Gestational Diabetes and Its Impact on the Neonate

Gestational diabetes mellitus is a relatively common medical condition that was described as early as the nineteenth century. This article discusses the maternal and fetal pathophysiology and the impact of the maternal condition on the neonate. Fetal macrosomia and infant respiratory distress syndrome, cardiomyopathy, hypoglycemia, hypocalcemia, hypomagnesemia, polycythemia, and hyperviscosity all can occur as a result of maternal hyperglycemia and are discussed in detail. Therapeutic approaches and treatment options for the mother, manifestations and diagnosis of the infant, and current research related to this condition are also included.

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Orthopedic Aspects of the Diabetic Foot

Current Pharmaceutical Design ◽

10.2174/1381612824666180328120347 ◽

2018 ◽

Vol 24 (12) ◽

pp. 1255-1269 ◽

Cited By ~ 1

Author(s):

Elvira J.A. Tijdens-Creusen ◽

Paul C. Jutte ◽

Wim M.H.H. Schoumakers ◽

Melanie M. Van der Klauw ◽

Marjan Wouthuyzen-Bakker

Keyword(s):

Diabetes Mellitus ◽

Diabetic Foot ◽

Medical Condition ◽

Treatment Options ◽

World Population ◽

Foot And Ankle ◽

Charcot Foot ◽

The World ◽

Common Medical Condition ◽

Foot Problems

Background: Diabetes Mellitus (DM) is a common medical condition affecting more than 6% of the world population. Besides well-known pathology like diabetic retinopathy and renal insufficiency, it carries important orthopedic implications, especially around the foot and ankle (diabetic foot). Focus: This article focusses on the three major areas confronting the orthopedist: 1) changes in foot statics and biology leading to ulceration with or without osteomyelitis, 2) ankle fractures, particularly complications after a fracture and 3) Charcot foot. Their pathophysiology, clinical features, classification, diagnostic dilemmas and treatment options are discussed. Conclusion: DM is very common and is often associated with foot problems. Diabetic foot is a special condition that needs special attention. This article aims to provide the necessary knowledge to a better understanding and treatment of the diabetic foot.

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What is known and what remains unresolved regarding gestational diabetes mellitus (GDM)

Journal of Perinatal Medicine ◽

10.1515/jpm-2020-0254 ◽

2020 ◽

Vol 48 (8) ◽

pp. 757-763

Author(s):

Katja Vince ◽

Pavo Perković ◽

Ratko Matijević

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Medical Condition ◽

Treatment Options ◽

Perinatal Outcomes ◽

Medical Community ◽

Public Health Issue ◽

Diagnostic Strategy ◽

Amount Of Knowledge

AbstractGestational diabetes mellitus (GDM) has become a major public health issue and one of the most discussed topics in contemporary obstetrics. Due to rising prevalence of GDM worldwide impact and importance of this medical condition in good quality antenatal care is growing. GDM is associated with serious adverse perinatal outcomes and unfavorable long-term health consequences for both, mother and her child. Despite a great amount of knowledge accumulated regarding GDM, medical community remains indecisive and still debates the most appropriate diagnostic strategy, screening policy, and treatment options for pregnancies complicated with GDM. These unresolved issues generate controversies, motivate further research and contribute to the growing interest surrounding GDM. In this review we will discuss and try to explain some of them.

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Gestational Diabetes Mellitus and Infant Adiposity at Birth: A Systematic Review and Meta-Analysis of Therapeutic Interventions

Journal of Clinical Medicine ◽

10.3390/jcm10040835 ◽

2021 ◽

Vol 10 (4) ◽

pp. 835

Author(s):

Manoja P. Herath ◽

Jeffrey M. Beckett ◽

Andrew P. Hills ◽

Nuala M. Byrne ◽

Kiran D. K. Ahuja

Keyword(s):

Diabetes Mellitus ◽

Adipose Tissue ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Fat Mass ◽

Metabolic Disorders ◽

Later Life ◽

Therapeutic Interventions ◽

Increased Risk ◽

The Impact

Exposure to untreated gestational diabetes mellitus (GDM) in utero increases the risk of obesity and type 2 diabetes in adulthood, and increased adiposity in GDM-exposed infants is suggested as a plausible mediator of this increased risk of later-life metabolic disorders. Evidence is equivocal regarding the impact of good glycaemic control in GDM mothers on infant adiposity at birth. We systematically reviewed studies reporting fat mass (FM), percent fat mass (%FM) and skinfold thicknesses (SFT) at birth in infants of mothers with GDM controlled with therapeutic interventions (IGDMtr). While treating GDM lowered FM in newborns compared to no treatment, there was no difference in FM and SFT according to the type of treatment (insulin, metformin, glyburide). IGDMtr had higher overall adiposity (mean difference, 95% confidence interval) measured with FM (68.46 g, 29.91 to 107.01) and %FM (1.98%, 0.54 to 3.42) but similar subcutaneous adiposity measured with SFT, compared to infants exposed to normal glucose tolerance (INGT). This suggests that IGDMtr may be characterised by excess fat accrual in internal adipose tissue. Given that intra-abdominal adiposity is a major risk factor for metabolic disorders, future studies should distinguish adipose tissue distribution of IGDMtr and INGT.

