Perinatal complications following gestational diabetes mellitus how ‘sweet’ is ill?

1996 ◽  
Vol 75 (9) ◽  
pp. 809-815 ◽  
Author(s):  
Moshe Hod ◽  
David Rabinerson ◽  
Bari Kaplan ◽  
Yoav Peled ◽  
Jacob Bar ◽  
...  
2017 ◽  
Vol 66 (5) ◽  
pp. 27-36
Author(s):  
Elena S. Akhmetova

Currently, the reduction of perinatal morbidity and mortality is a key challenge of maternity care in the world. An important role in the structure of perinatal pathology plays a gestational diabetes mellitus (GDM). High incidence of gestational diabetes mellitus (1-14%) and the associated perinatal mortality have not only medical but also social value. The aim of the study was to study the pathophysiological processes that occur in the body of the pregnant woman with GDM and lead to obstetric and perinatal complications, and possible genetic markers that increase execution risks of impaired glucose metabolism in pregnancy at the present stage of scientific development. Materials: literature data of domestic and foreign studies over the period 2006 to 2016. Methods: synthesis of literature data. Conclusion. It is necessary to identify the major genetic predictors of the development of gestational diabetes, with the aim of its prediction and timely prevention of obstetric and perinatal complications.


2019 ◽  
Vol 9 (2) ◽  
pp. 127-132
Author(s):  
Faryal Mustary ◽  
TA Chowdhury ◽  
Ferdousi Begum ◽  
Nusrat Mahjabeen

Background: Diabetes mellitus is the most frequently encountered endocrine disorder in pregnancy and is associated with adverse outcomes if remain undiagnosed or untreated. This study was done to compare the maternal and perinatal outcome of pregestational diabetes mellitus (PGDM) with that of gestational diabetes (GDM). Methods: This observational analytical study with group comparison was carried out in the Department of Obstetrics and Gynaecology, BIRDEM General Hospital, Dhaka from July 2015 to June 2016. This study was conducted on two groups of pregnant women: group A (PGDM) and group B (GDM). A total of 100 cases were selected and in each group 50 pregnant women were enrolled. Singleton pregnancy and age 18 to 45 years were included. Pregnancy with hypertension, heart disease, renal disease and other metabolic disorders were excluded. Results: In this study mean gestational age of the study subjects were 35.72 ± 2.61 weeks and 36.58 ± 2.34 weeks in PGDM and GDM groups. History of GDM [34.0% vs 16.0%], intrauterine death (IUD) [14.0% vs 2.0%] and abortion [22.0% vas 6.0%] were significantly higher among PGDM patients than GDM patients. Regarding present pregnancy complications, polyhydramnios [32.0% vs 14.0%], preterm delivery [38.0% vs 20.0%], vulvovaginitis [28.0% vs 12.0%] and premature rupture of membrane (PROM) [24.0% vs 8.0%] were significantly higher in PGDM than GDM patients. Wound infection was significantly high in PGDM groups [35.7% vs 11.1%] among the patients delivered by lower uterine Cesarean section (LUCS). Regarding perinatal complications, hypoglycemia [22.0% vs 8.0%], birth asphyxia [24.0% vs 8.0%], RDS [24.0% vs 8.0%] were significantly higher among PGDM comparing GDM patients. Conclusion: The maternal and perinatal outcomes of pregestational diabetes mellitus were less favorable than those of gestational diabetes mellitus. Birdem Med J 2019; 9(2): 127-132


2013 ◽  
Vol 305 (11) ◽  
pp. E1327-E1338 ◽  
Author(s):  
Raymond C. Pasek ◽  
Maureen Gannon

