Gestational Diabetes Mellitus: Current Challenges and New Insights

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Endocrinology & Metabolism".

Deadline for manuscript submissions: closed (31 October 2023) | Viewed by 5497

Special Issue Editor


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Guest Editor
Department of Obstetrics, University Hospital Jena, Friedrich Schiller University, Jena, Germany
Interests: obstetrics; endothelial dysfunction; preeclampsia; hypertension; atherosclerosis; diabetes; screening; fetal growth restriction; cardiovascular disease

Special Issue Information

Dear Colleagues, 

Currently, gestational diabetes mellitus (GDM) is the most common medical complication of pregnancy. Although screening strategies and management guidelines have been established worldwide during the last decade, GDM is still associated with increased risk of pregnancy-induced hypertension, macrosomia, caesarean delivery, and other obstetric complications. If glycemic control is not obtained during pregnancy, the offspring is at increased risk of developing overweight and diabetes during adulthood. Women with a history of GDM are at increased risk for type 2 diabetes, obesity, hypertension, dyslipidemia, and metabolic syndrome. Both management during pregnancy and follow-up of patients after GDM represent a major challenge. More research is needed to identify successful strategies to prevent hyperglycemia and manage GDM. This Special Issue aims to provide an overview of recent advances in the field of GDM. Therefore, researchers in the field of GDM are encouraged to submit an original research article or review to this Special Issue.

Prof. Dr. Tanja Groten
Guest Editor

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Keywords

  • gestational diabetes mellitus
  • pregnancy complication
  • diabetes
  • screening
  • prevention
  • management

Published Papers (3 papers)

