{"id":9144,"date":"2018-05-16T11:26:04","date_gmt":"2018-05-16T09:26:04","guid":{"rendered":"https:\/\/latam.patiadiabetes.com\/en\/?p=9144"},"modified":"2020-12-07T18:14:01","modified_gmt":"2020-12-07T16:14:01","slug":"gestational-diabetes-mellitus-gdm-an-update-based-on-evidence","status":"publish","type":"post","link":"https:\/\/latam.patiadiabetes.com\/en\/gestational-diabetes-mellitus-gdm-an-update-based-on-evidence\/","title":{"rendered":"Gestational Diabetes Mellitus (GDM): an update based on evidence"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 hundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"background-color: rgba(255,255,255,0);background-position: center center;background-repeat: no-repeat;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;margin-bottom: 0px;margin-top: 0px;border-width: 0px 0px 0px 0px;border-color:#eae9e9;border-style:solid;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"margin-top:0px;margin-bottom:10px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-1\"><h1>Gestational Diabetes Mellitus (GDM): an update based on evidence<\/h1>\n<blockquote>\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/mesh\/68016640\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Gestational Diabetes Mellitus (GDM)<\/span><\/a><span style=\"font-weight: 400;\"> is generally defined as any degree of glucose intolerance with onset or first recognition during pregnancy (American Diabetes Association). Therefore, GDM does not include the situation of those women who previously suffer from diabetes before becoming pregnant. <\/span><\/p>\n<\/blockquote>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"margin-top:0px;margin-bottom:10px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-2\"><p><span style=\"font-weight: 400;\">GDM is usually highlighted from the equator and towards the end of the gestation period. Run with resistance to insulin, glucose intolerance and hyperglycemia. This situation of hyperglycemia also affects the development of the fetus in the uterus, being one of the consequences <\/span><a href=\"https:\/\/link.springer.com\/article\/10.1007%2Fs00404-014-3545-5\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">the birth of babies significantly greater and of greater weight than average<\/span><\/a><span style=\"font-weight: 400;\">. Known as macrosomia: birth weight greater than 4 kg, or above 90<\/span><span style=\"font-weight: 400;\">th<\/span><span style=\"font-weight: 400;\"> percentile in height-for-age tables.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Some women are more likely than other to get GDM we shall consider <\/span><a href=\"https:\/\/link.springer.com\/article\/10.1007%2Fs00404-014-3545-5\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">the NICE (National Institute for Health and Care Excellence)<\/span><\/a><span style=\"font-weight: 400;\"> risk factors, being at higher risk if any of the following apply :<\/span><\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_2_3 2_3 fusion-two-third fusion-column-first\" style=\"width:65.3333%; margin-right: 4%;margin-top:0px;margin-bottom:10px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-3\"><ul>\n<li><span style=\"font-weight: 400;\">Previous gestational diabetes<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Previous macrosomia baby weighing 4.5 kg or above<\/span><\/li>\n<li><span style=\"font-weight: 400;\">BMI above 30 kg\/<\/span><span style=\"font-weight: 400;\">m<\/span><span style=\"font-weight: 400;\">2<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Family history of diabetes (first degree relative with diabetes)<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Maternal age (&gt;35 years old are at greater risk)<\/span><\/li>\n<\/ul>\n<\/div><div class=\"fusion-text fusion-text-4\"><p><span style=\"font-weight: 400;\">Not forgetting the existence of new genetic test that can help us to know the genetic risk of GDM such <\/span><span style=\"font-weight: 400;\"><a href=\"https:\/\/latam.patiadiabetes.com\/en\/patia\/diabetes\/gestational-diabetes\/\">Patia\u00b4s GDMpredict<\/a>.<\/span><\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_3 1_3 fusion-one-third fusion-column-last\" style=\"width:30.6666%;margin-top:0px;margin-bottom:10px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-5\"><p><a href=\"https:\/\/latam.patiadiabetes.com\/en\/patia\/diabetes\/diabetes-gestacional\/\" target=\"_blank\" rel=\"attachment wp-att-9082 noopener noreferrer\"><img decoding=\"async\" class=\"lazyload alignnone size-full wp-image-9082\" src=\"data:image\/svg+xml,%3Csvg%20xmlns%3D%27http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg%27%20width%3D%27300%27%20height%3D%27200%27%20viewBox%3D%270%200%20300%20200%27%3E%3Crect%20width%3D%27300%27%20height%3D%27200%27%20fill-opacity%3D%220%22%2F%3E%3C%2Fsvg%3E\" data-orig-src=\"https:\/\/latam.patiadiabetes.com\/wp-content\/uploads\/2018\/05\/gdm_predict-300x200-1.jpg\" alt=\"Test riesgo gen\u00e9tico diabetes gestacional\" width=\"300\" height=\"200\" \/><\/a><\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"margin-top:0px;margin-bottom:10px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-6\"><h2>GDM no good outlook for the mother<\/h2>\n<p><span style=\"font-weight: 400;\">Although the situation of hyperglycemia of GDM is often reversed at the end of pregnancy, health outlook for both, the mother and the baby, is not particularly flattering.