Ukrainian Journal Health of Woman. 2022. 6(163): 38-42; doi 10.15574/HW.2022.163.38
Yavir V. S., Mellina I. M.
Bogomolets National Medical University, Kyiv, Ukraine

For citation: Yavir VS, Mellina IM. (2022). Providing medical care to women with gestational diabetes: definition, prevalence, risk factors and consequences of the disease. Ukrainian Journal Health of Woman. 6(163): 38-42; doi 10.15574/HW.2022.163.38.
Article received: Oct 11, 2022. Accepted for publication: Dec 10, 2022.

The article highlights the main issues related to the topical topic of gestational diabetes (GD). As the prevalence of GD is steadily increasing, the definition of this disease, its prevalence in pregnant women, the reasons for its rapid spread, as well as the impact on the health of the pregnant woman, fetus and newborn, and maternal and child pathology in the future are considered.
Purpose – to draw attention to the problem of GD prevalence in order to reduce its level among pregnant women.
Particular attention is paid to providing a clear definition of GD. This is necessary primarily for the timely diagnosis of GD, monitoring of indicators in such pregnant women and treatment in cases where it is needed.
The social factors of the prevalence of this nosology are considered, as it is economically significant for each country and has a direct impact on fertility, working capacity and mortality rates. Given the risk factors for GD, it becomes clear that this disease is more common in highly developed countries. Particular attention is paid to the correlation between the prevalence of obesity and the risk of GD. Although recommendations for the management of obese pregnant women and women planning a pregnancy vary, counselling on pregnancy risks, a healthy diet, exercise and dietary supervision are recommended to manage weight loss and gain during pregnancy.
The clinician managing a pregnancy with GD should be aware of the factors that increase the risk of this nosology, the consequences of the disease for the mother during pregnancy, after delivery and the course of labour. The impact on the fetus during pregnancy is extremely important. There are also long-term consequences for a child whose mother had GD.
No conflict of interests was declared by the authors.
Keywords: gestational diabetes (GD), prevalence, risk factors, obesity, insulin resistance, hyperglycemia, impaired carbohydrate metabolism, miscarriage, birth trauma.
REFERENCES

1. Alesi S, Ghelani D, Rassie K, Mousa A. (2021, May 24). Metabolomic Biomarkers in Gestational Diabetes Mellitus: A Review of the Evidence. Int J Mol Sci. 22 (11): 5512. https://doi.org/10.3390/ijms22115512; PMid:34073737 PMCid:PMC8197243

2. American Diabetes Association. (2018). Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes-2018. Diabetes Care. 41 (1): S137-S143. https://doi.org/10.2337/dc18-S013; PMid:29222384

3. Buchanan TA, Kitzmiller JL. (1994). Metabolic interactions of diabetes and pregnancy. Annu Rev Med. 45: 245. https://doi.org/10.1146/annurev.med.45.1.245; PMid:8198381

4. Caughey AB. (2021, Sep). Gestational diabetes mellitus: Obstetric issues and management. Literature review current through. URL: https://www.uptodate.com/contents/gestational-diabetes-mellitus-obstetric-issues-and-management.

5. Chan M. (2017, Mar). Obesity and Diabetes: The Slow-Motion Disaster. Milbank Q. 95 (1): 11-14. https://doi.org/10.1111/1468-0009.12238; PMid:28266071 PMCid:PMC5339378

6. Cho NH, Shaw JE, Karuranga S, Huang Y, da Rocha Fernandes JD, Ohlrogge AW, Malanda B. (2018, Apr). IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 138: 271-281. https://doi.org/10.1016/j.diabres.2018.02.023; PMid:29496507

7. Gunderson EP, Lewis CE, Lin Y et al. (2018). Lactation Duration and Progression to Diabetes in Women Across the Childbearing Years: The 30-Year CARDIA Study. JAMA Intern Med. 178: 328. https://doi.org/10.1001/jamainternmed.2017.7978; PMid:29340577 PMCid:PMC5885916

8. Hauth JC, Clifton RG, Roberts JM et al. (2011). Maternal insulin resistance and preeclampsia. Am J Obstet Gynecol. 204: 327.e1. https://doi.org/10.1016/j.ajog.2011.02.024; PMid:21458622 PMCid:PMC3127262

