Abstract
With the rising trend in obesity, the incidence of gestational diabetes mellitus (GDM) and perinatal complications associated with the condition are also on the rise. Since the early 1900s, much knowledge has been gained about the diagnosis, implications, and management of gestational diabetes with improved outcomes for the mother and fetus. Worldwide, there is variation in the definition of GDM, methods to screen for the condition, and management options. The International Association of Diabetes in Pregnancy Study Groups has published recommendations for a one-step approach to screen pregnant women for GDM, in order to develop outcome-based criteria that can be used internationally. However, management of GDM continues to be varied, and currently several options are available for treatment of hyperglycemia during pregnancy. A review of various aspects of GDM is discussed with a focus on the medical management during pregnancy, as practiced in the United States.
Highlights
A worldwide rising trend in obesity has been reported from 1975 to 2016, affecting females and males alike [1]
Based on the published literature, we have reviewed the history of gestational diabetes mellitus (GDM), screening options, and management, with focus on the management options for persistent hyperglycemia
We report an increasing incidence of diabetes and GDM in association with increasing incidence in maternal obesity
Summary
A worldwide rising trend in obesity has been reported from 1975 to 2016, affecting females and males alike [1]. The rising obesity has led to an increase in the incidence of gestational diabetes mellitus (GDM) as well as associated pregnancy and perinatal complications. Known non-modifiable risk factors for predisposition to GDM include advanced maternal age, ethnicity, and family history of type 2 diabetes mellitus [2]. It is reported to be higher in some countries with rates as high as 17.8–41.9% when using the International Association of Diabetes in Pregnancy Study Groups (IADPSG) GDM criteria [4,5]. The recommendations for pharmacotherapy in patients with GDM have evolved over the past two decades. We have included the recent data on the options for medical management, as well as data on the current recommendations based on safety data of these pharmacotherapeutic options during pregnancy
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