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Review
- Metabolic Risk/Epidemiology
- Gestational Diabetes Mellitus: Diagnostic Approaches and Maternal-Offspring Complications
- Joon Ho Moon, Hak Chul Jang
- Diabetes Metab J. 2022;46(1):3-14. Published online January 27, 2022
- DOI: https://doi.org/10.4093/dmj.2021.0335
- 51,934 View
- 1,793 Download
- 273 Web of Science
- 282 Crossref
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ePub - Gestational diabetes mellitus (GDM) is the most common complication during pregnancy and is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. GDM is associated with adverse pregnancy outcomes and long-term offspring and maternal complications. For GDM screening and diagnosis, a two-step approach (1-hour 50 g glucose challenge test followed by 3-hour 100 g oral glucose tolerance test) has been widely used. After the Hyperglycemia and Adverse Pregnancy Outcome study implemented a 75 g oral glucose tolerance test in all pregnant women, a one-step approach was recommended as an option for the diagnosis of GDM after 2010. The one-step approach has more than doubled the incidence of GDM, but its clinical benefit in reducing adverse pregnancy outcomes remains controversial. Long-term complications of mothers with GDM include type 2 diabetes mellitus and cardiovascular disease, and complications of their offspring include childhood obesity and glucose intolerance. The diagnostic criteria of GDM should properly classify women at risk for adverse pregnancy outcomes and long-term complications. The present review summarizes the strengths and weaknesses of the one-step and two-step approaches for the diagnosis of GDM based on recent randomized controlled trials and observational studies. We also describe the long-term maternal and offspring complications of GDM.
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American Journal of Reproductive Immunology.2025;[Epub] CrossRef - Increased First Trimester Serum Uric Acid as A Predictor of Gestational Diabetes Mellitus
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Diabetology.2025; 6(4): 27. CrossRef - The impact of environmental and dietary exposure on gestational diabetes mellitus: a comprehensive review emphasizing the role of oxidative stress
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Diabetes & Metabolism Journal.2025; 49(3): 403. CrossRef - The influence of socioeconomic status on the association between residential greenness and gestational diabetes mellitus in an urban setting: a multicenter study
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BMC Public Health.2025;[Epub] CrossRef - Mediating effect of osteocalcin underlying the link between insulin-like growth factor-I and gestational diabetes mellitus
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Frontiers in Endocrinology.2025;[Epub] CrossRef - Association of maternal thyroid function and gestational diabetes with pregnancy outcomes: a retrospective cohort study
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Xiaoting Gu, Yutian Cai, Chaoyue Zheng, Keran Li, Shuwen Zhu, Shaohan Zhang, Ziqi Wang, Jianxiong Xiang, Zhipeng Cheng, Xiaoyu Ai, Cheng Yang
European Journal of Pharmaceutical Sciences.2025; 212: 107161. CrossRef - Expression and clinical significance of mir-520g-3p in patients with gestational diabetes mellitus
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Nutrients.2025; 17(13): 2128. CrossRef - Construct a nomogram prediction and evaluation of influencing factors of adverse pregnancy outcomes in GDM patients based on plasma miR-144-3p levels
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Frontiers in Endocrinology.2025;[Epub] CrossRef - Correlation between serum advanced glycation end-products and their receptor-mediated oxidative stress and perinatal outcomes in gestational diabetes mellitus
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Shinae Kang, Seon Mee Kang, Jong Han Choi, Seung-Hyun Ko, Bo Kyung Koo, Hyuk-Sang Kwon, Mi Kyung Kim, Sang Yong Kim, Soo-Kyung Kim, Young-eun Kim, Eun Sook Kim, Jae Hyeon Kim, Chong Hwa Kim, Ji Min Kim, Hae Jin Kim, Min Kyong Moon, Sun Joon Moon, Jun Sung
Diabetes & Metabolism Journal.2025; 49(4): 582. CrossRef - Household income modifies the association between social capital and gestational diabetes mellitus in Japan: Results from TMM BirThree Cohort Study
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Frontiers in Genetics.2025;[Epub] CrossRef - Intergenerational associations between maternal body mass index before or during pregnancy with offspring metabolomics: a systematic review and meta-analysis
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International Journal of Obesity.2025; 49(10): 1899. CrossRef - The potential of 1H NMR spectroscopy for diabetes diagnosis: a review of current applications and future directions
