Gestational Diabetes Mellitus (GDM): GDM
has been defined as glucose intolerance that begins,
or is first recognized, during pregnancy.21 Risk factors
for the condition are: advanced maternal age; obesity;
high blood pressure; multiple pregnancies; previous
delivery of a macrosomic infant; family history of
type-2 diabetes; and, previous stillbirths or
congenital malformations.22,23 Normal pregnancy
has been characterized as a “diabetogenic state” due
to changes in the pattern of insulin secretion and
sensitivity. In the late second and early third trimester,
insulin sensitivity is reduced by human placental
lactogen, leptin, prolactin and cortisol. During
normal pregnancy, compensation for the marked
reduction in insulin sensitivity takes place by way of
an increase in β-cell secretion. If this compensation
is not sufficient, abnormal glucose tolerance
develops.2
Gestational Diabetes Mellitus (GDM): GDMhas been defined as glucose intolerance that begins,or is first recognized, during pregnancy.21 Risk factorsfor the condition are: advanced maternal age; obesity;high blood pressure; multiple pregnancies; previousdelivery of a macrosomic infant; family history oftype-2 diabetes; and, previous stillbirths orcongenital malformations.22,23 Normal pregnancyhas been characterized as a “diabetogenic state” dueto changes in the pattern of insulin secretion andsensitivity. In the late second and early third trimester,insulin sensitivity is reduced by human placentallactogen, leptin, prolactin and cortisol. Duringnormal pregnancy, compensation for the markedreduction in insulin sensitivity takes place by way ofan increase in β-cell secretion. If this compensationis not sufficient, abnormal glucose tolerancedevelops.2
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