The Experts below are selected from a list of 70653 Experts worldwide ranked by ideXlab platform

Aaron B. Caughey - One of the best experts on this subject based on the ideXlab platform.

  • Gestational Diabetes: diagnosis and management
    Journal of Perinatology, 2008
    Co-Authors: Yvonne W. Cheng, Aaron B. Caughey
    Abstract:

    Purpose: To review the diagnosis and management of Gestational Diabetes. Epidemiology: In the United States, approximately 2 to 5% of all pregnant women have Gestational Diabetes. Those women with a family history of type 2 Diabetes mellitus, Asian or native American race, Latina ethnicity or obesity are at higher risk for developing Gestational Diabetes. Conclusion: Women with Gestational Diabetes who are treated appropriately can achieve good outcomes in the majority of pregnancies. Frequent blood glucose monitoring, nutrition counseling and frequent physician contact allow for individualized care to achieve optimal outcomes. Such treatment includes diet, exercise and insulin. The use of oral hypoglycemic agents is controversial and there is some concern about worse maternal and neonatal outcomes as compared to treatment with insulin. Evolving technologies promise to provide more therapeutic options.

  • Gestational Diabetes: diagnosis and management.
    Journal of perinatology : official journal of the California Perinatal Association, 2008
    Co-Authors: Yvonne W. Cheng, Aaron B. Caughey
    Abstract:

    To review the diagnosis and management of Gestational Diabetes. In the United States, approximately 2 to 5% of all pregnant women have Gestational Diabetes. Those women with a family history of type 2 Diabetes mellitus, Asian or native American race, Latina ethnicity or obesity are at higher risk for developing Gestational Diabetes. Women with Gestational Diabetes who are treated appropriately can achieve good outcomes in the majority of pregnancies. Frequent blood glucose monitoring, nutrition counseling and frequent physician contact allow for individualized care to achieve optimal outcomes. Such treatment includes diet, exercise and insulin. The use of oral hypoglycemic agents is controversial and there is some concern about worse maternal and neonatal outcomes as compared to treatment with insulin. Evolving technologies promise to provide more therapeutic options.

Donald R. Coustan - One of the best experts on this subject based on the ideXlab platform.

  • Gestational Diabetes Mellitus
    Clinical chemistry, 2013
    Co-Authors: Donald R. Coustan
    Abstract:

    Background: Gestational Diabetes mellitus, defined as Diabetes diagnosed during pregnancy that is not clearly overt Diabetes, is becoming more common as the epidemic of obesity and type 2 Diabetes continues. Newly proposed diagnostic criteria will, if adopted universally, further increase the prevalence of this condition. Much controversy surrounds the diagnosis and management of Gestational Diabetes. Content: This review provides information regarding various approaches to the diagnosis of Gestational Diabetes and the recommendations of a number of professional organizations. The implications of Gestational Diabetes for both the mother and the offspring are described. Approaches to self-monitoring of blood glucose concentrations and treatment with diet, oral medications, and insulin injections are covered. Management of glucose metabolism during labor and the postpartum period are discussed, and an approach to determining the timing of delivery and the mode of delivery is outlined. Summary: This review provides an overview of current controversies as well as current recommendations for Gestational Diabetes care.

  • Screening and testing for Gestational Diabetes mellitus.
    Obstetrics and gynecology clinics of North America, 1996
    Co-Authors: Donald R. Coustan
    Abstract:

    Gestational Diabetes mellitus is defined as carbohydrate intolerance of variable severity first diagnosed during pregnancy. Although universal screening for Gestational Diabetes mellitus is practiced by more than 75% of obstetricians in the United States, agreement is lacking worldwide regarding the appropriateness of this approach. This article discusses the assumption that some type of screening program is desirable and considers how best to conduct screening and diagnostic testing for Gestational Diabetes mellitus.

