Maternal dysglycemia-including diabetes, impaired glucose tolerance, and impaired fasting glucose-affects one in six pregnancies worldwide and represents a significant health risk to the mother and the fetus. Maternal dysglycemia is an independent risk factor for perinatal mortality, major congenital anomalies, and miscarriages. Furthermore, it increases the longer-term risk of type 2 diabetes mellitus, metabolic syndrome, cardiovascular morbidity, malignancies, and ophthalmic, psychiatric, and renal diseases in the mother. The most commonly encountered form of maternal dysglycemia is gestational diabetes. Currently, international consensus does not exist for diagnostic criteria defining gestational diabetes at 24-28 weeks gestation, and potential diagnostic glucose thresholds earlier in gestation require further investigation. Likewise, recommendations regarding the timing and modality (, lifestyle or pharmacological) of treatment vary greatly. Because a precise diagnosis determines the appropriate treatment and outcome of the pregnancy, it is imperative that a better definition of maternal dysglycemia and its treatment be achieved. This article will address some of the controversies related to diagnosing and managing maternal dysglycemia. In addition, the article will discuss the impact of maternal dysglycemia on complications experienced by the mother and infant, both at birth and in later life.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8020552 | PMC |
| http://dx.doi.org/10.1089/jwh.2020.8853 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Management of Dysglycemia in a Pregnancy Complicated by Fanconi-Bickel Syndrome.
AACE Clin Case Rep
July 2024
Division of Endocrinology, Metabolism, and Molecular Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Background/objective: Fanconi-Bickel Syndrome (FBS) is an inherited disorder of glucose metabolism resulting from functional loss of glucose transporter 2 characterized by fasting hypoglycemia oscillating with postprandial hyperglycemia. Dysglycemia treatment strategies during FBS pregnancy have not been reported, and insulin therapy carries significant risk due to fasting hypoglycemia in FBS. We report for the first time: (1) glycemic profiles obtained via continuous glucose monitoring (CGM), (2) CGM-guided strategies for cornstarch and nutritional therapy for fasting hypoglycemia and postprandial hyperglycemia, respectively, and (3) placental glucose transporter 2 isoform expression in a pregnant individual with FBS.
View Article and Find Full Text PDFEvaluation of postpartum dysglycemia by serum glycosylated hemoglobin in patients with gestational diabetes mellitus: a national data analysis.
Arch Gynecol Obstet
December 2024
Department of Obstetrics and Gynecology, Rappaport Faculty of Medicine, Lady Davis Carmel Medical Center, Technion University, 7 Michal Street, 34361, Haifa, Israel.
Purpose: To assess the postpartum sensitivity and accuracy of serum HbA1c levels, compared to the gold standard of 75-g Oral Glucose Tolerance Test (OGTT), for diagnosis of dysglycemia in patients with a history of gestational diabetes mellitus (GDM).
Methods: A nationwide retrospective analysis of individuals with a history of GDM and with records of both postpartum 2 h-OGTT and serum HbA1c measured anytime between delivery until 12 months post-delivery. Results were stratified into 3 different intervals: 0-3 months, 3-12 months, and > 12 months after delivery, according to the timing of both OGTT and HbA1c performance.
Even moderate liver fat accumulation below conventional fatty liver cutoffs is linked to multiple metabolomic alterations and gestational dysglycemia in Asian women of reproductive age.
BMC Med
November 2024
Institute for Human Development and Potential (IHDP), Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Singapore, 117609, Singapore.
Article Synopsis
- * In a sample of 382 Asian women planning to conceive, the research identifies a new liver fat cutoff of 2.07% for diagnosing MetS, with trends indicating worsened MetS traits and plasma metabolomic changes as liver fat increases.
- * Results show that preconception liver fat levels significantly correlate with the risk of gestational diabetes, with moderate liver fat (2.07% to 5.56%) doubling and high liver fat (≥5.56%) increasing the risk seven
Association of early dysglycemia with intraventricular hemorrhage and mortality in very low birth weight infants.
Eur J Pediatr
December 2024
Clinical Pharmacy Department, Pharmaceutical Care Services, King Saud Medical City, Riyadh, Saudi Arabia.
Article Synopsis
- The study examines the combined effects of hyperglycemia and hypoglycemia on intraventricular hemorrhage (IVH) and mortality in very preterm infants admitted to a neonatal intensive care unit from January 2020 to January 2024.
- Out of 554 infants analyzed, 75.5% experienced hyperglycemia and/or hypoglycemia in their first postnatal week, with IVH occurring in 28.5% of infants and 13.7% resulting in death during the study.
- The findings indicate that both isolated hyperglycemia and the combination of hypo- and hyperglycemia significantly increase the risk of IVH and correlate with higher mortality rates among these infants.
An observational cohort study to investigate the impact of dolutegravir in pregnancy and its obesogenic effects on the metabolic health of women living with HIV and their children: Study protocol.
PLoS One
August 2024
Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Western Cape, Cape Town, South Africa.
Introduction: Dolutegravir (DTG)-based antiretroviral therapy is the World Health Organization's preferred first-line regimen for all persons with HIV, including pregnant women. While DTG has been implicated as an obesogen associated with greater weight gain compared to other antiretrovirals, there is a paucity of data in pregnant women and their children. The Obesogenic oRigins of maternal and Child metabolic health Involving Dolutegravir (ORCHID) study is investigating associations between DTG, weight gain, and metabolic outcomes in the context of HIV.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!