Gestational Diabetes Mellitus: A Review of the Literature
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Authors
Selik, Brooke A.
Issue Date
2013
Type
Thesis
Language
en_US
Keywords
Alternative Title
Abstract
The rise in obesity rates both in the United States and worldwide has lead to an
increase in prevalence of gestational diabetes mellitus (GDM), which is diabetes with
onset during pregnancy. While changes in maternal insulin sensitivity are necessary
during pregnancy to accommodate the energy requirements of the growing fetus, GDM
results from severe insulin resistance for which the mother cannot compensate. Several
placental hormones and secreted factors including hPGH and TNF-α have been
implicated in GDM pathogenesis because of their known anti-insulin properties. Most
pregnant women are tested for GDM with some form of oral glucose tolerance test at 24-
28 weeks’ gestation. However, lack of standardization in screening and diagnosis
methods remains a major hurdle in GDM diagnosis and management. Current
management options for GDM include blood glucose monitoring, medical nutrition
therapy, exercise, and insulin therapy, if necessary. Oral hypoglycemic agents such as
metformin and glyburide are being studied for their potential use as therapeutic agents in
GDM patients, but their teratogenicity is unclear. Because women with a history of
GDM and their children are at increased risk of developing type 2 diabetes later in life, it
is crucial that they be monitored closely postpartum. They should also be counseled
about the benefits of lifestyle interventions in delaying or preventing the onset of diabetes.
More research needs to be done and more steps need to be taken in order to lower GDM
prevalence and better the health of these women and their families.
Description
v, 64 p.
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