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]
Skin
- Flushing
If the bed is up against a wall or headboard, make sure it is flush against the surface – no cracks or openings. Some people even pull their bed away from the wall to eliminate the possibility of getting stuck between the bed and the wall. [marksdailyapple.com]
In the early morning hours of day 11 a nurse came in to flush out the line, and my son cried that it hurt. [judytsafrirmd.com]
The body tries to rid the blood of excess glucose by flushing it out of the system with increased urination. This process can cause dehydration and upset the body's electrolyte balance as sodium and potassium are lost in the urine. [labtestsonline.org]
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]
Neurologic
- Apathy
Although the infant is generally asymptomatic, symptoms may include jitteriness, irritability, apathy, poor feeding, high-pitched or weak cry, hypotonia, or frank seizure activity. [emedicine.medscape.com]
Urogenital
- Polyuria
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]
Workup
Serum
- Hypoglycemia
Hypoglycemia that requires intervention may persist for as long as 1 week. Hypoglycemia is caused by hyperinsulinemia due to hyperplasia of fetal pancreatic beta cells consequent to maternal-fetal hyperglycemia. [emedicine.medscape.com]
Code P70.1 Syndrome of infant of a diabetic mother 2016 2017 2018 2019 Billable/Specific Code Code on Newborn Record Applicable To Newborn (with hypoglycemia) affected by maternal (pre-existing) diabetes mellitus Type 1 Excludes newborn (with hypoglycemia [icd10data.com]
A newborn infant of a diabetic mother may develop one, or more, of the following: Hypoglycemia Hypoglycemia refers to low blood glucose in the baby immediately after delivery. [stanfordchildrens.org]
CM P70.0 Syndrome of infant of mother with gestational diabetes Or: 2015/16 ICD-10-CM P70.1 Syndrome of infant of a diabetic mother Approximate Synonyms Infant of diabetic mother Applies To Maternal diabetes mellitus affecting fetus or newborn (with hypoglycemia [icd9data.com]
In GDM, use of metformin is associated with a lower risk of hypoglycemia and potentially a lower weight gain. [excemed.org]
- Hyperinsulinemia
Polycythemia seen in 10-20%, may result from chronic hypoxia or as a result of too much stimulation of erythropoietin production by hyperinsulinemia. [utmb.edu]
Hypoglycemia is caused by hyperinsulinemia due to hyperplasia of fetal pancreatic beta cells consequent to maternal-fetal hyperglycemia. [emedicine.medscape.com]
Generally, the placental blood flow is impaired and transplacental exchanges are poor in the presence of hyperglycemia and hyperinsulinemia and a state of chronic relative hypoxemia occurs. [dmsjournal.biomedcentral.com]
Hyperinsulinemia and macrosomia in the fetus of the diabetic mother. Diabetes Care. 1994;18:640–648. 23. Mitanchez D, Yzydorczyk C, Siddeek B, Boubred F, Benahmed M, Simeoni U. [dovepress.com]
Laboratory parameters, associated with the metabolic syndrome of insulin resistance, are also observed more frequently in women with hypertension during pregnancy, such as: hyperinsulinemia, hyperlipidemia and elevated levels of Plasminogen Activator [diapedia.org]
- 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]