Contemporary Topics in Gestational Diabetes Mellitus Veeraswamy Seshiah
INDEX
Please note page numbers with f, t, and b indicate figure, table, and box, respectively.
A
Abortions 3
Abruptio placentae 177
Acarbose 67, 184
Acquired Immunodeficiency syndrome 2
Adipocytes 20, 67, 152, 157
Adipocytokines 214
Adipokines 111, 239
Adiponectin 20, 214, 241
Adipose tissue 27, 68, 111, 158
inflammation in 157
Adrenal
glands 15
hemorrhage 149
Adrenocorticotropic hormone (ACTH) 13
Adverse pregnancy outcomes (HAPO) 135, 182
Air bronchograms 141
Albumin 85, 114
Aldosterone 11, 15
Alpha-cells 78
Alpha-glucosidase 72, 75
inhibitors 67, 69, 74
Alternatively activated macrophages (AAM) 158
American College of Obstetricians and Gynecologists (ACOG) 56, 114
American Diabetes Association (ADA) 32, 60, 73, 93, 183
American Thyroid Association 207
Androgen 110
Aneuploidy, biochemical screening 180
Angiotensin 15
Anorectal malformation 149
Anovulation 110
Antenatal
care 180
venous thrombosis 165
Anti-TG antibodies 207
Anti-thyroid drugs 207
Anti-TPO antibody 207
Aortic stenosis 147
Apgar score 198
Arginine vasopressin level 13
Arthrogryposis 149
Asparagine 84
Asphyxia 140, 152, 179t
Assisted reproductive treatment (ART) 137
Atherosclerosis, gestational diabetes mellitus 217
Atrial septal defects 147
Australian Carbohydrate Intolerance in Pregnancy (ACHOIS) 194
Australian Carbohydrate Intolerance Study (ACHOIS) 57
Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) 182
Autoimmune
diabetes 160
thyroid disease 203
B
Bariatric surgery 110
complications of 113
in women of childbearing age 112
obesity role in
gastric band 111
Roux-en-Y gastric bypass 111
sleeve gastrectomy 111
pre- and postoperative evaluation 114
Basal-bolus schedule 84t
Beta cell 67, 78, 159, 213, 214
dysfunction 215
insufficiency 211
Betamimetic drugs 185
Birth
defects 177
injury 110
trauma 152
Blood
glucose, self-monitoring of 57, 77, 94
urea nitrogen 180
Body mass index (BMI) 18, 20, 25, 26, 37, 45, 59, 70, 81, 110, 111, 159, 164, 165, 167, 177, 190, 225
classification in united states 229t
Brachial plexus
injuries 140, 179t
trauma 151
Breast cancer resistance protein (BCRP) 68
Breastfeeding 25
and lactation 265
C
Caesarean 52, 60, 79, 85
delivery 25, 165
section 35, 68, 71, 78, 141, 169, 186, 196
Calcitonin 14
Calcium 114
channel blockers 87, 185
homeostasis 14
intracellular 67
Carbohydrate metabolism 49
Cardiovascular diseases 1, 152
Caudal regression syndrome 147, 148f
Cephalhematoma 140
Cholelithiasis 12, 113
Chorioamnionitis 177
Classically activated macrophages (CAM) 158
Clavicular fracture 140
Coarctation 147
Combined oral contraceptive 188
Complex carbohydrates 68
Conducting delivery 187b
Congenital malformations 26t
Connecting peptide (C-peptide) 83
Continuous glucose monitoring (CGM) 93
comparison of blood glucose 103
devices 94, 94f
impact on glycosylated hemoglobin 98
in normal pregnancy 100
in obese pregnancy 100
interstitial glucose 102
limitations of 105
pregestational diabetes 99
quality of 104
safety of 95
training and education 105
Controlled antenatal thyroid screening study (CATS) 205
Copper T (CuT 380A) 266
Corticosteroids 88, 141
Corticotropin-releasing hormone (CRH) 13
Cortisol 15, 59, 120, 211
binding globulin 15
C-peptide 18, 195, 227, 228, 230
C-reactive protein (CRP) 157, 215
Cystic kidney 149
Cytokine 16, 211, 214, 215, 241
D
Decreased gestational glucose tolerance (DGGT) 81