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Diabetes Research and Clinical Practice.2025; 226: 112380. CrossRef - Upregulation of the Antioxidant Response-Related microRNAs miR-146a-5p and miR-21-5p in Gestational Diabetes: An Analysis of Matched Samples of Extracellular Vesicles and PBMCs
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International Journal of Molecular Sciences.2025; 26(14): 6902. CrossRef - Gestational Diabetes and Cardiovascular Risk in Women: A Comprehensive Review of Thrombosis, Hemostasis, and Emerging Insights Into Coagulation and Fibrinolysis
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American Journal of Translational Research.2025; 17(7): 4986. CrossRef - Assessing Artificial Intelligence-Generated Patient Educational Material on Gestational Diabetes Mellitus
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Journal of Perinatal & Neonatal Nursing.2025; 39(3): 210. CrossRef - Low prolactin levels as a marker of gestational diabetes in late pregnancy
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Diabetes Research and Clinical Practice.2025; 227: 112404. CrossRef - Cardiovascular Health Optimization Through Life’s Essential 8 Scores Reduces Gestational Diabetes Risk: Mediation by Platelet Activity and Inflammatory Pathways in a Nationwide Cohort
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International Journal of Women's Health.2025; Volume 17: 2511. CrossRef - Reduced IL-17A levels in neonates born to mothers with diabetes mellitus or infection during pregnancy
Tingting Li, Sufen Hu, Fangfang Guo, Youming He, Haiping Cheng, Mengying Wu, Yan Mao, Kexin Zhang, Juan Lin, Rui Li, Defei Ma, Shiting Li, Cheng Chen, Bing Hu, Mingbang Wang, Yingmei Xie
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Antioxidants.2025; 14(9): 1064. CrossRef - From Molecular Insights to Clinical Management of Gestational Diabetes Mellitus—A Narrative Review
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International Journal of Molecular Sciences.2025; 26(17): 8719. CrossRef - Effects of Liver Enzyme Levels During Pregnancy on Birth Weight
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Maternal and Child Health Journal.2025; 29(10): 1415. CrossRef - Are Phoenixin-14 Levels Linked to Birth Weight and Maternal Diabetes? A Comparison of Phoenixin-14 Levels in Umbilical Cord Blood in Relation to Birth Weight in Term Infants
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Experimental and Therapeutic Medicine.2025; 30(5): 1. CrossRef - Kisspeptin‐10 Improves Gestational Diabetes Mellitus Symptoms in Rats by Suppressing Insulin Resistance in Placental Trophoblast Cells by Activating the Cyclic AMP/Protein Kinase A Pathway
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Chemical Biology & Drug Design.2025;[Epub] CrossRef - Knowledge, attitudes and practices towards gestational diabetes mellitus among obstetric and gynaecological healthcare workers: a cross-sectional study of 68 hospitals in Hubei Province, China
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BMJ Open.2025; 15(9): e101475. CrossRef - A Preliminary Study of circ‐PNPT1/miR‐144‐3p/UBE2G1 Expression in Placental Tissues and Serum and Its Mechanism in Patients With Gestational Diabetes Mellitus
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Molecular Reproduction and Development.2025;[Epub] CrossRef - Exosomal miR-152-5p promotes trophoblast apoptosis by inhibiting the PI3K/AKT/FOXO3a signaling pathway via targeting VAMP3 in gestational diabetes mellitus
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Placenta.2025; 172: 51. CrossRef - Pregnancy and Caffeine Metabolism: Updated Insights and Implications for Maternal–Fetal Health
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Nutrients.2025; 17(19): 3173. CrossRef - Enhancing gestational diabetes mellitus education: a randomized controlled trial of King’s theory and FMEA-PDCA integration for improved patient outcomes
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BMC Pregnancy and Childbirth.2025;[Epub] CrossRef - Anti-hyperglycemic effect of NiO–sodium alginate–polyethylene glycol–crocin nanocomposite via attenuating TLR4/MyD88/NFκB signaling in gestational diabetes triggered rats
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3 Biotech.2025;[Epub] CrossRef - Comparison of the Efficacy of Intensive Insulin Therapy Regimens for Type A2 Gestational Diabetes Mellitus and Their Effects on Maternal and Infant Metabolic Indices
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Clinical and Experimental Obstetrics & Gynecology.2025;[Epub] CrossRef - Optimizing gestational diabetes diagnostic criteria to predict adverse perinatal outcomes in the United Arab Emirates: The Mutaba’ah Study
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Frontiers in Endocrinology.2025;[Epub] CrossRef - Pregnancy Complications and Transgenerational Health Outcomes: Mechanistic Pathways and Future Research Horizons
