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THE MANAGEMENT OF GESTATIONAL DIABETEAS.
MedLine Citation:
PMID:  22587510     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The incidence of gestational diabetes is increasing, with higher obesity in the pregnant population, lifestyle changes and migration thought to underlie this. Recent large studies, such as the MiG, HAPO and ACHOIS trials, have furthered our understanding of both the implications of the disease and the management options available. Previous CEMACH (Confidential Enquiries into Maternal and Child Health) studies of diabetes in pregnancy have shown a significant proportion of patients receiving sub-optimal care. We aim to summarise the current standard of management strategies in pregnancy, whilst acknowledging controversies and limitations in the existing evidence. Antenatal management involves service organisation to provide multi-disciplinary team reviews to address glycaemic control, fetal monitoring and associated conditions such as obesity and hypertensive disorders of pregnancy. The use of diet, exercise, oral hypoglycaemic agents and insulins will be discussed, along with specific considerations for the management of preterm labour and administration of corticosteroids for fetal lung maturity. The timing and management of labour, including mechanisms of delivery, will be covered, including neonatal considerations and the use of breast feeding. Finally, a discussion of appropriate post delivery care will consider contraception and the prevention of, and screening for, the development of type 2 diabetes.
Authors:
Caroline Ovadia; Archana Dixit
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-14
Journal Detail:
Title:  Current diabetes reviews     Volume:  -     ISSN:  1875-6417     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101253260     Medline TA:  Curr Diabetes Rev     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
West MiddleSex University Hospital, Twickenham Road, Isleworth, Middlesex TW76AF, UK. Caroline.ovadia@doctors.net.uk.
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