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Chapter 56 - Gestational Diabetes Mellitus

from Section 10 - Endocrine Disorders in Pregnancy

Published online by Cambridge University Press:  23 February 2023

By
Amira El-Messidi  and
Alan D. Cameron
Edited by
Amira El-Messidi  and
Alan D. Cameron
Amira El-Messidi
Affiliation:
McGill University, Montréal
Alan D. Cameron
Affiliation:
University of Glasgow
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Summary

A healthy 38-year-old secundigravida presents for a first prenatal visit after sonography at your hospital center just dated a spontaneous intrauterine pregnancy at 12+4 weeks’ gestation. Early fetal morphology and sonographic screening markers for aneuploidy are unremarkable. You learn that she and her husband just moved to the country. Five years ago, she had gestational diabetes mellitus (GDM) and delivered vaginally. The patient has no obstetric complaints and has been taking folate-containing prenatal vitamins. She does not drink alcohol, smoke cigarettes, or use any recreational substances.

Keywords

Gestational diabetes mellitusRisk factorsPathophysiology, placental hormones, insulin resistanceDiagnosisPerinatal risks, complications, maternal-fetal morbidity, adverse outcomeAntepartum, intrapartum, postpartum managementCounselling, preconception, antepartumLifestyle modifications
Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
 , pp. 718 - 730
Publisher: Cambridge University Press
Print publication year: 2023

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References

Primary Sources

ACOG Practice Bulletin No. 190: gestational diabetes mellitus. Obstet Gynecol. 2018;131(2):e49–e64.Google Scholar
American Diabetes Association. Management of diabetes in pregnancy: standards of medical care in diabetes – 2021. Diabetes Care. 2021;44(Suppl 1):S200–S210.CrossRefGoogle Scholar
(a)Berger, H, Gagnon, R, Sermer, M. Guideline No. 393 – diabetes in pregnancy. J Obstet Gynaecol Can. 2019;41(12):1814–1825. [Correction in J Obstet Gynaecol Can. 2020 Oct;42(10):1288]Google Scholar
Diabetes Canada Clinical Practice Guidelines Expert Committee, Feig, DS, Berger, H, et al. Diabetes and pregnancy. Can J Diabetes. 2018;42(Suppl 1):S255–S282. [Correction in Can J Diabetes. 2018 Jun;42(3):337]CrossRefGoogle ScholarPubMed
Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: a World Health Organization Guideline. Diabetes Res Clin Pract. 2014;103(3):341–363.Google Scholar
Duarte-Gardea, MO, Gonzales-Pacheco, DM, Reader, DM, et al. Academy of Nutrition and Dietetics gestational diabetes evidence-based nutrition practice guideline. J Acad Nutr Diet. 2018;118(9):1719–1742.Google Scholar
(a)FIGO: 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 Gynaecol Obstet. 2015;131(Suppl 3):S173–S211.Google Scholar
FIGO: McIntyre, HD, Oats, JJN, Kihara, AB, et al. Update on diagnosis of hyperglycemia in pregnancy and gestational diabetes mellitus from FIGO’s Pregnancy and Non-Communicable Diseases Committee. Int J Gynaecol Obstet. 2021;154(2):189–194.CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence (NICE). Diabetes in pregnancy: management from preconception to the postnatal period; NICE guideline. February 25, 2015. Available at www.nice.org.uk/guidance/ng3. Accessed July 18, 2021.Google Scholar
Scottish Intercollegiate Guidelines Network (SIGN). Management of diabetes, a national clinical guideline. March 2010, updates November 2017. Available at www.sign.ac.uk/assets/sign116.pdf. Accessed July 18, 2021.Google Scholar
Society of Maternal-Fetal Medicine (SMFM) Publications Committee. SMFM Statement: pharmacological treatment of gestational diabetes. Am J Obstet Gynecol. 2018;218(5):B2–B4.Google Scholar
US Preventive Services Task Force, Davidson, KW, Barry, MJ, et al. Screening for gestational diabetes: US Preventive Services Task Force recommendation statement. JAMA. 2021;326(6):531–538.Google Scholar

Secondary Sources

Dickens, LT, Thomas, CC. Updates in gestational diabetes prevalence, treatment, and health policy. Curr Diab Rep. 2019;19(6):33.CrossRefGoogle ScholarPubMed
Egan, AM, Dow, ML, Vella, A. A review of the pathophysiology and management of diabetes in pregnancy. Mayo Clin Proc. 2020;95(12):2734–2746.Google Scholar
Johns, EC, Denison, FC, Norman, JE, et al. Gestational diabetes mellitus: mechanisms, treatment, and complications. Trends Endocrinol Metab. 2018;29(11):743–754.Google Scholar
Lende, M, Rijhsinghani, A. Gestational diabetes: overview with emphasis on medical management. Int J Environ Res Public Health. 2020;17(24):9573.CrossRefGoogle ScholarPubMed
Mussa, J, Meltzer, S, Bond, R, et al. Trends in national Canadian guideline recommendations for the screening and diagnosis of gestational diabetes mellitus over the years: a scoping review. Int J Environ Res Public Health. 2021;18(4):1454.CrossRefGoogle ScholarPubMed
Saravanan, P, Diabetes in Pregnancy Working Group. Maternal Medicine Clinical Study Group, Royal College of Obstetricians and Gynaecologists, UK. Gestational diabetes: opportunities for improving maternal and child health. Lancet Diabetes Endocrinol. 2020;8(9):793–800.CrossRefGoogle ScholarPubMed
Thayer, SM, Lo, JO, Caughey, AB. Gestational diabetes: importance of follow-up screening for the benefit of long-term health. Obstet Gynecol Clin North Am. 2020;47(3):383–396.CrossRefGoogle ScholarPubMed
Tieu, J, McPhee, AJ, Crowther, CA, et al. Screening for gestational diabetes mellitus based on different risk profiles and settings for improving maternal and infant health. Cochrane Database Syst Rev. 2017;8(8):CD007222.Google Scholar
Zhang, M, Zhou, Y, Zhong, J, et al. Current guidelines on the management of gestational diabetes mellitus: a content analysis and appraisal. BMC Pregnancy Childbirth. 2019;19(1):200.Google Scholar

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