Gestacijski diabetes mellitus

Abstract

Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy, developing when pancreas function of women is not enough to transcend diabetic surroundings of pregnancy. Risk factors for GDM are: macrosomic babies in previous pregnancy, polycystic ovary syndrome, pregnancy induced hypertension, previous spontaneous abortion, inexplicable stillborn, previous GDM. The diagnosis of GDM is according to OGTT with 100g glucosae, usually during 24th to 28th weeks of gestation, based on two or more values: fasting blood glucose > 5.3mmol/L, after 1h > 10.0mmol/L, after 2h > 8.6mmol/L, after 3h > 7.8mmol/L. GDM usually appears in the third trimester when placenta matures, in general it is mild, and does not endanger women´s health, but hyperglycemia increases fetal morbidity. Standard approach to GDM treatment is insulin therapy when women cannot achieve satisfying glycemic control with diet, usually with conventional intensive insulin therapy with four daily doses. American Diabetes Association recommends the delivery during the 38th week of gestation. The purpose of the prevention and treatment of GDM is not only normalization of the disturbed glucose metabolism in mother, but also the improvement of adequate prenatal, perinatal and postnatal development in children of mothers with GDM, as well as reducing metabolic and cardiovascular risk in these children later in life.