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Recent efforts to clarify the diagnosis of GDM ( 4 ) should help with the recruitment of more
uniform populations to studies seeking to address such issues, which in turn should reduce the
heterogeneity of the results they produce and aid the drawing of more definitive conclusions. The
aim of this narrative review is to summarize the most recent findings of diagnosis and treatment of
GDM in order to underline the importance to promote adequate prevention of this disease, especially
through lifestyle interventions such as diet and physical activity. International Diabetes Federation,
2019. ? Goueslard K, Cottenet J, Mariet AS, Sagot P, Petit JM, Quantin C. During her research, she
discovers Diabetes Alliance and the quality improvement strategy they have developed to empower
Indigenous communities to create their own plans to combat diabetes. KK has acted as a consultant
and speaker for Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, Servier, and Merck Sharp and
Dohme; has received grants in support of investigator and investigator initiated trials from Novartis,
Novo Nordisk, Sanofi-Aventis, Lilly, Pfizer, Boehringer Ingelheim, and Merck Sharp and Dohme;
and has received funds for research, honoraria for speaking at meetings and has served on advisory
boards for Lilly, Sanofi-Aventis, Merck Sharp and Dohme, and Novo Nordisk. Strengths and
limitations Among the strengths of this study are the substantial number of recently published
studies, assessing a large total number of individuals, and with long term follow-up, ranging from
one to 25 years. Guidelines for the screening, diagnosis, and follow-up care for women with GDM
have changed in a number of countries over the past decade, while the overall prevalence of T2DM
has increased. Whilst there had been a number of previous reports of small studies (outlined in
Cheung ( Reference Cheung 150 ) ), the use of metformin as a treatment (either as a sole agent or in
conjunction with insulin injections) in recent years has been dominated by the Metformin in
Gestational Studies study (MiG) ( Reference Rowan, Hague and Gao 151 ). For many women,
insulin or its rapid-acting analogues are the first-line pharmacological treatment of GDM. NICE and
the guideline from India also use a one-step strategy but using different criteria. This disease can be
seen in three forms: cutaneous, cutaneous-mucous, and visceral. However, this increased risk was not
found with the consumption of other sugar-sweetened or diet beverages, making the factor in cola
that causes this association difficult to ascertain (presumably being some sort of interaction between
effects of the sugar sweetener and the cola flavouring or colouring). The impact of ethnicity on
glucose regulation and the metabolic syndrome following gestational diabetes. Funding: This report
is the independent research of EV, supported by the National Institute for Health Research (NIHR)
Applied Research Collaboration-East Midlands as part of a PhD project. However, it was noted that
low-GI diets appear promising and that several larger trials of low-GI diets are under way (
Reference Tieu, Crowther and Middleton 107 ). The two studies exhibited conflicting data regarding
maternal weight gain ( Reference Clapp 109, Reference Moses, Luebcke and Davis 113 ), along with
particularly evident heterogeneity for all the study findings with the exception of maternal fasting
glucose concentrations ( Reference Tieu, Crowther and Middleton 107 ). However, by day 16 of the
21 d pregnancy, in the third trimester about the time when GDM becomes more prevalent in humans
( Reference Seshiah, Balaji and Balaji 85 ), the areas under the curves of intra-peritoneal glucose
tolerance tests performed in phenotypically wild-type mice carrying H19 knockout offspring was 28
% higher than those from wild-type mice carrying only wild-type offspring. In early pregnancy, the
appropriate diagnostic criteria for the diagnosis of GDM remain poorly defined, and an effect of
early diagnosis and treatment on the risk of adverse outcomes has not been demonstrated. ROBINS-
I: a tool for assessing risk of bias in non-randomised studies of interventions. For abstracts,
disagreements between the reviewers were discussed and resolved by consensus. We excluded hits
derived entirely from another guideline and those for which we could not identify detailed
information on development. A fresh look to a busy corner Gabriella Zito 2019, Journal of Neonatal-
Perinatal Medicine BACKGROUND: Gestational diabetes mellitus (GDM) is a common pregnancy
complication characterized by hyperglycaemia with onset or first recognition during pregnancy. The
cumulative incidence of T2DM was found to be higher in a population with a mix of ethnicities or a
non-white population than in white populations, for both women who had had GDM, and healthy
controls. Pharmacological treatment For some women, especially those with a relatively severe form
of the condition that develops earlier than in the third trimester ( Reference Seshiah, Balaji and
Balaji 85 ), GDM cannot be adequately controlled by diet and exercise alone. In stud - ies of
screening by means of histor y taking, sensitivi- ties a re report ed in the vic inity of 50%. Practice
Bulletin No. 137: Gestational diabetes mellitus. The funders had no role in considering the study
design or in the collection, analysis, interpretation of data, writing of the report, or decision to submit
the article for publication. This method is mainly recommended in some of the North American
guidelines (ACOG, NIH and SOGC). Marie knows something needs to be done, so she undertakes
research to determine whether there are any interventions that can help her community prevent, treat,
and manage type 2 diabetes. The subsequent risk of T2DM in both women with previous GDM and
healthy controls was estimated using relative risks, as person years of follow-up were not reported
for every study.