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Research

12 pages, 913 KiB  
Article
Disease Perception and Mental Health in Pregnancies with Gestational Diabetes—PsychDiab Pilot Study
by Claudia Rieß, Yvonne Heimann, Ekkehard Schleußner, Tanja Groten and Friederike Weschenfelder
J. Clin. Med. 2023, 12(10), 3358; https://doi.org/10.3390/jcm12103358 - 09 May 2023
Cited by 1 | Viewed by 1192
Abstract
(1) Background: The aim of this work is to investigate the extent to which pregnant women’s well-being is burdened by the diagnosis of gestational diabetes, as well as their sensitivities and illness perceptions. Since gestational diabetes is associated with mental disorders, we hypothesized [...] Read more.
(1) Background: The aim of this work is to investigate the extent to which pregnant women’s well-being is burdened by the diagnosis of gestational diabetes, as well as their sensitivities and illness perceptions. Since gestational diabetes is associated with mental disorders, we hypothesized that the burden of illness might be related to pre-existing mental distress. (2) Methods: Patients treated for gestational diabetes in our outpatient clinic were retrospectively asked to complete a survey, including the self-designed Psych-Diab-Questionnaire to assess treatment satisfaction, perceived limitations in daily life and the SCL-R-90 questionnaire to assess psychological distress. The association between mental distress and well-being during treatment was analyzed. (3) Results: Of 257 patients invited to participate in the postal survey, 77 (30%) responded. Mental distress was found in 13% (n = 10) without showing other relevant baseline characteristics. Patients with abnormal SCL-R-90 scores showed higher levels of disease burden, were concerned about glucose levels as well as their child’s health, and felt less comfortable during pregnancy. (4) Conclusions: Analogous to the postpartum depression screening, screening for mental health problems during pregnancy should be considered to target psychologically distressed patients. Our Psych-Diab-Questionnaire has been shown to be suitable to assess illness perception and well-being. Full article
(This article belongs to the Special Issue Gestational Diabetes Mellitus: Current Challenges and New Insights)
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11 pages, 409 KiB  
Article
Establishing the Optimal Time for Induction of Labor in Women with Diet-Controlled Gestational Diabetes Mellitus: A Single-Center Observational Study
by Patrik Šimják, Hana Krejčí, Markéta Hornová, Miloš Mráz, Antonín Pařízek, Michal Kršek, Martin Haluzík and Kateřina Anderlová
J. Clin. Med. 2022, 11(21), 6410; https://doi.org/10.3390/jcm11216410 - 29 Oct 2022
Cited by 2 | Viewed by 1757
Abstract
To determine the optimal week for labor induction in women with diet-controlled gestational diabetes mellitus by comparing differences in perinatal and neonatal outcomes of labor induction to expectant management at different gestational weeks. Methods: This was a retrospective analysis of a prospectively [...] Read more.
To determine the optimal week for labor induction in women with diet-controlled gestational diabetes mellitus by comparing differences in perinatal and neonatal outcomes of labor induction to expectant management at different gestational weeks. Methods: This was a retrospective analysis of a prospectively recruited cohort of 797 singleton pregnancies complicated by diet-controlled gestational diabetes mellitus that were diagnosed, treated, and delivered after 37 weeks in a tertiary, university-affiliated perinatal center between January 2016 and December 2021. Results: The incidence of neonatal complications was highest when delivery occurred at 37 weeks, whereas fetal macrosomia occurred mostly at 41 weeks (20.7%); the frequency of large for gestational age infants did not differ between the groups. Conversely, the best neonatal outcomes were observed at 40 weeks due to the lowest number of neonates requiring phototherapy for neonatal jaundice (1.7%) and the smallest proportion of neonates experiencing composite adverse neonatal outcomes defined as neonatal hypoglycemia, phototherapy, clavicle fracture, or umbilical artery pH < 7.15 (10.4%). Compared with expectant management, the risk for neonatal hypoglycemia was increased for induction at 39 weeks (adjusted odds ratio 12.29, 95% confidence interval 1.35–111.75, p = 0.026) and that for fetal macrosomia was decreased for induction at 40 weeks (adjusted odds ratio 0.11, 95% confidence interval 0.01–0.92, p = 0.041), after adjusting for maternal pre-pregnancy body mass index, nulliparity, and mean pregnancy A1c. Conclusions: The lowest rate of neonatal complications was observed at 40 weeks. Labor induction at 40 weeks prevented fetal macrosomia. Full article
(This article belongs to the Special Issue Gestational Diabetes Mellitus: Current Challenges and New Insights)
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17 pages, 735 KiB  
Article
Higher Thyroid fT3-to-fT4 Ratio Is Associated with Gestational Diabetes Mellitus and Adverse Pregnancy Outcomes
by Lore Raets, Caro Minschart, Annick Van den Bruel, Emmelien Van den Bogaert, Paul Van Crombrugge, Carolien Moyson, Johan Verhaeghe, Sofie Vandeginste, Hilde Verlaenen, Chris Vercammen, Toon Maes, Els Dufraimont, Nele Roggen, Christophe De Block, Yves Jacquemyn, Farah Mekahli, Katrien De Clippel, Anne Loccufier, Annouschka Laenen, Roland Devlieger, Chantal Mathieu, Brigitte Decallonne and Katrien Benhalimaadd Show full author list remove Hide full author list
J. Clin. Med. 2022, 11(17), 5016; https://doi.org/10.3390/jcm11175016 - 26 Aug 2022
Cited by 6 | Viewed by 2053
Abstract
Aim: To determine the association between thyroid function and the risk of developing gestational diabetes mellitus (GDM) and adverse pregnancy outcomes. Methods: This case–control study was a sub-analysis of the BEDIP-N study, in which 199 GDM women were matched for age and body [...] Read more.
Aim: To determine the association between thyroid function and the risk of developing gestational diabetes mellitus (GDM) and adverse pregnancy outcomes. Methods: This case–control study was a sub-analysis of the BEDIP-N study, in which 199 GDM women were matched for age and body mass index with 398 controls. Thyroid-stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), and thyroid peroxidase (TPO) antibodies were measured at 6–14 weeks and 26–28 weeks during pregnancy. TSH and fT4 were also measured in early postpartum in GDM women. Results: The fT3-to-fT4 ratio at 26–28 weeks was positively associated with GDM risk with an adjusted odds ratio (aOR for smoking, education, parity, ethnicity, gestational weight gain, and (family) history of diabetes or GDM) of 2.12 (95% CI 1.07; 4.23), comparing the highest with the lowest tertile. Higher fT3 levels and a higher fT3-to-fT4 ratio were associated with a less favorable metabolic profile with higher BMI and more insulin resistance during pregnancy and postpartum. Women in the upper fT3 tertile and the upper fT3-to-fT4 ratio had a higher rate of preeclampsia [4.6% (10) vs. 1.0% (2), p = 0.040, and 4.4% (9) vs. 0.5% (1), p = 0.020], gestational hypertension [8.3% (18) vs. 3.1% (6), p = 0.034 and 8.9% (18) vs. 2.0% (4), p = 0.003], and caesarean sections [29.4% (63) vs. 16.1% (31), p = 0.002 and 32.2% (65) vs. 12.7% (25), p < 0.001]. Conclusion: A higher fT3-to-fT4 ratio late into pregnancy was associated with GDM, adverse pregnancy outcomes, and an adverse metabolic profile in early postpartum. Full article
(This article belongs to the Special Issue Gestational Diabetes Mellitus: Current Challenges and New Insights)
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