Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-14T08:54:07.523Z Has data issue: false hasContentIssue false

Chapter 10 - Gestational Diabetes

from Section II - Hormones and Gestational Disorders

Published online by Cambridge University Press:  09 November 2022

Felice Petraglia
Affiliation:
Università degli Studi, Florence
Mariarosaria Di Tommaso
Affiliation:
Università degli Studi, Florence
Federico Mecacci
Affiliation:
Università degli Studi, Florence
Get access

Summary

Gestational Diabetes (GDM) is the most common metabolic disorder of pregnancy, and it is associated with short and long term adverse outcome for the mother and the offspring. The prevalence of GDM is growing rapidly worldwide in association with pandemic obesity and rising maternal age, but controversy still remains over screening and diagnostic criteria. This chapter describes normal metabolic modification in pregnancy and GDM physiopathology, maternal and offspring complication, diagnosis, and management.

Type
Chapter
Information
Hormones and Pregnancy
Basic Science and Clinical Implications
, pp. 91 - 106
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Hod, M, Kapur, A, Sacks, DA, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on gestational diabetes mellitus: A pragmatic guide for diagnosis, management, and care. Int J Gynecol Obstet. 2015, 131(S3):S173–211.Google Scholar
Catalano, PM, Tyzbir, ED, and Roman, MN. Longitudinal changes in insulin release and insulin resistance in non obese pregnant women. Am J Ob Gynecol. 1991, 165: 16671672.Google Scholar
Di Cianni, G, Miccoli, R, Volpe, L, et al. Intermediate metabolism in normal pregnancy and in gestational diabetes. Diabetes Metabol Res Review. 2003, 19:259270.Google Scholar
Hernandez, TL, Friedman, JE, Van Pelt, RE, et al. Patterns of glycemia in normal pregnancy: Should the current therapeutic targets be challenged? Diabetes Care. 2011, 34(7):16601668.Google Scholar
Butte, NF. Carbohydrate and lipid metabolism in pregnancy: Normal compared with gestational diabetes mellitus. Am J Clin Nutr. 2000, 71(5):1256S1261S.Google Scholar
Ryan, EA, and Enns, L. Role of gestational hormones in the induction of insulin resistance. J Clin Endocrinol Metab. 1988, 67:341347.Google Scholar
Zhou, J, Wu, NN, Yin, RL, et al. Activation of brown adipocytes by placentalgrowth factor. Biochem Biophys Res Commun. 2018, 504:470477.Google Scholar
Powe, CE. Early pregnancy biochemical predictors of gestational diabetes mellitus. Curr Diab Rep. 2017, 17(2):12.Google Scholar
Simpson, S, Smith, L, and Bowe, J. Placental peptides regulating islet adaptation to pregnancy: Clinical potential in gestational diabetes mellitus. Curr Opin Pharmacol. 2018, 43:5965.CrossRefGoogle ScholarPubMed
Lorenzo-Almorós, A, et al. Predictive and diagnostic biomarkers for gestational diabetes and its associated metabolic and cardiovascular diseases. Cardiovasc Diabetol. 2019, 30;18(1):140.Google Scholar
McIntyre, HD, Chang, AM, Callaway, LK, et al. Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study cooperative research group: Hormonal and metabolic factors associated with variations in insulin sensitivity in human pregnancy. Diabetes Care. 2010, 33:356360.Google Scholar
Catalano, PM, Hoegh, M, Minium, J, et al. Adiponectin in human pregnancy: Implications for regulation of glucose and lipid metabolism. Diabetologia. 2006, 49:16771685.Google Scholar
Buchanan, TA. Pancreatic B cell defects in gestational diabetes: Implications for the pathogenesis and prevention of type 2 diabetes. J. Clin. Endocrinol. Metab. 2001, 86:989993.Google Scholar
Abouzeid, M, Versace, VL, Janus, ED, et al. Socio-cultural disparities in GDM burden differ by maternal age at first delivery. PLoS ONE. 2015, 10(2):e0117085.Google Scholar
