Abstract
Gestational diabetes mellitus (GDM) is one of the most common complications in pregnancy. It affects 3-15% of women, depending on the background diabetes risk of the population and applied diagnostic criteria. GDM is associated with neonatal problems such as macrosomia and neonatal hypoglycemia as well as a long term increased risk of diabetes and obesity of offspring. Current therapy of GDM focuses on tightly controlling maternal glucose levels, resulting in insulin therapy in up to 50% of women to reach the fasting glucose target of < 90 mg/dl and 2h-postprandial glucose < 120 mg/dl. However, the rate of macrosomia and C-sections remains increased in pregnancy with GDM despite therapy. This review introduces the diagnosis and implications of GDM and then examines two strands of research aimed at improving current therapy: first, research into predictive markers of GDM pregnancies requiring intensified insulin therapy, and second, research into hypoglycaemic agents for therapy or even prevention of GDM in high risk women such as women with polycystic ovarian syndrome. Predictive markers include amniotic fluid insulin, which requires an invasive amniocentesis procedure, and measures of fetal abdominal circumference early in the third trimester, which have successfully been used to reduce rates of macrosomia. Potential hypoglycemic agents include glyburides and metformin, which have been shown not to have adverse outcomes on neonates, although oral agents are generally contra-indicated because of possible teratogenic and toxic effects observed in animal studies and missing long term outcome data.
Keywords: Gestational diabetes, glyecmic control, therapy, fetal growth, ultrasound, oral agents
Current Diabetes Reviews
Title: Diagnosis and New Approaches in the Therapy of Gestational Diabetes Mellitus
Volume: 2 Issue: 3
Author(s): Ute M. Schaefer-Graf and Helmut Kleinwechter
Affiliation:
Keywords: Gestational diabetes, glyecmic control, therapy, fetal growth, ultrasound, oral agents
Abstract: Gestational diabetes mellitus (GDM) is one of the most common complications in pregnancy. It affects 3-15% of women, depending on the background diabetes risk of the population and applied diagnostic criteria. GDM is associated with neonatal problems such as macrosomia and neonatal hypoglycemia as well as a long term increased risk of diabetes and obesity of offspring. Current therapy of GDM focuses on tightly controlling maternal glucose levels, resulting in insulin therapy in up to 50% of women to reach the fasting glucose target of < 90 mg/dl and 2h-postprandial glucose < 120 mg/dl. However, the rate of macrosomia and C-sections remains increased in pregnancy with GDM despite therapy. This review introduces the diagnosis and implications of GDM and then examines two strands of research aimed at improving current therapy: first, research into predictive markers of GDM pregnancies requiring intensified insulin therapy, and second, research into hypoglycaemic agents for therapy or even prevention of GDM in high risk women such as women with polycystic ovarian syndrome. Predictive markers include amniotic fluid insulin, which requires an invasive amniocentesis procedure, and measures of fetal abdominal circumference early in the third trimester, which have successfully been used to reduce rates of macrosomia. Potential hypoglycemic agents include glyburides and metformin, which have been shown not to have adverse outcomes on neonates, although oral agents are generally contra-indicated because of possible teratogenic and toxic effects observed in animal studies and missing long term outcome data.
Export Options
About this article
Cite this article as:
Schaefer-Graf M. Ute and Kleinwechter Helmut, Diagnosis and New Approaches in the Therapy of Gestational Diabetes Mellitus, Current Diabetes Reviews 2006; 2 (3) . https://dx.doi.org/10.2174/157339906777950615
DOI https://dx.doi.org/10.2174/157339906777950615 |
Print ISSN 1573-3998 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6417 |
Call for Papers in Thematic Issues
Advancing Diabetic Wound Healing: Mechanisms and Interventions
In recent years, diabetic wounds have become a global health concern with the increase in the incidence of diabetes. Diabetic wounds are a kind of chronic and refractory ulcer. It is generally due to the microcirculatory disturbances and the reduced levels of endogenous growth factors. Delayed cutaneous wound healing is ...read more
Oxidative and inflammatory responses in the development of secondary diabetic complications
Diabetes, along with its associated secondary complications, represents a significant global health challenge, contributing significantly to morbidity and mortality. Unhealthy lifestyle habits, reduced physical activity, environmental pollutants, and stress are pivotal factors in the onset of diabetes, particularly type-2 diabetes. Poorly managed hyperglycemia can lead to various complications, including neuropathy, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Advancement in Obesity Management: Leptin and Adiponectin Patents
Recent Patents on Endocrine, Metabolic & Immune Drug Discovery Reproductive Toxicity of T Cells in Early Life: Abnormal Immune Development and Postnatal Diseases
Current Drug Targets Lipid Composition of Cell Membranes and Its Relevance in Type 2 Diabetes Mellitus
Current Diabetes Reviews Asymmetric Dimethylarginine: Clinical Significance and Novel Therapeutic Approaches
Current Medicinal Chemistry Gut Involvement in NOD Mouse Diabetes
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) Screening Haemostasis – Looking for Global Assays: The Overall Haemostasis Potential (OHP) Method – A Possible Tool for Laboratory Investigation of Global Haemostasis in Both Hypo- and Hypercoagulable Conditions
Current Vascular Pharmacology Recurrent Pregnancy Losses
Current Women`s Health Reviews The Role of Adipokines in Hypertension and Cardiovascular Disease
Current Hypertension Reviews Redox Regulation and the Autistic Spectrum: Role of Tryptophan Catabolites, Immuno-inflammation, Autoimmunity and the Amygdala
Current Neuropharmacology Neural Stem Cell Niches in Health and Diseases
Current Pharmaceutical Design Impact of Seasonality on Gestational Diabetes Mellitus
Endocrine, Metabolic & Immune Disorders - Drug Targets Response to <i>Letter to the Editor</i> by Briana and Malamitsi-Puchner: Effects of Pregnancy-induced Insulin Resistance on the Fetus and the Future Development of Metabolic Diseases in Adulthood
Current Vascular Pharmacology Lifestyle, Maternal Nutrition and Healthy Pregnancy
Current Vascular Pharmacology Surfactant Protein D in Chronic Obstructive Pulmonary Disease (COPD)
Recent Patents on Endocrine, Metabolic & Immune Drug Discovery Advances in Quantitative Mass Spectrometry Analysis: Weighing in on Isotope Coding and Label-Free Approaches for Expression and Functional Proteomics
Current Analytical Chemistry Thrombophilia and Female Sex Hormones
Current Women`s Health Reviews Diet and Contaminants: Driving the Rise to Obesity Epidemics?
Current Medicinal Chemistry Extrinsic Factors Promoting Insulin Producing Cell-Differentiation and Insulin Expression Enhancement-Hope for Diabetics.
Current Stem Cell Research & Therapy Renal Venous Thrombosis in Neonates
Current Pediatric Reviews IgA/IgM Responses to Gram-Negative Bacteria are not Associated with Perinatal Depression, but with Physio-somatic Symptoms and Activation of the Tryptophan Catabolite Pathway at the End of Term and Postnatal Anxiety
CNS & Neurological Disorders - Drug Targets