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Gestational diabetes: current aspects on pathogenesis and treatment.
1National Centre for Diabetes Care, Diabetes Unit of 1st Department of Internal Medicine, Semmelweis University, Faculty of Medicine, Budapest, Hungary. tamgyu@bell.sote.hu
Summary
Gestational diabetes (GDM) increases risks for mothers and infants. Early detection and management, including diet and insulin, are crucial for preventing long-term complications like type 2 diabetes and cardiovascular disease.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Public Health
Background:
- Gestational diabetes mellitus (GDM) is a pregnancy complication characterized by carbohydrate intolerance and hyperglycemia.
- Its incidence varies globally (0.15-15%), often linked to inadequate insulin secretion.
- Untreated GDM elevates risks for maternal (preeclampsia) and fetal (macrosomia, birth trauma) adverse outcomes.
Purpose of the Study:
- To review current literature and clinical experience regarding GDM.
- To emphasize the importance of GDM screening, management, and long-term follow-up.
- To highlight GDM as a predictor of future metabolic and cardiovascular diseases.
Main Methods:
- Review of current literature and clinical experience.
- Discussion of WHO-recommended screening methods using the 75g oral glucose tolerance test (oGTT).
- Outline of GDM management strategies, including dietary education and insulin therapy.
Main Results:
- GDM is associated with increased prevalence of hypertension.
- The 75g oGTT, evaluating fasting and/or 2-hour blood glucose, is recommended for universal screening.
- Dietary changes and insulin therapy are key management components.
Conclusions:
- GDM is a significant predictor of future type 2 diabetes (approx. 50% cumulative incidence at 5 years).
- Prior GDM is considered an early manifestation of metabolic syndrome and a cardiovascular risk factor.
- Yearly check-ups are essential for women with a history of GDM to screen for and prevent long-term complications.