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Clinical and Experimental Obstetrics & Gynecology.2025;[Epub] CrossRef - Maternal Pre-Pregnancy Glycemic Status and Growth Delay in Korean Children Aged 18–36 Months: A Population-Based Study
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Journal of Clinical Medicine.2025; 14(20): 7230. CrossRef - Identifying the correlation between the number of OGTT abnormalities and perinatal outcomes in twin pregnancies: a retrospective cohort study
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Diabetes, Metabolic Syndrome and Obesity.2025; Volume 18: 3985. CrossRef - Perillaldehyde Attenuates Insulin Resistance and High Glucose-Induced Ferroptosis in Trophoblast Cells via Regulation of PTPN1/Akt/Foxo1 Signaling Pathway
Xing Wang, Yu Lu, Suyu Wang, Xueqin Wang, Shufang Yang, Chengyuan Zhao
Reproductive Sciences.2025; 32(11): 3770. CrossRef - Melatonin and Inflammatory Cytokines as Modulators of the Interaction Between Gestational Diabetes Mellitus and Pregnancy-Specific Urinary Incontinence
Danielle Cristina Honório França, Eduardo Luzia França, Adenilda Cristina Honório-França, Kênia Maria Rezende Silva, Adriele Ataídes de Queiroz, Tassiane Cristina Morais, Emanuelle Carolina Honorio França, Carolina Neiva Frota de Carvalho, Danny Laura Gom
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Meditsinskiy sovet = Medical Council.2025; (16): 188. CrossRef - Nutritional and inflammatory indices in gestational and pregestational diabetes: emphasis on the Controlling Nutritional Status (CONUT) score
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BMC Pregnancy and Childbirth.2025;[Epub] CrossRef - A systematic review and meta-analysis on the association of triglyceride-glucose index levels with risk of gestational diabetes mellitus
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British Journal of Nutrition.2024; 131(1): 54. CrossRef - Ferritin and iron supplements in gestational diabetes mellitus: less or more?
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European Journal of Nutrition.2024; 63(1): 67. CrossRef - Comparing the screening methods for gestational diabetes mellitus before and during the COVID‐19 pandemic: A systematic review
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Journal of Diabetes Investigation.2024; 15(4): 500. CrossRef - Protective Effects of Paeoniflorin Against Inflammation and Oxidative Stress in Rats with Gestational Diabetes Mellitus via Inhibiting the RhoA/ROCK Signaling Pathway
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Revista Brasileira de Farmacognosia.2024; 34(3): 536. CrossRef - METTL14‐mediated lncRNA XIST silencing alleviates GDM progression by facilitating trophoblast cell proliferation and migration via the miR‐497‐5p/FOXO1 axis
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International Immunopharmacology.2024; 129: 111626. CrossRef - Aberrant NK cell profile in gestational diabetes mellitus with fetal growth restriction
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Frontiers in Immunology.2024;[Epub] CrossRef - Maternal Diabetes and Risk of Hypospadias: A Systemic Review and Meta-Analysis
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Diabetes Research and Clinical Practice.2024; 211: 111659. CrossRef - Assessment of the Level of Knowledge About Risk Factors, Prevention, and Treatment of Gestational Diabetes Mellitus in a Community Sample From Saudi Arabia
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Meditsinskiy sovet = Medical Council.2023; (5): 136. CrossRef - Effect of folic acid supplementation in the association between short sleep duration and gestational diabetes mellitus
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Experimental & Molecular Medicine.2023; 55(10): 2269. CrossRef - Physiological Mechanisms Inherent to Diabetes Involved in the Development of Dementia: Alzheimer’s Disease
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Original Articles
- Clinical Diabetes & Therapeutics
- Progression to Gestational Diabetes Mellitus in Pregnant Women with One Abnormal Value in Repeated Oral Glucose Tolerance Tests
- Sunyoung Kang, Min Hyoung Kim, Moon Young Kim, Joon-Seok Hong, Soo Heon Kwak, Sung Hee Choi, Soo Lim, Kyong Soo Park, Hak C. Jang
- Diabetes Metab J. 2019;43(5):607-614. Published online February 28, 2019
- DOI: https://doi.org/10.4093/dmj.2018.0159
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Abstract
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Background Women with one abnormal value (OAV) in a 100 g oral glucose tolerance test (OGTT) during pregnancy are reported to have an increased risk of adverse pregnancy outcomes. However, there is limited data about whether women with OAV will progress to gestational diabetes mellitus (GDM) when the OGTT is repeated.