Dehydroepiandrosterone sulfate 15
Diabetes 1, 3
in pregnancy
long-term complications 152
perinatal complications 151
role of counseling 153
mellitus 4, 18, 20, 22, 42, 51, 67, 77, 111, 113, 120, 136, 205, 223
Diabetic
cardiomyopathy 95
fetopathy 137
ketoacidosis 87
nephropathy 95
neuropathy 95
retinopathy 51, 95, 176
Diaphragmatic nerve paralysis 140
Dietary reference intakes (DRI) 60
Disodium cromoglycate (DSCG) 158
Distress syndrome 88
Down’s syndrome 181
DPP-IV inhibitors 69, 72, 75
saxagliptin 68
sitagliptin 68
vildagliptin 68
Dual-energy X-ray absorptiometry scans 27
Duodenal atresia 149, 149f
Dyslipidemia 30, 211
Dystocia 110, 167
E
Eclampsia 177, 195
Ectopic thyroid 202
Endocrine
function 238
metabolism, role of placenta 12
Endogenous glucose production 78
Endoscopic dilatation 113
Endothelial
dysfunction, gestational diabetes mellitus 217
nitric oxide synthase 225
Epinephrine 15
Erb’s palsy 140
Erythrokinetics 50
E-selectin 217
Estrogen 12t, 15, 201, 203, 211, 213
stimulated hypertrophy 13
Euglycemia 81
Excessive fetal growth 26t
Exogenous insulin therapy 49
F
Facial nerve injury 140
Fatty acids 28, 58
Fatty liver 111
Fetal
abnormality 43, 110
congenital malformations 25
distress 165
hypothalamo-pituitary-thyroid axis 14
lung maturation 141
malformations 51
Food exchange list 278282
Free fatty acids (FFA) 18
Fuel-mediated teratogenesis 49
G
Gallstones 113
Gastric
band 111
erosion 113
bypass surgery 115
Gestational
diabetes mellitus (GDM) 2, 33, 33t, 216, 248
assessing glycemic control 53
glycosylated hemoglobin 53
self-monitoring blood glucose 53
autoimmunity 160
beta cell function 19
breastfeeding 263
contraceptive choices 266
diagnosis 194
implementing diagnostic 38
new WHO criteria 38
single test procedure 35
diet charts
North Indian 269272
South Indian 273275
evidence-based WHO criterion 34
exercise 197
fetal risks 194
glycemic
control assessment 49
control monitoring 53
homeostasis 49
targets 49, 51
high risk for 33t
inflammation 157t
insulin resistance 18
low risk for 33t
maternal health 232
medical nutrition therapy 5665
neonatal aspects 135153
nutrition therapy 197t
pathogenesis 1822, 213
pharmacotherapy 198
placenta 19
cytokines 19
leptin levels 19
nutritional factors 20
placental inflammation 159
postpartum
care 263
recommendations 264t
risk factors for 136
development 213
type 2 diabetes mellitus 243t, 246
treatment of 182, 196
exercise 183
medical nutrition therapy 182
oral antidiabetic agents 184
pharmacotherapy 183
transient thyrotoxicosis 206
weight gain 168, 235
Glibenclamide 73, 198, 199
Gliclazide 73, 74
Glucagon 22, 78
Glucocorticoids 15, 185
Glucose
challenge test 32, 70
homeostasis 158
intolerance 35, 38, 211
metabolism 113
oral glucose tolerance test 32
oxidase-peroxidase
hexokinase 36
method 43
Glulisine 84
Glutamic acid 84
decarboxylase 160
Glyburide 68, 69, 70, 71, 72, 73, 74, 184, 199
Glycation end products (AGE) 21
Glycemic
control 73, 78, 79, 86, 113, 153, 177
intrapartum 88
monitoring 181
excursions 50
index 59, 80, 229
meal 53
of common Indian foods 276, 277
targets 58, 78
Glycolysis 113
Glycosuria 156
Glycosylated hemoglobin 18, 42, 50, 77, 93
GOD-POD method 45
Gonadotrophs 13
Graves’ disease 206, 207
Growth hormone (GH) 13
H
HAPO study 194, 195, 196
Hemolytic anemia 50
Hemorrhage 110
Heparin 114
Hepatic gluconeogenesis 59, 67
High-density lipoprotein cholesterol (HDLC) 211, 245