In conclusion, there remain a number of key questions that need answering before regimens for
treating GDM can be considered optimal. All authors have approved the final draft of the
manuscript. PhD Thesis, p. 230. Copenhagen: Danish Science Press. Based on the guidelines of the
scale, a cohort study can be awarded a maximum of one star for each numbered item from the
selection and outcome categories and a maximum of two stars for the category of comparability. 22
A study can be awarded from zero up to nine stars. 22 As the Newcastle-Ottawa scale does not
adequately assess potential confounders in study analyses, further information was extracted on
which confounders had been considered by each study. We excluded hits derived entirely from
another guideline and those for which we could not identify detailed information on development.
Retnakaran R, Qi Y, Sermer M, Connelly PW, Hanley AJ, Zinman B. In addition, it would be of
great importance to study the screening strategy for specific populations and various resources. The
aim of the study was to investigate the age-stratified seroprevalence and epidemiological
characteristics of CMV infection in Antalya (a province located in Mediterranean region of Turkey).
Third, for policy-makers and researchers, this review will provide an insight into the strength and
limitation of each guideline, which will help to improve the quality of guidelines. Therefore, further
studies may focus on the comparison of multiple clinical outcomes and health cost of different
strategies. In our own studies of a common variant in the imprinted, maternally expressed H19 gene,
when transmitted to the baby the variant was associated with maternal glucose levels in pregnancy (
Reference Petry, Ong and Barratt 81 ). Such genes are likely to include some of those already
associated with either type 1 or 2 diabetes (and possibly offspring birth weight). KK has acted as a
consultant and speaker for Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, Servier, and Merck Sharp
and Dohme; has received grants in support of investigator and investigator initiated trials from
Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, Pfizer, Boehringer Ingelheim, and Merck Sharp and
Dohme; and has received funds for research, honoraria for speaking at meetings and has served on
advisory boards for Lilly, Sanofi-Aventis, Merck Sharp and Dohme, and Novo Nordisk. For type 2
diabetes, the most common form, studies of large DNA cohorts that have been assessed by whole-
genome association have allowed the elucidation of genetic markers of risk in or near genes that
would have been extremely unlikely to have been considered using a candidate approach with an a
priori hypothesis. However, metformin does cross the placenta and it is not known yet whether it
causes long-term metabolic programming effects in the offspring. These radar maps illustrate the
final scores for every guideline in each of the six domains, expressed as a percentage. Dalam
program ini, individu atau keluarga yang disebut sebagai orang tua asuh berperan sebagai pengganti
orang tua biologis untuk memberikan cinta, perhatian, dan arahan kepada anak-anak yang
membutuhkan perlindungan tambahan. In this study, the prevalence of cutaneous leishmaniosis and
its treatment methods in traditional medicine were studied in areas of Kabul province, Afghanistan.
Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy. As shown in
table 4, guidelines that were strongly recommended share several advantages. To address this
problem, a diet and activity intervention during pregnancy, which was based on social learning
theory, was initiated in 4 Cree communities. Furthermore, the importance of postpartum care and the
heightened risk of Type 2 diabetes in women with a history of GDM is discussed, underscoring the
need for long-term monitoring and preventive measures. Comparison with other studies Our findings
are similar to results from previously published systematic reviews, suggesting a higher incidence of
T2DM in women with GDM than in those unaffected, with the overall 95% confidence interval
obtained by Bellamy et al overlapping with the one we identified. 12 13 In this systematic review
and meta-analysis, we incorporated evidence from the most recent studies and identified a higher
estimated risk of T2DM than found previously. To try and clarify the situation, the Consensus Panel
of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) recently
recommended that high-risk women found to have diabetes at their initial prenatal visit should be
diagnosed as having overt diabetes rather than GDM ( 4 ). Download Free PDF View PDF Free
PDF ?Existe una Bibliotecologia desde Nuestra America. Methods A phenomenological
methodology underpinned semi-structured in-depth interviews with eleven Aboriginal women and
seven health professionals across the Northern Territory from October 2019- February 2020. This is
an Open Access article distributed in accordance with the Creative Commons Attribution Non
Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon
this work non-commercially, and license their derivative works on different terms, provided the
original work is properly cited and the use is non-commercial. See:. References ? American Diabetes
Association. Working in partnerships with Indigenous health organizations, we recruited four groups
comprising participants from diverse Indigenous communities (two urban, two rural) in three
provinces of Canada. More than half of the guidelines evaluated in the present review, including
WHO, IADPSG, FIGO, ADA, ES, DDG, HKCOG, ADIPS and Queensland guideline, adopt the
IADPSG criteria ( table 4 ) for GDM screening. One similar randomised trial concerned with the
potential prevention of GDM by exercise is already under way ( Reference Chasan-Taber, Marcus
and Stanek 124 ), the study investigators previously having found a small beneficial effect of
exercise on the risk of developing GDM in a prospective cohort study of 1006 mainly Hispanic
women ( Reference Chasan-Taber, Schmidt and Pekow 125 ).
To our knowledge, the present article is the first review of GDM guidelines that focus on the
screening and diagnosis of GDM. Despite this, it was stated that whilst it may not have implications
for the pregnancy, enrolment in an exercise programme may elicit lifestyle changes that could alter
the woman's risk of developing type 2 diabetes in the future ( Reference Ceysens, Rouiller and
Boulvain 123 ). The article also highlights the positive impact of breastfeeding on glycemic control
for both mother and baby. Guidelines that were developed before 2009 and not been updated before
November 2018 would be excluded since they may be out of date. Upload Read for free FAQ and
support Language (EN) Sign in Skip carousel Carousel Previous Carousel Next What is Scribd.
Discussion Principal findings The results of this systematic review and meta-analysis suggest that
women with a history of GDM are almost 10 times more likely to develop T2DM than those with a
normoglycaemic pregnancy. First, we discuss the nature of political differences and from this
construct an interpretation of the dimensionality of the political space needed to describe a given
real setting, underscoring the essentially metaphorical and instrumental use of this concept.
Hakkarainen H, Huopio H, Cederberg H, Paakkonen M, Voutilainen R, Heinonen S. The first is
about the language attitude of the stand’s owners of the Parahyangan apartment in choosing the
language of their food menu names include the positive. E arly studies u sed th e same diag nost ic
criteria for diabetes in pregnancy that were applied in th e non pregnant state. A meta-analysis of
studies where metformin has been used to treat GDM highlights the lower rates of neonatal
hypoglycaemia in comparison with offspring of those mothers treated with insulin ( Reference
Nicholson, Bolen and Witkop 153 ). For women with a high risk for hyperglycaemia in pregnancy,
there is a consensus among most of the guidelines that a screen for GDM should be conducted
during the first trimester, or at the first prenatal visit. The magnitude of this risk is consistent with
