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A Clinical Update on Gestational Diabetes Mellitus

Gestational diabetes mellitus (GDM) traditionally refers to abnormal glucose tolerance with onset or first recognition during pregnancy. GDM has long been associated with obstetric and neonatal complications primarily relating to higher infant birthweight and is increasingly recognized as a risk fac...

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Autores principales: Sweeting, Arianne, Wong, Jencia, Murphy, Helen R, Ross, Glynis P
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9512153/
https://www.ncbi.nlm.nih.gov/pubmed/35041752
http://dx.doi.org/10.1210/endrev/bnac003
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author Sweeting, Arianne
Wong, Jencia
Murphy, Helen R
Ross, Glynis P
author_facet Sweeting, Arianne
Wong, Jencia
Murphy, Helen R
Ross, Glynis P
author_sort Sweeting, Arianne
collection PubMed
description Gestational diabetes mellitus (GDM) traditionally refers to abnormal glucose tolerance with onset or first recognition during pregnancy. GDM has long been associated with obstetric and neonatal complications primarily relating to higher infant birthweight and is increasingly recognized as a risk factor for future maternal and offspring cardiometabolic disease. The prevalence of GDM continues to rise internationally due to epidemiological factors including the increase in background rates of obesity in women of reproductive age and rising maternal age and the implementation of the revised International Association of the Diabetes and Pregnancy Study Groups’ criteria and diagnostic procedures for GDM. The current lack of international consensus for the diagnosis of GDM reflects its complex historical evolution and pragmatic antenatal resource considerations given GDM is now 1 of the most common complications of pregnancy. Regardless, the contemporary clinical approach to GDM should be informed not only by its short-term complications but also by its longer term prognosis. Recent data demonstrate the effect of early in utero exposure to maternal hyperglycemia, with evidence for fetal overgrowth present prior to the traditional diagnosis of GDM from 24 weeks’ gestation, as well as the durable adverse impact of maternal hyperglycemia on child and adolescent metabolism. The major contribution of GDM to the global epidemic of intergenerational cardiometabolic disease highlights the importance of identifying GDM as an early risk factor for type 2 diabetes and cardiovascular disease, broadening the prevailing clinical approach to address longer term maternal and offspring complications following a diagnosis of GDM.
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spelling pubmed-95121532022-09-28 A Clinical Update on Gestational Diabetes Mellitus Sweeting, Arianne Wong, Jencia Murphy, Helen R Ross, Glynis P Endocr Rev Review Gestational diabetes mellitus (GDM) traditionally refers to abnormal glucose tolerance with onset or first recognition during pregnancy. GDM has long been associated with obstetric and neonatal complications primarily relating to higher infant birthweight and is increasingly recognized as a risk factor for future maternal and offspring cardiometabolic disease. The prevalence of GDM continues to rise internationally due to epidemiological factors including the increase in background rates of obesity in women of reproductive age and rising maternal age and the implementation of the revised International Association of the Diabetes and Pregnancy Study Groups’ criteria and diagnostic procedures for GDM. The current lack of international consensus for the diagnosis of GDM reflects its complex historical evolution and pragmatic antenatal resource considerations given GDM is now 1 of the most common complications of pregnancy. Regardless, the contemporary clinical approach to GDM should be informed not only by its short-term complications but also by its longer term prognosis. Recent data demonstrate the effect of early in utero exposure to maternal hyperglycemia, with evidence for fetal overgrowth present prior to the traditional diagnosis of GDM from 24 weeks’ gestation, as well as the durable adverse impact of maternal hyperglycemia on child and adolescent metabolism. The major contribution of GDM to the global epidemic of intergenerational cardiometabolic disease highlights the importance of identifying GDM as an early risk factor for type 2 diabetes and cardiovascular disease, broadening the prevailing clinical approach to address longer term maternal and offspring complications following a diagnosis of GDM. Oxford University Press 2022-01-18 /pmc/articles/PMC9512153/ /pubmed/35041752 http://dx.doi.org/10.1210/endrev/bnac003 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Review
Sweeting, Arianne
Wong, Jencia
Murphy, Helen R
Ross, Glynis P
A Clinical Update on Gestational Diabetes Mellitus
title A Clinical Update on Gestational Diabetes Mellitus
title_full A Clinical Update on Gestational Diabetes Mellitus
title_fullStr A Clinical Update on Gestational Diabetes Mellitus
title_full_unstemmed A Clinical Update on Gestational Diabetes Mellitus
title_short A Clinical Update on Gestational Diabetes Mellitus
title_sort clinical update on gestational diabetes mellitus
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9512153/
https://www.ncbi.nlm.nih.gov/pubmed/35041752
http://dx.doi.org/10.1210/endrev/bnac003
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