| Gestational prediabetes: a new term for early prevention? | |
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MedLine Citation:
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PMID: 20847369 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Women with gestational diabetes mellitus (GDM) have higher rates of foetal macrosomia, shoulder dystocia and pregnancy-induced hypertension, and are at higher risk of developing type 2 diabetes. Herein, we introduce a new conceptual term, "gestational prediabetes", which requires the absence of diabetes before pregnancy, and the presence of blood glucose levels (or a related marker) in early pregnancy that are higher than normal, but not yet high enough to meet the diagnostic criteria for GDM. Identifying women with gestational prediabetes might be done in early pregnancy (e.g., 12 weeks' gestation) using conventional glycaemic testing, assessment of visceral abdominal adiposity or hepatic fat by ultrasonography, or measuring serum sex hormone-binding globulin or adiponectin. However, none of these approaches has been systematically compared to conventional predictors, such as maternal body mass index or waist circumference. Any early-pregnancy predictor of gestational prediabetes risk needs to have low cost, ease of administration, and a short turnaround time. The theoretical advantage of identifying women with gestational prediabetes would be to "prevent" the onset of GDM (and its inherent risks to the pregnancy) in a timelier manner. One sensible starting point would be an intervention to prevent early excessive weight gain in pregnancy, which is currently being evaluated by two randomized clinical trials. In addition, early intervention could offset the need for resource-intense GDM management or insulin therapy. |
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Authors:
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Joel G Ray; Howard Berger; Lorraine L Lipscombe; Mathew Sermer |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: The Indian journal of medical research Volume: 132 ISSN: 0971-5916 ISO Abbreviation: Indian J. Med. Res. Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-09-17 Completed Date: 2011-01-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0374701 Medline TA: Indian J Med Res Country: India |
Other Details:
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Languages: eng Pagination: 251-5 Citation Subset: IM |
Affiliation:
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Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada. rayj@smh.toronto.on.ca |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Biological Markers
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blood Blood Glucose / analysis Diabetes, Gestational / classification*, diagnosis*, pathology Female Humans Prediabetic State / classification*, diagnosis*, pathology Pregnancy Weight Gain / physiology |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Blood Glucose |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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