Pharmacological treatment of gestational diabetes

    Research output: Chapter in Book / Conference PaperChapter

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    Abstract

    Hyperglycaemia in the antenatal period can have a major impact on foetal beta cell and adipocyte development and can lead to neonatal hypoglycaemia, macrosomia, polycythaemia, hyperbilirubinaemia, and hypomagnesaemia. There is growing evidence that exposure to hyperglycaemia in utero may increase the risk of future obesity and diabetes in the offspring. The relationship between maternal hyperglycaemia and adverse maternal/neonatal adverse outcomes is continuous with no threshold. Managing hyperglycaemia in the antenatal period is associated with a reduction in perinatal and maternal pregnancy-related complications, although there remains debate over the optimal glycaemic criteria for both diagnosis and initiating/intensifying pharmacological therapy. As gestational diabetes mellitus (GDM) is diagnosed when “hyperglycaemia is detected for the first time during pregnancy,” there may have been preexisting dysglycaemia (diabetes, impaired glucose tolerance, impaired fasting glucose) as well as newly developed hyperglycaemia, and this will clearly influence likelihood of pharmacological therapy. Generally, GDM is detected after organogenesis (i.e., after the first 8 weeks), and this chapter will focus on the impact of pharmacological agents after this time, although comment on malformations will be made where relevant.
    Original languageEnglish
    Title of host publicationGestational Diabetes: Origins, Complications, and Treatment
    EditorsClive J. Petry
    Place of PublicationU.S.
    PublisherCRC Press
    Pages157-191
    Number of pages35
    ISBN (Electronic)9781439879979
    ISBN (Print)9781439879962
    Publication statusPublished - 2014

    Keywords

    • diabetes
    • hyperglycaemia
    • pregnancy

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