Chapter 10. Gestational Diabetes Mellitus

  1. R. Williams2,
  2. W. Herman3,
  3. A.-L. Kinmonth5 and
  4. N. J. Wareham4
  1. David R. McCance

Published Online: 9 APR 2003

DOI: 10.1002/0470846585.ch10

The Evidence Base for Diabetes Care

The Evidence Base for Diabetes Care

How to Cite

McCance, D. R. (2002) Gestational Diabetes Mellitus, in The Evidence Base for Diabetes Care (eds R. Williams, W. Herman, A.-L. Kinmonth and N. J. Wareham), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/0470846585.ch10

Editor Information

  1. 2

    Nuffield Institute for Health, University of Leeds, 71-75 Clarendon Road, Leeds LS2 9PL, UK

  2. 3

    Department of Internal Medicine and Epidemiology, 1500 East Medical Center Drive, 3920 Taubman Center, Box 0345, Ann Arbor, MI 48109, USA

  3. 4

    Department of Public Health and Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

  4. 5

    General Practice and Primary Care Research Unit, Dept. of Public Health & Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

Author Information

  1. Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast BT12 6BA, Northern Ireland, UK

Publication History

  1. Published Online: 9 APR 2003
  2. Published Print: 27 AUG 2002

ISBN Information

Print ISBN: 9780471988762

Online ISBN: 9780470846582

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Keywords:

  • hyperglycaemia;
  • diagnosis;
  • risk factor;
  • surrogate marker;
  • screening;
  • diet;
  • exercise;
  • maternal morbidity;
  • perinatal mortality

Summary

Few areas in diabetes research have aroused such confusion and controversy as the concept and diagnosis of gestational diabetes. The difficulty lies in the apparent absence of a threshold separating subjects into low and high risk groups for adverse pregnancy outcome. This chapter addresses three questions. 1) Is hyperglycaemia in pregnancy associated with adverse outcomes for the foetus and mother? This covers maternal morbidity, perinatal mortality, surrogate markers and maternal risk factors. 2) How can hyperglycaemia in pregnancy be detected? Problems include physiological considerations, test timing and sensitivity, ethnic variations and definition of relevant end-points. 3) Does treatment of hyperglycaemia in pregnancy reduce adverse outcomes? Interventions may be dietary, physical activity or insulin therapy. The case for screening is discussed, as are the prospects for progress.