Homeostasis
maternal 12
model assessment (HOMA) 227
Homeostatic model assessment (HOMA) 2
model 20
Hormone-sensitive lipase (HSL) 28f
Hormono-metabolic adaptations, in pregnancy 1116
Human
Chorionic
gonadotropin 12, 12t
somatomammotrophin 12t, 18
immunodeficiency virus 2
placental
growth hormone 211
lactogen 15, 18, 211
Hyaline membrane disease 141
Hydramnios 42, 43, 43t
Hydronephrosis 149
Hyperaminoacidemia 78
Hyperbilirubinemia 78, 264
Hypercortisolemia 120
Hypercortisolism 16
Hyperestrogenemia 15
Hyperglycemia 182, 184
during pregnancy 3
fetal 137, 138f
in pregnancy, risks associated 5t
postprandial 78, 97
Hyperinsulinemia 22, 137, 152, 179, 215
fetal 44, 49
Hyperinsulinism, secondary fetal 137
Hyperlipidemia 15, 78
Hypertension 78, 85, 111, 169, 171, 176, 226
arterial 5
gestational 25, 26t, 176, 195, 216
diabetes mellitus 216
management 231
pregnancy-induced 3, 5t, 110
pulmonary 142
severe 177
Hypertensive syndromes 79
Hypertrophic cardiomyopathy 265b
Hypoglycemia
neonatal 5t, 49, 51, 68, 70, 71, 78, 79, 88, 156
management of 143
nocturnal 87, 89, 97
prolonged hyperinsulinemic 68
Hypoglycemic, nocturnal 85
Hypoplastic
femur 149
left heart syndrome 147
Hypothyroidism 118, 202206
clinical features 202
congenital 206
diagnosis 203
etiology 202
management of 204f
subclinical 203
treatment 203
Hypoxemia 71
Hypoxic ischemic encephalopathy 179t
I
Impaired
fasting glycemia (IFG) 263
glucose tolerance (IGT) 4, 168, 189, 245
Indomethacin 87
Induction of labor 185
Infant
of diabetic mothers
cardiovascular anomalies 146
congenital malformations 147
evaluation of 151
hematological problems 145
hyperbilirubinemia 145
hypocalcemia 143
hypoglycemia 142
impaired fetal growth 140
pulmonary disease in 141
thrombocytopenia 145
respiratory distress syndrome 5t
Infertility 110, 118
Inflammatory
cytokine 29, 29f
markers, gestational diabetes mellitus 217
Institute of Medicine (IOM) 25t, 170, 235, 236f
nutrition 59
prepregnancy body mass index 26t
weight categories 25t
Insulin 15, 45, 77, 78
antibodies 49
basal 79, 81, 83, 85
bolus 79, 81, 83
breastfeeding 89
choice, in pregnancy 80, 82f
delivery 88
detemir 85
dosage adjustment 87
elective caesarean delivery 89
fetal 49
glargine 85, 86
glulisine 84
human 80, 84
infusion, intravenous 88
intermediate-acting 87, 89
labor 88
lispro 83, 84
long-acting 87
non-immunogenic 80
NPH 82, 85
postpartum 89
premixed human 84
preterm delivery 87
pump 86
rapid-acting 81, 88
receptor substance 28f, 29f, 214
regimens 81
requirement, factors affecting 79
resistance 29f, 68, 72, 152, 157, 158, 160, 164, 183, 186, 211
abnormal lipid metabolism 214
adipocytokines 214
cellular mechanisms 214
peripheral 79
role of placental hormones 213
secretagogue 199
secretion 183
sensitivity 113, 237f
short-acting 82, 87, 88
therapy 67, 79
in pregnancy 78
Intercellular adhesion molecule 1 217
Internal hernias 113
International Association of Diabetes and Pregnancy Study Groups (IADPSG) 27, 194
International Conference on Population and Development (ICPD) 6
International Diabetes Federation 3
Interventricular septal hypertrophy 149
Intranatal care 186
elective caesarean section 187
glucose monitoring in labor 187
insulin 187
Intrapartum asphyxia 151
Intrauterine
deaths 3, 5t
fetal demise 179, 226
growth
restriction 151, 177
retardation 78, 113
Intussusception 113
Islet cell autoantibodies (ICA) 160
Isolated maternal hypothyroxinemia 206
J
