Presentation
Metabolic and electrolyte abnormalities Hypoglycemia may present within the first few hours of life. [emedicine.medscape.com]
Renal vein thrombosis presents with hematuria and a flank mass. The etiology is unknown. Small left colon syndrome presents with abdominal distension. Contrast enema shows a small left colon. [utmb.edu]
This is supported by the present study results showing that the greater the number of MetS components, the greater the increase in risk of GDM. [em-consulte.com]
Presented at: 77th Annual American Diabetes Association (ADA) Scientific Sessions; June 9-13, 2017; San Diego, CA. Abstract 1459. [endocrinologyadvisor.com]
Written by an esteemed list of international authors, Gestational Diabetes: Origins, Complications, and Treatment presents timely reviews relating to some of the most important aspects of gestational diabetes, specifically its causes, consequences, and [books.google.com]
Entire Body System
- Weight Gain
Maintain a healthy weight Overview Healthy weight gain can refer to your overall weight gain or your weekly rate of weight gain. [slideshare.net]
Prevention of pregnancy-related weight retention, including excessive gestational and postpartum weight gain, is important for the prevention of MeS. [bmjopen.bmj.com]
Follow up of all cases in antenatal care clinic, with clinical assessment including weight gain, blood pressure, urine examination for proteinuria and fetal well being tests. [clinicaltrials.gov]
Maternal weight gain is the amount of weight gained by the mother during the pregnancy period. According to Institute of medicine and nutrition the normal maternal weight gain during pregnancy is 11.5 – 16kg. 7. [ijddr.in]
With too much sugar, her fetus can gain a lot of weight. [acog.org]
- Fatigue
[…] and muscle weakness Hypothyroidism Fatigue Weight gain Muscle weakness Cold intolerance Mental status changes ranging from irritability and depression to coma It is important to recognize that there are many physiologic changes that occur in pregnancy [clinicaladvisor.com]
Here are some possible signs of gestational diabetes that should be brought to your doctor’s attention: Blurred vision Tingling or numbness in the hands and/or feet Excessive thirst Frequent urination Sores that heal slowly Excessive fatigue Gestational [thebump.com]
These symptoms are mostly related to abnormal blood sugar levels, and can include fatigue, excessive thirst and increased urination. Causes During pregnancy, changes happen in the mother's body to make sugar more available to the fetus, said Dr. [livescience.com]
Some women may experience mild symptoms such as: fatigue excessive thirst increased urinary urgency and frequency snoring increased weight gain However, gestational diabetes can increase your risk of other conditions. [healthline.com]
- Weight Loss
A weight loss can be dangerous during any part of the pregnancy, therefore any weight loss needs to be reported to a health care provider right away. [slideshare.net]
Eating a balanced diet low in carbohydrates and maintaining a healthy weight can help lessen the symptoms of PCOS. Regular exercise helps weight loss and also aids the body in reducing blood glucose levels and using insulin more efficiently. [diabetes.org]
The Diabetes Prevention Program recommendations to promote weight and decrease the risk of type 2 diabetes include breast-feeding and establishing a diet plan for specific weight loss and an exercise regimen of at least 150 minutes per week. 4,13,14 [pharmacytimes.com]
She may experience: Hair loss Weight gain Acne Excess body hair Pale skin Loss of libido Lack of energy You’re not vain because you want to avoid these things. The above symptoms, and others, are strong indicators of your overall health. [blog.bulletproof.com]
- Inflammation
The inflammation in these skin conditions is in the epidermis, or outer layer of the skin, and this is the main distinction between eczema and other skin conditions. [thepaleomom.com]
These include lower-than-normal concentrations of oxygen in the blood of the fetus (hypoxia), oxidative stress in the placental tissue and cord blood, changes in gene expression and chronic inflammation. [medicalnewstoday.com]
