The post-HAPO situation with gestational diabetes: the bright and dark sides

Lapolla, Annunziata; Metzger, Boyd E.

doi:10.1007/s00592-018-1146-7

Cited by 27 publications

(23 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The frequently recommended guideline is that of the International Association of Diabetes in Pregnancy Study Group (IADPSG) [8]. Presently, this guideline's importance is declining because of the comment that even at centers that accepted IADPSG recommendation, the approach varies and needs revision for standardization of the strategy for diagnosing GDM [9]. All the diagnostic criteria require women to be in fasting, but most of the time, pregnant women do not come in the fasting state because of commutation [10].…”

Section: Problems and Solutions For Screeningmentioning

confidence: 99%

Diagnosis and principles of management of gestational diabetes mellitus in the prevailing COVID-19 pandemic

Seshiah

Balaji

Banerjee

et al. 2020

Int J Diabetes Dev Ctries

View full text Add to dashboard Cite

Background Limited medical facilities are available due to Covid-19 pandemic. Nevertheless, all efforts should be made in planning judicial and possible methods of delivering health care, particularly to pregnant woman with GDM. GDM may play a crucial role in the increasing prevalence of diabetes and obesity and also may be the origin of cardiometabolic diseases. Methods It is mandatary to diagnose and care pregnant woman with GDM. The test suggested to diagnose GDM has to be evidence based and in this regard "a single test procedure" evaluated meets this requirement. This doable test has been accepted by the Diabetes in Pregnancy Study Group India (DIPSI) and approved by MHFW-GOI, WHO, International Diabetes Federation, and International Federation of Obstetricians and Gynecologists. MHFW-GOI also recommends testing at first antenatal visit and then at 24-28 weeks of gestation. This opportunity can also be utilized for performing ultrasonography for assessing fetal development. Result The first-line management is MNT and life style modifications. Non-responders may require insulin or OHA. The target glycemic control is FPG~5.0 mmol/dl (90 mg/dl) and 2 h PPPG~6.7 mmol/dl (120 mg/dl). The goal is to obtain newborns birth weight appropriate for gestational age between 2.5 and 3.5 kg, a step to prevent offspring developing diabetes. Conclusion The essential precaution required during COVID pandemic is to wear face mask, avoid crowded places, and maintain social distancing. Finally, the economical and evidence based "single test procedure" of DIPSI is most appropriate for screening during the COVID pandemic. Keywords Gestational diabetes mellitus (GDM). Medical nutrition therapy (MNT). Oral hypoglycemic agent (OHA). Postprandial plasma glucose(PPPG). Fasting plasma glucose (FPG). Ministry of Health and Family Welfare. Government of India (MHFW-GOI)

show abstract

Section: Problems and Solutions For Screeningmentioning

confidence: 99%

Diagnosis and principles of management of gestational diabetes mellitus in the prevailing COVID-19 pandemic

Seshiah

Balaji

Banerjee

et al. 2020

Int J Diabetes Dev Ctries

View full text Add to dashboard Cite

show abstract

“…Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance developing or first recognized during pregnancy that is not clearly overt diabetes (1). GDM affects from 5-6% to as many as 15-20% of pregnancies worldwide, and its prevalence is increasing due mainly to rising rates of obesity, sedentary lifestyles, and women becoming pregnant at an older age (2,3).…”

Section: Introductionmentioning

confidence: 99%

“…Even if GDM is currently the most common medical complication of pregnancy, no single diagnostic modality to screen and diagnose this condition is universally applied. In this context it is difficult to assess its real frequency and related complications (3,4).…”

Section: Introductionmentioning

confidence: 99%

Genetics and Epigenetics: New Insight on Gestational Diabetes Mellitus

et al. 2020

Self Cite

View full text Add to dashboard Cite

Gestational diabetes mellitus (GDM) is the most common metabolic complication of pregnancy, with a prevalence that has increased significantly in the last decade, coming to affect 12–18% of all pregnancies. GDM is believed to be the result of a combination of genetic, epigenetic and environmental factors. Following the identification of susceptibility genes for type 2 diabetes by means of genome-wide association studies, an association has also been demonstrated between some type 2 diabetes susceptibility genes and GDM, suggesting a partial similarity of the genetic architecture behind the two forms of diabetes. More recent genome-wide association studies, focusing on maternal metabolism during pregnancy, have demonstrated an overlap in the genes associated with metabolic traits in gravid and non-gravid populations, as well as in genes apparently unique to pregnancy. Epigenetic changes—such as DNA methylation, histone modifications and microRNA gene silencing—have also been identified in GDM patients. Metabolomics has been used to profile the metabolic state of women during pregnancy, based on the measurement of numerous low-molecular-weight metabolites. Measuring amino acids and conventional metabolites has revealed changes in pregnant women with a higher insulin resistance and high blood glucose levels that resemble the changes seen in non-gravid, insulin-resistant populations. This would suggest similarities in the metabolic profiles typical of insulin resistance and hyperglycemia whether individuals are pregnant or not. Future studies combining data obtained using multiple technologies will enable an integrated systems biology approach to maternal metabolism during a pregnancy complicated by GDM. This review highlights the recent knowledge on the impact of genetics and epigenetics in the pathophysiology of GDM and the maternal and fetal complications associated with this pathology condition.