Jaundice, neonatal 179
K
Ketonemia 190
Ketonuria 190
Ketosis 58
Klumpke’s paralysis 140
L
Lactic acidosis 71
Lactotrophs 13
Leptin 214
Levonorgestrel-releasing intrauterine devices (IUDs) 188, 266
Lifestyle interventions, during pregnancy 236
Lipid profile, gestational diabetes mellitus 216
Lipogenic genes 239
Lipolysis 15, 18, 28, 29
Lipoprotein receptors 16
Low
density lipoproteins 13
glycemic index diet 236
platelet syndrome 78
Lysine 84
M
Macrosomia 4, 44, 51, 58, 70, 78, 79, 80, 98, 103, 106, 110, 137, 156, 165, 166, 178, 179, 182, 185, 186, 196, 198, 226, 236
fetal 49
risk of 140
Magnesium, sulphate 87, 185
Malaria 2
Maternal
Diabetes
classification of 137
pathophysiology 137
hyperglycemia, infant risks related 264
obesity
birth complications 165
fetal 166
management 171
neonatal complications 166
offspring obesity 168
pregnancy complications 164
serum alphafetoprotein 180
vasculopathy 179
Maturity onset diabetes of young (MODY) 18
McRoberts maneuver 186
Medical nutrition therapy (MNT) 45, 56, 59, 183
Caloric
allotment 58
distribution 58
intake 60
carbohydrate intake 58
continuation 59
glycemic
control 61
index 60, 61
monitoring goals 61
insulin therapy 61
planning and execution 58
practical limitations 57
primary goal 59
Medroxyprogesterone 114
acetate 189
Membrane
rupture of 43t
type matrix metalloproteinase 1 19
Metabolic syndrome 4, 5, 152, 211, 222, 223
definition of 212
diet therapy 229
dietary precautions 230
effects 222f
gestational diabetes mellitus 217
hyperglycemia associated 225
hypoglycemic agents 230
impact on pregnancy 225
in early pregnancy 218t
insulin resistance 212
lifestyle changes 228
management of 227
micronutrients 230
pathophysiology of 215, 225
insulin resistance 215
preconception counselling 227
pregnancy care 228
Metagestational diabetes 56
Metformin 69, 70, 72, 73, 74, 184, 198, 253
longer-term outcomes glyburide 71
pharmacokinetics 71
Micronutrient deficiencies 114
Millennium development goals 6
Miscarriage 177
Mothers After Gestational Diabetes in Australia Diabetes Prevention Program (MAGDA-DPP) 252
Multiple daily injections (MDI) 86
N
National Institute for Health and Clinical Excellence (NICE) 73, 141, 185
Neonatal
adiposity 195
electrolyte abnormality 156
hypoglycemia 198
jaundice 156
mortality 51
Neural tube defects 147, 178, 225
biochemical screening 180
Neutral protamine hagedorn (NPH) 81
Nitrosamines 21
Nonalcoholic fatty liver disease 168
Noncommunicable diseases (NCDs) 1
Norepinephrine 15
Normal glucose tolerant (NGT) 36, 44
Nuchal translucency (NT) 181
O
Obesity 2530
associated diabetes 160
childhood 222
Obesogenic maternal microbiome 58
Obstructed labor 4
Obstructive sleep apnea (OSA) 21, 111
Oral
antihyperglycemic agents (OHA) 198
glucose tolerance test (OGTT) 80
hypoglycemic agents 56, 67
alpha-glucosidase inhibitors 67
biguanides 67
congenital anomalies 69
crossing placenta 68
diabetes 73
dipeptidyl peptidase 4
inhibitors 67
during lactation 74
early use of 68
efficacy glyburide 69
gestational diabetes mellitus 73
glucagon-like peptide-1 agonists 67
long term outcomes 72
mechanisms of action 67
miglitol 67
safety glyburide 69
sulfonylureas 67
transfer into breast milk 74
voglibose 68
Organogenesis 83
P
Pancreatic beta cells 152
Parathyroid
glands 14
hormone 12t, 14
Pedersen hypothesis 137, 138f, 199
Perinatal asphyxia 141
Peroxisome proliferator-activated receptor-gamma 68, 215
Phenytoin 202