The metabolic syndrome: inflammation, diabetes mellitus, and cardiovascular disease Am J Cardiol 2006 ; 97 : 3A-11A [cross-ref] [3] Hotamisligil G.S. [em-consulte.com]
“The authors suggest it could be the result of direct damage to the developing brain because of too much glucose or inflammation, which have already been associated with autism,” says Halladay. [endocrineweb.com]
Inflammation is considered to be the missing link between GDM and MS, which is associated with insulin resistance [40]. [journals.plos.org]
- Myxedema
Concomitant glucocorticoid therapy is also given in myxedema coma because of the possibility of adrenal insufficiency, especially in cases of secondary hypothyroidism. 3. [clinicaladvisor.com]
Respiratoric
- Respiratory Distress
Abstract Perinatal data on 805 infants of diabetic mothers and 10,152 infants of nondiabetic mothers were examined for a relation between maternal diabetes and respiratory-distress syndrome of the newborn. [nejm.org]
Initially, the differential diagnosis includes transient tachypnea of the newborn, respiratory distress syndrome, pneumonia, and persistent pulmonary hypertension. [emedicine.medscape.com]
Respiratory distress (difficulty breathing) Too much insulin in a baby's system due to diabetes can delay surfactant production which is needed for lung maturation. [stanfordchildrens.org]
Diabetic cardiomyopathy presents with respiratory distress and symptoms of congestive failure. [utmb.edu]
Early labor and delivery comes with its own set of risks, including infant respiratory distress syndrome, a health disorder marked by difficulties in breathing. [birthinjuryguide.org]
Gastrointestinal
- Increased Appetite
Signs and symptoms of type 1 and type 2 diabetes with hyperglycemia may include: Increased thirst Increased urination Increased appetite (with type 1, weight loss is also seen) Fatigue Nausea, vomiting, abdominal pain (especially in children) Blurred [labtestsonline.org]
- Polydipsia
Diabetic ketoacidosis Nausea, vomiting, abdominal pain, ileus Polyuria and polydipsia Mental status changes Tachycardia and hyperventilation (Kussmaul respirations) Hypovolemia Osmotic diuresis Acute adrenal insufficiency Hypotension and hypovolemic shock [clinicaladvisor.com]
Cardiovascular
- Hypertension
Available data suggest that insulin resistance, already linked to the pathogenesis of essential hypertension, contributes to the development of hypertension during pregnancy as well, be it gestational hypertension or pre-eclampsia. [diapedia.org]
[…] twofold increased odds of preeclampsia and pregnancy-induced hypertension than women without these conditions. [excemed.org]
Therefore, we defined MS as ≥2 of the following 4 criteria: obesity, hypertension, evidence of dyslipidemia (low HDL levels or elevated triglyceride levels), and glucose intolerance. [pediatrics.aappublications.org]
Initially, the differential diagnosis includes transient tachypnea of the newborn, respiratory distress syndrome, pneumonia, and persistent pulmonary hypertension. [emedicine.medscape.com]
The prevalence of chronic hypertension, gestational hypertension, pre-eclampsia, and superimposed pre–eclampsia are all more frequent in diabetic pregnancies. [dmsjournal.biomedcentral.com]
Eyes
- Blurred Vision
Here are some possible signs of gestational diabetes that should be brought to your doctor’s attention: Blurred vision Tingling or numbness in the hands and/or feet Excessive thirst Frequent urination Sores that heal slowly Excessive fatigue Gestational [thebump.com]
It can lead to hunger, sweating, irregular and rapid heart beat, confusion, blurred vision, dizziness, fainting, and seizures. Severely low blood glucose can lead fairly quickly to insulin shock and death. [labtestsonline.org]
Symptoms of hyperglycaemia include: feeling more thirsty needing to wee more often than usual having a dry mouth feeling more tired getting recurring infections, such as thrush or urinary tract infections (UTIs) having blurred vision (NHS 2016) If you [babycenter.com.au]