The maintenance of glucose homeostasis during pregnancy is critical to the health and well-being of both the mother and the developing fetus. Strikingly, approximately 7% of human pregnancies are characterized by insufficient insulin production or signaling, resulting in gestational diabetes mellitus (GDM). In addition to the acute health concerns of hyperglycemia, women diagnosed with GDM during pregnancy have an increased incidence of complications during pregnancy as well as an increased risk of developing type 2 diabetes (T2D) later in life. Furthermore, children born to mothers diagnosed with GDM have increased incidence of perinatal complications, including hypoglycemia, respiratory distress syndrome, and macrosomia, as well as an increased risk of being obese or developing T2D as adults. No single environmental or genetic factor is solely responsible for the disease; instead, a variety of risk factors, including weight, ethnicity, genetics, and family history, contribute to the likelihood of developing GDM, making the generation of animal models that fully recapitulate the disease difficult. Here, we discuss and critique the various animal models that have been generated to better understand the etiology of diabetes during pregnancy and its physiological impacts on both the mother and the fetus. Strategies utilized are diverse in nature and include the use of surgical manipulation, pharmacological treatment, nutritional manipulation, and genetic approaches in a variety of animal models. Continued development of animal models of GDM is essential for understanding the consequences of this disease as well as providing insights into potential treatments and preventative measures.


Diabetes ◽  
1991 ◽  
Vol 40 (Supplement_2) ◽  
pp. 74-78 ◽  
Author(s):  
M. Hod ◽  
P. Merlob ◽  
S. Friedman ◽  
A. Schoenfeld ◽  
J. Ovadia

2021 ◽  
pp. 1-13
Author(s):  
Xian Wang ◽  
Wanting Liu ◽  
Huizhen Chen ◽  
Qiu Chen

<b><i>Aim:</i></b> This systematic and meta-analysis was conducted to evaluate the efficacy and safety of insulin, metformin, and glyburide on perinatal complications for gestational diabetes mellitus (GDM). <b><i>Methods:</i></b> Medline (PubMed), EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials [CENTRAL], and Cochrane Methodology Register), Web of Science (Science and Social Science Citation Index), and ClinicalTrials (Clinicaltrials.gov) were searched, as well as manual searching. We included randomized controlled trials comparing efficacy and safety of metformin versus glyburide, metformin versus insulin, and glyburide versus insulin in patients with GDM. <b><i>Results:</i></b> We included 32 articles including 5,964 patients published from inception to July 2020. Compared with insulin, metformin was more effective at lower incidence of macrosomia (RR: 0.66, 95% CI: 0.50–0.88, <i>p</i> = 0.005), lower incidence of neonatal intensive care unit admission (RR: 0.78, 95% CI: 0.67–0.91, <i>p</i> = 0.002), less neonatal hypoglycemia (RR: 0.67, 95% CI: 0.56–0.80, <i>p</i> &#x3c; 0.0001), decreased birth weight (BW) (SMD: −0.37, 95% CI: −0.62 to −0.12, <i>p</i> = 0.004), lower incidence of large for gestational age (RR: 0.76, 95% CI: 0.50–0.90, <i>p</i> = 0.002), shorter gestation age at delivery (MD: −0.22, 95% CI: −0.34 to −0.10, <i>p</i> = 0.0002), lower maternal weight gain (MD: −1.41, 95% CI: −2.28 to −0.55, <i>p</i> = 0.001), less incidence of caesarean section delivery (RR: 0.86, 95% CI: 0.78–0.95, <i>p</i> = 0.0004), lower maternal postprandial blood glucose (SMD: −0.41, 95% CI: −0.72 to −0.11, <i>p</i> = 0.008), and lower incidence of pregnancy-induced hypertension (RR: 0.47, 95% CI: 0.27–0.83, <i>p</i> = 0.01). However, glyburide, compared with insulin, was associated with higher BW (MD: 54.95, 95% CI: 3.87–106.03, <i>p</i> = 0.03) and increased the incidence of neonatal hypoglycemia (RR: 1.52, 95% CI: 1.12–2.07, <i>p</i> = 0.007). Meanwhile, compared to glyburide, metformin was associated with higher maternal fasting blood glucose (SMD: 0.20, 95% CI: 0.05–0.36, <i>p</i> = 0.01) and lower incidence of induction of labor (RR: 0.76, 95% CI: 0.59–0.97, <i>p</i> = 0.03). <b><i>Conclusions:</i></b> This review suggests that metformin can decrease the incidence of perinatal complications, and it should be considered as a generally safe alternative to insulin.


ISRN Obesity ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Akke Vellinga ◽  
A. Zawiejska ◽  
J. Harreiter ◽  
B. Buckley ◽  
G. Di Cianni ◽  
...  