show abstract

“…GDM is the most common metabolic complication of pregnancy, affecting up to 14% of all pregnancies [ 2 ]. Its prevalence depends on the diagnostic criteria used and on the ethnic group considered [ 3 , 4 ]. The incidence of GDM is increasing globally due to the increasing prevalence of obesity, sedentary lifestyles, and advancing maternal age.…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of GDM is increasing globally due to the increasing prevalence of obesity, sedentary lifestyles, and advancing maternal age. Adoption of the new, stricter diagnostic criteria proposed by the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) has also contributed to its rising incidence [ 3 , 4 ]. Untreated GDM is associated with adverse outcomes for both mother and fetus during pregnancy and childbirth, including pre-eclampsia, cesarean delivery, birth trauma, macrosomia, and neonatal hypoglycemia and hyperbilirubinemia [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Celiac Disease and Pregnancy Outcomes in Patients with Gestational Diabetes Mellitus

Dalfrà

Vescovo

Burlina

et al. 2020

International Journal of Endocrinology

Self Cite

View full text Add to dashboard Cite

Aim. Gestational diabetes mellitus (GDM) and celiac disease, if not diagnosed and properly treated, are associated with adverse outcomes of pregnancy. The aim of our study was to examine pregnancies complicated by GDM in celiac and nonceliac women in terms of their metabolic parameters and maternal and fetal outcomes. Methods. The study involved 60 women with GDM, 20 with and 40 without celiac disease. Maternal clinical and metabolic parameters (glucose and insulin levels in the oral glucose tolerance test (OGTT), fasting plasma glucose, HbA1c, lipid profile, prepregnancy BMI, gestational weight gain, and chronic diseases), pregnancy outcomes (gestational hypertension, pre-eclampsia, eclampsia, time, and mode of delivery), and fetal parameters (weight and length at birth, and neonatal complications) were recorded. Results. The two groups did not differ significantly in maternal parameters other than blood glucose levels at 120′ in the diagnostic OGTT (141.2 ± 35.2 vs 161.2 ± 35.4, mg/dl, p = 0.047 ), prepartum cLDL (127.2 ± 43.5 vs 179.6 ± 31.7 mg/dl, p ≤ 0.001 ), and total cholesterol (229.0 ± 45.9 vs 292.5 ± 42.1 mg/dl, p ≤ 0.001 ), which were significantly lower in celiac women than in nonceliac controls. Children born from celiac women had a significantly higher birth weight (3458.1 ± 409.8 vs 3209.0 ± 432.7 g, p = 0.044 ) and ponderal index (2.89 ± 0.32 vs 2.66 ± 0.25 g/cm3, p = 0.006 ) and were more likely to be large for gestational age (27.8% vs 2.5%, p = 0.012 ). Analyzing the composition of the celiac and nonceliac women’s diet showed that, for the same amount of kilocalories, the gluten-free diet was associated with a slight increase in the amount of carbohydrates (49.75% vs 48.54%) and a reduction in the amount of protein (21.10% vs 23.31%) and especially of fiber (9.84% vs 12.71%). Conclusions. Celiac women with GDM have much the same pregnancy outcomes as nonceliac women with GDM, except for fetal overgrowth. Gluten-free food, being richer in carbohydrates and less rich in fiber and protein, could have a role in fetal growth in celiac women.

show abstract

The post-HAPO situation with gestational diabetes: the bright and dark sides

Abstract: So the challenge lies in making every effort to achieve a global standardization of the strategies for detecting, diagnosing and treating GDM.

Cited by 27 publications

References 53 publications

Diagnosis and principles of management of gestational diabetes mellitus in the prevailing COVID-19 pandemic

Diagnosis and principles of management of gestational diabetes mellitus in the prevailing COVID-19 pandemic

Genetics and Epigenetics: New Insight on Gestational Diabetes Mellitus

Celiac Disease and Pregnancy Outcomes in Patients with Gestational Diabetes Mellitus

Contact Info

Product

Resources

About