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Gestational Diabetes

Gestational Diabetes 

  • A pregnancy complicated by diabetes is called gestational diabetes. Women with previous gestational diabetes have 10-fold higher risk of gestational diabetes in subsequent pregnancies. The risk is increased 26-fold in the third pregnancy if both prior pregnancies had gestational diabetes.1
  • Women with prediabetes, prehypertension, and BMI >25 have 5-fold risk of gestational diabetes than women with normal levels.2
  • Hispanics and Asian/Pacific Islanders have higher rates of recurrence.1 Asian women are also at greater risk of gestational diabetes, thereby putting their children at risk for diabetes later in life.3
  • High intakes of dietary fat, especially saturated fat, and low intake of polyunsaturated fat have been implicated in triggering gestational diabetes.4
  • Because of the higher risk of complications, the criteria for gestational diabetes are different than diabetes in general. A task force of the International Association of Diabetes and Pregnancy Study Groups recommends that the diagnosis of gestational diabetes be made when any of the following three 75-g, 2-hour oral glucose tolerance test thresholds are met or exceeded: fasting 92 mg/dL, 1-hour 180 mg/dL, or 2 hours 153 mg/dL. Various authoritative bodies around the world are expected to deliberate the adoption of these criteria.5
  • Glucose tolerance test is not used for diagnosing diabetes in the US since two fasting blood sugar readings of more than 125 is sufficient to make a diagnosis. An A1C greater than 6.5 is also considered diabetes regardless of blood sugar levels (see Diabetes A1C). When used, two hour glucose value of 200mg/dL meets the criteria for diagnosis.

Sources

1. Getahun D, Fassett MJ, Jacobsen SJ. Gestational diabetes: risk of recurrence in subsequent pregnancies. Am J Obstet Gynecol. Nov 2010;203(5):467 e461-466.

2. Hedderson MM, Darbinian JA, Quesenberry CP, Ferrara A. Pregravid cardiometabolic risk profile and risk for gestational diabetes mellitus. Am J Obstet Gynecol. May 26 2011.

3. Chan JC, Malik V, Jia W, et al. Diabetes in Asia: epidemiology, risk factors, and pathophysiology. JAMA. May 27 2009;301(20):2129-2140.

4. Ying H, Wang DF. [Effects of dietary fat on onset of gestational diabetes mellitus]. Zhonghua Fu Chan Ke Za Zhi. Nov 2006;41(11):729-731.

5. Coustan DR, Lowe LP, Metzger BE, Dyer AR. The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study: paving the way for new diagnostic criteria for gestational diabetes mellitus. Am J Obstet Gynecol. Jun 2010;202(6):654 e651-656.

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