Objective. Assess the impact of Gestational Diabetes Mellitus (GDM) and obesity on neonatal and maternal pregnancy outcomes. Methods. Cross-sectional data (3343 pregnancies) from seven European centres were included in a multilevel analysis of the association between GDM/obesity and caesarean section, macrosomia and neonatal morbidities. Results. Comparison of databases identified reporting differences between countries due to the inclusion of true population based samples or pregnancies from specialised tertiary centres, resulting in higher prevalences of GDM for some countries. The analysis showed that obesity and GDM were independent risk factors of perinatal complications. Only BMI had a dose-dependent effect on the risk of macrosomia and caesarean section. Both obesity (BMI > 30 kg/m2) and GDM were independent risk factors of neonatal morbidities. Conclusions. Obesity and GDM were independent risk factors of perinatal complications. The effect of the worldwide obesity and diabetes epidemic is extending to the next generation.


Author(s):  
Abhishek Kumar Sinha ◽  
Madhu B. ◽  
Narayana Murthy M. R.

Background: Gestational diabetes mellitus is defined as carbohydrate intolerance with onset/recognition during pregnancy where maternal and perinatal complications are increased. Aged care facilities in rural areas reports disparity in the management of gestational diabetes as compared with urban counter parts. As a need to address this, study conducted with objective to estimate prevalence of gestational diabetes mellitus within 16 weeks of gestation for GDM by oral glucose challenges test.Methods: Antenatal mothers attending primary health centers within 16 weeks of gestation were screened for GDM. Two hours, venous samples were calculated for estimation of blood glucose level. Plasma glucose level of >140mg/dl was considered as OGTT positive.Results: Among 301 patients examined 11 mothers had OGTT positive results. GDM was seen in 3.7% of Mothers. GDM is found significantly associated with increasing age (p=0.01, t=2.52, mean difference 2.54 CI 0.5-4.5), weight (p=0.04, t=2.24, mean difference 10.8 CI 0.11-21.5), and BMI (p<0.01, t=2.97, mean difference 3.6 CI 1.2-6). GDM was seen more in multigravida (P=0.01). Statistically significant association of GDM was found with mean systolic (p<0.01, t=2.62, mean difference 8.08 CI 2.01-14.14) and diastolic blood pressure (P<0.01, t=3.44, mean difference 7.87 CI 3.38-12.36). A multiple regression shows these variables statistically significantly predicted GDM, F (5, 295)= 7, p<0.001, R2=0.106.Conclusions: GDM is statistically associated with increasing age, increasing weight, BMI and multiple gravida in pregnancy. It is recommended to screen for GDM within the 1st trimester & follow up needed to prevent further complications.


2021 ◽  
Vol 17 (37) ◽  
pp. 48-56
Author(s):  
Yuli Puspita DEVI ◽  
Rumaisah ABDILLAH ◽  
Muthmainnah MUTHMAINNAH

Background: Gestational Diabetes Mellitus (GDM) is a glucose tolerance disorder that first appears during pregnancy. GDM can cause a variety of obstetric and perinatal complications for pregnant women and their fetuses. The prevalence of GDM in the city of Surabaya in 2015 amounted to 2.29%, increasing to 3.88% in 2018. Aim: The purpose of this study was to analyze the determinants (family history of diabetes mellitus, BMI, history of birth weight, parity, and the age of the pregnant woman) that influence the GDM. Methods: This research is an analytical study with an observational approach. The research design was carried out using a case-control study. In this study, the number of samples was 36 people, 6 cases, and 30 people as controls, and were taken randomly. The data source obtained from secondary data (medical records of pregnant women) at Mulyorejo Health Center Surabaya. The analysis used in this study was a simple logistic regression test. Results and Discussion: The result showed an effect of a family history of diabetes mellitus (p = 0.035) on the incidence of GDM. Parity was a potential variable (p = 0.077) on the incidence of GDM. Meanwhile, BMI, history of birth weight, and mother's age did not affect the incidence of GDM. Conclusion: Pregnant women with a family history of diabetes who are not balanced with maintaining a good lifestyle can experience complications of developing GDM.


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