scholarly journals Pharmacotherapy of Gestational Diabetes Mellitus: Current Recommendations

2021 ◽  
Author(s):  
Miroslav Radenković ◽  
Ana Jakovljević
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pathological Condition ◽  
Symptom Relief ◽  
Glucose Monitoring ◽  
Lifestyle Changes ◽  
Moderate Physical Activity ◽  
Adverse Pregnancy ◽  
Oral Hypoglycemic Drugs

The incidence of gestational diabetes mellitus (GDM) is still rising, and this pathological condition is strongly associated with some serious adverse pregnancy outcomes. Therefore, GDM must be timely recognized and adequately managed. Treatment of GDM is aimed to maintain normal glycemia and it should involve regular glucose monitoring, dietary modification, lifestyle changes, moderate physical activity, and pharmacotherapy, when necessary. As for the pharmacotherapy, needed in approximately one-third of GDM women, insulin administration is the first choice of pharmacological treatment, although oral hypoglycemic drugs, for example, metformin (a biguanide agent) or glyburide (a second-generation sulfonylurea drug), could be indicated, too. Metformin is considered as a reasonable and safe first-line alternative to insulin. If comparing two oral agents, metformin seems to be safer than glyburide, since glyburide was found to be linked to neonatal hypoglycemia and higher birth weight, which can for example increase the hazard for shoulder dystocia and a necessity for Cesarean delivery. Finally, it should be underlined that many pregnant women turn to complementary and alternative medicine for health maintenance or symptom relief, including traditional herbal medicine and the use of supplements. Given the previous facts, this chapter will address current pharmacotherapy options and challenges related to GDM treatment.

A lifestyle intervention of weight-gain restriction: diet and exercise in obese women with gestational diabetes mellitus

2007 ◽  
Vol 32 (3) ◽  
pp. 596-601 ◽  
Author(s):  
Raul Artal ◽  
Rosemary B. Catanzaro ◽  
Jeffrey A. Gavard ◽  
Dorothea J. Mostello ◽  
Joann C. Friganza
Keyword(s):  
Diabetes Mellitus ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Lifestyle Changes ◽  
Obese Women ◽  
Office Visits ◽  
Maternal Weight ◽  
Obese Subjects ◽  
Adverse Pregnancy

Objective: This study assessed whether a weight-gain restriction regimen, with or without exercise, would impact glycemic control, pregnancy outcome, and total pregnancy weight gain in obese subjects with gestational diabetes mellitus (GDM). A total of 96 subjects with GDM met the inclusion criteria and were sequentially recruited, with 39 subjects self-enrolled in the exercise and diet (ED) group, and the remaining 57 subjects self-enrolled in the diet (D) group owing to contraindications or a lack of personal preference to exercise. All patients were provided a eucaloric or hypocaloric consistent carbohydrate meal plan and instructed in the self-monitoring of blood glucose. In addition, all ED subjects were prescribed an exercise routine equivalent to a 60% symptom-limited VO2 max. Subjects were followed at weekly or biweekly office visits. Results showed maternal weight and body mass index (35.2 ± 7.2 (ED) vs. 33.5 ± 9.2 (D)) at study entry as well as number of weeks into the study (7.7 ± 5.7 (ED) vs. 9.4 ± 4.7 (D)) were similar in both the ED and D groups. Weight gain per week was significantly lower in the ED group than in the D group (0.1 ± 0.4 kg vs. 0.3 ± 0.4 kg; p < 0.05). Subjects (either ED or D) who gained weight had a higher percentage of macrosomic infants than those subjects who lost weight or had no weight change during pregnancy. Other pregnancy and fetal outcomes such as complications, gestational age at delivery, and rate of cesarean delivery were similar in both groups. Conclusions of this study were that caloric restriction and exercise result in limited weight gain in obese subjects with GDM, less macrosomic neonates, and no adverse pregnancy outcomes. Pregnancy is an ideal time for behaviour modification, and this intervention may also help promote long-term healthy lifestyle changes.