Methods To identify clinical and metabolic predictors for GDM in women with OAV, we conducted a retrospective study and identified women with OAV in the OGTT done at 24 to 30 weeks gestational age (GA) and repeated the second OGTT between 32 and 34 weeks of GA.
Results Among 137 women with OAV in the initial OGTT, 58 (42.3%) had normal, 40 (29.2%) had OAV and 39 (28.5%) had GDM in the second OGTT. Maternal age, prepregnancy body mass index, weight gain from prepregnancy to the second OGTT, GA at the time of the OGTT, and parity were similar among normal, OAV, and GDM groups. Plasma glucose levels in screening tests were different (151.8±15.7, 155.8±14.6, 162.5±20.3 mg/dL,
P <0.05), but fasting, 1-, 2-, and 3-hour glucose levels in the initial OGTT were not. Compared to women with screen negative, women with untreated OAV had a higher frequency of macrosomia.Conclusion We demonstrated that women with OAV in the initial OGTT significantly progressed to GDM in the second OGTT. Clinical parameters predicting progression to GDM were not found. Repeating the OGTT in women with OAV in the initial test may be helpful to detect GDM progression.
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Citations
Citations to this article as recorded by- Analysis of the gut microflora in women with gestational diabetes mellitus
Xuping Wang, Bingfeng Bian, Fuman Du, Chaofeng Xiang, Yu Liu, Na Li, Binhong Duan
International Journal of Diabetes in Developing Countries.2024; 44(S1): 38. CrossRef - Fetal abdominal obesity in women with one value abnormality on diagnostic test for gestational diabetes mellitus
Wonjin Kim, Soo Kyung Park, Yoo Lee Kim, Clive J. Petry
PLOS ONE.2024; 19(6): e0304875. CrossRef - Maternal and fetal outcomes of pregnancies associated with single versus double abnormal values in 100 gr glucose tolerance test
Mohammadali Shahriari, Ali Shahriari, Maryam Khooshideh, Anahita Dehghaninezhad, Arezoo Maleki-Hajiagha, Rana Karimi
Journal of Diabetes & Metabolic Disorders.2023; 22(2): 1347. CrossRef - One abnormal value or vomiting after oral glucose tolerance test in pregnancy: incidence and impact on maternal-fetal outcomes
Humberto Navarro-Martinez, Juana-Antonia Flores-Le Roux, Gemma Llauradó, Lucia Gortazar, Antonio Payà, Laura Mañé, Juan Pedro-Botet, David Benaiges
Gynecological Endocrinology.2023;[Epub] CrossRef - The association between gestational impaired glucose tolerance and hyperglycemic markers: A prospective study
Ohad Gluck, Hadas Ganer Herman, Nataly Fainstein, Neri Katz, Jacob Bar, Michal Kovo
International Journal of Gynecology & Obstetrics.2022; 156(1): 82. CrossRef - Association of abnormal-glucose tolerance during pregnancy with exposure to PM2.5 components and sources
