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Hyperglycemia Diagnosed in Pregnancy: Diagnosis, Interventions, Outcomes and Knowledge Gaps

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Women's Health".

Deadline for manuscript submissions: closed (31 August 2022) | Viewed by 2009

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Guest Editor
Chair of Medical Education, Poznan University of Medical Sciences, 61-701 Poznan, Poland
Interests: early origins of health and disease; non-communicable disorders in women; maternal health; diabetes; metabolism; obesity; gestational diabetes; insulin resistance; PCOS; endocrine disorders; menopause
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Special Issue Information

Dear Colleagues,

Hyperglycemia is among the most frequent yet serious complications of pregnancy. Although this disorder is commonly recognised as a major risk factor for fetomaternal adverse outcomes, such as excessive fetal growth, macrosomia, excessive maternal gestational weight gain, or hypertensive disorders of pregnancy, the magnitude of these interactions differs across the populations, and their mechanisms are yet to be fully elucidated.

Moreover, new areas of clinical and research interest are emerging, such as specific approaches to target populations at high risk for developing hyperglycemia in pregnancy and to detect hyperglycemia in early pregnancy, which leaves an open question of the usability of various criteria in early pregnancy or trimester-specific glycemic thresholds necessary for ameliorating fetomaternal risks. We are also gathering more evidence on nonglycemic risk factors for complications, including maternal gestational weight gain, environmental or lifestyle stressors, or alterations in maternal and placental metabolism, which can still only be partly tracked  with increasing numbers of circulating biomarkers. There is also an increasing amount of evidence on an association between hyperglycemia in pregnancy and a vicious circle of premature morbidity for non-communicable disorders in mothers and their offspring. This recent evidence raises further questions about whether effective treatment of hyperglycemia in pregnancy could be translated into long-term benefits for both generations.

Therefore, we would like to invite experts in the field to share their results from observational and interventional clinical trials or mechanistic studies. We also expect reviews and meta-analyses identifying knowledge gaps in this area.

Dr. Agnieszka Zawiejska
Guest Editor

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Keywords

  • gestational diabetes mellitus
  • diabetes diagnosed in pregnancy
  • hyperglycemia detected in early pregnancy
  • maternal and fetal outcomes
  • glycemic thresholds in pregnancy
  • treatment of hyperglycemia in pregnancy
  • maternal comorbidities in GDM pregnancy
  • biomarkers of insulin resistance in GDM pregnancy

Published Papers (1 paper)

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Research

9 pages, 643 KiB  
Article
Early vs. Late Gestational Diabetes: Comparison between Two Groups Diagnosed by Abnormal Initial Fasting Plasma Glucose or Mid-Pregnancy Oral Glucose Tolerance Test
by Tatiana Assuncao Zaccara, Cristiane Freitas Paganoti, Fernanda C. Ferreira Mikami, Rossana P. Vieira Francisco and Rafaela Alkmin Costa
Int. J. Environ. Res. Public Health 2022, 19(21), 13719; https://doi.org/10.3390/ijerph192113719 - 22 Oct 2022
Cited by 3 | Viewed by 1675
Abstract
Gestational diabetes mellitus (GDM) is one of the most common complications in pregnancy. It may be diagnosed using a fasting plasma glucose (FPG) early in pregnancy (eGDM) or a 75-g oral glucose tolerance test (OGTT) (late GDM). This retrospective cohort of women with [...] Read more.
Gestational diabetes mellitus (GDM) is one of the most common complications in pregnancy. It may be diagnosed using a fasting plasma glucose (FPG) early in pregnancy (eGDM) or a 75-g oral glucose tolerance test (OGTT) (late GDM). This retrospective cohort of women with GDM presents data from 1891 patients (1004 in the eGDM and 887 in the late GDM group). Student’s t-test, chi-squared or Fisher’s exact test and the Bonferroni test for post hoc analysis were used to compare the groups. Women with eGDM had higher pre-pregnancy BMI, more frequent family history of DM, more frequent history of previous GDM, and were more likely to have chronic hypertension. They were more likely to deliver by cesarean section and to present an abnormal puerperal OGTT. Even though they received earlier treatment and required insulin more frequently, there was no difference in neonatal outcomes. Diagnosing and treating GDM is necessary to reduce complications and adverse outcomes, but it is still a challenge. We believe that women with eGDM should be treated and closely monitored, even though this may increase healthcare-related costs. Full article
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