scholarly journals Gestational diabetes mellitus: management during and after pregnancy - a systematic literature review

2020 ◽  
Vol 3 (2) ◽  
pp. 63-72
Author(s):  
Claudia Banowati Subarto ◽  
Mohammad Hakimi ◽  
Yuli Isnaeni
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Dietary Intervention ◽  
Nutrition Therapy ◽  
Future Health ◽  
History Of

Introduction: Gestational Diabetes Mellitus (GDM) is one of the most common complications of pregnancy. Women with gestational diabetes have a higher risk of serious health outcomes for mother and baby such as preeclampsia, premature birth and the long term development of type 2 diabetes. This study was conducted to present a review of available research in several countries about GDM management during and after pregnancy. Method: Several databases including PubMed, ScienceDirect and EBSco were searched for relevant articles published between January 2009 and January 2019. Result: Of the 1186 initial articles identified, this study analyzed 7 relevant articles that met the inclusion criteria. This study showed that management for GDM includes medical nutrition therapy, exercise, monitoring of blood glucose, and insulin therapy if blood glucose is not achieved with that treatment. Exclusive breast feeding for at least three months has been shown reducing the risk of childhood obesity of children, particularly in those born to obese and mothers with GDM Conclusion: There is a need to increase awareness of long-term consequences on gestational diabetes, both in patients and in healthcare professionals. Counseling is needed for dietary intervention and physical activity for all postpartum women with a history of GDM to stay healthy or to improve future health

scholarly journals Lactation Duration and Long-term Risk for Incident Type 2 Diabetes in Women With a History of Gestational Diabetes Mellitus

Diabetes Care ◽  
2020 ◽  
Vol 43 (4) ◽  
pp. 793-798 ◽  
Author(s):  
Sylvia H. Ley ◽  
Jorge E. Chavarro ◽  
Mengying Li ◽  
Wei Bao ◽  
Stefanie N. Hinkle ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Incident Type ◽  
Incident Type 2 Diabetes ◽  
History Of ◽  
Lactation Duration

Long-Term Metabolic Consequences in Patients with a History of Gestational Diabetes

2020 ◽  
Vol 26 (43) ◽  
pp. 5564-5572
Author(s):  
Eleni Kousta ◽  
Adamantia Kontogeorgi ◽  
Stephen Robinson ◽  
Desmond G. Johnston
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Increased Risk ◽  
Metabolic Complication ◽  
History Of

Gestational diabetes mellitus is a common metabolic complication of pregnancy. Universal guidelines on gestational diabetes have been impeded by the long-term controversies on its definition and screening strategies. The prevalence of gestational diabetes is rising all over the world, is significantly influenced by ethnicity and its rise is mainly attributed to increasing maternal obesity and age. Gestational diabetes mellitus has important long-term implications, including gestational diabetes recurrence, increased risk for developing type 2 diabetes, metabolic syndrome and cardiovascular disease for the mother. Gestational diabetes mellitus may be viewed as a chronic metabolic disorder that is identified in women during gestation and may provide a unique opportunity for the early identification and primary prevention of type 2 diabetes mellitus and cardiovascular disease in these women. In this mini-review, the evolution of screening tests for gestational diabetes and guidelines are briefly described and metabolic and cardiovascular long-term consequences of women with a history of gestational diabetes are summarized. A summary of our own St. Mary’s Hospital-UK Research series on long-term metabolic consequences of 368 women with a history of gestational diabetes of 3 different ethnic groups and 482 control women is also included. We found that approximately 2 years following delivery, 37% of women with a history of gestational diabetes had abnormal glucose concentrations, but, most importantly, even those who were normoglycaemic, postpartum displayed metabolic abnormalities on detailed testing. Future research needs to focus on the prevention of gestational diabetes long-term complications, but also in identification of pre-pregnancy predictors and risk reduction before conception.

Searching for Utopia, the Challenge of Standardized Medical Nutrition Therapy Prescription in Gestational Diabetes Mellitus Management: A Critical Review

2021 ◽  
Author(s):  
Nina Meloncelli ◽  
Shelley A. Wilkinson ◽  
Susan de Jersey
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Lifestyle Modification ◽  
Nutrition Therapy ◽  
Medical Nutrition Therapy ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Medical Nutrition

AbstractGestational diabetes mellitus (GDM) is a common pregnancy disorder and the incidence is increasing worldwide. GDM is associated with adverse maternal outcomes which may be reduced with proper management. Lifestyle modification in the form of medical nutrition therapy and physical activity, as well as self-monitoring of blood glucose levels, is the cornerstone of GDM management. Inevitably, the search for the “ultimate” diet prescription has been ongoing. Identifying the amount and type of carbohydrate to maintain blood glucose levels below targets while balancing the nutritional requirements of pregnancy and achieving gestational weight gain within recommendations is challenging. Recent developments in the area of the gut microbiota and its impact on glycemic response add another layer of complexity to the success of medical nutrition therapy. This review critically explores the challenges to dietary prescription for GDM and why utopia may never be found.

