Controversies Around Gestational Diabetes. Practical Information for Family Doctors

Overview

Journal Can Fam Physician

Specialties General Medicine
Public Health

Date 2005 Jun 7

PMID 15934273

Citations 6

Authors

Len Kelly

Laura Evans

David Messenger

Affiliations

Soon will be listed here.

Abstract

Objective: To summarize some of the issues facing primary care physicians who are seeing increasing numbers of patients with gestational diabetes mellitus (GDM) and to explore new developments in use of oral hypoglycemics during pregnancy.

Quality Of Evidence: All the literature on screening for GDM offers level III evidence. Much of the literature on treatment is also level III, but newer studies offer level I evidence and are more useful for daily practice. Existing research leaves many important questions unanswered; research findings are inconsistent among studies, and treatment strategies are challenging to implement.

Main Message: Recent studies have clarified that rates of neonatal mortality and congenital malformations are not higher among the offspring of mothers with GDM. Treatment might affect birth weight, but whether treatment is associated with reductions in rates of shoulder dystocia and cesarean section is unclear. Several level I studies conclude that the oral hypoglycemic glyburide can be used safely and effectively during the second and third trimesters of pregnancy.

Conclusion: Management of GDM remains a controversial area in obstetric care. It is a growing area of research, and new developments that might clarify risk and simplify treatment are expected in the coming years.

Citing Articles

Gestational diabetes mellitus and obstetric outcomes in a Ghanaian community.

Bawah A, Ngala R, Alidu H, Seini M, Wumbee J, Yeboah F Pan Afr Med J. 2019; 32:94.

PMID: 31223385 PMC: 6560956. DOI: 10.11604/pamj.2019.32.94.17334.

Camel whey protein improves lymphocyte function and protects against diabetes in the offspring of diabetic mouse dams.

Mahmoud M, Badr G, El Shinnawy N Int J Immunopathol Pharmacol. 2016; 29(4):632-646.

PMID: 27694615 PMC: 5806827. DOI: 10.1177/0394632016671729.

Maternal supplementation of diabetic mice with thymoquinone protects their offspring from abnormal obesity and diabetes by modulating their lipid profile and free radical production and restoring lymphocyte proliferation via PI3K/AKT signaling.

Badr G, Mahmoud M, Farhat K, Waly H, Zin Al-Abdin O, Rabah D Lipids Health Dis. 2013; 12:37.

PMID: 23506302 PMC: 3608164. DOI: 10.1186/1476-511X-12-37.

The possible role of epigenetics in gestational diabetes: cause, consequence, or both.

Fernandez-Morera J, Rodriguez-Rodero S, Menendez-Torre E, Fraga M Obstet Gynecol Int. 2010; 2010:605163.

PMID: 21052542 PMC: 2968420. DOI: 10.1155/2010/605163.

Diabetes mellitus during pregnancy and increased risk of schizophrenia in offspring: a review of the evidence and putative mechanisms.

Van Lieshout R, Voruganti L J Psychiatry Neurosci. 2008; 33(5):395-404.

PMID: 18787655 PMC: 2527714.

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