engleski

Gestational diabetes mellitus

Gestational diabetes mellitus (GDM) is glucose intolerance that is first diagnosed in pregnancy. A diagnosis of GDM has implications for both the pregnancy and future health of the mother. The incidence of GDM ranges between 1% and 8%. A general decrease in perinatal mortality and especially in perinatal morbidity has made their proportion due to GDM increasingly recognizable and more significant. A disturbed intrauterine environment in patients with unrecognized or inadequately treated GDM may produce foetal jeopardy. The most important step in the management of GDM is its diagnosis. All women with GDM should be given dietary counselling and be monitored at least weekly for fasting and postprandial hyperglycemia. If hyperglycemia occurs, insulin should be administered to restore glucose homeostasis and reduce the risk of perinatal mortality. Once this has been achieved, almost every type of management protocol has been associated with reduction in the perinatal mortality rate. This is probably a reflection of the increased maternal and foetal surveillance prompted by this diagnosis, along with general improvements in perinatal care. The management of high risk situations is also directed toward lowering of perinatal morbidity. This paper outlines a plan of management which includes the above mentioned considerations. A protocol for the management of GDM patients is recommended.

gestational diabetes mellitus; diagnosis; screening; pathophysiology; management; long-term sequelae

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