recommendations ranging from aggressive screening to no routine screening at all. As a result, real-world practice is equally varied. This article recaps the latest evidence-based recommendations for the diagnosis and classification of GDM. It reviews the current evidence base for intensive multidisciplinary treatment of GDM and provides recommendations for postpartum management to delay and/or prevent progression to type 2 diabetes.

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Available from: Rúben Fernandes, Mar 25, 2015
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    ABSTRACT: Gestational diabetes mellitus (GDM) is a hyperglycemic condition caused by increased insulin resistance and impaired insulin secretion during pregnancy. It is known to be temporary, but it can cause perinatal complications in the mother and baby. Additionally, it may progress to type 2 diabetes mellitus (T2DM). In the present study, we evaluated the risk factors for complications and progression to T2DM in patients with GDM.
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    ABSTRACT: Today, 88% of pregnancies has a physiological course during which just basic care, while in 12% of cases there is a high-risk pregnancy that requires additional assistance and specific. The approach that should be used is that of supervision in all pregnant women considering their potential to have a normal pregnancy until there is no clear evidence to the contrary. Pregnancy is considered at risk if there are medical conditions that may affect maternal or fetal health or life of the mother, fetus or both. Among the risk factors for pregnancy there is first the woman's age, in fact the increase in high-risk pregnancies in the last 20 years is attributable to the increase in the average age of women who face pregnancy. In addition, the diet is very important during pregnancy and diabetes or autoimmune diseases often lead to the failure of a pregnancy. Risk factors for pregnancy, also, are the complications that occur during its course as hypertension during pregnancy, and infectious diseases. Fears and anxieties typical of a high-risk pregnancy prevent the couple to live happily in the months of gestation. Effective communication, control and early detection are important tools that doctors must be able to ensure that women in order to plan the best treatment strategies and to minimize the risks of maternal and / or fetal.
    No preview · Article · Aug 2014 · Minerva ginecologica
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    ABSTRACT: Objective: To investigate the effect of the interaction between gestational diabetes mellitus (GDM) and maternal body mass index (BMI) on the individual neonatal growth parameters. Design: Retrospective cohort study. Setting: A tertiary maternity service in Sydney, Australia, between 2005 and 2009. Population: A cohort of 8859 women. Methods: Generalized linear models. Main outcome measures: Neonatal growth parameters, represented by z-scores for infant birth weight (BW), birth length (BL), and head circumference (HC) in GDM and non-GDM groups. Results: Only GDM alone had an independent and positive effect on BL (p = 0.02) but not on BW or HC. In addition, in pregnancies complicated with GDM, the association between maternal weight and BW was significantly stronger (p < 0.001). In combination, GDM and maternal BMI significantly affected z-score differences between BW and BL (p < 0.001), in that underweight mothers had babies that were lighter relative to their length and inversely obese mothers had babies that were heavier relative to their length. Conclusion: GDM independently influences BL and increases the association between maternal BMI and BW. In accordance with the hypothesis of the fetal origins of health and disease, the pronounced effects of GDM on fetal growth patterns demonstrated in this study are likely to influence long-term health outcomes in children.
    Full-text · Article · Oct 2014 · Frontiers in Pediatrics
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