Abstract
Normal pregnancy is a state of insulin resistance. To spare glucose for the developing fetus, the placenta produces several hormones that antagonize maternal insulin, shifting the principal energy source from glucose to ketones and free fatty acids. Most pregnant women maintain normal blood glucose levels despite the increased insulin resistance through enhanced insulin production and release by the pancreas, both in the basal state and in response to meals. Gestational diabetes mellitus is a state of carbohydrate intolerance that develops or is first recognized during pregnancy. In some women, β-cell production of insulin cannot keep pace with the resistance to insulin produced by the diabetogenic hormones from the placenta. The prevalence of gestational diabetes mellitus in the USA is 2-5%, and is proportional to the prevalence of type 2 diabetes in the population under examination, because they share a similar pathophysiology. The prevalence of gestational diabetes mellitus, along with the prevalence of type 2 diabetes, appears to be increasing. It is the most common medical complication of pregnancy and is clearly linked to several maternal and fetal complications including fetal macrosomia with operative delivery and birth trauma, preeclampsia and hypertensive disorders, metabolic complications in the neonate including hypoglycemia, hypocalcemia, and hyperbilirubinemia, prematurity, and perinatal mortality.
| Original language | English (US) |
|---|---|
| Title of host publication | Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach: Sixth Edition |
| Publisher | Wiley-Blackwell |
| Pages | 168-173 |
| Number of pages | 6 |
| ISBN (Print) | 9780470655764 |
| DOIs | |
| State | Published - Jan 4 2012 |
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Keywords
- Antepartum care in pregestational diabetes
- Criteria for avoiding laboratory screening for GDM
- Diabetes screening in pregnancy
- Exercise, key component in diabetes care
- GDM state of carbohydrate intolerance in pregnancy
- GDM, and guidelines for diagnostic algorithms
- Gestational diabetes mellitus (GDM)
- Glucose tolerance, reassessed in postpartum period
- Therapeutic modalities, in gestational diabetes
- Timing of delivery, delicate balance complicated by diabetes
ASJC Scopus subject areas
- Medicine(all)
Cite this
Gestational Diabetes Mellitus. / Conway, Deborah L.
Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach: Sixth Edition. Wiley-Blackwell, 2012. p. 168-173.Research output: Chapter in Book/Report/Conference proceeding › Chapter
}
TY - CHAP
T1 - Gestational Diabetes Mellitus
AU - Conway, Deborah L
PY - 2012/1/4
Y1 - 2012/1/4
N2 - Normal pregnancy is a state of insulin resistance. To spare glucose for the developing fetus, the placenta produces several hormones that antagonize maternal insulin, shifting the principal energy source from glucose to ketones and free fatty acids. Most pregnant women maintain normal blood glucose levels despite the increased insulin resistance through enhanced insulin production and release by the pancreas, both in the basal state and in response to meals. Gestational diabetes mellitus is a state of carbohydrate intolerance that develops or is first recognized during pregnancy. In some women, β-cell production of insulin cannot keep pace with the resistance to insulin produced by the diabetogenic hormones from the placenta. The prevalence of gestational diabetes mellitus in the USA is 2-5%, and is proportional to the prevalence of type 2 diabetes in the population under examination, because they share a similar pathophysiology. The prevalence of gestational diabetes mellitus, along with the prevalence of type 2 diabetes, appears to be increasing. It is the most common medical complication of pregnancy and is clearly linked to several maternal and fetal complications including fetal macrosomia with operative delivery and birth trauma, preeclampsia and hypertensive disorders, metabolic complications in the neonate including hypoglycemia, hypocalcemia, and hyperbilirubinemia, prematurity, and perinatal mortality.
AB - Normal pregnancy is a state of insulin resistance. To spare glucose for the developing fetus, the placenta produces several hormones that antagonize maternal insulin, shifting the principal energy source from glucose to ketones and free fatty acids. Most pregnant women maintain normal blood glucose levels despite the increased insulin resistance through enhanced insulin production and release by the pancreas, both in the basal state and in response to meals. Gestational diabetes mellitus is a state of carbohydrate intolerance that develops or is first recognized during pregnancy. In some women, β-cell production of insulin cannot keep pace with the resistance to insulin produced by the diabetogenic hormones from the placenta. The prevalence of gestational diabetes mellitus in the USA is 2-5%, and is proportional to the prevalence of type 2 diabetes in the population under examination, because they share a similar pathophysiology. The prevalence of gestational diabetes mellitus, along with the prevalence of type 2 diabetes, appears to be increasing. It is the most common medical complication of pregnancy and is clearly linked to several maternal and fetal complications including fetal macrosomia with operative delivery and birth trauma, preeclampsia and hypertensive disorders, metabolic complications in the neonate including hypoglycemia, hypocalcemia, and hyperbilirubinemia, prematurity, and perinatal mortality.
KW - Antepartum care in pregestational diabetes
KW - Criteria for avoiding laboratory screening for GDM
KW - Diabetes screening in pregnancy
KW - Exercise, key component in diabetes care
KW - GDM state of carbohydrate intolerance in pregnancy
KW - GDM, and guidelines for diagnostic algorithms
KW - Gestational diabetes mellitus (GDM)
KW - Glucose tolerance, reassessed in postpartum period
KW - Therapeutic modalities, in gestational diabetes
KW - Timing of delivery, delicate balance complicated by diabetes
UR - http://www.scopus.com/inward/record.url?scp=84889375109&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84889375109&partnerID=8YFLogxK
U2 - 10.1002/9781119963783.ch20
DO - 10.1002/9781119963783.ch20
M3 - Chapter
AN - SCOPUS:84889375109
SN - 9780470655764
SP - 168
EP - 173
BT - Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach: Sixth Edition
PB - Wiley-Blackwell
ER -