Schwartz, N, Nachum, Z, and Green, MS. The prevalence of gestational diabetes mellitus recurrence – Effect of ethnicity and parity: A metaanalysis. Am J Obstet Gynecol. 2015, 213(3):310317.Google Scholar
Palomba, S, de Wilde, MA, Falbo, A, et al. Pregnancy complications in women with polycystic ovary syndrome. Hum Reprod Update. 2015, 21(5):575592.Google Scholar
HAPO Study Cooperative Research Group. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008, 358:19912002.Google Scholar
International Association of Diabetes and Pregnancy Study Groups Consensus Panel. Metzger, BE, Gabbe, SG, Persson, B, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010, 33(3):676682.Google Scholar
McIntyre, HD, Sacks, DA, Barbour, LA, et al. Issues with the diagnosis and classification of hyperglycemia in early pregnancy. Diabetes Care. 2016, 39(1):5354.Google Scholar
Mitanchez, D, Yzydorczyk, C, Siddeek, B, et al. The offspring of the diabetic mother – Short- and long-term implications. Best Pract Res ClinObstet Gynaecol. 2015, 29: 256269.Google Scholar
Rosenstein, MG, Cheng, YW, Snowden, JM, et al. The risk of stillbirth and infant death stratified by gestational age in women with gestational diabetes. Am J Obstet Gynecol. 2012, 206(4):309.e1–7.Google ScholarPubMed
Mastrogiannis, DS, Spiliopoulos, M, Mulla, W, et al. Insulin resistance: The possible link between gestational diabetes mellitus and hypertensive disorders of pregnancy. Curr Diab Rep. 2009, 9(4):296302.CrossRefGoogle ScholarPubMed
Khan, GH, Galazis, N, Docheva, N, et al. Overlap of proteomics biomarkers between women with pre-eclampsia and PCOS: A systematic review and biomarker database integration. Hum Reprod. 2015, 30:133148.Google Scholar
Desoye, G, and Hauguel-de, MS. The human placenta in gestational diabetes mellitus: The insulin and cytokine network. Diabetes Care. 200730(S2):S120S126.Google Scholar
Kim, C, Newton, KM, and Knopp, RH. Gestational diabetes and the incidence of type 2 diabetes: A systematic review. Diabetes Care. 2002, 25:18621868.Google Scholar
Bellamy, L, Casas, JP, Hingorani, AD, et al. Type 2 diabetes mellitus after gestational diabetes: A systematic review and meta-analysis. Lancet. 2009, 373(9677):17731779.Google Scholar
Guo, J, Chen, JL, Whittemore, R, et al. Postpartum lifestyle interventions to prevent type 2 diabetes among women with history of gestational diabetes: A systematic review of randomized clinical trials. J Women’s Health. 2016, 25(1):3849.CrossRefGoogle ScholarPubMed
Golden, SH, Bennett, WL, Baptist-Roberts, K, et al. Antepartum glucose tolerance test results as predictors of type 2 diabetes mellitus in women with a history of gestational diabetes mellitus: A systematic review. Gend. Med. 2009, 6(S1):109122.Google Scholar
Shah, BR, Retnakaran, R, and Booth, GL. Increased risk of cardiovascular disease in young women following gestational diabetes mellitus. Diabetes Care. 2008, 31:16681669.Google Scholar
Tobias, DK, Stuart, JJ, Li, S, et al. Association of history of gestational diabetes with long-term cardiovascular disease risk in a large prospective cohort of US women. JAMA Intern Med. 2017, 177(12):17351742.Google Scholar
Retnakaran, R, and Shah, BR. Role of type 2 diabetes in determining retinal, renal, and cardiovascular outcomes in women with previous gestational diabetes mellitus. Diabetes Care. 2017, 40:101108.Google Scholar
Clausen, TD, et al. High prevalence of type 2 diabetes and pre-diabetes in adult offspring of women with gestational diabetes mellitus or type 1 diabetes: The role of intrauterine hyperglycemia. Diabetes Care. 2008, 31:340346.Google Scholar
