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[Gestational diabetes]
1Service d'endocrinologie et diabétologie, CHRU de Lille, clinique Marc Linquette, 59037 Lille. p-fontaine@chru-lille.fr
La Revue Du Praticien
|January 16, 2004
Summary
Gestational diabetes affects 6% of pregnancies, necessitating systematic screening. Early glycemic control through diet or insulin therapy can reduce feto-maternal complications and long-term type 2 diabetes risk.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Public Health
Context:
- Gestational diabetes mellitus (GDM) complicates approximately 6% of pregnancies globally.
- It can occur in women without traditional risk factors, highlighting the need for universal screening.
- Current screening and diagnostic criteria lack global consensus, with France employing a two-step approach.
Purpose:
- To outline the current understanding of gestational diabetes screening and diagnosis.
- To describe the feto-maternal implications of gestational diabetes.
- To discuss therapeutic management and long-term implications for affected women.
Summary:
- Screening for gestational diabetes is recommended between 24-28 weeks of gestation.
- Diagnosis in France involves an O'Sullivan test followed by a 100g oral glucose tolerance test (OGTT) using Carpenter and Coustan criteria.
- Management includes dietary changes and, in 40% of cases, insulin therapy to achieve normoglycemia.
Impact:
- Effective glycemic control during pregnancy reduces feto-maternal complications such as macrosomia, respiratory distress, and metabolic issues.
- Women with a history of GDM have an increased risk of developing type 2 diabetes later in life.
- There is a need for defined long-term management and prevention programs for women diagnosed with gestational diabetes.