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Chapter-06 Screening and Diagnosis of Hyperglycemia in Pregnancy: Challenges and Controversies

BOOK TITLE: Clinical Guidelines for Management of Diabetes in Pregnancy

Author
1. Saxena Pikee
2. Nigam Aruna
ISBN
9789352703951
DOI
10.5005/jp/books/18049_7
Edition
1/e
Publishing Year
2018
Pages
10
Author Affiliations
1. Lady Hardinge Medical College, New Delhi, India, Lady Hardinge Medical College and SSK Hospital New Delhi, India, Reproductive Biomedicine National Institute of Health and Family Welfare, New Delhi, Lady Hardinge Medical College and Suchitra Kripalani Hospital New Delhi, Lady Hardinge Medical College and Smt Sucheta Kriplani Hospital, New Delhi, India
2. Lady Hardinge Medical College and SSK Hospital, New Delhi, India, Hamdard Institute of Medical Sciences and Research, New Delhi, India, Hamdard Institute of Medical, Sciences and Research, Jamia Hamdard, New Delhi, India
Chapter keywords
Hyperglycemia, pregnancy, diabetes, type 1 diabetes, type 2 diabetes, gestational diabetes mellitus, GDM, oral glucose tolerance test, OGTT, glucose loading test, GLT

Abstract

This chapter focuses on screening and diagnosis of hyperglycemia. Pregnancy is a diabetogenic state due to a number of hormones such as placental lactogen, growth hormone, and corticotropin-releasing hormone, secreted primarily by the placenta. As Indians belong to high-risk ethnic group with high prevalence of diabetes, early universal screening for diabetes is recommended at the first antenatal visit. The IADPSG criteria is the only outcome based criteria, it has the ability to diagnose and treat GDM earlier, thereby reducing the fetal and maternal complications associated with GDM. This one step method is accurate and is close to international consensus but it is inconvenient, costly, and increases the prevalence of GDM due to lower thresholds.

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