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Gestational Diabetes Mellitus Treatment Schemes Modify Maternal Plasma Cholesterol Levels Dependent to Women´s Weight: Possible Impact on Feto-Placental Vascular Function

Nutrients ◽

10.3390/nu12020506 ◽

2020 ◽

Vol 12 (2) ◽

pp. 506 ◽

Cited By ~ 1

Author(s):

Susana Contreras-Duarte ◽

Lorena Carvajal ◽

María Jesús Garchitorena ◽

Mario Subiabre ◽

Bárbara Fuenzalida ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Vascular Function ◽

Plasma Cholesterol ◽

Umbilical Vein ◽

Maternal Plasma ◽

Maternal Weight ◽

Cholesterol Levels ◽

The Impact

Gestational diabetes mellitus (GDM) associates with fetal endothelial dysfunction (ED), which occurs independently of adequate glycemic control. Scarce information exists about the impact of different GDM therapeutic schemes on maternal dyslipidemia and obesity and their contribution to the development of fetal-ED. The aim of this study was to evaluate the effect of GDM-treatments on lipid levels in nonobese (N) and obese (O) pregnant women and the effect of maternal cholesterol levels in GDM-associated ED in the umbilical vein (UV). O-GDM women treated with diet showed decreased total cholesterol (TC) and low-density lipoproteins (LDL) levels with respect to N-GDM ones. Moreover, O-GDM women treated with diet in addition to insulin showed higher TC and LDL levels than N-GDM women. The maximum relaxation to calcitonin gene-related peptide of the UV rings was lower in the N-GDM group compared to the N one, and increased maternal levels of TC were associated with even lower dilation in the N-GDM group. We conclude that GDM-treatments modulate the TC and LDL levels depending on maternal weight. Additionally, increased TC levels worsen the GDM-associated ED of UV rings. This study suggests that it could be relevant to consider a specific GDM-treatment according to weight in order to prevent fetal-ED, as well as to consider the possible effects of maternal lipids during pregnancy.

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Fetal Sex and Maternal Risk of Gestational Diabetes Mellitus: The Impact of Having a Boy

Diabetes Care ◽

10.2337/dc14-2551 ◽

2015 ◽

Vol 38 (5) ◽

pp. 844-851 ◽

Cited By ~ 59

Author(s):

Ravi Retnakaran ◽

Caroline K. Kramer ◽

Chang Ye ◽

Simone Kew ◽

Anthony J. Hanley ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Fetal Sex ◽

Maternal Risk ◽

The Impact

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Using Resistance Training in Women with Gestational Diabetes Mellitus to Improve Glucose Regulation

10.5772/intechopen.101076 ◽

2021 ◽

Author(s):

Brittany R. Allman ◽

Samantha McDonald ◽

Linda May ◽

Amber W. Kinsey ◽

Elisabet Børsheim

Keyword(s):

Diabetes Mellitus ◽

Resistance Training ◽

Glycemic Control ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Type Ii Diabetes Mellitus ◽

Glucose Regulation ◽

Pharmacological Treatments ◽

Short And Long Term ◽

The Impact

Gestational diabetes mellitus (GDM) poses a significant threat to the short- and long-term health of the mother and baby. Pharmacological treatments for GDM do not fully correct the underlying problem of the disease; however, non-pharmacological treatments such as exercise are increasingly recognized as foundational to glycemic management in other populations with disordered glucose regulation, such as non-gravid women with type II diabetes mellitus (T2DM). Much of the research regarding the impact of exercise on glycemic control in T2DM leverages aerobic training as the primary modality; yet research has demonstrated the effectiveness of resistance training on improving glycemic control in T2DM. This chapter will review the rationale for resistance training in the management of GDM using evidence from individuals with T2DM; then the chapter will review available studies on the effectiveness of resistance training on glucose control in women with GDM.