<\/span><\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-5 fusion_builder_column_3_5 3_5 fusion-three-fifth fusion-column-first\" style=\"width:58.4%; margin-right: 4%;margin-top:0px;margin-bottom:10px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-7\"><p><span style=\"font-weight: 400;\">The consequences related to mother\u00b4s health affect both the course of pregnancy and her health after it. Women diagnosed with GDM have an increased risk of suffering from different pathologies associated with their situation. Among them, the most important is preeclampsia, a possible complication of pregnancy that is characterized by a set of symptoms, among which high blood pressure and maternal proteinuria (elevated proteins in the urine) with or without pathological edema.<\/span><\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-6 fusion_builder_column_2_5 2_5 fusion-two-fifth fusion-column-last\" style=\"width:37.6%;margin-top:0px;margin-bottom:10px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-8\"><p><img decoding=\"async\" class=\"lazyload alignnone wp-image-8988 size-full\" src=\"https:\/\/latam.patiadiabetes.com\/wp-content\/uploads\/2018\/05\/img-20170720-597096d53a2a6-e1525691203588.jpg\" data-orig-src=\"https:\/\/latam.patiadiabetes.com\/wp-content\/uploads\/2018\/05\/img-20170720-597096d53a2a6-e1525691203588.jpg\" alt=\"Diabetes gestacional: una actualizaci\u00f3n basada en la evidencia\" width=\"875\" height=\"562\" srcset=\"data:image\/svg+xml,%3Csvg%20xmlns%3D%27http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg%27%20width%3D%27875%27%20height%3D%27562%27%20viewBox%3D%270%200%20875%20562%27%3E%3Crect%20width%3D%27875%27%20height%3D%27562%27%20fill-opacity%3D%220%22%2F%3E%3C%2Fsvg%3E\" data-srcset=\"https:\/\/latam.patiadiabetes.com\/wp-content\/uploads\/2018\/05\/img-20170720-597096d53a2a6-e1525691203588-300x193.jpg 300w, https:\/\/latam.patiadiabetes.com\/wp-content\/uploads\/2018\/05\/img-20170720-597096d53a2a6-e1525691203588-460x295.jpg 460w, https:\/\/latam.patiadiabetes.com\/wp-content\/uploads\/2018\/05\/img-20170720-597096d53a2a6-e1525691203588-768x493.jpg 768w, https:\/\/latam.patiadiabetes.com\/wp-content\/uploads\/2018\/05\/img-20170720-597096d53a2a6-e1525691203588.jpg 875w\" data-sizes=\"auto\" data-orig-sizes=\"(max-width: 875px) 100vw, 875px\" \/><\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-7 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"margin-top:0px;margin-bottom:10px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-9\"><p><a href=\"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/abs\/10.1111\/aogs.12764\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">GDM increases the risk for diabetes in the next pregnancy<\/span><\/a><span style=\"font-weight: 400;\"> and alter in life. Thus, estimating the risk of GDM in further pregnancies provides a time frame for possible preventive measures. Recurrence of diet<\/span><span style=\"font-weight: 400;\">\u2010<\/span><span style=\"font-weight: 400;\">treated GDM was 47.2% in primiparous women with previous GDM and the recurrence was associated with weight gain between pregnancies.<\/span><\/p>\n<\/div><div class=\"fusion-text fusion-text-10\"><p><span style=\"font-weight: 400;\">Women with GDM are diagnosed with T2D and hypertension much earlier in life. This expands the current evidence that GDM is potentially an important indicator for preventive cardiovascular risk management. Of these women, 35% to 60% develop T2D within 10 years. The presence of <\/span><a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/abs\/10.1111\/dme.12635\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">both high maternal weight and GDM<\/span><\/a><span style=\"font-weight: 400;\"> compounds the risk of developing diabetes. However, the association between overweight alone and GDM alone and hypertension and cardiovascular disease appears similar suggesting a need for effective interventions to manage both these conditions to improve the health of these patients. And happens with the so-called <\/span><a href=\"https:\/\/academic.oup.com\/jcem\/article\/90\/7\/4004\/2837265\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">metabolic syndrome<\/span><\/a><span style=\"font-weight: 400;\">. The prevalence of this syndrome of women with GDM is three-fold higher than in general population.