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Related Concept Videos

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...
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...
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...
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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Monitoring Blood Glucose in Mouse Offspring After Intracytoplasmic Sperm Injection
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Monitoring Blood Glucose in Mouse Offspring After Intracytoplasmic Sperm Injection

Published on: May 17, 2024

Diagnosing gestational diabetes.

E A Ryan1

  • 1Division of Endocrinology and Metabolism, Department of Medicine, 362 Clinical Wing, Heritage Medical Research Building, Alberta Diabetes Institute, University of Alberta, Edmonton, AB, Canada. edmond.ryan@ualberta.ca

Diabetologia
|January 5, 2011
PubMed
Summary
This summary is machine-generated.

New gestational diabetes criteria will double diagnoses, identifying more women with mild hyperglycemia. The benefits of diagnosing these additional cases, like preventing large-for-gestational age infants, appear modest and warrant further discussion.

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Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Public Health

Background:

  • Newly proposed diagnostic criteria for gestational diabetes mellitus (GDM) are based on the Hyperglycemia Adverse Pregnancy Outcome (HAPO) study.
  • These criteria utilize a single oral glucose tolerance test (OGTT) and are linked to a 1.75-fold increased risk of delivering large-for-gestational age (LGA) infants.

Purpose of the Study:

  • To evaluate the impact of new diagnostic criteria for GDM on prevalence rates.
  • To assess the predicted benefits of diagnosing additional cases of GDM under the proposed criteria.
  • To question the clinical utility and resource allocation for implementing these new criteria.

Main Methods:

  • Analysis of a large cohort of 23,316 pregnancies to determine GDM prevalence under new versus existing criteria.
  • Comparison of the number of GDM diagnoses using a 1.75-fold LGA risk threshold versus a 2-fold LGA risk threshold.
  • Estimation of the potential reduction in adverse pregnancy outcomes, such as LGA, shoulder dystocia, and birth injuries.

Main Results:

  • The proposed criteria would increase GDM prevalence to 17.8%, diagnosing 4,150 women instead of 2,448.
  • This change is expected to prevent 140 cases of LGA, 21 shoulder dystocia cases, and 16 birth injuries.
  • Maternal obesity is identified as a stronger predictor of LGA than glucose levels under the proposed criteria.

Conclusions:

  • The new GDM diagnostic criteria significantly increase case detection but have questionable clinical benefit.
  • The poor reproducibility of OGTT for mild hyperglycemia and the modest outcome benefits suggest caution.
  • Further debate is recommended before widespread implementation and resource allocation for the new GDM diagnostic criteria.