Very hungry Very tired Shaky or trembling Sweating or clamminess Nervous Confused Like you’re going to pass out or faint Blurred vision * Report any abnormal blood sugar level to your health care provider right away, in case a change in your treatment [slideshare.net]
Urogenital
- Cesarean Section
They also have an increased risk of delivering small babies, most often by cesarean section. All classes have an increased risk of abnormally large amounts of amniotic fluid (polyhydramnios). [pediatricweb.com]
The baby is larger than normal and you may need to deliver by cesarean section. [the-diabetic-voice.com]
In addition, your baby’s growth and development will be even more carefully monitored—if the baby is growing too large, labor may be induced early or you may need to undergo a cesarean section to deliver. [thediabetescouncil.com]
section; §Adjustment for maternal age, parity and gestational age *p-value They are more likely to be delivered by emergency Cesarean Section (CS), Odds Ratio (OR) 1.94, 95% Confidence Intervals (CI) (1.14-3.28), p=0.008 or elective CS, OR 3.68, 95%CI [omicsonline.org]
Comparison Between Early and Late Diagnosis of GDM Periods There was a significant difference in cesarean section (86.69%) (P = 0.013**) hypoglycemia (41.23%) (P = 0.002**) and SGA were found to be highly significant (14.43%) (P = 0.0001***) where as [ijddr.in]
Neurologic
- Stroke
We are indebted to the many physicians and nurses who compiled the data of the National Institute of Neurological Diseases and Stroke Collaborative Study and the data on infants of diabetic mothers from 1958 to 1968 at the Boston Hospital for Women, and [nejm.org]
Hyperviscosity due to polycythemia increases the IDM’s risk for stroke, seizure, necrotizing enterocolitis, and renal vein thrombosis. [emedicine.medscape.com]
[…] sugar) for energy, but as with most things, too much of any substance can be detrimental—and too much glucose in the blood for any length of time can damage the nerves, the kidneys, the eyes and other organs as well as put you at risk for heart disease, stroke [thediabetescouncil.com]
Women who have high blood pressure or preeclampsia during pregnancy also are at greater risk of heart disease and stroke later in life. [acog.org]
Chronic high blood glucose can cause long-term damage to blood vessels, nerves, and organs throughout the body and can lead to other conditions such as kidney disease, loss of vision, strokes, cardiovascular disease, and circulatory problems in the legs [labtestsonline.org]
- Hyperactivity
An increased risk of hyperactivity disorders. An increased risk of problems with motor skill development. Other activities requiring balance and coordination. [the-diabetic-voice.com]
Workup
Serum
- Insulin Increased
As pregnancy advances -Progressive increase in tissue resistance to insulin Increase insulin secretion to maintain euglycemia Suppressed glucagon response Inc. prolactin, cortisol HPL has GH like effects 9. CHO Metabolism 10. [slideshare.net]
Treatment
Treatment for infants of diabetic mothers Treatment of a baby born to a diabetic mother often depends upon the control of diabetes during the last part of pregnancy and during labor. [stanfordchildrens.org]
Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if your child is having problems. [myhealth.alberta.ca]
Treatment Results from various studies have concluded that proper treatment has a significant impact on the health of both mother and child. [pharmacytimes.com]
Treatment GDM can cause serious consequences for you and your baby but these can be greatly reduced by treatment. Treatment includes following advice about diet and physical activity. Medicines to lower your blood sugar levels may be required. [patient.info]
Prognosis
Prognosis DKA represents an acute emergency to both maternal and fetal well-being. Prompt initiation of treatment will correct the associated maternal and fetal metabolic acidosis, hyperglycemia, ketosis, and volume depletion.. [clinicaladvisor.com]
HbA1c for diagnosis and prognosis of gestational diabetes mellitus. Diabetes Res Clin Pract 110, 38-43, 2015. Lacroix M, Battista MC, Doyon M, Houde G, Menard J, Ardilouze JL, Hivert MF, Perron P. [degruyter.com]
