Pregnancy gestational diabetes

Gestational diabetes mellitus (GDM) is defined as glucose intolerance which is first recognized during pregnancy. Gestational diabetes complicates about 7% of all pregnancies. Clinical detection is important, as therapy will reduce perinatal morbidity and mortality. 

Histoiy of gestational diabetes (diabetes that develops during pregnancy but disappears when pregnancy is over)... 

Concern has been expressed over the use of SGAs in pregnancy because of the risk for weight gain and potential risk for gestational diabetes. 

Gestational diabetes Pregnancy Usually transitory but many women have an increased long-term risk of diabetes. 

In six women with gestational diabetes, acarbose 50 mg before meals normalized fasting and postprandial glucose concentrations (67). The pregnancies were uneventful and the neonates were healthy. Internal discomfort persisted during the whole pregnancy. 

Simmons D, Thompson CF, Conroy C, Scott DJ. Use of insulin pumps in pregnancies complicated by type 2 diabetes and gestational diabetes in a multiethnic community. Diabetes Care 2001 24(12) 2078-82. 

Gestational diabetes meUitus resembles type 2 diabetes, but is transient, occurring in about 2-5% of pregnancies. While it is fully treatable, about 20-50% of affected women develop type 2 diabetes later in life. 

Impaired glucose tolerance is common in pregnancy and may be severe enough to be classified as diabetes meUitus (so-called gestational diabetes), which usually resolves on parturition. A number of studies have shown that supplements of 100 mg of vitamin Bg per day result in improved glucose tolerance (Rose et al., 1975). 

Gestations diabetes mellitus Gestations diabetes mellitus develops during the second or third trimester of pregnancy and resolves after delivery. During the pregnancy, this is treated with diet and insulin injections if necessary. 

Current mformation suggests that maternal serum AFP concentrations are not altered among women with gestational diabetes, even if insulin is subsequently required later in pregnancy. 

Berkowitz K, Reyes C, Saadat P> Kjos SL. Fetal lung maturation. Comparison of biochemical indices in gestational diabetic and nondiabetic pregnancies. J Reprod Med 1997 42 793-800. 

Aguayo, C., Flores, C., Parodi, J., Rojas, R., Mann, G.E., Pearson, J.D., and Sobrevia, L. (2001) Modulation of adenosine transport by insulin in human umbilical artery smooth muscle ceUs from normal or gestational diabetic pregnancies. The Journal of Physiology, 534 (Pt 1), 243-254. 

Gestational Diabetes Mellitus (GDM) Glucose intolerance that is first recognized during pregnancy is classified as GDM. The prevalence of GDM varies among... 

Gestational diabetes mellitus (GDM) complicates roughly 7% of all pregnancies in the United States. Most women will return to normoglycemia postpartum, but 30% to 50% will develop type 2 DM or glucose intolerance later in life. 

Diabetes is a metabolic disorder characterized by resistance to the action of insnlin, insnfflcient insnlin secretion, or both. The clinical manifestation of these disorders is hyperglycemia. The vast majority of diabetic patients are classified into one of two broad categories type 1 diabetes cansed by an absolnte deficiency of insnlin, or type 2 diabetes defined by the presence of insnlin resistance with an inadequate compensatory increase in insnlin secretion. Women who develop diabetes due to the stress of pregnancy are classified as having gestational diabetes. Finally, nncommon types of diabetes cansed by infections, drugs, endocrinopathies, pancreatic destmction, and known genetic defects are classified separately (Table 72-1). 

In contrast to the American Diabetes Association dietary recommendations, a Cochrane Review revealed that there is insufficient evidence to recommend dietary interventions for women with abnormal glucose tolerance in pregnancy. Neither large-birth-weight deliveries nor need for cesarean delivery was influenced by adherence to dietary interventions for gestational diabetes. ... 

Many women with pregnancy-inflnenced gastrointestinal issues can be treated safely with lifestyle modification or medications, many of them nonprescription. Gestational diabetes, hypertension, and thyrotoxicosis may or may not require drug therapy venous thromboembolism usually will require therapy with a low-molecular-weight heparin and compression stockings. 

Other relative contraindications should be considered on an individual basis, including migraine headaches, hypertension, diabetes mellitus, obstructive jaundice of pregnancy or prior oral contraceptive use, and gallbladder disease. If elective surgery is planned, many physicians discontinue oral contraceptives for several weeks to minimize the possibility of thromboembolism. These agents should be used with care in women with prior gestational diabetes or uterine fibroids low-dose pills are preferred in such cases. 

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