Continuous glucose monitoring system in patients with gestational diabetes mellitus: a prospective study

2017 ◽  
Author(s):  
Rosa Marquez-Pardo ◽  
Isabel Torres-Barea ◽  
Mgloria Baena-Nieto ◽  
Concepcion Cruzado-Begines ◽  
Manuel Cayon-Blanco ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Prospective Study ◽  
Monitoring System ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Continuous Glucose Monitoring System ◽  
A Prospective Study

Association of First-Trimester Fasting Plasma Glucose with Gestational Diabetes Mellitus and Adverse Pregnancy Outcomes

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1448-P
Author(s):  
PING LI ◽  
SHUO LIN ◽  
LING LI ◽  
JINHUI CUI ◽  
JIANHUI FAN
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Adverse Pregnancy Outcomes ◽  
Fasting Plasma ◽  
Adverse Pregnancy

1382-P: Does Tight Gestational Diabetes Mellitus Control Have an Impact on the Maternal and Neonatal Outcome Compared with General Populations? Which Factors Predict the Adverse Pregnancy Outcomes?

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1382-P
Author(s):  
PETROS THOMAKOS ◽  
OLGA KEPAPTSOGLOU ◽  
CAROL BARRETO ◽  
ANASTASIA TROUVA ◽  
DIMITRIS TROUVAS ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnancy Outcomes ◽  
Neonatal Outcome ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Pregnancy ◽  
General Populations

scholarly journals Recent Advances in Gestational Diabetes Mellitus

2021 ◽  
Vol 10 (10) ◽  
pp. 2202
Author(s):  
Katrien Benhalima
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Clinical Medicine ◽  
Metabolic Risk ◽  
Special Issue ◽  
Recent Advances ◽  
Adverse Pregnancy ◽  
New Biomarkers

The incidence of gestational diabetes mellitus (GDM) and overt diabetes in pregnancy is rising globally. GDM leads to increased risks for maternal and neonatal adverse pregnancy outcomes. In addition, GDM is also associated with an increased long-term metabolic risk in mothers and offspring [1]. Although much is known about GDM, evidence gaps persist. For instance, more research is needed on how to prevent GDM, on whether screening and treatment of GDM in early pregnancy are beneficial, on non-fasting biomarkers to screen for GDM, on new biomarkers to predict pregnancy complications, and on how to reduce the long-term metabolic risk in mothers and infants after delivery. To address this important health issue, the present Special Issue in the Journal of Clinical Medicine was dedicated to recent advances in the field of GDM. This Special Issue published 16 articles on this topic. [...]

scholarly journals Gestational Diabetes Mellitus in Southeast Asia: A Scoping Review

2021 ◽  
Vol 18 (3) ◽  
pp. 1272
Author(s):  
Thubasni Kunasegaran ◽  
Vinod R. M. T. Balasubramaniam ◽  
Valliammai Jayanthi Thirunavuk Arasoo ◽  
Uma Devi Palanisamy ◽  
Amutha Ramadas
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Southeast Asia ◽  
Scoping Review ◽  
Economic Status ◽  
Lifestyle Changes ◽  
Population Characteristics ◽  
Research Trend ◽  
Lifestyle Modifications

A rapid increase in the prevalence of gestational diabetes mellitus (GDM) has been associated with various factors such as urbanization, lifestyle changes, adverse hyperglycemic intrauterine environment, and the resulting epigenetic changes. Despite this, the burden of GDM has not been well-assessed in Southeast Asia. We comprehensively reviewed published Southeast Asian studies to identify the current research trend in GDM in this region. Joanna Briggs Institute’s methodology was used to guide the scoping review. The synthesis of literature findings demonstrates almost comparable clinical evidence in terms of risk factors and complications, challenges presented in diagnosing GDM, and its disease management, given the similarities of the underlying population characteristics in Southeast Asia. Evidence suggests that a large proportion of GDM risk in women may be preventable by lifestyle modifications. However, the GDM burden across countries is expected to rise, given the heterogeneity in screening approaches and diagnostic criteria, mainly influenced by economic status. There is an urgent need for concerted efforts by government and nongovernmental sectors to implement national programs to prevent, manage, and monitor the disease.

