Gestational diabetes mellitus (GDM), a common medical complication of pregnancy, is defined as “any degree of glucose intolerance with onset or first.

Slides:



Advertisements
Similar presentations
Diabetes in pregnancy Dr Than Than Yin.
Advertisements

P REDICTION OF GESTATIONAL DIABETES MELLITUS BY MATERNAL FACTORS AND BIOMARKERS AT 11 TO 13 WEEKS.
The risk of Insulin Resistence and Metabolic Syndrome among overweight/obese children born of mothers with Gestational Diabetes Mosca A., Vania A Dept.
Diabetes during pregnancy
Diabetes in Pregnancy Screening.
Update in Diagnosis and Management
UPDATE ON GESTATIONAL DIABETES: CONTROVERSIES, CHANGES AND CHALLENGES JAMES R. SCOTT, MD I HAVE NO CONFLICT OF INTEREST TO DISCLOSE.
My Story Meet Tausi Suedi… AND her beautiful children!
Screening for Prediabetes Kelly Moore, MD, FAAP IHS Division of Diabetes Treatment & Prevention.
DR. TARIK Y. ZAMZAMI MD, CABOG, FICS ASSOCIATE PROFESSOR CONSULTANT OB/GYN
A medical test to determine the ability of an individual to maintain HOMEOSTASIS of Blood Glucose The most commonly performed version of the Test (OGTT)
Tam H. Nguyen, PhD, MSN/MPH, RN
Critical evaluation of the diagnosis of Gestational Diabetes Mellitus (GDM) Simon Weitzman, MD, MPH.
Normal physiology of pregnancy First trimester-Increased insulin sensitivity. Late 2 nd and 3 rd trimester insulin resistance possible associated with.
Screening for Diabetes in Pregnancy 1. Gestational Diabetes Mellitus Screening GDM, gestational diabetes mellitus. Handelsman YH, et al. Endocr Pract.
Disclosures D. Ware Branch, MD Nothing to discloseNothing to disclose.
M.G.S.D. The Gestational Diabetes Study in the Mediterranean Region Protocol C. Savona-Ventura Research Management Committee – M.G.S.D.
Update in Diagnosis and Management
PRE-EXISTING DIABETES AND PREGNANCY 2003 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada.
成大醫院 內科部 內分泌新陳代謝科 歐弘毅醫師
Gestational Diabetes Testing Paradigms in a Rural Office November 7, 2014.
DiabetesAndPregnancy. Etiological Classification ►Type 1 A ■ Immune-mediated β-cell destruction ►Type 1 B ■ Idiopathic β-cell destruction ►Type 2 ■ Range.
HEFT - Good Hope Gestational diabetes service. HEFT – Good Hope, Birmingham Heartlands and Solihull Hospitals Two very different patient populations >12000.
GDM-DEFINITION Gestational Diabetes Mellitus (GDM) is defined as ‘carbohydrate intolerance with recognition or onset during pregnancy’, irrespective of.
IDC 1.1 Global and National Burden of Diabetes Diabetes Mellitus: classification New (WHO) Screening and Diagnostic Criteria –Diabetes, Impaired Glucose.
RATIONALE PROF. S. DURAN GARCIA SPAIN.  Gestational Diabetes Mellitus (GDM) was defined as a biochemical disturbance of glucose tolerance first diagnosed.
DIABETES. Type I Diabetes: Preconception Counseling The most important aspect of the management of the Type I diabetic during pregnancy is preconception.
Journal Club 亀田メディカルセンター 糖尿病内分泌内科 Diabetes and Endocrine Department, Kameda Medical Center 松田 昌文 Matsuda, Masafumi 2008 年5月 22 日 8:20-8:50 B 棟8階 カンファレンス室.
The Relative Contribution of Prepregnancy Overweight and Obesity, Gestational Weight Gain, and IADPSG-Defined Gestational Diabetes Mellitus to Fetal Overgrowth.
POSTTERM PREGNANCY: THE IMPACT ON MATERNAL AND FETAL OUTCOME Dr. Hussein. S. Qublan- Al-Hammad Jordanian Board in Obstet &Gynecology European Board in.
The Hyperglycemia and Adverse Pregnancy Outcome Study
Josephine Carlos-Raboca, MD
 SC Guidelines for Diabetes Care Screening for Diagnosis of Diabetes To test for diabetes or to assess risk of future diabetes, either A1C, Fasting.
Gestational Diabetes Gestational Diabetes. Definition Any degree of glucose intolerance with onset or 1 st recognition during pregnancy. Any degree of.
Diabetes in pregnancy Timing and Mode of Delivery
Diabetes during pregnancy. Introduction  Diabetes is a endocrinological disorder.  The prevalence of diabetes is about 3% in the whole population. 
Diabetes Mellitus and Pregnancy. Introduction Pregnancy is characterized, in part, by insulin resistance and hyperinsulinemia, thus it may predispose.
Diabetes. Objectives: Diabetes Mellitus (DM) Discuss the prevalence of diabetes in the U.S. Contrast the main types of diabetes. Describe the classic.
ANTENATAL CARE OF DIABETES IN PREGNANCY: AUDIT Rachael Read ST2 O&G Supervisor: Mr E Njiforfut Consultant.
HYPOTHYROIDISM. INTRODUCTION  Hypothyroidism is defined as a deficiency in thyroid hormone secretion and action that produces a variety of clinical signs.
Authors: Dr. Majid Valizadeh Dr. Zahra Piri Dr. Kourosh Kamali Dr. Farnaz Mohammadian Dr. Hamidreza Amirmioghadami Presenter: Piri Z. MD.
Mei-Chun LU, Song-Shan HUANG, Yuan-Horng YAN, Panchalli WANG, Yueh-Han HSU, Wei CHEN Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi,
Carbohydrates: Clinical applications Carbohydrate metabolism disorders include: Hyperglycemia: increased blood glucose Hypoglycemia: decreased blood glucose.
UOG Journal Club: March 2016 Prediction of large-for-gestational-age neonates: screening by maternal factors and biomarkers in the three trimesters of.
Screening System for Hypertension and Diabetes at Primary Care Level
N323: Parent-Child Nursing
Definition. GESTATIONAL DIABETES MELLITUS Dr Abha Gupta Professor of Medicine, LLRM Medical College, Meerut  
Metformin versus Insulin for the Treatment of Gestational Diabetes
UOG Journal Club: March 2016
DIP, GDM; CLINICAL IMPORTANCE AND NEW WHO DIAGNOSTIC CRITERIA FOR GDM
Screening for Diabetes in Pregnancy
Turkish Guidelines for the management of pregnancies with GDM
Inonu University, Turgut Ozal Medical Centre
Hypothyroidism during pregnancy
A Study on Gestational Diabetes in Eastern India
Shaheen Mannan Amaju Ikomi
Department of Obstetrics & Gynecology
L. Bozkurt1, C. S. Göbl2 , A.-T. Hörmayer1, Anton Luger1, Sabina Baumgartner-Parzer1, A. Kautzky-Willer1 Implications of pregestational overweight.
Mean HPO Fasting Plasma Glucose
Dietary treatment in gestational diabetes: Relation to birth weight
Capacity Building for Prevention of Complication from Gestational Diabetes in Public health system, UP Dr Rajesh Jain Project Manager Diabetes Prevention.
D2d participating clinical sites
Gestational Diabetes Lab 4.
Screening for Diabetes in Pregnancy
17-alpha Hydroxyprogesterone caproate did not reduce the rate of recurrent preterm birth in a prospective cohort study David B. Nelson, MD; Donald D. McIntire,
GESTATIONAL DIABETES RISKS AND FUTURE. GESTATIONAL DIABETES RISKS AND FUTURE.
Obstetric Cholestasis (lntrahepatic cholestasis of pregnancy):
ROGER S. MAZZE, Ph.D., CHRISTOPHER L. KROGH, M.D. 
Stratified analysis of the association between GDM and abdominal circumference (AC) >90th percentile at 28 wkGA. Stratified analysis of the association.
Chantal Nelson BORN Annual Conference April 25, 2017
Presentation transcript:

Gestational diabetes mellitus (GDM), a common medical complication of pregnancy, is defined as “any degree of glucose intolerance with onset or first recognition during pregnancy.”

There is consensus that overt diabetes during pregnancy, whether symptomatic or not, is associated with significant risk of adverse perinatal outcome.

THE HAPO STUDY

The objective of the HAPO study was to clarify associations of levels of maternal glucose lower than those diagnostic of diabetes with perinatal outcome.

This was accomplished by performing a 75-g oral glucose tolerance test (OGTT) on a heterogeneous, multinational, multicultural, ethnically diverse cohort of 25,000 women in the third trimester of gestation.

Primary outcomes in the blinded HAPO cohort were birth weight 90th percentile, primary cesarean section delivery, clinically defined neonatal hypoglycemia, and cord C-peptide 90th percentile.

Secondary outcomes were preclampsia, preterm delivery, shoulder dystocia/ birth injury, hyperbilirubinemia, and intensive neonatal care.

Importantly, there were continuous graded relationships between higher maternal glucose and increasing frequency of the primary outcomes, independent of other risk factors. Similar associations were also observed for secondary outcomes.

Thus, by these new criteria, the total incidence of GDM was 17.8%; the FPG plus 1-h plasma glucose levels identified a large majority of these individuals.

To achieve reliable diagnosis and classification of hyperglycemia in pregnancy, clinical laboratories must measure venous plasma or serum glucose using an enzymatic method with high accuracy and precision.

Identification of overt diabetes

Timing of the initial test. It is desirable to detect overt diabetes in pregnancy as early as possible to provide an opportunity to optimize pregnancy outcome

It is desirable to detect overt diabetes in pregnancy as early as possible to provide an opportunity to optimize pregnancy outcome.

Decision to perform blood testing for evaluation of glycemia on all pregnant women or only on women with characteristics indicating a high risk for diabetes is to be made on the basis of the background frequency of abnormal glucose metabolism in the population and on local circumstances.

Recently, it was reported that higher first trimester FPG levels (lower than those diagnostic of diabetes) are associated with increased risks of later diagnosis of GDM and adverse pregnancy outcomes.

Universal early testing in populations with a high prevalence of type 2 diabetes is recommended, especially if metabolic testing in this age-group is not commonly performed outside of pregnancy.

It is recommended that an FPG value in early pregnancy 92 mg/dl also be classified as GDM.

If enrollment is at 24 weeks’ gestation or later and overt diabetes is not found, the initial test should be followed by a 75-g OGTT.

Indeterminate results of initial testing

However, there have not been sufficient studies performed to know whether there is benefit of generalized testing to diagnose and treat GDM before the usual window of 24 –28 weeks’ gestation. Therefore, the IADPSG Consensus Panel does not recommend routinely performing OGTTs before 24–28 weeks’ gestation.

SUMMARY OF DETECTION STRATEGY