Gestational Diabetes

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Группа авторов. Gestational Diabetes

Frontiers in Diabetes

Gestational Diabetes

Contents

Preface

Epidemiology of Gestational and Pregestational Diabetes Mellitus

Abstract

Background: Categories of Diabetes Mellitus

Diabetes in Pregnancy: Diagnosis

Prevalence and Characteristics of Women with Pregestational Diabetes

Prevalence and Characteristics of Women with GDM

Future Predictions

References

Maternal Metabolic Adaptation to Pregnancy

Abstract

Carbohydrate Metabolism

Steroid and Peptide Hormones (Table 1)

Adipocytokines (Table 2)

Tumor Necrosis Factor Alpha

Adiponectin

Other Adipocytokines

Lipid Metabolism

Protein Metabolism

Lactation

Gestational Diabetes

References

Obesity in Pregnancy: Epidemiology, Mechanisms, Nutritional and Metabolic Management

Abstract

Definitions

Epidemiology of Obesity in Pregnancy

Population Risks and Prevention

Infant of Obese Mother

Mechanisms Underlying Effects of Obesity in Pregnancy

GDM/Obesity: Interrelationships, Common and Divergent Mechanisms. Insulin Resistance

Evidence Base for the Treatment of Obesity and GDM

Metabolic Management of Obesity in Pregnancy. Metformin

Myoinositol

Probiotics

Fish Oil

Bariatric Surgery

Summary and Future Research

References

Lesson from the Hyperglycemia and Adverse Pregnancy Outcome Study: New Diagnostic Criteria for Gestational Diabetes Mellitus

Abstract

Introduction

Strategies for GDM Diagnosis

O’Sullivan and Mahan Study

Pre-IADPSG Criteria (Tables 1, 2)

HAPO Study

IADPSG Criteria (Tables 3, 4)

Crowther’s and Landon’s Study

Adopting the IADPSG Consensus

The Prevalence of GDM

Early and Overt Diabetes in Pregnancy

Choosing the Outcome

Setting the Threshold

Diabetes, Obesity, and Diabesity

Cost, Cost-Effective, and Cost-Saving

Clinical and Economic Consequences of Adopting the IADPSG Criteria

Current Policies around the World

Conclusion

Disclosure Statement

Funding Sources

References

Nutritional Management of Gestational Diabetes Mellitus

Abstract

Introduction

Glycemic Targets in Diabetic Pregnancies

Caloric Intake and Weight Gain

Macronutrients

Micronutrients [18, 35] (Table 2)

Water [18]

Fiber

Sweeteners [41]

How to Prescribe Nutrition Therapy in Diabetic Pregnancy?

Vegetarian Diets

References

Pharmacological Treatment of Gestational Diabetes Mellitus: When Lifestyle Intervention Is Not Enough

Abstract

Metformin

Glyburide

Insulin

Lispro

Aspart

Glulisine

Faster Aspart

Lispro Protamine Suspension

Premixed Insulin

Glargine

Detemir

Degludec

Other Insulin Analogs

GDM and Insulin Pumps

Other Drugs

Nutraceuticals

Conclusions

References

New Insulin to Treat Pregestational Diabetes in Pregnancy

Abstract

Introduction

Rapid-Acting Analogs

Long-Acting Insulin Analogs

Insulin Analogs in Pregnancy

Is There a Best Insulin Type and Regimen for Pregnant Women with Preexisting Diabetes?

Conclusions

References

Technology and Diabetes in Pregnancy

Abstract

Introduction

Stand-Alone Continuous Subcutaneous Insulin Infusion (Insulin Pump) Benefits of Insulin Pumps in the Nonpregnant Population

