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Printable Handouts
Navigable Slide Index
- Introduction
- Issues to cover
- What causes GDM?
- Glycaemia
- What causes insulin resistance?
- Insulin receptor and transport mechanism
- Insulin resistance in GDM
- TNF-alpha
- Transport mechanism and TNF-alpha
- Pathogenesis of GDM - progesterone
- Pathogenesis of GDM - cortisol
- Pathogenesis of GDM - prolactin
- Pathogenesis of GDM - human placental lactogen
- Pathogenesis of GDM - leptin
- Beta-cell dysfunction
- Summary of GDM pathogenesis
- Diagnosis of GDM
- Hyperglycemia & adverse pregnancy outcomes
- HAPO protocol
- Associations: glucose & first degree outcomes
- Model II OR per SD glucose difference
- Pedersen hypothesis
- Translating these findings
- IADPSG recommendations
- GDM diagnosis in pregnancy
- Threshold and frequency of outcomes
- Correlations among OGTT measurements
- Other considerations: measurement of glucose
- Frequency GDM HAPO FC- age adjusted
- Diagnosis of overt diabetes in pregnancy
- Hyperglycemic disorders in pregnancy (1)
- Hyperglycemic disorders in pregnancy (2)
- Prevalence of diabetes/prediabetes in the USA
- Treatment of GDM (Crowther study)
- Treatment of GDM (Landon study)
- Management of GDM
- Recommended glycaemic targets
- Exercise
- Medical nutritional therapy (individualization)
- Medical nutritional therapy (composition)
- Oral hypoglycaemic agents
- Delivery
- Postpartum
- Long term - diabetes mellitus
- Long term - obesity offspring
- Summary
Topics Covered
- Pathophysiology of gestational diabetes
- Diagnostic criteria
- Management of gestational diabetes
- Long term-consequences for mother and child
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Oats, J.J.N. (2014, May 12). Understanding and managing gestational diabetes [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 5, 2024, from https://doi.org/10.69645/WZUR6874.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Jeremy J. N. Oats has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
A selection of talks on Gynaecology & Obstetrics
Transcript
Please wait while the transcript is being prepared...
0:00
The topic I
will cover in this presentation
is gestational diabetes.
First about my background.
I am an obstetrician with
a longstanding interest
in diabetes and pregnancy.
Till recently I was head
of the Diabetes Service
at the Royal Women's Hospital
in Melbourne, Australia.
I'm a member of the HAPO--
Hyperglycemia and Adverse Pregnancy
Outcome-- steering group with the
Secretary General of the IADPSG-
that's the International
Association of Diabetes
in Pregnancy Study Groups.
I will be making reference
during this presentation
to the findings from HAPO and
the IADPSG recommendations
on the diagnosis and classification
of hyperglycemia in pregnancy.
0:42
Issues I will covering
in this presentation
are what causes GDM, the
diagnostic criteria for GDM,
what is the evidence that treatment
improves outcomes, the treatment
options, diet, exercise, and the
place of pharmacological agents
to help achieve normal glycemia,
the timing and mode of delivery,
and then the follow up of women
who've had gestational diabetes
post-pregnancy and preparation if
they plan to become pregnant again.
1:12
Before we discuss what is thought
to cause gestational diabetes
we need to define what
we mean by the term, GDM.
Traditionally, it has
been defined as quote,
"carbohydrate intolerance
of variable severity
with onset or first recognition
in pregnancy," end quote.
This acknowledges the intolerance
may precede a pregnancy,
and we will return to this
point when we discussed
the IADPSG diagnostic
recommendations.
So what causes GDM?
It's been demonstrated that
women destined to develop GDM
have increased insulin resistance
and/or diminished insulin creatory
capacity before they become
pregnant, when compared with women
who do not become
hyperglycemic and develop GDM,
and these disorders of carbohydrate
metabolism persist after pregnancy.