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Environmental Pollution.2022; 292: 118468. CrossRef - Postprandial Free Fatty Acids at Mid-Pregnancy Increase the Risk of Large-for-Gestational-Age Newborns in Women with Gestational Diabetes Mellitus
So-Yeon Kim, Young Shin Song, Soo-Kyung Kim, Yong-Wook Cho, Kyung-Soo Kim
Diabetes & Metabolism Journal.2022; 46(1): 140. CrossRef - The Clinical Characteristics of Gestational Diabetes Mellitus in Korea: A National Health Information Database Study
Kyung-Soo Kim, Sangmo Hong, Kyungdo Han, Cheol-Young Park
Endocrinology and Metabolism.2021; 36(3): 628. CrossRef - Gestational Diabetes Mellitus: Diagnosis and Glycemic Control
Tae Jung Oh, Hak Chul Jang
The Journal of Korean Diabetes.2020; 21(2): 69. CrossRef - Health literacy and diabetes control in pregnant women
Azar Pirdehghan, Mohammad Eslahchi, Farzaneh Esna-Ashari, Shiva Borzouei
Journal of Family Medicine and Primary Care.2020; 9(2): 1048. CrossRef
- Analysis of the gut microflora in women with gestational diabetes mellitus
- Maternal and Neonatal Outcomes in Korean Women with Type 1 and Type 2 Diabetes
- Hee-Sook Kim, Hye-Jung Jang, Jeong-Eun Park, Moon-Young Kim, Sun-Young Ko, Sung-Hoon Kim
- Diabetes Metab J. 2015;39(4):316-320. Published online August 17, 2015
- DOI: https://doi.org/10.4093/dmj.2015.39.4.316
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- 42 Download
- 9 Web of Science
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Abstract
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Background The purpose of this study was to evaluate maternal and neonatal outcomes in Korean women with type 1 diabetes and type 2 diabetes.
Methods We performed a retrospective survey of 163 pregnancies in women with type 1 diabetes (
n =13) and type 2 diabetes (n =150) treated from 2003 to 2010 at Cheil General Hospital & Women's Healthcare Center, Korea. We compared maternal characteristics as well as maternal and neonatal outcomes between groups.Results Differences in glycosylated hemoglobin between type 1 and type 2 diabetes were not significant. Birth weight (3,501±689.6 g vs. 3,366±531.4 g) and rate of major congenital malformations (7.7% vs. 5.6%) were not significantly different. However, women with type 1 diabetes had higher rates of preeclampsia (38.5% vs. 8.2%,
P =0.006), large for gestational age (LGA; 46.2% vs. 20.4%,P =0.004), macrosomia (38.5% vs. 13.4%,P =0.032), and admission for neonatal care (41.7% vs. 14.8%,P =0.03) than women with type 2 diabetes.Conclusion Maternal and neonatal outcomes for women with type 1 diabetes were poorer than for women with type 2 diabetes, especially preeclampsia, LGA, macrosomia and admission to the neonatal intensive care unit.
