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Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis01:25

Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis

Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...
Pathophysiology of Diabetes01:20

Pathophysiology of Diabetes

Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility, suggesting a...
Diabetes: Symptoms, Diagnosis, and Complications01:15

Diabetes: Symptoms, Diagnosis, and Complications

For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is based on...
Hyperglycemia01:29

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
Diabetes Mellitus: Introduction01:26

Diabetes Mellitus: Introduction

Diabetes mellitus consists of chronic metabolic disorders characterized by persistent hyperglycemia. This elevated blood glucose results from defects in insulin secretion, impaired insulin action, or both. Insulin, produced by pancreatic β-cells, is essential for maintaining glucose homeostasis by facilitating cellular glucose uptake for energy or storage. Disruptions in insulin production or function lead to glucose accumulation in the bloodstream, causing the clinical features and long-term...

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Assessment of insulin adherence in diabetic outpatients: An observational study.

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A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-19
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When should screening be performed for gestational diabetes?

A-M Guedj1

  • 1Service maladies métaboliques et endocriniennes, hôpital Caremeau, CHU de Nîmes, place Pr. Debré, 30900 Nîmes, France.

Diabetes & Metabolism
|December 18, 2010
PubMed
Summary

Early screening for gestational diabetes mellitus (GDM) in high-risk pregnancies is not supported by current evidence. Standard GDM screening between 24-28 weeks remains recommended for all pregnancies.

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Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Maternal-Fetal Medicine

Background:

  • Gestational diabetes mellitus (GDM) screening is typically recommended between 24-28 weeks of gestation.
  • Rising prevalence of type 2 diabetes in women of childbearing age necessitates evaluating earlier screening protocols.
  • Current guidelines focus on the standard screening period due to physiological changes in glucose tolerance.

Purpose of the Study:

  • To evaluate the evidence supporting GDM screening outside the conventional 24-28 week gestational period.
  • To assess the utility of early GDM screening in high-risk pregnancies.
  • To review current recommendations from major obstetrics and diabetology societies.

Main Methods:

  • Comprehensive literature search of PubMed and Cochrane databases (1990-2010).
  • Consultation of guidelines from leading diabetology and obstetrics & gynecology societies.
  • Analysis of studies investigating early GDM screening and its diagnostic efficacy.

Main Results:

  • While early screening with fasting blood glucose is proposed for high-risk women, prospective studies do not support its benefit for GDM detection.
  • Oral glucose tolerance testing in early pregnancy is not currently recommended for GDM diagnosis.
  • Screening for GDM is universally recommended between 24-28 weeks, irrespective of risk factors or prior early screening.
  • No evidence supports the need for GDM screening later in pregnancy beyond the standard period.

Conclusions:

  • Current evidence does not support routine GDM screening before 24 weeks, even in high-risk individuals.
  • The established screening window of 24-28 weeks remains the standard of care for GDM detection.
  • Further research is needed to clarify the role, if any, of early or late GDM screening.