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Chapter-02 Metabolic Alterations in Diabetic Pregnancy

BOOK TITLE: Clinical Guidelines for Management of Diabetes in Pregnancy

Author
1. Shah Siddharth N
2. Tuteja Tanvi
3. Mehta Nihar
ISBN
9789352703951
DOI
10.5005/jp/books/18049_3
Edition
1/e
Publishing Year
2018
Pages
3
Author Affiliations
1. University of Mumbai, Consulting Physician and Diabetologist, SL Raheja Hospital and All India Institute of Diabetes, Saifee Hospital, Bhatia Hospital, Sir Hurkisondas, N Hospital, Mumbai, Maharashtra, India, University of Mumbai, Consulting Physician and Diabetologist, SL Raheja Hospital and All India Institute, of Diabetes, Saifee Hospital, Bhatia Hospital, Sir Hurkisondas, N Hospital, Mumbai, Maharashtra, India, Bhatia Hospitals, Mumbai, Maharashtra, India, S. L. Raheja Hospital, Bhatia Hospital, and Sir H. N. Hospital, Mumbai, SL Raheja Hospital, Mumbai, Maharashtra, India, Bhatia Hospital, Saifee Hospital; Journal of Association of Physicians of India; API Textbook of Medicine, IX Edition, Mumbai, Maharashtra, India, Mumbai, Maharashtra, India, Bhatia Hospital, Mumbai, Maharashtra, India, Sir HN Reliance Hospital, Bhatia Hospital, SL Raheja Hospital, Saifee Hospital, Global Hospital, Mumbai, Maharashtra, India; JAPI, API Textbook of Medicine, Xth Edition
2. KJ Somaiya Medical College and Hospital, Mumbai, Maharashtra, India, Somaiya Super Speciality Hospital; KJ Somaiya Medical College and Hospital, Sunny Hospital, Chembur Apollo Spectra Hospital, Mumbai, Maharashtra, India
3. Jaslok Hospital and Research Center, Mumbai, Maharashtra, India, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India, Jaslok Hospital and Research Center, KJ Somaiya Super Speciality Hospital, Bhatia Hospital, Mumbai, Maharashtra, India
Chapter keywords
Gestational diabetes, pregnancy, type 1 diabetes, type 2 diabetes, metabolic disorder, insulin, feto-placental vascular function, metabolism

Abstract

Gestational diabetes is diabetes first detected in pregnancy. Although type 1 diabetes is more likely to develop in pregnancy, the great majority of women have pretype 2 diabetes, and many will go on to develop diabetes later in life. Gestational diabetes mellitus is a disease of the mother that associates with altered feto-placental vascular function. It describes a heterogeneous group of hyperglycemic metabolic disorders detected in pregnancy. It is characterized by inadequate beta cell secretion for the level of insulin resistance present whether the insulin response is normal or elevated. Insulin is a key factor playing a modulatory role in GDM associated altered angiogenesis, and metabolism of lipids in human feto-placental vascular bed. Clinical management of insulin sensitivity is considered a therapeutic target in treatment of mothers with GDM and this could result in reversal of insulin resistance along with GDM-associated alterations in angiogenesis and lipid metabolism.

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