Introduction

Gestational diabetes mellitus (GDM) is defined as glucose intolerance first recognized during pregnancy (1). This definition applies regardless of treatment regimens and does not distinguish between those unrecognized cases of diabetes that may have preceded pregnancy. GDM occurs in 0.5% to 12.3% of pregnancies depending on the criteria used and the population being tested (2,3). In the United States, prevalence rates are higher in African, Hispanic, Native American, and Asian women than in white women (4-6).

GDM conveys both short-and long-term risk to both mother and offspring. During the index pregnancy, women with GDM suffer from an increased prevalence of pregnancy-induced hypertension, toxemia, polyhydramnios, fetal macrosomia, birth trauma, neonatal metabolic complications (hypoglycemia, hyperbilirubinemia, hypocalcemia) and the need for primary Caesarian section delivery (7). Although most women revert to normal glucose tolerance postpartum, approximately 20% have impaired glucose tolerance (IGT) in the immediate postpartum phase (8,9). The lifetime risk of development of type 2 diabetes exceeds 50% (10-15).

Maternal glucose values have been directly correlated with neonatal mortality (16-18). Furthermore, fasting plasma glucose (FPG) showed an odds ratio (OR) of two for the development of macrosomia. For every 18mg/dL increase in fasting glucose, the likelihood of developing macrosomia doubles (19). At delivery, GDM is associated with fetal macrosomia, with resultant shoulder dystocia and neonatal hypoglycemia. Long-term complications for infants of diabetic mothers include obesity and increased risk of abnormal glucose tolerance by adolescence.

Diabetes 2

Diabetes 2

Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...

Get My Free Ebook


Post a comment