The Need for Personalized Risk-Stratified Approaches to Treatment for Gestational Diabetes: A Narrative Review

Shamil D. Cooray; Jacqueline A. Boyle; Georgia Soldatos; Shakila Thangaratinam; Helena J. Teede

doi:10.1055/s-0041-1723778

Seminars in Reproductive Medicine, Inhaltsverzeichnis

Semin Reprod Med 2020; 38(06): 384-388
DOI: 10.1055/s-0041-1723778

Review Article

The Need for Personalized Risk-Stratified Approaches to Treatment for Gestational Diabetes: A Narrative Review

Shamil D. Cooray

¹Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia

²Diabetes Unit, Monash Health, Clayton, Victoria, Australia

,

Jacqueline A. Boyle

¹Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia

³Monash Women's Program, Monash Health, Clayton, Victoria, Australia

,

Georgia Soldatos

¹Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia

⁴Diabetes and Endocrinology Units, Monash Health, Clayton, Victoria, Australia

,

Shakila Thangaratinam

⁵Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom

,

Helena J. Teede

¹Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia

⁴Diabetes and Endocrinology Units, Monash Health, Clayton, Victoria, Australia

› Institutsangaben

Abstract

Gestational diabetes mellitus (GDM) is common and is associated with an increased risk of adverse pregnancy outcomes. However, the prevailing one-size-fits-all approach that treats all women with GDM as having equivalent risk needs revision, given the clinical heterogeneity of GDM, the limitations of a population-based approach to risk, and the need to move beyond a glucocentric focus to address other intersecting risk factors. To address these challenges, we propose using a clinical prediction model for adverse pregnancy outcomes to guide risk-stratified approaches to treatment tailored to the individual needs of women with GDM. This will allow preventative and therapeutic interventions to be delivered to those who will maximally benefit, sparing expense, and harm for those at a lower risk.

Keywords

gestational diabetes - prediction model - adverse pregnancy outcomes - large-for-gestational age

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Referenzen

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