gestational diabetes mellitus

gestational diabetes mellitus (GDM),

a disorder characterized by an impaired ability to metabolize carbohydrates, usually caused by a deficiency of insulin or insulin resistance, occurring in pregnancy. It disappears after delivery of the infant but, in a significant number of cases, returns years later as type 2 diabetes mellitus. Evidence suggests that placental lactogen and considerable destruction of insulin by the placenta play a role in precipitating GDM. Treatment consists of self-monitoring of blood glucose, insulin administration, increased activity, a meal plan that controls the amount of carbohydrates eaten, and an adequate intake of calcium and iron. See also diabetes mellitus.

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diabetes mellitus

a broadly applied term used to denote a complex group of syndromes that have in common a disturbance in the oxidation and utilization of glucose, which is secondary to a malfunction of the beta cells of the pancreas, whose function is the production and release of insulin. Because insulin is involved in the metabolism of carbohydrates, proteins and fats, diabetes is not limited to a disturbance of glucose homeostasis alone.

Diabetes mellitus has been recorded in all species but is most commonly seen in middle-aged to older, obese, female dogs. A familial predisposition has been suggested. It is possible to identify two types of diabetes, corresponding to the disease in humans, depending on the response to an intravenous glucose tolerance test. Type I is insulin-dependent and comparable to the juvenile onset form of the disease in children in which there is an absolute deficiency of insulin—there is a very low initial blood insulin level and a low response to the injected glucose. This form is seen in a number of dog breeds, particularly the Keeshond, Doberman pinscher, German shepherd dog, Poodle, Golden retriever and Labrador retriever.

Type II is non-insulin-dependent, similar to the adult onset diabetes in humans due to pancreatic damage—there is a high or normal initial blood insulin level and no increase in insulin levels as a result of the glucose load. It is the form seen most often in cats.

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brittle diabetes mellitus

diabetes mellitus that is difficult to control, characterized by unexplained oscillation between hypoglycemia and diabetic ketoacidosis.

gestational diabetes mellitus

diabetes mellitus in which onset or recognition of impaired glucose tolerance occurs during pregnancy.

hyperosmolar diabetes mellitus

a syndrome of marked hyperglycemia and hyperosmolarity with central nervous signs, resembling diabetic coma.

insulin-dependent diabetes mellitus (IDDM)

due to deficient secretion of insulin by the beta cells of the pancreas. See diabetes mellitus type I (above).

juvenile diabetes mellitus

develops in the young; see diabetes mellitus type I (above).

non-insulin-dependent diabetes mellitus (NIDDM)

the secretion of insulin is unimpaired but the response of tissue receptors is diminished. See diabetes mellitus type II (above).

secondary diabetes mellitus

hyperglycemia may occur in association with pancreatitis, hyperadrenocorticism, acromegaly, and treatment with glucocorticoids or progesterone.

steroid diabetes mellitus

altered carbohydrate tolerance is induced by glucocorticoids and progestogens. Hyperglycemia and diabetes mellitus can be associated with the administration of such drugs or hyperadrenocorticism.

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gestational diabetes mellitus

Glucose intolerance first detected during pregnancy Associations ↑ Maternal and fetal perinatal complications, tendency to develop glucose intolerance in absence of pregnancy 5-10 yrs later Incidence Up to 5% of pregnancies Complications–maternal Preterm labor, HTN, polyhydramnios, C-section for macrosomia, ↑ subsequent DM Complications–fetal Macrosomia, shoulder dystocia, perinatal mortality–2 to 5%, congenital malformation–cardiac, CNS. See Fetal diabetes 'syndrome.', Glucose tolerance curve.

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Patient discussion about gestational diabetes mellitus.

Q. How do I prevent Gestational diabetes? The first pregnancy I developed Gestational diabetes at the 26 week. How do I prevent it from happening?

A. There are no guarantees when it comes to preventing gestational diabetes — but the more healthy habits you can adopt before pregnancy, the better. Because the risk factors are the same as diabetes type 2 – the same measures should be taken- Eat healthy foods, Get more physical activity, Lose excess pounds.

Q. What complications have you had with gestational diabetes? I have just found out that I have gestational diabetes and I am over 37 weeks pregnant. It has gone undiagnosed and we have found out that I why my baby is so large. She is already 8 pounds 12 ounces based on the ultra sound. My concerns are now with my baby and I want her to be healthy. Any personal experiences would be great!

A. Thanks for the help..

Q. Can gestational diabetes really be diagnosed without the 3 hour test? My doctor's office only did the one hour test and said I have gestational diabetes. Since I've been testing myself for a couple of days (four times a day) my average is in the 90's. Do you think it was really fair to diagnose me without giving me the 3 hour test and what can I do about it? I don't think I have it but they seem to think that one test is enough.

A. It can be diagnosed with only one test, but that result has to be quite high. Considering that diagnosis can prevent you from getting life insurance, I would insist that the doctor do a proper test or move to a different doctor.