Benefits of Insulin Pumps in the Pregnant Population

Continuous Glucose Monitoring

“Professional” and “Real-Time” CGM

Professional CGM

PCGM in Diabetic Pregnancies

A Guide for a More Precise Therapeutic Approach

RTCGM in Diabetic Pregnancies

The “CONCEPTT” Study

Flash Glucose Monitoring: between CGM and SMBG

Closed-Loop Systems

Closed Loop in Pregnancy

Conclusions

References

Hypoglycemia in Diabetic Pregnancy

Abstract

Introduction

Definition and Epidemiology of Hypoglycemia in Pregnancy

Risk Factors of Hypoglycemia in Pregnancy

Pathophysiology of Hypoglycemia in Pregnancy

Hypoglycemic Symptoms

Maternal Consequences

Fetal Consequences

Treatment

Conclusions

References

Ketoacidosis

Abstract

Pathophysiology

Risk Factors of DKA

Symptoms and Signs of DKA

Treatment of DKA

Prevention of DKA

Maternal and Fetal Complications

Conclusions

References

Embryopathy and Diabetes

Abstract

Introduction

Etiological Observations

Oxidative Stress

ER Stress

Nitrosative Stress

Hexosamine Stress

Enhanced Apoptosis

Diminished Autophagy

Folic Acid Deficiency

Epigenetics

Remarks on Intervention

Remarks on the Teratogenicity of Diabetic Pregnancy

References

The Placenta in Diabetic Pregnancy: New Methodological Approaches

Abstract

OMICS Technologies. Methylome

Transcriptome

Metabolome

Lipidome

Proteome

Metallome

Microbiome

Exosomics

Challenges and Emerging Directions of OMICS Technologies

References

Role of Ultrasound Scan in Diabetic Pregnancy

Abstract

Introduction

Ultrasound in the Diagnosis of Congenital Malformations

Ultrasound in Estimation of Fetal Weight and Body Composition

Ultrasound in the Guidance of Maternal Glycemic Control and Therapeutic Management

Conclusion

References

Hypertension and Preeclampsia in Pregnancy Complicated by Diabetes

Abstract

Hypertensive Disorders in Pregnancy: Definition and Classification

Hypertensive Disorders in Pregnancy: Pathophysiology

PE and Diabetes in Pregnancy: Is There a Link?

PE and Gestational Diabetes

PE and Pregestational Diabetes

The Risk of Diabetes after a Preeclamptic Pregnancy

Diabetic Complications after a Preeclamptic Pregnancy

References

Management of Delivery: Obstetric Aspects

Abstract

Introduction

Rational

Timing. Gestational Diabetes Mellitus

Pregestational DM

Other Considerations Regarding Timing of Delivery

Mode

International Societies Recommendations

Intrapartum Monitoring

Anesthesia

Possible Complications

Breastfeeding

Conclusions

Disclosure Statement

Funding Sources

References

Offspring of Mothers with Hyperglycemia in Pregnancy: Short-Term Consequences for Newborns and Infants

Abstract

Introduction

Teratogenesis

Fetal Growth and Organ Development

The Neonate Born to a Diabetic Mother

Conclusion

References

Diabetes in Pregnancy: Long-Term Complications of Offsprings

Abstract

Introduction

Offspring Metabolic Outcomes. Overweight

Prediabetes/Diabetes

Insulin Function

Incretin Function and Glucagon

Hypertension, Cardiovascular Disease, and the Metabolic Syndrome

Low-Grade Inflammation

Offspring Cognitive Function

Potential Pathways

Cognitive Performance

Influence of Glycemic Control in Pregnancy

Cognitive Morbidity: Autism Spectrum Disorders and Attention Deficits

Offspring Epigenetic Markers. Introduction to Epigenetics

DOHaD and Epigenetics

DNA Methylation

MicroRNAs

Other Mechanisms: Telomere Length

Summary

Clinical Implications and Future Research

References

Maternal Long-Term Outcomes after a Pregnancy Complicated by Gestational Diabetes Mellitus

Abstract

Introduction

Pathophysiology

The Inflammatory Response

The Incretin Effect

The Microbiota

The Genes

Risk Factors of Long-Term Morbidity

The Influence of the Screening Method for GDM

The Impact of the Treatment during Pregnancy

Postpartum Weight Change

Postpartum Testing

Postpartum Diabetes

Cardiovascular Disease and the Metabolic Syndrome

Other Long-Term Consequences

Postpartum Intervention

Summary

References

Autoimmunity in Gestational Diabetes Mellitus

Abstract

Introduction

Immune Adaptations in Pregnancy

DRA in GDM. Prevalence

Persistence

Epitopes

Transplacental Passage

Clinical Features and Immunogenetics

Pregnancy and Postnatal Outcomes

Risk of Abnormal Glucose Tolerance after Delivery in Women with Autoimmune GDM (Table 2)

Concluding Remarks

References

Maturity-Onset Diabetes of the Young: Epidemiology and Management in Pregnancy

Abstract

Introduction

GCK-MODY

HNF1A-MODY

HNF4A-MODY

HNF1B-MODY

Management of MODY in Pregnancy (Table 1) GCK-MODY

HNF1A-MODY

HNF4A-MODY

HNF1B-MODY

References

The Omics and Pregnancy-Induced Complications: Gestational Diabetes and Metabolomics

Abstract

Metabolomics

Gestational Diabetes and Metabolomics

Future Perspectives

References

Author Index

Subject Index

Отрывок из книги

Gestational Diabetes A Decade after the HAPO Study

Series Editor

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Emerging New Aspects

Autoimmunity in Gestational Diabetes Mellitus

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