  • Screening and diagnosis of Gestational Diabetes.
    Seminars in perinatology, 1994
    Co-Authors: Donald R. Coustan
    Abstract:

    A number of different recommendations have been made regarding screening and diagnostic testing for Gestational Diabetes. Although the ideal blinded study of the natural history of Gestational Diabetes has not been reported, nor has the perfect randomized clinical trial of various forms of treatment been performed, it seems likely that Gestational Diabetes has adverse effects on pregnancy outcome, and it is clear that this condition is a risk factor for subsequent Diabetes. The problem remaining to be resolved is the precise level of glucose abnormality at which intervention may be beneficial. Once that is established, cost-benefit considerations can be applied to various screening recommendations. For the present, we have chosen to screen all pregnant women at 24 to 28 weeks gestation, using a 50-g, 1-hour oral glucose challenge. If the plasma glucose, determined in a standard laboratory analyzer using an enzymatic method, is greater than or equal to 130 mg/dL, a diagnostic 3-hour OGTT is recommended. Gestational Diabetes is diagnosed based on thresholds outlined in Table 6. A survey by Landon and Gabbe in 1990 found that despite the ACOG recommendations, three fourths of generalist obstetricians and 90% of Maternal Fetal Medicine subspecialists report that they perform universal screening for Gestational Diabetes.

  • Management of Gestational Diabetes.
    Clinical obstetrics and gynecology, 1991
    Co-Authors: Donald R. Coustan
    Abstract:

    The treatment of Gestational Diabetes is based on maintaining near-normal maternal glucose levels. To accomplish this goal, dietary counseling is used. circulating glucose is measured regularly, and exogenous insulin is sometimes necessary. Early delivery is not routine. Cesarean section is reserved for obstetric indications, but the presence of fetal macrosomia may be responsible for increasing the overall cesarean section rate in individuals with this disorder. The most important component of the treatment of Gestational Diabetes is probably the identification of the individual with this condition.

Elly M J Xenakis - One of the best experts on this subject based on the ideXlab platform.

  • Gestational Diabetes: The consequences of not treating
    American journal of obstetrics and gynecology, 2005
    Co-Authors: Oded Langer, Yariv Yogev, Orli Most, Elly M J Xenakis
    Abstract:

    Objective: Untreated Gestational Diabetes mellitus carries significant risks of perinatal morbidity at all severity levels; treatment will enhance outcome. Study design: A matched control of 555 gravidas, Gestational Diabetes mellitus diagnosed after 37 weeks, were compared with 1110 subjects treated for Gestational Diabetes mellitus and 1110 nondiabetic subjects matched from the same delivery year for obesity, parity, ethnicity, and Gestational age at delivery. The nondiabetic subjects and those not treated for Gestational Diabetes mellitus were matched for prenatal visits. Results: A composite adverse outcome was 59% for untreated, 18% for treated, and 11% for nondiabetic subjects. A 2- to 4-fold increase in metabolic complications and macrosomia/large for Gestational age was found in the untreated group with no difference between nondiabetic and treated subjects. Comparison of maternal size, parity, and disease severity revealed a 2- to 3-fold higher morbidity rate for the untreated groups, compared with the other groups. Conclusion: Untreated Gestational Diabetes mellitus carries significant risks for perinatal morbidity in all disease severity levels. Timely and effective treatment may substantially improve outcome.

Yvonne W. Cheng - One of the best experts on this subject based on the ideXlab platform.

  • Gestational Diabetes: diagnosis and management
    Journal of Perinatology, 2008
    Co-Authors: Yvonne W. Cheng, Aaron B. Caughey
    Abstract:

    Purpose: To review the diagnosis and management of Gestational Diabetes. Epidemiology: In the United States, approximately 2 to 5% of all pregnant women have Gestational Diabetes. Those women with a family history of type 2 Diabetes mellitus, Asian or native American race, Latina ethnicity or obesity are at higher risk for developing Gestational Diabetes. Conclusion: Women with Gestational Diabetes who are treated appropriately can achieve good outcomes in the majority of pregnancies. Frequent blood glucose monitoring, nutrition counseling and frequent physician contact allow for individualized care to achieve optimal outcomes. Such treatment includes diet, exercise and insulin. The use of oral hypoglycemic agents is controversial and there is some concern about worse maternal and neonatal outcomes as compared to treatment with insulin. Evolving technologies promise to provide more therapeutic options.

