Diabetes in Pregnancy: Long-Term Complications of Offsprings

2019 ◽  
pp. 201-222
Author(s):  
Louise Kelstrup ◽  
Birgitte Bytoft ◽  
Line Hjort ◽  
Azadeh Houshmand-Oeregaard ◽  
Elisabeth R. Mathiesen ◽  
...  
Author(s):  
Louise Kelstrup ◽  
Tine Dalgaard Clausen ◽  
Azadeh Houshmand-Oeregaard ◽  
Elisabeth R. Mathiesen ◽  
Peter Damm

2008 ◽  
Vol 19 (3) ◽  
pp. 245-269 ◽  
Author(s):  
RINAT GABBAY BEN-ZIV ◽  
MOSHE HOD

Gestational diabetes (GDM) is defined as “carbohydrate intolerance of variable severity with onset or first recognition during pregnancy.” The definition is applicable regardless of whether insulin is used for treatment or the condition persists after pregnancy. It does not exclude the possibility that unrecognized glucose intolerance may have antedated the pregnancy”. GDM complicates 3–15% of all pregnancies and is a major cause of perinatal morbidity and mortality, as well as maternal long term morbidity. Of all types of diabetes, gestational diabetes (GDM) accounts for approximately 90–95% of all cases of diabetes in pregnancy.


2018 ◽  
Vol 4 (2) ◽  
pp. 145-149
Author(s):  
Sharmin Jahan ◽  
MA Hasanat

Hyperglycemia is the most common endocrine disorder of pregnancy. As compared to Diabetes in pregnancy(DIP) the management of gestational DM(GDM) has always been a topic of controversy. Medical nutrition therapy(MNT) is the cornerstone of GDM management. 80-90% of GDM mothers can be treated by MNT alone and the rest will require drugs. Considerable controversy surrounds the use of oral anti-diabetic medications in pregnancy. The most widely studied drugs are glyburide and metformin. Conflicting results have been produced by different studies. However recent meta-analyses have shown that they can be an attractive alternative to insulin if long term safety data become available. Till then it might be too early to make a final comment on their use in GDM.Journal of National Institute of Neurosciences Bangladesh, 2018;4(2): 145-149


2011 ◽  
Vol 2011 ◽  
pp. 1-12 ◽  
Author(s):  
Akadiri Yessoufou ◽  
Kabirou Moutairou

The adverse outcomes on the offspring from maternal diabetes in pregnancy are substantially documented. In this paper, we report main knowledge on impacts of maternal diabetes on early and long-term health of the offspring, with specific comments on maternal obesity. The main adverse outcome on progenies from pregnancy complicated with maternal diabetes appears to be macrosomia, as it is commonly known that intrauterine exposure to hyperglycemia increases the risk and programs the offspring to develop diabetes and/or obesity at adulthood. This “fetal programming”, due to intrauterine diabetic milieu, is termed as “metabolic memory”. In gestational diabetes as well as in macrosomia, the complications include metabolic abnormalities, degraded antioxidant status, disrupted immune system and potential metabolic syndrome in adult offspring. Furthermore, there is evidence that maternal obesity may also increase the risk of obesity and diabetes in offspring. However, women with GDM possibly exhibit greater macrosomia than obese women. Obesity and diabetes in pregnancy have independent and additive effects on obstetric complications, and both require proper management. Management of gestational diabetes mellitus and maternal obesity is essential for maternal and offspring's good health. Increasing physical activity, preventing gestational weight gain, and having some qualitative nutritional habits may be beneficial during both the pregnancy and offspring's future life.


2010 ◽  
Vol 2 (1) ◽  
pp. 1-5
Author(s):  
Neeta Deshpande

ABSTRACT Gestational diabetes mellitus is carbohydrate intolerance with onset or first recognition during pregnancy. Pregnancy could also occur in a woman with pre-existing diabetes. Congenital anomalies, macrosomia, birth injuries, obstetric and neonatal complications are associated with diabetes in pregnancy. The long-term implications in both mother and offspring include the development of obesity, metabolic syndrome and diabetes. Screening would identify patients and many guidelines exist for the same. Universal screening is advocated. The glycemic goals are stringent, although data indicate that thresholds should be lowered further. Nutritional therapy is the mainstay of treatment. Insulin is the agent of choice if glycemic goals are not met. Newer insulin analogs are advantageous. Oral antidiabetic agents show promise for the future, although more long-term trials are needed. Self monitoring of glucose is an important tool in the management of diabetes in pregnancy. Rates of cesarean section are high in diabetic pregnancies. If macrosomia occurs, other obstetric complications ensue. Maternal hyperglycemia can lead to neonatal hypoglycemia. Postpartum, maternal glycemic status should be reassessed and treatment modified accordingly. In the long-term, both mother and offspring are ideal candidates for lifestyle modification for the prevention of type 2 diabetes. Preconception care in women with pre-existing diabetes and/or its complications is desirable to minimize complications and congenital anomalies.


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