Gestational diabetes: Difference between revisions
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== Description == | == Description == | ||
<div>Gestational Diabetes Mellitus (GDM) is | <div>Gestational Diabetes Mellitus (GDM) is characterised by hyperglycaemia first recognised in pregnancy. Its prevalence varies widely in the literature, but is thought to effect 4-7.5% of all pregnancies <ref name="1" /><ref name="2">Lawreance, J.M., Contereras, R., Chen, W. and Sacks, D.A. (2008) 'Trends in the prevelance of preexisting diabetes mellitus and GDM among a racially/ethnically diverse population of pregnant women, 1999-2005', Diabetes Care, 31(5), 899-904.</ref> and is increasing <ref name="1">Dabelea, D., Snell-Bergeon, J.K., Hartsfield, C.L., Bischoff, K.J., Hamman, R.F., McDuffie, R.S. (2005) 'Increasing Prevelance of Gestational Diabetes Mellitus (GDM) Over Time and by Birth Cohort', Diabetes Care, 28(3), 579-584.</ref> more common among older women, obese women and certain ethnic groups<ref name="2" />. It usually presents after the beginning of the second trimester<ref name="4">Alwan, N., Tuffnell,D.J., West, J. (2009) 'Treatments for Gestational Diabetes', The Cochrane Library, Issue 3.</ref>.<br></div> | ||
== Pathological Process<br> == | == Pathological Process<br> == | ||
Revision as of 23:48, 30 November 2013
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Description[edit | edit source]
<ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title and is increasing Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title more common among older women, obese women and certain ethnic groupsCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. It usually presents after the beginning of the second trimesterCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title.Pathological Process
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Several hormones produced during pregnancy block the action of insulin at a cellular level. As a result, blood glucose levels rise and more insulin is produced in response. As the pregnancy develops, the insulin demands increase further, and insulin resistance also increases due to rising levels of pregnancy hormones. However, this is a normal physiological change in pregnancy. The specific development of GDM, or why certain women develop GDM, is not known.
Consequences of Gestational Diabetes Mellitus[edit | edit source]
For Mother[edit | edit source]
GDM typically resolves after birth. However, there have been many studies detailing the increased risk of developing DM Type II after having GDM, particularly in the first 5 years postpartum Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title.
For Baby[edit | edit source]
Diagnositc Procedures[edit | edit source]
Risk Factors[edit | edit source]
Several factors have been identified which increase the risk of women developing GDM. These include:
Older age
Ethnicity, namely black, Native American, Pacific Islander, Hispanic, South or East Asian and Indigenous Australian
High pre-pregnancy BMI
Family history of diabetes
Previous GDM
Multigravid women
Excessive weight gain during pregnancy
Short stature
SmokingCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Local regimens use various screening tools in conjunction with these risk factors to identify women in need of further testing.
Screening for Gestational Diabetes Mellitus[edit | edit source]
GDM can only be confirmed by an abnormal glucose tolerance test. The World Health Organisation classify GDM as:
- A fasting blood glucose level of >7mmol/l
- A blood glucose level of >7.8mmol/l 2 hours after a 75g glucose drinkCite error: Invalid
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Medical Management / Interventions
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Medication
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Dietary Advise[edit | edit source]
Weight Management[edit | edit source]
The Role for Physiotherapy
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Physiotherapy in the Prevention of Gestational Diabetes Mellitus
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Physiotherapy in the Management of Gestational Diabetes Mellitus[edit | edit source]
Key Evidence[edit | edit source]
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Resources
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Case Studies[edit | edit source]
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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