  • Gestational Diabetes: diagnosis and management.
    Journal of perinatology : official journal of the California Perinatal Association, 2008
    Co-Authors: Yvonne W. Cheng, Aaron B. Caughey
    Abstract:

    To review the diagnosis and management of Gestational Diabetes. In the United States, approximately 2 to 5% of all pregnant women have Gestational Diabetes. Those women with a family history of type 2 Diabetes mellitus, Asian or native American race, Latina ethnicity or obesity are at higher risk for developing Gestational Diabetes. Women with Gestational Diabetes who are treated appropriately can achieve good outcomes in the majority of pregnancies. Frequent blood glucose monitoring, nutrition counseling and frequent physician contact allow for individualized care to achieve optimal outcomes. Such treatment includes diet, exercise and insulin. The use of oral hypoglycemic agents is controversial and there is some concern about worse maternal and neonatal outcomes as compared to treatment with insulin. Evolving technologies promise to provide more therapeutic options.

Gregory E Rice - One of the best experts on this subject based on the ideXlab platform.

  • Fetal programming and Gestational Diabetes mellitus.
    Placenta, 2015
    Co-Authors: Lara J Monteiro, Gregory E Rice, Jane E Norman, Sebastián E Illanes
    Abstract:

    Gestational Diabetes mellitus is defined by new-onset glucose intolerance during pregnancy. About 2-5% of all pregnant women develop Gestational Diabetes during their pregnancies and the prevalence has increased considerably during the last decade. This metabolic condition is manifested when pancreatic β-cells lose their ability to compensate for increased insulin resistance during pregnancy, however, the pathogenesis of the disease remains largely unknown. Gestational Diabetes is strongly associated with adverse pregnancy outcome as well as with long-term adverse effects on the offspring which likely occurs due to epigenetic modifications of the fetal genome. In the current review we address Gestational Diabetes and the short and long term complications for both mothers and offspring focusing on the importance of fetal programming in conferring risk of developing diseases in adulthood.

  • Screening for biomarkers predictive of Gestational Diabetes mellitus
    Acta Diabetologica, 2008
    Co-Authors: Harry M. Georgiou, Adinda Marita, Valerie J. Bryant, George M. Georgiou, Zeinab Khalil, Michael Permezel, Martha Lappas, Richard Hiscock, Gregory E Rice
    Abstract:

    Screening for glucose intolerance during pregnancy provides an opportunity to offer management to those women diagnosed with Gestational Diabetes mellitus. However, there is a need to diagnose Gestational Diabetes early to minimize exposure of the developing fetus to suboptimal conditions and prevent perinatal complications and their sequelae. The purpose of this study was to identify potential biomarkers for impending Gestational Diabetes that appear in the plasma before impaired glucose tolerance. Pregnant women were prospectively recruited to the study and blood was collected at the first antenatal visit and at the time of routine oral glucose tolerance test. Women diagnosed with Gestational Diabetes were matched with an equal number of normal pregnant (control) women. Biomarkers under investigation included endocrine and metabolic hormones, cytokines and chemokines, and surrogate markers of oxidative stress. Compared to controls, women with Gestational Diabetes exhibited elevated plasma insulin and reduced plasma adiponectin concentrations at 28 weeks gestation. Significant differences in insulin and adiponectin concentrations were also observed in plasma at 11 weeks gestation. Bivariate logistic regression analysis showed that both insulin and adiponectin are associated with subsequent development of Gestational Diabetes. Plasma insulin and adiponectin concentrations, when measured at 11 weeks, may be predictive of impending Gestational Diabetes. Further studies are warranted to determine the reliability of these biomarkers.