Gestational diabetes mellitus: Beliefs, emotions and treatment compliance: A Pakistani Cohort.

2021 ◽  
Vol 28 (03) ◽  
pp. 361-365
Author(s):  
Maryam Zulfiqar ◽  
Muhammad Imran Hasan Khan ◽  
Salman Shakeel ◽  
Usama Azhar
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Mode Of Delivery ◽  
Treatment Compliance ◽  
Subsequent Pregnancy ◽  
Medical Institute ◽  
Lifestyle Modifications ◽  
Diabetes Clinic ◽  
Adverse Pregnancy

To find out the factors regarding patient’s beliefs and concerns about Gestational Diabetes and its treatment. Study Design: Purposive Sampling. Setting: Diabetes Clinic & Antenatal Clinic of Lahore General Hospital/ Post Graduate Medical Institute/ Ameer ud Din Medical College, Lahore. Period: July 2019 to December 2019. Material & Methods: 46 females who were 24-38 weeks pregnant and having gestational diabetes mellitus, type1 diabetes mellitus or having type 2 diabetes mellitus first diagnosed during pregnancy were enrolled. Data was collected by an interview based questionnaire, analyzed using SPSS version 23, and 95% confidence interval was used as test of significance. Results: The mean age was 27±9 years. 20% of the participants were Illiterate 80% were literate. GDM in the all three trimesters was 45.6%, 39% and15% respectively.  30.5% were hypertensive and 100% adopted lifestyle modifications, 89% were using insulin and 10.8% were taking metformin. 33% had history of instruments delivery and 36% had adverse pregnancy or perinatal outcomes. Regarding patients belief’s, 10% believed in diet control, 26% were not comfortable with lab and physician’s counselling, 38% were in state of denial, 26% were unaware of screening, 70% were frightened of unexpected diagnosis and consequences. 18% were concerned of target organs damage, 16% were concerned of mode of delivery, 25% regarding subsequent pregnancy, 53% were concerned about insulin treatment and its duration and 33% were keen to know about adverse pregnancy outcomes. Conclusions: Educational status is not known to influence gestational diabetes mellitus, Major concern of patient with GDM was her health and surroundings, treatment options, adverse effect on baby and subsequent pregnancies outcomes.

scholarly journals Uric Acid and Xanthine Levels in Pregnancy Complicated by Gestational Diabetes Mellitus—The Effect on Adverse Pregnancy Outcomes

2018 ◽  
Vol 19 (11) ◽  
pp. 3696 ◽  
Author(s):  
Anna Pleskacova ◽  
Vendula Bartakova ◽  
Katarina Chalasova ◽  
Lukas Pacal ◽  
Katerina Kankova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Uric Acid ◽  
High Risk ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Perinatal Outcomes ◽  
Anthropometric Parameters ◽  
Pregnancy And Postpartum ◽  
Adverse Perinatal Outcomes ◽  
Adverse Pregnancy

Uric acid (UA) levels are associated with many diseases including those related to lifestyle. The aim of this study was to evaluate the influence of clinical and anthropometric parameters on UA and xanthine (X) levels during pregnancy and postpartum in women with physiological pregnancy and pregnancy complicated by gestational diabetes mellitus (GDM), and to evaluate their impact on adverse perinatal outcomes. A total of 143 participants were included. Analyte levels were determined by HPLC with ultraviolet detection (HPLC-UV). Several single-nucleotide polymorphisms (SNPs) in UA transporters were genotyped using commercial assays. UA levels were higher within GDM women with pre-gestational obesity, those in high-risk groups, and those who required insulin during pregnancy. X levels were higher in the GDM group during pregnancy and also postpartum. Positive correlations between UA and X levels with body mass index (BMI) and glycemia levels were found. Gestational age at delivery was negatively correlated with UA and X levels postpartum. Postpartum X levels were significantly higher in women who underwent caesarean sections. Our data support a possible link between increased UA levels and a high-risk GDM subtype. UA levels were higher among women whose glucose tolerance was severely disturbed. Mid-gestational UA and X levels were not linked to adverse perinatal outcomes.

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