evidence that the two conditions share common pathogenic mechanisms and risk factors, 52
suggesting that GDM could potentially serve as a predictor for future development of T2DM. We
carried out unstructured interviews that were recorded, transcribed, and subject to qualitative
content analysis. See Full PDF Download PDF Free Related PDFs Gestational diabetes mellitus:
Prevention, diagnosis and treatment. Funding: This report is the independent research of EV,
supported by the National Institute for Health Research (NIHR) Applied Research Collaboration-
East Midlands as part of a PhD project. Conclusions In summary, women with a history of GDM
have a nearly 10-fold increased risk of developing T2DM, in comparison with those with a
normoglycaemic pregnancy. Yefet E, Schwartz N, Sliman B, Ishay A, Nachum Z. After the above
steps were performed, we provided an overall assessment of each set of guidelines. Data were
pooled by random effects meta-analysis models, and heterogeneity was assessed by use of the I 2
statistic. Search strategy and inclusion criteria We searched Ovid Medline and Embase 20 for
observational studies published between January 2000 and December 2019, choosing 2000 as the
start date, after release of the 1999 World Health Organization recommendations for performance of
the 75 g oral glucose tolerance test at six weeks and onward after labour. 21 A search strategy was
developed with the assistance of a clinical librarian. Postpartum screening practices, progression to
abnormal glucose tolerance and its related risk factors in Asian women with a known history of
gestational diabetes: a systematic review and meta-analysis. Our study also has some limitations
besides that imposed by AGREE II. Long-term changes in glucose metabolism after gestational
diabetes: a double cohort study. Subgroup analyses by study level ethnicity, length of study follow-
up, study design, and screening method used in pregnancy to diagnose GDM (one step v two step)
were undertaken to investigate sources of heterogeneity between studies. Where the baby is female,
exposure to maternal hyperglycaemia in utero increases their own risk of subsequently developing
GDM in their own pregnancies ( Reference Claesson, Aberg and Marsal 22 ). A summary of study
characteristics is presented in table 1 with added definitions in box 1. Publication bias was assessed
with funnel plots for asymmetry using the Begg’s and Egger’s tests. 20 Data extraction and statistical
analysis Two authors (EV and SCA) independently undertook data extraction according to The
Cochrane Handbook guidelines, 20 and findings were reported according to PRISMA 18 and
MOOSE guidance. 19 Any disagreement was settled by consensus among all authors. Comparable
results were found in a similar but smaller randomised, open-label trial of insulin aspart in women
with GDM ( Reference Pettitt, Ospina and Howard 134 ). Thus, approximately half of wome n with
gestational diabetes do not have his- tor ic risk fac tors, and approximately half of nond ia- betic
wome n do have histor ic risk fac tor s.
Download Free PDF View PDF Free PDF Gestational Diabetes Mellitus article review (1) Joice
Gunawan Download Free PDF View PDF Free PDF A Comprehensive Review Of Gestational
Diabetes Mellitus International Journal of Pharmaceutical Sciences 2023, INTERNATIONAL
JOURNAL IN PHARMACEUTICAL SCIENCES Gestational Diabetes Mellitus (GDM) is a
common medical condition affecting pregnant women, characterized by glucose intolerance that
develops during pregnancy. Interviews were analysed using an inductive analysis framework to
address the barriers and enablers of proposed diabetes prevention programs identified by participants.
Second, only guidelines and recommendations published in the English language were recruited in
the present review. A further limitation was that although we assessed the cumulative incidence by
study length of follow-up, it was difficult to reach conclusions about the timing of T2DM onset
using study level data, as the cumulative incidence was known only at the end of the study and not
when the events occurred. The estimated pooled relative risk was 17.06 (95% confidence interval
8.95 to 32.55) for studies with follow-up of one to five years, 10.42 (5.68 to 19.11) for those with
follow-up of more than five years and up to 10 years, and 8.09 (4.34 to 15.08) for those with follow-
up of more than 10 years. Individuals with gestational diabetes may have increased risk for perinat al
mortality and morbidity and clearly are at increased risk for th e later devel opment of diabetes and
perhaps cardiova scular disease. First, we discuss the nature of political differences and from this
construct an interpretation of the dimensionality of the political space needed to describe a given
real setting, underscoring the essentially metaphorical and instrumental use of this concept.