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Citations
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Maria Lúcia R. Oppermann, Maria Amélia A. Campos, Giulia L. Guerra, Vânia N. Hirakata, Viviane C. Castanho, Francieli Ariane L. Muck, Angela J. Reichelt
International Journal of Gynecology & Obstetrics.2026; 172(1): 196. CrossRef - Fetal death in diabetic pregnancy: An anticipated complication? A systematic review of predictability, residual risk, and preventability in the modern era
Sarma Nursani Lumbanraja, Dudy Aldiansyah, Muara Panusunan Lubis, Melvin Nova Gunawanto Barus, Wiku Andonotopo, Muhammad Adrianes Bachnas, Wisnu Prabowo, Eric Edwin Yuliantara, Mochammad Besari Adi Pramono, Julian Dewantiningrum, Efendi Lukas, I Nyoman Ha
Philippine Journal of Obstetrics and Gynecology.2026; 50(2): 73. CrossRef - Usefulness of glycated albumin levels in predicting the maternal or neonatal complications of gestational diabetes mellitus during ;ate pregnancy in South Korea: a retrospective study
Jihan Kim, Sami Lee, Jong Sung Kim
Korean Journal of Family Medicine.2025; 46(6): 401. CrossRef - Glycosylated Hemoglobin Levels in the Third Trimester for Predicting Adverse Pregnancy and Neonatal Outcomes in Women with Pre-Gestational Diabetes: A Multi-Center Retrospective Cohort Study in South Korea
Su-Yeon Park, Mi-Ju Kim, Su-Been Hong, Ji-Hee Sung, Hyun-Joo Seol, Joon-Ho Lee, Seung-Chul Kim, Seung-Mi Lee, Se-Jin Lee, Han-Sung Hwang, Gi-Su Lee, Hyun-Soo Park, Soo-Jeong Lee, Sae-Kyung Choi, Ji-Young Kwon, Geum-Joon Cho, Soo-Ran Choi, Hyun-Sun Ko
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Subeen Hong, Kyung A. Lee, Young Mi Jung, Heechul Jeong, Ji-Hee Sung, Hyun-Joo Seol, Won Joon Seong, Soo Ran Choi, Joon Ho Lee, Seung Chul Kim, Sae-Kyoung Choi, Ji Young Kwon, Hyun Soo Park, Hyun Sun Ko, Geum Joon Cho
Scientific Reports.2025;[Epub] CrossRef - The Impact of Type 2 Diabetes on Women’s Health and Well-being During Their Reproductive Years: A Mixed-methods Systematic Review
Aycan Celik, Rita Forde, Simona Racaru, Angus Forbes, Jackie Sturt
Current Diabetes Reviews.2022;[Epub] CrossRef - Application of the electronic nose in predicting preeclampsia in high-risk pregnancies. Pilot study
Karen Beatriz Méndez Rodríguez, Luis Manuel Ramírez Gómez, Leticia Carrizales Yáñez, Rogelio Flores Ramírez, Omar Ornelas-Rebolledo, Jaime Antonio Borjas-García, Francisco Pérez-Vázquez, Maribel Rodríguez Aguilar
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Andrew Williams, Katherine Grantz, Indulaxmi Seeni, Candace Robledo, Shanshan Li, Marion Ouidir, Carrie Nobles, Pauline Mendola
Journal of Autoimmunity.2019; 103: 102287. CrossRef - Effects of maternal age, parity and pre-pregnancy body mass index on the glucose challenge test and gestational diabetes mellitus
Adel T. Abu-Heija, Majeda R. Al-Bash, Moza A. Al-Kalbani
Journal of Taibah University Medical Sciences.2017; 12(4): 338. CrossRef - Deficient Vitamin E Uptake During Development Impairs Neural Tube Closure in Mice Lacking Lipoprotein Receptor SR-BI
Nicolás Santander, Carlos Lizama, María José Parga, Alonso Quiroz, Druso Pérez, Guadalupe Echeverría, Lorena Ulloa, Verónica Palma, Attilio Rigotti, Dolores Busso
Scientific Reports.2017;[Epub] CrossRef
- Prevalence of congenital anomalies in pregnancies complicated by type 2 diabetes: Systematic review and meta‐analysis
- Pregnancy Outcome in Korean Women with Gestational Diabetes Mellitus Diagnosed by the Carpenter-Coustan Criteria.
