scholarly journals Gestational diabetes and its implication for the future development of type 2 diabetes and cardiovascular disease

2019 ◽  
Vol 22 (3) ◽  
pp. 133
Author(s):  
Lencioni, C.
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Cardiovascular Diseases ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Lifestyle Changes ◽  
Pharmacological Interventions ◽  
History Of

Gestational Diabetes Mellitus (GDM) is a very common complication of pregnancy. Although glucose tolerance returns to normal levels after delivery in the majority of women with GDM, this condition represents an early stage in the natural history of type 2 Diabetes Mellitus. Moreover, women with previous GDM exhibit an increased cardiovascular risk profile and a raised incidence of cardiovascular diseases. Lifestyle changes and pharmacological interventions might be able to reduce the incidence of type 2 diabetes in women with previous Gestational Diabetes, results are still not conclusive although encouraging. Pharmacological interventions are not yet recommended for prevention. Long term continuous program specifically addressed to women with previous GDM should be implemented, especially addressed to encourage them to regularly check glucose tolerance, lipid profile and other parameters related to cardiovascular diseases, aimed at improving women’s health. In this paper, we will review the relationship between type 2 diabetes, cardiovascular diseases and a history of GDM. KEY WORDS gestational diabetes; type 2 diabetes; cardiovascular disease.

scholarly journals Risk perception and unrecognized type 2 diabetes in women with previous gestational diabetes mellitus

2009 ◽  
Vol 2 (3) ◽  
pp. 107-110 ◽  
Author(s):  
Janine Malcolm ◽  
Margaret L Lawson ◽  
Isabelle Gaboury ◽  
Erin Keely
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Risk Perception ◽  
High Risk ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Fasting Glucose ◽  
Newly Diagnosed ◽  
History Of

Women with a history of gestational diabetes mellitus (GDM) have a high chance of developing type 2 diabetes mellitus (T2DM) following the index pregnancy, however, little is known of women's perception of this risk. The objectives were to (1) determine women's perception of risk of future development of T2DM following a GDM pregnancy and (2) describe the prevalence of undetected dysglycaemia in a Canadian population. The study was designed as a 9–11 year follow-up study of women previously enrolled in a randomized controlled trial of tight versus minimal intervention for GDM. Women's perception of future risk of diabetes was determined by questionnaire. Fasting lipid profile, height and weight were performed on all participants. Oral glucose tolerance tests were performed on all women without prior history of diabetes mellitus type 2 (DM2). The study was conducted at Ottawa Hospital General Campus and Children's Hospital of Eastern Ontario, in Ottawa, Canada. Eighty-nine of 299 (30%) of the original cohort were recruited. Eighty-eight women completed the questionnaire and 77 women without known diabetes underwent two hour glucose tolerance testing. Twenty-three (30%) felt their risk was no different than other women or did not know, 27 (35%) felt risk was increased a little and 27 (35%) felt risk was increased a lot. Only 52% (40/77) had normal glucose tolerance. Of all, 25/88 (28%) patients had diabetes (11 previously diagnosed and 14 diagnosed within the study). Of those newly diagnosed with DM2, four (29%) were diagnosed by fasting glucose, six (42%) by two hour glucose tolerance test (GTT) alone and four (29%) by both. Twenty-four of the women (27%) had impaired glucose tolerance (IGT). Of those with IGT, 12 (57%) had a fasting food glucose < 5.6 mmol/L. In the high-risk perception group with newly diagnosed diabetes, two were overweight, seven were obese, four had a family history of DM2, and all had a waist circumference >88 cm. In conclusion the perception of being at high risk for T2DM did not prevent women from having undetected T2DM. Many factors are likely to contribute to this, including the reliance on screening tests (i.e. fasting glucose) rather than a two hour GTT to detect diabetes. Further studies on effective public and health-care provider education and intervention are needed to identify this high-risk population.

Long-Term Metabolic Consequences in Patients with a History of Gestational Diabetes

2020 ◽  
Vol 26 (43) ◽  
pp. 5564-5572
Author(s):  
Eleni Kousta ◽  
Adamantia Kontogeorgi ◽  
Stephen Robinson ◽  
Desmond G. Johnston
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Increased Risk ◽  
Metabolic Complication ◽  
History Of

Gestational diabetes mellitus is a common metabolic complication of pregnancy. Universal guidelines on gestational diabetes have been impeded by the long-term controversies on its definition and screening strategies. The prevalence of gestational diabetes is rising all over the world, is significantly influenced by ethnicity and its rise is mainly attributed to increasing maternal obesity and age. Gestational diabetes mellitus has important long-term implications, including gestational diabetes recurrence, increased risk for developing type 2 diabetes, metabolic syndrome and cardiovascular disease for the mother. Gestational diabetes mellitus may be viewed as a chronic metabolic disorder that is identified in women during gestation and may provide a unique opportunity for the early identification and primary prevention of type 2 diabetes mellitus and cardiovascular disease in these women. In this mini-review, the evolution of screening tests for gestational diabetes and guidelines are briefly described and metabolic and cardiovascular long-term consequences of women with a history of gestational diabetes are summarized. A summary of our own St. Mary’s Hospital-UK Research series on long-term metabolic consequences of 368 women with a history of gestational diabetes of 3 different ethnic groups and 482 control women is also included. We found that approximately 2 years following delivery, 37% of women with a history of gestational diabetes had abnormal glucose concentrations, but, most importantly, even those who were normoglycaemic, postpartum displayed metabolic abnormalities on detailed testing. Future research needs to focus on the prevention of gestational diabetes long-term complications, but also in identification of pre-pregnancy predictors and risk reduction before conception.