Phosphoionositol-3 kinase 214
Phosphotidyl inositol 3
kinase 28f
Placental hormones, functions 12t
Plasma prolactin 13
Plasminogen activator inhibitor 1 215
Pneumonia 142
Polycystic ovary syndrome (PCOS) 4, 21, 110, 118, 191
Polycythemia 152, 265b
Polyhydramnios 4, 5t, 150, 176, 177, 185, 226
Polyuria 177
Ponderal index 70
Postnatal care 188
breastfeeding 188
contraception 188
glucose homeostasis 144f
management of diabetes 188
Postoperative hemorrhage 26t
Postpartum
hemorrhage 25, 166, 179t
screening 253259
at community health centers 258
at district hospitals 258
at primary centers 257
at subcenters 257
diabetes 189
thyroiditis 208
screening test 254
Postprandial glucose excursions 82
Preconceptional
care 190
counseling 52
Preeclampsia 7, 25, 26t, 52, 78, 85, 150, 165, 169, 171, 176, 185, 186, 195, 216, 225, 226, 236
Pregestational diabetes mellitus 136, 137, 166
Pregnancy complications 43t
Premature delivery 78
Preterm
births 43, 60
labor 176, 177, 225
management of 185
Previous caesarean section 186
Progesterone 12t, 12, 15, 18, 211, 213
Prolactin 211, 213
Propylthiouracil (PTU) 207
Prostaglandin synthetase inhibitors 185
Psychosocial aspects
diabetes in pregnancy 117, 117t
antenatal phase 118
glycemic control 122
history taking 121
impact on health 120
management 121
medical nutrition therapy 122
postpartum phase 119
preconception counseling 121
psychosocial concerns 118t
Pyelonephritis 150
R
Rapid-acting insulin analogs 53, 83
in pregnancy 82
Recurrent
laryngeal nerve damage 140
spontaneous abortions 226
Renal
agenesis 149
vein thrombosis 149
Renin 15
Respiratory distress syndrome 141, 147, 151, 225, 265
Retinopathy 180
Rifampicin 202
Ritodrine 87
Roux-en-Y gastric bypass 112, 113
S
Serum
human chorionic gonadotropin 201
low-density lipoprotein 214
total cholesterol 214
triglycerides 214
Sex hormone-binding globulin 15
Shoulder dystocia 140, 151, 186, 196, 225
complications due to 179t
maneuvers 187b
Sleeve gastrectomy 112
Small
bowel obstruction 113
for gestational age 45
left colon syndrome 149, 150
Solitary toxic nodule 206
Spontaneous
abortions 4, 5t, 25, 26t
preterm labor 185
Still births 3, 4, 5t, 78, 110, 167, 179
Stroke 5, 177
Subdermal implants 266
Subfertility 110, 111, 118
Sulphonylureas 73
Surrogate markers 168
T
T cells 159
T helper 1
cells 158
T regulatory cells 158
Terbutaline 87
Thiamine 114
Thiazolidinediones 68, 69, 72, 75
Threonine 85
Threshold plasma glucose (PG) 33
Thromboembolism 25, 26t, 114, 225
Thyroglobulin antibodies 203
Thyroid
disorders, in pregnancy 201209
function tests 203
gland 13
peroxidase (TPO) 203
tumors 202
Thyroiditis
destructive 208
subacute 206
Thyroid-stimulating hormone 13, 180, 201
Thyrotoxicosis 206, 209
Thyrotrophs 13
Thyroxine 201
binding globulin 14, 201
Tocolytic therapy 87
Tolbutamide 68
Transdermal contraceptive patches 113
Transient tachypnea of newborn 147
Transthyretin 14
Triiodothyronine 14, 201
Tripod trial 253
TSH-R
antibodies 208, 209
stimulating antibodies 207
Tumor necrosis factor 20, 29, 29f, 211, 225
U
Unconjugated estriol 181
Ureteric duplication 149
Urinary tract infections 25, 26t
Uteroplacental perfusion 179
V
Vaginal lacerations 179t
Very low-density lipoprotein 214
Victoza 232
Vitamin
B12 20, 22, 50, 114
D 20, 21, 114
D binding globulin 14
W
Wood’s screw maneuver 186
Z
Zavanelli maneuver 186
×
Chapter Notes

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