Abstract P051: Lifestyle Change In Mid-life And Long-term Weight Gain In Women With And Without History Of Gestational Diabetes Mellitus

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Jiaxi Yang ◽  
Janet Rich-Edwards ◽  
Molin Wang ◽  
Wafaie W Fawzi ◽  
Cuilin Zhang ◽  
...  
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Body Weight ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Weight Change ◽  
Lifestyle Change ◽  
History Of

Introduction: Identifying strategies to mitigate gradual long-term weight gain is critical for preventing obesity and its related chronic diseases, particularly for persons at high risk, such as women with a history of gestational diabetes mellitus (GDM). We prospectively examined the independent associations between lifestyle changes in mid-life with long-term weight change among women with and without a history of GDM. Hypothesis: We hypothesized that favorable improvements in lifestyle would be associated with less long-term weight gain, particularly among women with a history of GDM. Methods: We used data from the longitudinal Nurses’ Health Study II, with self-reported lifestyle, diet via food frequency questionnaire, and body weight updated every 2-4 years. We analyzed repeated 4-year changes of the following lifestyle factors among parous women after age 40: adherence to a healthy dietary pattern (Alternate Healthy Eating Index score [AHEI]), physical activity (MET-hrs/wk), moderate alcohol intake (servings/d), and non-smoking, in relation to concurrent 4-year change in body weight (lb). We used multivariable generalized estimating equation models to estimate the least-squares mean of 4-year weight change and 95% confidence interval (CI) for each lifestyle change category (e.g., decrease, remain stable, and increase). Results: Our analysis included 61,637 women, of which 3,444 (5.6%) had a history of GDM. Mean of repeated 4-year weight change after age 40 was 3.0 lb (SD=14.3). Improving diet was associated with favorable 4-year weight change, particularly among women with a history of GDM vs. without GDM (AHEI score change from low to high: -6.3 lb [CI: -9.3, -3.4] vs. -2.7 lb [CI: -3.2, -2.2], respectively; p-interaction=0.04). Increasing physical activity was associated with weight maintenance for GDM women only (MET-hrs/wk change from low to high: 0.6 lb [95% CI: -0.6, 1.7] vs. 2.0 lb [95% CI: 1.8, 2.2] for GDM vs. non-GDM, respectively; p-interaction=0.01). Reducing alcohol (decreased servings/d: 1.9 lb [95% CI: 1.2, 2.6] and 2.8 lb [95% CI: 2.6, 2.9] for GDM vs. non-GDM, respectively) and smoking cessation (recent quitter: 9.8 lb [95% CI: 7.1, 12.5] and 8.5 lb [95% CI: 8.0, 9.1] for GDM vs. non-GDM, respectively) were associated with similar patterns in weight change for women with and without prior GDM. Further, the joint association of improving both diet and physical activity from low to high was related to -12.3 lb (95% CI: -19.5, -5.0) and -6.1 lb (95% CI: -8.0, -4.2) of weight loss for GDM vs. non-GDM women, respectively. Conclusions: We observed that attainable improvements in diet quality and physical activity were associated with weight gain prevention. These findings support continued efforts to improve lifestyle as a beneficial strategy to prevent long-term weight gain, particularly among women with a history of GDM.

scholarly journals Weight Gain and Progression to Type 2 Diabetes in Women With a History of Gestational Diabetes Mellitus

2015 ◽  
Vol 100 (9) ◽  
pp. 3548-3555 ◽  
Author(s):  
Joon Ho Moon ◽  
Soo Heon Kwak ◽  
Hye Seung Jung ◽  
Sung Hee Choi ◽  
Soo Lim ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
History Of

scholarly journals Gestational Diabetes Mellitus: a review of the diagnosis, clinical implications and management

2013 ◽  
Vol 4 (2) ◽  
pp. 127-139
Author(s):  
Vincent Wing-Ming Wong
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Management Strategies ◽  
Nutrition Therapy ◽  
Clinical Implications ◽  
The Future ◽  
Medical Nutrition

Gestational diabetes mellitus (GDM) is a condition that affects the wellbeing of mother and fetus. Women with GDM are at risk of type 2 diabetes mellitus in the future, while fetal exposure to hyperglycaemia in-utero may affect their glycometabolic profile later in life. Appropriate screening and management of this problem is important in ensuring good pregnancy outcomes. In this review, the clinical implications, the various ways to screen and diagnose GDM, and management strategies during pregnancy will be discussed. For years, insulin is the mainstay of treatment if medical nutrition therapy fails to maintain adequate glycaemic control, but use of other oral pharmacotherapy may gain greater acceptance in the future. Following delivery, ongoing follow-up of these women is worthwhile as early intervention through lifestyle or pharmacotherapy may prevent the development of diabetes.

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