Lowe, WL Jr., et al. Association of gestational diabetes with maternal disorders of glucose metabolism and childhood adiposity. JAMA. 2018, 320:10051016.Google Scholar
Crowther, CA, et al. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med. 2005, 352:24772486.Google Scholar
Landon, MB, et al. A multicenter, randomized trial of treatment for mild gestational diabetes. N Engl J Med. 2009, 361:13391348.Google Scholar
American Diabetes Association. 13. Management of diabetes in pregnancy: sStandards of medical care in diabetes – 2020. Diabetes Care. 2020, 43(Suppl 1):S183S192.Google Scholar
Italian National Guidelines (Linee Guida Gravidanza Fisiologica). Sistema nazionale per le linee guida dell’Istituto Superiore di Sanità. Available at: www.snlg-iss.it/cms/files/Lg.Gravidanza.pdf.Google Scholar
Martis, R, Crowther, CA, Shepherd, E, et al. Treatments for women with gestational diabetes mellitus: An overview of Cochrane systematic reviews. Cochrane Database Syst Rev. 2018, 8:CD012327.Google Scholar
Brown, J, Grzeskowiak, L, Williamson, K, et al. Insulin for the treatment of women with gestational diabetes. Cochrane Database Syst Rev. 2017, 11:CD012037.Google Scholar
Mecacci, F, Lisi, F, Vannuccini, S, et al. Different gestational diabetes phenotypes: Which insulin regimen fits better? Front. Endocrinol. 2021.Google Scholar
Rowan, JA, Hague, WM, Gao, W, et al. MiG trial investigators: Metformin versus insulin for the treatment of gestational diabetes. N Engl J Med. 2008, 358: 20032015.Google Scholar
Balsells, M, Garca-Patterson, A, Sol, I, et al. Glibenclamide, metformin, and insulin for the treatment of gestational diabetes: A systematic review and meta-analysis. BMJ. 2015, 350:h102.CrossRefGoogle ScholarPubMed
Ijas, H., Vaarasmaki, M., Saarela, , et al. A follow-up of a randomised study of metformin and insulin in gestational diabetes mellitus: Growth and development of the children at the age of 18 months. BJOG. 2015, 122:9941000.Google Scholar
Rowan, JA, Rush, EC, Plank, LD, et al. Metformin in gestational diabetes: The offspring follow-up (MiG TOFU): Body composition and metabolic outcomes at 7–9 years of age. BMJ Open Diabetes Res Care. 2018, 6:e000456.Google Scholar
van Weelden, W, Wekker, V, de Wit, L, et al. Long-term effects of oral antidiabetic drugs during pregnancy on offspring: A systematic review and meta-analysis of follow-up studies of RCTs. Diabetes Ther. 2018, 9:18111829.Google Scholar
Shepherd, E, Gomersall, JC, Tieu, J, et al. Combined diet and exercise interventions for preventing gestational diabetes mellitus. Cochrane Database Syst Rev. 2017, 11(11):CD010443.Google Scholar
Glazer, NL, Hendrickson, AF, Schellenbaum, GD, et al. Weight change and the risk of gestational diabetes in obese women. Epidemiology. 2004, 15(6):733737.Google Scholar
Santamaria, A, Alibrandi, A, Di Benedetto, A ,et al. Clinical and metabolic outcomes in pregnant women at risk for gestational diabetes mellitus supplemented with myo-inositol: A secondary analysis from 3 RCTs. Am J Obstet Gynecol. 2018, 219(3):300.e1–300.Google Scholar
Dodd, JM et al. Effect of metformin in addition to dietary and lifestyle advice for pregnant women who are overweight or obese: The GRoW randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol. 2019, 7:1524.Google Scholar
Chiswick, C, et al. Effect of metformin on maternal and fetal outcomes in obese pregnant women (EMPOWaR): A randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol. 2015, 3:778786.Google Scholar
Zeng, XL, Zhang, YF, Tian, Q, et al. Effects of metformin on pregnancy outcomes in women with polycystic ovary syndrome: A meta-analysis. Medicine (Baltimore). 2016, 95(36):e4526.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×