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Glucose levels during gestational diabetes pregnancy and the risk of developing postpartum diabetes or prediabetes

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04352-w ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Chadakarn Phaloprakarn ◽

Siriwan Tangjitgamol

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Glycemic Control ◽

Gestational Diabetes ◽

Confidence Interval ◽

Control Group ◽

Oral Glucose ◽

Glucose Levels ◽

Blood Glucose Levels ◽

The Impact

Abstract Background Blood glucose levels during pregnancy may reflect the severity of insulin secretory defects and/or insulin resistance during gestational diabetes mellitus (GDM) pregnancy. We hypothesized that suboptimal glycemic control in women with GDM could increase the risk of postpartum type 2 diabetes mellitus (T2DM) or prediabetes. Our objective was to evaluate the impact of plasma glucose levels throughout GDM pregnancy on the risk of postpartum T2DM or prediabetes. Methods The medical records of 706 women with GDM who underwent a postpartum 75-g, 2-hour oral glucose tolerance test at our institution between January 2011 and December 2018 were reviewed. These women were classified into 2 groups according to glycemic control during pregnancy: ≤ 1 occasion of either fasting glucose ≥ 95 mg/dL or 2-hour postprandial glucose ≥ 120 mg/dL was defined as optimal glycemic control or else was classified as suboptimal glycemic control. Rates of postpartum T2DM and prediabetes were compared between women with optimal (n = 505) and suboptimal (n = 201) glycemic control. Results The rates of postpartum T2DM and prediabetes were significantly higher in the suboptimal glycemic control group than in the optimal glycemic control group: 22.4% vs. 3.0%, P < 0.001 for T2DM and 45.3% vs. 23.5%, P < 0.001 for prediabetes. In a multivariate analysis, suboptimal glucose control during pregnancy was an independent risk factor for developing either postpartum T2DM or prediabetes. The adjusted odds ratios were 8.4 (95% confidence interval, 3.5–20.3) for T2DM and 3.9 (95% confidence interval, 2.5–6.1) for prediabetes. Conclusion Our findings suggest that blood glucose levels during GDM pregnancy have an impact on the risk of postpartum T2DM and prediabetes.

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Analysis on the Impact of the Blood Sugar Control Levels of Gestational Diabetes Mellitus on the Maternal and Infant Outcomes

Proceedings of the 2015 International Forum on Bioinformatics and Medical Engineering ◽

10.2991/bme-15.2015.24 ◽

2015 ◽

Author(s):

Xueying Yang ◽

Qun Li ◽

Ruxia Liu

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Blood Sugar ◽

Infant Outcomes ◽

The Impact ◽

Maternal And Infant Outcomes

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Risk factor for gestational diabetes mellitus and impact of gestational diabetes mellitus on maternal and fetal health during the antenatal period

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20213169 ◽

2021 ◽

Author(s):

Uma Jain ◽

Kusumlata Singhal ◽

Shikha Jain ◽

Deepali Jain

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Congenital Malformation ◽

Fetal Health ◽

Antenatal Period ◽

Study Results ◽

History Of ◽

The Impact

Background: Gestational diabetes mellitus (GDM) is defined as any degree of dysglycaemia that occurs for the first time or is first detected during pregnancy. The adverse effects of GDM on pregnant women are pre-eclampsia, PIH, PPH, polyhydramanios, PROM, meanwhile, there would be an increase in dystocia, birth injury, and cesarean sectionMethods: This retrospective study was conducted in a Gynecology clinic in District Shivpuri to find out the various risk factors for GDM and to evaluate the impact of GDM on maternal and fetal health during the antenatal period. 84 patients who were diagnosed with GDM were included in the study. Results: Among risk factors; BMI >25 kg/m2 before pregnancy was found in 15.47% of the case, family history of diabetes mellitus 8.33%, Previous history of macrosomia 17.85%, Poor reproductive history 17.85%, baby with congenital malformation 8.33%, H/o unexplained IUFD 11.90%. H/o polyhydramnios 15.47%. History of PCOS 13.09% and preeclampsia was found in 17.85% of cases. In antenatal complications; miscarriages was found in 15.47%. polyhydramnios in 17.85%. Oligohydramnios in 8.33%, preterm labor in 11.90%, PROM in 9.52%, pre-eclampsia in 17.85%, sudden IUFD in 8.33% and congenital malformation was found in 4.76% of cases. On USG; IUGR was found in 7.14% of cases. Large for date fetus in 16.66% of cases and the normal growth was found in 76.19% of cases.Conclusions- In conclusion appropriate and timely diagnosis and treatment of GDM will result in decreased maternal and neonatal adverse outcomes comparable to general population rates, therefore, early diagnosis is important.

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