Preliminary data would suggest that the amount of exercise needed to have an effect is actually quite
small, however, as a study of ten women with GDM treated with diet and insulin found that a
structured walking programme led to a reduction in post-exercise, fasting and postprandial capillary
glucose concentrations, as well as a reduction in insulin requirements ( Reference Davenport, Mottola
and McManus 131 ). For example, ADA developed ADA evidence-grading system to update the
guideline, NIH applied Agency for Healthcare Research and Quality to evaluate literature. Close this
message to accept cookies or find out how to manage your cookie settings. In 2012, Greuter et al
conducted a general evaluation of eight GDM guidelines but provided limited analysis on the
screening and diagnosis of GDM. 30 Moreover, many guidelines were updated after 2012, with the
consideration of the HAPO study. Diagnostic criteria and classification of hyperglycaemia first
detected in pregnancy. As has already been stated, the risk factors for GDM ( Table 1 ) share
similarities with those for type 2 diabetes. Risk of bias and study quality We used the Newcastle-
Ottawa scale, a scale proposed by Wells et al 22 and designed to evaluate the quality of non-
randomised studies. The funnel plot and statistical tests performed showed no evidence of
publication bias in our meta-analysis. We thus conducted this systematic review to evaluate the
relationship between the quality and detailed recommendations of these guidelines. Whilst regular
human insulin is clinically safe, much attention has recently been focused on rapidly acting insulin
analogues due to their ability to reduce postprandial hyperglycaemia whilst also reducing the risk of
pre-prandial hypoglycaemia. Study group was selected by cluster sampling method. Of the more
recently described risk factors, high or low maternal birth weights ( Reference Innes, Byers and
Marshall 26 ) are important, given the previously described transgenerational effects. Vambergue A,
Dognin C, Boulogne A, Rejou MC, Biausque S, Fontaine P. Racial differences in the association
between gestational diabetes mellitus and risk of type 2 diabetes. Acknowledgements Funding for
studies described in this paper that I have been involved in come from the Medical Research Council,
The Wellcome Trust, The Evelyn Trust and National Institute for Health Research. C. J. P. has no
conflicts of interest to declare. Gestational diabetes mellitus: clinical predictors and long-term risk of
developing type 2 diabetes: a retrospective cohort study using survival analysis. The two other trials
included in the meta-analysis ( Reference Tieu, Crowther and Middleton 107 ) compared the effects
of the consumption of low- against high-GI diets. Given the limited number of guidelines, only
explorative quantitative analyses were possible. The resultin g values are shown in T able 35. 3. B
ecause th e ND DG. Future studies should examine strategies to improve screening uptake and
evaluate the effectiveness and cost effectiveness of preventive interventions, across heterogeneous
populations and over long periods. The strength of AGREE is the constitution of six domains and 23
key items that represent all important aspects in guideline development and application. Strengths
and limitations Among the strengths of this study are the substantial number of recently published
studies, assessing a large total number of individuals, and with long term follow-up, ranging from
one to 25 years. You will be able to get a quick price and instant permission to reuse the content in
many different ways.
A table comparing the recommendations from the selected guidelines were constructed and AGREE
II domain scores were calculated as means and categorical variables with the number of cases and
corresponding percentages. A more accurate assessment of cumulative incidence would require
individual patient data, in a cohort where regular screening took place. We excluded hits derived
entirely from another guideline and those for which we could not identify detailed information on
development. To try and clarify the situation, the Consensus Panel of the International Association
of Diabetes and Pregnancy Study Groups (IADPSG) recently recommended that high-risk women
found to have diabetes at their initial prenatal visit should be diagnosed as having overt diabetes
rather than GDM ( 4 ). This review provides an overview of GDM, including its definition,
prevalence, risk factors, and potential complications. You can download the paper by clicking the
button above. This broad definition of GDM therefore includes women whose glucose intolerance
develops during pregnancy and those that had pre-existing diabetes which had not been diagnosed
before pregnancy. Inconsistencies in the GDM diagnostic strategy between different guidelines have
led to challenges in making clinical diagnosis. Postpartum screening practices, progression to
abnormal glucose tolerance and its related risk factors in Asian women with a known history of
gestational diabetes: a systematic review and meta-analysis. A Cree-origin research partner and a
researcher jointly conducted interviews in-person or by teleconference. Finally, the cost effectiveness
of these interventions should be considered to promote their adoption by different healthcare systems
across the world. Gestational diabetes and the incidence of type 2 diabetes: a systematic review.
Discussion The present systematic review of clinical guidelines for the screening strategy of GDM
included 16 guidelines published between 2013 and 2018. With the thought of the presence of
maternal antibodies, 0-1 year age group was not included to the study. Kabul province in
Afghanistan is one of the important places infected with Leishmania parasites. In this study, we
aimed to understand the perspectives of Cree women with prior GDM living in northern Quebec,
where over a quarter of pregnancies are complicated by GDM.Research design and methodsA local
healthcare worker invited women with GDM in the prior 5 years to participate in semistructured
interviews. We included the last two studies because these reported the most relevant data for the
meta-analysis. Future research could further investigate the timing of onset of T2DM in these
populations, using individual patient data, to provide a more accurate estimate of time. Ethnic origin
was defined as white, non-white, or mixed. For abstracts, disagreements between the reviewers were
discussed and resolved by consensus. All other authors declare no competing interests, or activities
that could appear to have influenced the submitted work. Furthermore, it can be used as a
biocompatible reinforcing material due to the high content of CaCO3. It is likely th at th ere is a
contin uu m of metabolica lly related reproduct ive mor- bidity, with most cases of preexisting
diabetes near one end and most cases of ges tation al diabetes near th e oth er. Data sharing
statement All research results were uploaded. Systematic review registration PROSPERO
CRD42019123079. Meta-analysis of observational studies in epidemiology: a proposal for reporting.