scholarly journals Lactation Duration and Long-term Risk for Incident Type 2 Diabetes in Women With a History of Gestational Diabetes Mellitus

Diabetes Care ◽  
2020 ◽  
Vol 43 (4) ◽  
pp. 793-798 ◽  
Author(s):  
Sylvia H. Ley ◽  
Jorge E. Chavarro ◽  
Mengying Li ◽  
Wei Bao ◽  
Stefanie N. Hinkle ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Incident Type ◽  
Incident Type 2 Diabetes ◽  
History Of ◽  
Lactation Duration

scholarly journals The Pathophysiology of Gestational Diabetes Mellitus

2018 ◽  
Vol 19 (11) ◽  
pp. 3342 ◽  
Author(s):  
Jasmine Plows ◽  
Joanna Stanley ◽  
Philip Baker ◽  
Clare Reynolds ◽  
Mark Vickers
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Molecular Mechanisms ◽  
Overweight And Obesity ◽  
Chronic Hyperglycemia ◽  
Increased Risk

Gestational diabetes mellitus (GDM) is a serious pregnancy complication, in which women without previously diagnosed diabetes develop chronic hyperglycemia during gestation. In most cases, this hyperglycemia is the result of impaired glucose tolerance due to pancreatic β-cell dysfunction on a background of chronic insulin resistance. Risk factors for GDM include overweight and obesity, advanced maternal age, and a family history or any form of diabetes. Consequences of GDM include increased risk of maternal cardiovascular disease and type 2 diabetes and macrosomia and birth complications in the infant. There is also a longer-term risk of obesity, type 2 diabetes, and cardiovascular disease in the child. GDM affects approximately 16.5% of pregnancies worldwide, and this number is set to increase with the escalating obesity epidemic. While several management strategies exist—including insulin and lifestyle interventions—there is not yet a cure or an efficacious prevention strategy. One reason for this is that the molecular mechanisms underlying GDM are poorly defined. This review discusses what is known about the pathophysiology of GDM, and where there are gaps in the literature that warrant further exploration.

scholarly journals Weight Gain and Progression to Type 2 Diabetes in Women With a History of Gestational Diabetes Mellitus

2015 ◽  
Vol 100 (9) ◽  
pp. 3548-3555 ◽  
Author(s):  
Joon Ho Moon ◽  
Soo Heon Kwak ◽  
Hye Seung Jung ◽  
Sung Hee Choi ◽  
Soo Lim ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
History Of

scholarly journals Circulating progranulin levels in women with gestational diabetes mellitus and healthy controls during and after pregnancy

2012 ◽  
Vol 167 (4) ◽  
pp. 561-567 ◽  
Author(s):  
Jelena Todoric ◽  
Ammon Handisurya ◽  
Thomas Perkmann ◽  
Bernhard Knapp ◽  
Oswald Wagner ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Post Partum ◽  
Oral Glucose ◽  
Positive Correlation

ObjectiveProgranulin (PGRN) was recently introduced as a novel marker of chronic inflammatory response in obesity and type 2 diabetes capable of directly affecting the insulin signaling pathway. This study aimed to investigate the role of PGRN in gestational diabetes mellitus (GDM), which is regarded as a model for early type 2 diabetes.MethodsPGRN serum levels were measured in 90 pregnant women (45 GDM and 45 normal glucose tolerance (NGT)). In addition, PGRN was measured during a 2-h, 75 g oral glucose tolerance test in 20 pregnant women (ten GDM and ten NGT) and in 16 of them post partum (ten GDM and six NGT).ResultsPGRN concentrations were significantly higher in pregnant women compared with post partum levels (536.79±31.81 vs 241.53±8.86, P<0.001). Multivariate regression analyses showed a strong positive correlation of PGRN with estrogen and progesterone. The insulinogenic index, a marker of early insulin secretion, displayed a positive correlation with PGRN, both during and after pregnancy (R=0.47, P=0.034; R=0.63, P=0.012). HbA1c and the oral glucose insulin sensitivity index showed significant post partum associations with PGRN (R=0.43, P=0.049; R=−0.65, P=0.009).ConclusionsPGRN concentrations are markedly lower after pregnancy regardless of the gestational glucose tolerance state. PGRN levels per se do not discriminate between mild GDM and NGT in pregnant women. Therefore, the development of GDM appears to be due to impaired β-cell function that is not related to PGRN effect.

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