9. Hod M, Kapur A, McIntyre HD et al. (2019, Aug). Evidence in support of the International Association of Diabetes in Pregnancy study groups' criteria for diagnosing gestational diabetes mellitus worldwide in 2019. Am J Obstet Gynecol. 221 (2): 109-116. https://doi.org/10.1016/j.ajog.2019.01.206; PMid:30682358

10. Kitzmiller JL. (1993). Sweet success with diabetes. The development of insulin therapy and glycemic control for pregnancy. Diabetes Care. 16 (3): 107. https://doi.org/10.2337/diacare.16.3.107; PMid:8299468

11. Ley SH, Chavarro JE, Li M et al. (2020). Lactation Duration and Long-term Risk for Incident Type 2 Diabetes in Women With a History of Gestational Diabetes Mellitus. Diabetes Care. 43: 793. https://doi.org/10.2337/dc19-2237; PMid:32041900 PMCid:PMC7085808

12. McIntyre HD, Kapur A, Divakar H, Hod M. (2020, Dec 3). Gestational Diabetes Mellitus-Innovative Approach to Prediction, Diagnosis, Management, and Prevention of Future NCD-Mother and Offspring. Front Endocrinol (Lausanne). 11: 614533. https://doi.org/10.3389/fendo.2020.614533; PMid:33343512 PMCid:PMC7744927

13. Mitanchez D, Burguet A, Simeoni U. (2014). Infants born to mothers with gestational diabetes mellitus: mild neonatal effects, a long-term threat to global health. J Pediatr. 164: 445. https://doi.org/10.1016/j.jpeds.2013.10.076; PMid:24331686

14. Mitanchez D, Yzydorczyk C, Siddeek B et al. (2015). The offspring of the diabetic mother short and long-term implications. Best Pract Res Clin Obstet Gynaecol. 29: 256. https://doi.org/10.1016/j.bpobgyn.2014.08.004; PMid:25267399

15. Nold JL, Georgieff MK. (2004). Infants of diabetic mothers. Pediatr Clin North Am. 51: 619. https://doi.org/10.1016/j.pcl.2004.01.003; PMid:15157588

16. Philips AF, Dubin JW, Matty PJ, Raye JR. (1982). Arterial hypoxemia and hyperinsulinemia in the chronically hyperglycemic fetal lamb. Pediatr Res. 16: 653. https://doi.org/10.1203/00006450-198208000-00013; PMid:7050872

17. Riskin A, Itzchaki O, Bader D et al. (2020). Perinatal Outcomes in Infants of Mothers with Diabetes in Pregnancy. Isr Med Assoc J. 9: 503.

18. Saravanan P et al. (2020, Sep). Gestational diabetes: opportunities for improving maternal and child health. Lancet Diabetes Endocrinol. 8 (9): 793-800. https://doi.org/10.1016/S2213-8587(20)30161-3; PMid:32822601

19. Sarikabadayi YU, Aydemir O, Aydemir C et al. (2011). Umbilical cord oxidative stress in infants of diabetic mothers and its relation to maternal hyperglycemia. J Pediatr Endocrinol Metab. 24: 671. https://doi.org/10.1515/JPEM.2011.315; PMid:22145454

20. Tiselko AB. (2013). 7-i Mezhdunarodnyi simpozium «Diabet, gipertoniya, metabolicheskii sindrom i beremennost», 13-16 marta 2013 g., Florentsiya, Italiya. Sakharnyi diabet. 1: 106-107.

21. Wang T, Heianza Y, Sun D et al. (2019, Sep 1). Improving fruit and vegetable intake attenuates the genetic association with long-term weight gain. Am J Clin Nutr. 110 (3): 759-768. https://doi.org/10.1093/ajcn/nqz136; PMid:31301130 PMCid:PMC6736184

22. Widness JA, Teramo KA, Clemons GK et al. (1986). Temporal response of immunoreactive erythropoietin to acute hypoxemia in fetal sheep. Pediatr Res. 20: 15. https://doi.org/10.1203/00006450-198601000-00004; PMid:3945512

23. Widness JA, Teramo KA, Clemons GK et al. (1990). Direct relationship of antepartum glucose control and fetal erythropoietin in human type 1 (insulin-dependent) diabetic pregnancy. Diabetologia. 33: 378. https://doi.org/10.1007/BF00404643; PMid:2199280