Parties define and differentiate themselves in terms of substantive policy issues, and the
configuration of such issues that is required for a good description of political competition affects
how we think substantively about the underlying political space in which parties compete. Reviewers
summarised recommendations on screening and diagnosis strategies from each guideline and rated
the quality of guidelines by using the Appraisal of Guidelines Research and Evaluation (AGREE)
criteria. In the same cohort, consumption of a diet before pregnancy that contains large amounts of
red or processed meat was also associated with an increased risk of women developing GDM (
Reference Zhang, Schulze and Solomon 120 ). Strengths and limitations Among the strengths of this
study are the substantial number of recently published studies, assessing a large total number of
individuals, and with long term follow-up, ranging from one to 25 years.
Indeed, in the prospective Nurses' Health Study II cohort, the consumption of high-glycaemic load
(i.e. the product of the GI and the carbohydrate content) diets with low fibre contents before
pregnancy doubled the risk of developing GDM when pregnant during 8 years of follow-up (
Reference Zhang, Liu and Solomon 116 ). In our own studies of a common variant in the imprinted,
maternally expressed H19 gene, when transmitted to the baby the variant was associated with
maternal glucose levels in pregnancy ( Reference Petry, Ong and Barratt 81 ). Overall, the quality of
the guidelines is improving. Furthermore, it can be used as a biocompatible reinforcing material due
to the high content of CaCO3. As shown in figure 4, studies were separated by their length of
follow-up into three groups. The funnel plot and statistical tests performed showed no evidence of
publication bias in our meta-analysis. Meta-analysis of studies assessing such diets showed a lower
risk for the offspring being born large for gestational age and a lower offspring ponderal index at
birth, although the overall beneficial effect of consuming a low-GI diet was inconclusive in
pregnancy due to the small number of participants studied so far and the heterogeneity of results (
Reference Tieu, Crowther and Middleton 107 ). These findings will inform the Baby Steps study run
by the Diabetes Research Centre, which aims to implement a structured group education programme
for women with a history of gestational diabetes. Ethical approval: Ethical approval was not
required. Eligibility criteria for selecting studies Observational studies investigating progression to
T2DM. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. Increasing
incidence of abnormal glucose tolerance in women with prior abnormal glucose tolerance during
pregnancy: DIAGEST 2 study. We excluded hits derived entirely from another guideline and those
for which we could not identify detailed information on development. Factors such as age, obesity,
and family hist ory of diabet es also increase th e risk. If ethnicity was not reported, it was defined
on the basis of the predominant ethnicity of the country in which the study was conducted. The
limitation of AGREE II is that the domains were not weighted by their importance in guideline
development. 32. Risk perception for diabetes among women with histories of gestational diabetes
mellitus. Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Thus, we
could not investigate progression in ethnic subgroups, which could have been a cause of
heterogeneity between studies. These radar maps illustrate the final scores for every guideline in
each of the six domains, expressed as a percentage. Cochrane handbook for systematic reviews of
interventions. The summary of the meta-analysis was that for clinical practice implications the trials
were inconclusive due to the small number of studies published so far, the small number of
participants in each study and the high degree of heterogeneity amongst the variables measured. Of
the nineteen women consuming a high-GI diet that met the criteria for requirement for insulin
treatment, nine women subsequently managed to avoid this by switching to a low-GI diet. However,
several guidelines including the American College of Obstetricians and Gynecologists (ACOG)
Practice Bulletin, 18 the National Institutes of Health (NIH) consensus statement 19 and Society of
Obstetricians and Gynaecologists of Canada (SOGC) 20 did not support the IADPSG criteria.
Guidelines for the screening, diagnosis, and follow-up care for women with GDM have changed in a
number of countries over the past decade, while the overall prevalence of T2DM has increased. The
16 guidelines included in the present systematic review are from the following organisations: Flow
diagram of the identification process for clinical practice guidelines and consensus statements on
gestational diabetes mellitus (DM). To browse Academia.edu and the wider internet faster and more
securely, please take a few seconds to upgrade your browser. Good glycemic control of gestational
diabetes mellitus is associated with the attenuation of future maternal cardiovascular risk: a
retrospective cohort study. However, high-quality guidelines tend to recommend a universal
screening by one-step 75?g OGTT strategy with IADPSG criteria between 24 and 28 gestational
weeks, and the majority of these guidelines are likely to contain a list of high-risk factors and to
select evidence by GRADE criteria. Curren tly ava ilable enzy- matic methods are more specif ic for
glucose.