[…] with the drug, there remains a possibility of long-term complications from metformin therapy. [3] Babies born to women treated with metformin have been found to develop less visceral fat, making them less prone to insulin resistance in later life. [73] Prognosis [en.wikipedia.org]
Etiology
Etiology is islet cell hyperplasia due to maternal hyperglycemia with subsequent hyperinsulinemia. Much less frequent with good maternal prenatal diabetic control. Respiratory Distress Syndrome. [utmb.edu]
Cushing’s syndrome Treatment will depend on the etiology of the cortoisol excess and may include surgery, radiotherapy, chemotherapy, and/or cortisol-inhibiting medications, such as metyrapone, ketoconazole, or aminoglutethimide. [clinicaladvisor.com]
PubMed Google Scholar Kjos SL, Walther F: Prevalence and etiology of respiratory distress in infants of diabetic mothers: predictive value of lung maturation tests. Am J Obstet Gynecol. 1990, 163 (3): 898-903. [dmsjournal.biomedcentral.com]
Although the etiology and diagnostic criteria of MS is still a subject of debate, the condition shares common features with GDM, including insulin resistance, dyslipidemia, and endothelial dysfunction [10]. [journals.plos.org]
Epidemiology
Unlike previous epidemiological studies, BP, and lipid, glucose and insulin concentrations in early pregnancy, were precisely measured and not self-reported. [em-consulte.com]
Epidemiological studies confirmed that the prevalence of GDM is in direct proportion to the prevalence of type 2 diabetes mellitus (T2DM) [4]. [omicsonline.org]
Epidemiology Diabetic ketoacidosis Incidence of DKA is approximately 2% to 3% in pregnancy with an associated 10% perinatal mortality rate. [clinicaladvisor.com]
Epidemiology and causes of preterm birth. Lancet. 2008;371(9606):75–84. 29. Hedderson M, Ferrara A, Sacks D. Gestational diabetes mellitus and lesser degrees of pregnancy hyperglycemia: association with increased risk of spontaneous preterm birth. [dovepress.com]
American Journal of Epidemiology. 160 (12): 1168–76. doi : 10.1093/aje/kwh345. PMID 15583369. ^ Toulis KA, Goulis DG, Kolibianakis EM, Venetis CA, Tarlatzis BC, Papadimas I (August 2009). [en.wikipedia.org]
Pathophysiology
The final section discusses future prospects in screening, diagnosis, prevention, pathophysiology, and treatment of gestational diabetes. [books.google.com]
Pathophysiology Changes in glucose metabolism Variable glucose and insulin levels are seen in pregnancy depending upon the mother’s nutritional state. Fasting glucose levels can decrease by 10% to 20%. [clinicaladvisor.com]
Inflammatory and Other Biomarkers: Role in Pathophysiology and Prediction of Gestational Diabetes Mellitus. Int J Mol Sci 16, 13442‒13473, 2015. Aktun HL, Uyan D, Yorgunlar B, Acet M. Gestational diabetes mellitus screening and outcomes. [degruyter.com]
Diabetic-associated stillbirth: incidence, pathophysiology, prevention. Obstet Gynecol Clin North Am. 2007;34:293–307. 25. Mathiesen E, Ringholm L, Damm P. Stillbirth in diabetic pregnancies. Best Pract Res Clin Obstet Gynaecol. 2011;25:105–111. 26. [dovepress.com]
Pathophysiology [ edit ] Effect of insulin on glucose uptake and metabolism. Insulin binds to its receptor (1) on the cell membrane which in turn starts many protein activation cascades (2). [en.wikipedia.org]
Prevention
Women with diabetes need special care during pregnancy to prevent problems. Controlling blood sugar can prevent many problems. [medlineplus.gov]
The authors continued, "Prevention of excessive weight gain during pregnancy and promoting postpartum weight reduction by individual tailored lifestyle modifications have been effective against weight retention, and in preventing further cardiometabolic [medpagetoday.com]
[…] of excessive pregnancy-related weight retention are important in not only preventing GDM, but also in preventing later MeS. [bmjopen.bmj.com]
The final section discusses future prospects in screening, diagnosis, prevention, pathophysiology, and treatment of gestational diabetes. [books.google.com]
Because there is no cure for PCOS, it needs to be managed to prevent further problems. There are many medications to control the symptoms of PCOS. Doctors most commonly prescribe birth control pills for this purpose. [diabetes.org]