<\/span><\/p>\n<h2>GDM also bad outlook for the future of the baby<\/h2>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-8 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-first\" style=\"width:48%; margin-right: 4%;margin-top:0px;margin-bottom:10px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-11\"><p><span style=\"font-weight: 400;\">The baby affected by GDM during conception also assumes a series of risks, the mentioned <\/span><a href=\"https:\/\/link.springer.com\/article\/10.1007%2Fs00404-014-3545-5\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">macrosomia<\/span><\/a><span style=\"font-weight: 400;\">, complications in childbirth related to the need to practice cesarean section, shoulder dystocia, respiratory problems, fetal hypoglycemia and hyperbilirubinemia. But in addition, the baby in these circumstances also assumes a series of <\/span><a href=\"http:\/\/www.em-consulte.com\/article\/1029456\/alertePM\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">long-term risks<\/span><\/a><span style=\"font-weight: 400;\"> that will accompany him throughout his development and life as a result of &#8220;genetic programming in the womb&#8221;, among which there is a greater risk of obesity, suffering metabolic syndrome and type 2 diabetes itself. <\/span><\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-9 fusion_builder_column_1_2 1_2 fusion-one-half fusion-column-last\" style=\"width:48%;margin-top:0px;margin-bottom:10px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-12\"><p><img decoding=\"async\" class=\"lazyload alignnone size-full wp-image-9148\" src=\"https:\/\/latam.patiadiabetes.com\/wp-content\/uploads\/2018\/05\/Presio\u0301n-elevada-en-sangrePreeclampsia-amenaza-para-la-madre-e-hijoDiabetes-tipo-2-en-un-futuro-50-probabilidad-en-10-an\u0303os-6.png\" data-orig-src=\"https:\/\/latam.patiadiabetes.com\/wp-content\/uploads\/2018\/05\/Presio\u0301n-elevada-en-sangrePreeclampsia-amenaza-para-la-madre-e-hijoDiabetes-tipo-2-en-un-futuro-50-probabilidad-en-10-an\u0303os-6.png\" alt=\"Gestational Diabetes Mellitus (GDM): an update based on evidence\" width=\"900\" height=\"600\" srcset=\"data:image\/svg+xml,%3Csvg%20xmlns%3D%27http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg%27%20width%3D%27900%27%20height%3D%27600%27%20viewBox%3D%270%200%20900%20600%27%3E%3Crect%20width%3D%27900%27%20height%3D%27600%27%20fill-opacity%3D%220%22%2F%3E%3C%2Fsvg%3E\" data-srcset=\"https:\/\/latam.patiadiabetes.com\/wp-content\/uploads\/2018\/05\/Presio\u0301n-elevada-en-sangrePreeclampsia-amenaza-para-la-madre-e-hijoDiabetes-tipo-2-en-un-futuro-50-probabilidad-en-10-an\u0303os-6-300x200.png 300w, https:\/\/latam.patiadiabetes.com\/wp-content\/uploads\/2018\/05\/Presio\u0301n-elevada-en-sangrePreeclampsia-amenaza-para-la-madre-e-hijoDiabetes-tipo-2-en-un-futuro-50-probabilidad-en-10-an\u0303os-6-768x512.png 768w, https:\/\/latam.patiadiabetes.com\/wp-content\/uploads\/2018\/05\/Presio\u0301n-elevada-en-sangrePreeclampsia-amenaza-para-la-madre-e-hijoDiabetes-tipo-2-en-un-futuro-50-probabilidad-en-10-an\u0303os-6.png 900w\" data-sizes=\"auto\" data-orig-sizes=\"(max-width: 900px) 100vw, 900px\" \/><\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-10 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"margin-top:0px;margin-bottom:10px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-13\"><h2>To confront the GDM from the nutritional point of view<\/h2>\n<p><span style=\"font-weight: 400;\">An ounce on prevention is worth a pound of cure. Dietary recommendations are: index and low blood glucose charges, adequate fiber intake and close monitoring by a multidisciplinary team that includes periodic monitoring and the use of food journals. All of this, in general, is associated with Mediterranean dietary patterns or related to a <\/span><a href=\"https:\/\/www.nature.com\/articles\/ejcn2013296\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">diet known as DASH<\/span><\/a><span style=\"font-weight: 400;\"> (in English, Dietary Approaches to Stop Hypertension) that in some way can be linked, without problems, to the guidelines already known by our preferred diet guide , that is, those of the <\/span><a href=\"https:\/\/latam.patiadiabetes.com\/en\/food-self-management-to-prevent-type-2-diabetes-risk\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Healthy Food Plate<\/span><\/a><span style=\"font-weight: 400;\"> of the School of Public Health of the University of Harvard.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Another aspect of both prevention and treatment of DG is physical activity. It <\/span><a href=\"https:\/\/www.journalofphysiotherapy.com\/article\/S1836-9553(16)30053-4\/fulltext\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">has been shown that aerobic exercise<\/span><\/a><span style=\"font-weight: 400;\"> improves blood glucose levels in fasting. Also, after meals in women with gestational diabetes that exercise three to four times a week.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<\/span><\/p>\n<p>Juan Revenga, Dietician-nutritionist<\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><style type=\"text\/css\">.fusion-fullwidth.fusion-builder-row-1 { overflow:visible; }<\/style><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":18,"featured_media":9150,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[21],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v19.14 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Gestational Diabetes Mellitus (GDM): an update based on evidence - PATIA Diabetes<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/latam.patiadiabetes.com\/en\/gestational-diabetes-mellitus-gdm-an-update-based-on-evidence\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Gestational Diabetes Mellitus (GDM): an update based on evidence - 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