The limitation of AGREE II is that the domains were not weighted by their importance in guideline
development. 32. Use of glycated haemoglobin (HbA1c) in the diagnosis of diabetes mellitus. Owing
to limited resources, we had to exclude studies not published in English. PhD Thesis, p. 230.
Copenhagen: Danish Science Press. The PRISMA statement for reporting systematic reviews and
meta-analyses of studies that evaluate health care interventions: explanation and elaboration. RoIs
detections will be performed using a custom trained deep learning model using bounding box
regression with Keras and TensorFlow. We adopted an inductive thematic analysis framework to
categorize experiences and o. Any disagreement between the study authors was resolved by
discussion or by third party consultation, until consensus was reached. Predictive factors of
developing diabetes mellitus in women with gestational diabetes. When more than one study
investigated outcomes from the same cohort, the study with information most relevant to the
analysis was chosen for inclusion. Considering work performed on the system as a random variable,
we collect data for a large number of repeated cyclic processes of finite time. As has already been
stated, the risk factors for GDM ( Table 1 ) share similarities with those for type 2 diabetes. Marie
knows something needs to be done, so she undertakes research to determine whether there are any
interventions that can help her community prevent, treat, and manage type 2 diabetes. We define a
proper ideal P of R disjoint from S to be weakly S-primary if there exists an s. Second, only
guidelines and recommendations published in the English language were recruited in the present
review. Results Identified structural barriers to lifestyle change included: food insecurity, persuasive
marketing of unhealthy food. Therefore, these guidelines still recommend a two-step approach with
NDDG or C-C criteria. Acknowledgements Funding for studies described in this paper that I have
been involved in come from the Medical Research Council, The Wellcome Trust, The Evelyn Trust
and National Institute for Health Research. C. J. P. has no conflicts of interest to declare. NOTE: We
only request your email address so that the person you are recommending the page to knows that you
wanted them to see it, and that it is not junk mail. Despite the limitations in the available data
concerning the consumption of low-GI diets in pregnancy, the revised UK National Institute for
Health and Clinical Excellence guidelines for women with GDM suggest that they should consume
diets containing, where possible, carbohydrates from low-GI sources ( 92 ). GCT test is based on
oral intake of 50?g glucose solution followed by venous glucose examination 1?hour later. Download
Free PDF View PDF Free PDF Gestational Diabetes Mellitus article review (1) Joice Gunawan
Download Free PDF View PDF Free PDF A Comprehensive Review Of Gestational Diabetes
Mellitus International Journal of Pharmaceutical Sciences 2023, INTERNATIONAL JOURNAL IN
PHARMACEUTICAL SCIENCES Gestational Diabetes Mellitus (GDM) is a common medical
condition affecting pregnant women, characterized by glucose intolerance that develops during
pregnancy. The cumulative incidence in controls reached 1.90% (95% confidence interval 1.87% to
1.92%) for the longest studies. A search for websites of guideline development organisations was
also performed (see online supplementary table S1 ). The plot for the analysis estimates is provided in
supplementary figure S3. It is important that this is achieved without introducing other dangers,
however, as potentially could be found with a diet that focused solely on having a low GI without
consideration of other dietary requirements. However, by day 16 of the 21 d pregnancy, in the third
trimester about the time when GDM becomes more prevalent in humans ( Reference Seshiah, Balaji
and Balaji 85 ), the areas under the curves of intra-peritoneal glucose tolerance tests performed in
phenotypically wild-type mice carrying H19 knockout offspring was 28 % higher than those from
wild-type mice carrying only wild-type offspring. Pharmacological treatment For some women,
especially those with a relatively severe form of the condition that develops earlier than in the third
trimester ( Reference Seshiah, Balaji and Balaji 85 ), GDM cannot be adequately controlled by diet
and exercise alone. As this study was a systematic review and meta-analysis, patient recruitment or
use of patient data was not required. Comparable results were found in a similar but smaller
randomised, open-label trial of insulin aspart in women with GDM ( Reference Pettitt, Ospina and
Howard 134 ).