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Insulin Resistance in Pregnancy
Published in Emilio Herrera, Robert H. Knopp, Perinatal Biochemistry, 2020
A. Zorzano, M. Palacín, X. Testar
Furthermore, if insulin availability does not increase during pregnancy, a clear glucose intolerance is observed, leading to gestational diabetes. Gestational diabetes refers to the state which shows a carbohydrate intolerance of varying severity and which is identified for the first time during pregnancy.85 This diabetic state appears during the second half of pregnancy and it has been described in 1 to 3% of pregnancies.4,39 Gestational diabetes could disappear after pregnancy, and glucose tolerance returns to normal levels. However, women with gestational diabetes have a greater risk to develop a clear diabetes mellitus after pregnancy. That is one of the reasons it is very important to recognize the syndrome early in order to introduce a proper treatment.
DRCOG MCQs for Circuit A Questions
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Diabetes mellitus in pregnancy is associated with: Recurrent urinary tract infections.Pre-eclampsia.Sacral agenesis.Increase in insulin requirement during pregnancy.Prematurity.
Short-term implications of gestational diabetes mellitus: The neonate
Published in Moshe Hod, Lois G. Jovanovic, Gian Carlo Di Renzo, Alberto de Leiva, Oded Langer, Textbook of Diabetes and Pregnancy, 2018
Delphine Mitanchez, Catherine Yzydorczyk, Umberto Simeoni
Diabetes mellitus during pregnancy is responsible for significant complications in the fetus and neonate. Risk is higher in pregestational diabetes, but also if pure gestational diabetes (GDM) is not recognized and well managed. The current worldwide pandemic of type 2 diabetes (T2D) has devastating effects with T2D representing up to 25% of pregnancies with pregestational diabetes.1 The rate of fetal and neonatal complications in these pregnancies is not different to those affected by type 1 diabetes (T1D). Diabetes in pregnancy is still responsible for a significant perinatal mortality and morbidity in many countries.2
Previous adverse pregnancy events as a predictor of gestational diabetes mellitus in Southern Ethiopia: a case control study
Published in Current Medical Research and Opinion, 2022
Hailu Taye, Robel Hussen Kabthymer, Samrawit Hailu, Meiraf Daniel Meshesha, Girum Gebremeskel Kanno, Yesuneh Bayisa, Wondwosen Molla
Furthermore, among the types of adverse pregnancy outcomes, a history of stillbirth has been discovered to be an independent predictor of GDM in this study. Pregnant women who had a history of stillbirth were 2.2 times more likely to develop GDM than those who had no history of stillbirth [AOR 2.240 (1.222–4.105)]. This study’s findings were supported by other studies conducted in Nigeria23, Iran24 and other parts of the world25, which discovered that women with diabetes mellitus during pregnancy were two times more likely than non-diabetic women to have a stillbirth. This can be explained by the fetus’s delayed growth in utero as a result of poor circulation or other related issues such as high blood pressure or microvascular disease, which can make a diabetic pregnancy more difficult20,21,26. However, a multicenter randomized controlled trial study conducted in Saudi Arabia27 and a cross-sectional study conducted in Yemen revealed that there is no significant relationship between stillbirth delivery and the development of GDM28. Now a day, available scientific evidence suggests that having a history of stillbirth delivery significantly increases the risk of developing GDM, and women with GDM have a significantly increased risk of having stillbirths’ delivery29.
Prediction of gestational diabetes mellitus in the first trimester by fasting plasma glucose which cutoff is better?
Published in Archives of Physiology and Biochemistry, 2022
A. Seval Ozgu-Erdinc, Umit Yasemin Sert, Hatice Kansu-Celik, Ozlem Moraloglu Tekin, Yaprak Engin-Ustun
The physiology of pregnancy is associated with insulin resistance (IR) resulting in hyperinsulinemia which is an important predisposing factor for diabetes mellitus (DM) in pregnancy. The definition of gestational diabetes mellitus (GDM) varies between different study groups. GDM was traditionally described as glucose intolerance which first appears or diagnosed in the pregnancy by National Diabetes Data Group (National Diabetes Data Group 1979). American Diabetes Association (ADA) introduced the definition of GDM as the diagnosis of diabetes in the second or third trimester of pregnancy in 2018 (American Diabetes Association 2018). Endocrine Society has suggested distinguishing hyperglycaemia in terms of “pregnancy-associated” and “antedated to pregnancy” (Blumer et al. 2013). First determined hyperglycaemia in the pregnancy was assessed as “overt diabetes” or “gestational diabetes” by The International Association of Diabetes and Pregnancy Study Groups (IADPSG) in 2010 (International Association of Diabetes and Pregnancy Study Groups Consensus Panel 2010). The World Health Organisation (WHO) has announced a recommendation concerning hyperglycaemia during pregnancy in 2013. WHO classified hyperglycaemia during pregnancy as “diabetes mellitus in pregnancy” and “GDM” and The International Federation of Gynecology and Obstetrics (FIGO) endorsed this definition (Vrachnis et al. 2013, Wielgoś et al. 2017).
Sleep disordered breathing in pregnant women: maternal and fetal risk, treatment considerations, and future perspectives
Published in Expert Review of Respiratory Medicine, 2018
Kimberly Kay Truong, Christian Guilleminault
Gestational diabetes mellitus (GDM) develops in women whose pancreatic function is insufficient to overcome the insulin resistance associated with the pregnant state. It is a state of abnormal glucose tolerance typically in the second or third trimester, and is associated with adverse maternal and fetal outcomes. GDM is one of the most common complications in pregnancy, with up to 25% prevalence depending on patient demographics and diagnostic thresholds [64]. Diabetes mellitus of pregnancy is associated with significant perinatal outcomes, including increased birth weight, neonatal hypoglycemia, hydramnios, and preterm delivery [65].