Gestational diabetes diagnosed in third trimester pregnancy and pregnancy outcome

Lao, Terence T.; Tam, Kar-Fai

doi:10.1034/j.1600-0412.2001.801106.x

Cited by 31 publications

(10 citation statements)

References 32 publications

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“…One study by the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study Cooperative Research Group was originally published in 2008, with additional data published in 2012 [45]; data from both publications are included. Thirteen studies were conducted in the USA [6,8,10,14,18,20,24,[26][27][28][31][32][33], 10 in Europe [9,15,17,19,22,29,35,[38][39][40], two in Canada [12,30], two in Australia [3,16] and 11 from other countries [7,11,13,21,23,25,34,36,37,41,42] (including Japan, Saudi Arabia, Turkey, Iran, China and Taiwan). We grouped studies according to the diagnostic criteria used ( Fig.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic thresholds for gestational diabetes and their impact on pregnancy outcomes: a systematic review

et al. 2014

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Higher glucose thresholds did not consistently demonstrate greater risk, possibly because studies did not compare mutually exclusive groups of women. A pragmatic approach for diagnosis of gestational diabetes using Hyperglycemia and Adverse Pregnancy Outcome Study odds ratio 2.0 thresholds warrants further consideration until additional analysis of the data comparing mutually exclusive groups of women is provided and large randomized controlled trials investigating different diagnostic and treatment thresholds are completed.

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Section: Resultsmentioning

confidence: 99%

Diagnostic thresholds for gestational diabetes and their impact on pregnancy outcomes: a systematic review

et al. 2014

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“…Lao and Tam [26] suspect that the higher frequency of preeclampsia among GDM women and the shorter length of gestation is more likely to reflect a pathologic process rather than the physiologic effect of pregnancy on maternal glucose tolerance [26]. Vambergue et al [27•] found that PIH prevalence was positively associated with the degree of the carbohydrate metabolic disturbance in the multicenter Diagest Study.…”

Section: Hypertensionmentioning

confidence: 98%

Current controversies in the mechanisms and treatment of gestational diabetes

Tamás

Kerényi²

2002

Curr Diab Rep

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Gestational diabetes mellitus (GDM) is a heterogeneous entity, including carbohydrate intolerance of variable severity with onset or first recognition during pregnancy. Insulin resistance and beta-cell dysfunction are thought to be major determinants of its development. Its pathomechanism in many ways resembles that of type 2 diabetes. There is an evolving body of evidence from the last decade presenting similarities between gestational diabetes and the metabolic (insulin resistance) syndrome. These new observations suggest that GDM might be an early manifestation of the metabolic syndrome. The desired treatment target of GDM is normoglycemia. It can be reached by dietary treatment; however, if it fails, maternal glycemic monitoring or combined fetal-maternal monitoring, or even insulin (if required) can help reach it. Multiple daily insulin regimens are becoming more widely accepted for the treatment of GDM. Insulin analogues, however, need some more evidence to support their usefulness and safety during pregnancy. The screening for GDM, the reclassification, regular care, and follow-up of these women after pregnancy are of the utmost importance to delay or prevent not only type 2 diabetes but cardiovascular complications as well.

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“…The HAPO study has demonstrated clearly that untreated but sub-threshold glucose intolerance was associated with adverse maternal and neonatal outcomes, including Caesarean delivery, pre-eclampsia and preterm birth, neonatal hypoglycaemia, fetal hyperinsulinaemia, birth injury (predominantly shoulder dystocia), neonatal hyperbilirubinaemia and neonatal intensive care unit admission [8]. Among Hong Kong Chinese women, those with gestational diabetes diagnosed in the third trimester not only had different characteristics, including higher age and BMI at booking and third-trimester haemoglobin levels, but also a significantly higher incidence of pre-eclampsia and shorter length of gestation, despite apparent satisfactory glycaemic control with dietary management [68]. Indeed, the incidence of preterm birth before 37 weeks and before 32 weeks' gestation in Chinese women was significantly correlated with increasing glucose intolerance, and the oral glucose tolerance test 2-h glucose value was an independent determinant of gestational length, even when treatment was given to all women diagnosed with gestational diabetes [69].…”

Section: Maternal and Neonatal Complicationsmentioning

confidence: 99%

Diabetes and pregnancy: perspectives from Asia

et al. 2014

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There has been a marked increase in the prevalence of diabetes in Asia over recent years. Diabetes complicating pregnancy, in particular gestational diabetes, has also increased markedly in the region. Multi-ethnic studies have highlighted the increased risk of gestational diabetes mellitus among the different Asian populations. Prevalence of gestational diabetes in Asian countries varies substantially according to the screening strategy and diagnostic criteria applied, and ranges from 1% to 20%, with evidence of an increasing trend over recent years. The International Association for Diabetes in Pregnancy Study group criteria have been adopted by some Asian countries, although they present significant challenges in implementation, especially in low-resource settings. Studies on offspring of mothers with gestational diabetes have reported adverse cardiometabolic profiles and increased risk of diabetes and obesity. Gestational diabetes is likely to be a significant factor contributing to the epidemic of diabetes and other non-communicable diseases in the Asian region. In recognition of this, several large-scale prevention and intervention programmes are currently being implemented in different Asian countries in order to improve glucose control during pregnancy, as well as overall maternal health. Lessons emerging from gestational diabetes studies in Asia may help inform and provide insights on the overall burden and treatment strategies to target gestational diabetes, with the ultimate aim to reduce its adverse short-and long-term consequences.

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Gestational diabetes diagnosed in third trimester pregnancy and pregnancy outcome

Cited by 31 publications

References 32 publications

Diagnostic thresholds for gestational diabetes and their impact on pregnancy outcomes: a systematic review

Diagnostic thresholds for gestational diabetes and their impact on pregnancy outcomes: a systematic review

Current controversies in the mechanisms and treatment of gestational diabetes

Diabetes and pregnancy: perspectives from Asia

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