- Hak Chul Jang, Young Min Cho, Kyong Soo Park, Seong Yeon Kim, Hong Kyu Lee, Moon Young Kim, Jae Hyug Yang, Son Moon Shin
- Korean Diabetes J. 2004;28(2):122-130. Published online April 1, 2004
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Abstract
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- BACKGROUND
The American Diabetes Association recently proposed the Carpenter-Coustan criteria for the diagnosis of gestational diabetes mellitus(GDM) based on the results of the Toronto Tri-Hospital Study. The prevalence of GDM in Korean women increased, on average, by 60% when the Carpenter-Coustan criteria were applied. However, the pregnancy outcome of Korean women with GDM with regard to the Carpenter-Coustan criteria tremains to be reported. The pregnancy outcomes of those Korean women with GDM by the Carpenter- Coustan criteria, but not by the NDDG criteria were assessed. METHODS: In this study, a total of 2776 pregnant women underwent universal screening for GDM, between January 1993 and December 1994, as recommended by the Third International Workshop-Conference on Gestational Diabetes Mellitus with minor modifications. The primary pregnancy outcomes were preeclampsia, premature delivery, delivery by C-section, birth weight and LGA infants. RESULTS: Of the 2776 women, 656 screened-positive for GDM. Of these, 37 and 74 had GDM by the Carpenter-Coustan and NDDG criteria, respectively. With increasing glucose intolerance, there was a stepwise increase in premature deliveries, deliveries by C-section and preeclampsia from those screening negative to GDM by the NDDG criteria, with a similar trend for the frequency of LGA infants. The LGA infant screening-negative and positive were 13.5 and 16.1%, but those with a normal glucose tolerance were 27.0 and 33.8% in those screening positive to GDM by the Carpenter-Coustan and NDDG criteria, respectively(P<0.001). CONCLUSION: Our study demonstrated that increasing glucose tolerance was associated with increasing frequencies of adverse pregnancy outcomes in Korean women. The maternally complicated and LGA infants were significantly higher in women with GDM by the Carpenter-Coustan criteria. Thus the Carpenter- Coustan criteria are recommended for the diagnosis of GDM in Korean Women.
- Effect of Self-monitoring of Blood Glucose on Pregnancy Outcome in Women with Mild Gestational Diabetes.
- Hak Chul Jang, Jeong Eun Park, Chang Hoon Yim, Ho Yeun Chung, Ki Ok Han, Hyun Koo Yoon, In Kwon Han, Moon Young Kim, Jae Hyug Yang, Mi Jung Kim, Sun Young Ko, Yeon Kyung Lee
- Korean Diabetes J. 2001;25(1):93-102. Published online February 1, 2001
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- 46 Download
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Abstract
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- BACKGROUND
Self-monitoring of blood glucose (SMBG) and intensive therapy with insulin demonstrated to have a positive effects in the reduction of the neonatal complications in women with gestational diabetes (GDM). However the utility of SMBG in the mild GDM who does not requiring insulin has not been formally reported. Therefore, to evaluate the effectiveness of SMBG in the management of mild GDM, we compared the pregnancy outcome and the postpartum glucose tolerance of women who monitored their glycemic control by SMBG to those of women who monitored by laboratory glucose test at each office visit during pregnancy. METHODS: We studied 185 women diagnosed as a GDM by NDDG criteria and their fasting glucose concentration < 5.8 mM. All subjects had singleton pregnancy,and no medical diseases that may affect fetal growth, and were certain of gestational age by early ultrasonography. They were treated with an identical GDM management protocol except glucose monitoring. One hundred five women were monitored by laboratory glucose test at each office visit (office group) and 80 women were monitored by SMBG (SMBG group). Pregnancy outcome including rates of cesarian section, obstetric complication, LGA infant and glucose tolerance status at postpartum were compared between two groups. RESULTS: The age, height, prepregnancy weight, weight at delivery and parity were not significantly different between the two groups. Fasting, 1-h, 2-h glucose concentration during the diagnostic test of GDM in SMBG group were similar to those of office group. However, 3-h glucose concentration of office group was 0.3 mM higher than that of SMBG group. The rate of primary cesarian section, preterm labor and pregnancy-induced hypertension of SMBG group were similar to those of office group. The mean postprandial 2-h glucose concentration of office group measured at each office was 0.5 mM higher than that of SMBG group. Although 5% of office group were treated with insulin, 24% of SMBG group were requiring insulin therapy. The birth weight and LGA infant rate of office group were 3403 432 g and 28%, those were heavier and higher than those of SMBG group (3169 447 g, 13.8%). The 90% of office group and 84% of SMBG group were performed 75 g oral glucose tolerance test at postpartum 6-8 weeks. There was no significant difference in rates of diabetes and IGT between office and SMBG group (9.5%, 11.6%; 7.5%, 9.0% respectively). CONCLUSIONS: This study demonstrated that SMBG is very seful in early detection of maternal hyperglycemia and lowing the postprandial glucose, as well as reducing the rate of LGA infants in women with mild GDM.
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