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DOI: 10.1055/s-0041-1736086
Advantages of Screening for Glucose Tolerance in the Sequential Weeks of Gestation
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Abstract
Prelife exposure relates to development during the time preceding the first appearance of life, a time course from “conception to confinement.” From single cell zygote to finally formed fetus at confinement, a remarkable change occurs due to maternal fuels and hormonal influence on the fetal development. The crucial period in the fetal development is the first trimester. Early exposure to aberrant maternal metabolism in the embryonic developmental stage would result in congenital malformation and fetal wastage. Maintaining maternal glucose at the recommended level of fasting 80 to 90 mg and 2 hours postprandial plasma glucose 110 to 120 mg/dL during preconceptional period and throughout pregnancy is the assurance for the healthy offspring with ideal birth weight of 2.5 to 3.5 kg and prevention of noncommunicable diseases in the future.
Publication History
Article published online:
31 December 2021
© 2021. Novo Nordisk Education Foundation. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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References
- 1 Barker DJ. The developmental origins of adult disease. J Am Coll Nutr 2004; 23 (06) (Suppl 588S-595S
- 2 Lucas A. Programming by early nutrition in man. In: Bock GR, Whelan J, editors. The childhood environment and adult disease. Chichester: John Wiley & Sons 1991: 38-55
- 3 Carpenter MW, Canick JA, Hogan JW, Shellum C, Somers M, Star JA. Amniotic fluid insulin at 14-20 weeks’ gestation: association with later maternal glucose intolerance and birth macrosomia. Diabetes Care 2001; 24 (07) 1259-1263
- 4 Brown HM, Green ES, Tan TCY. et al. Periconception onset diabetes is associated with embryopathy and fetal growth retardation, reproductive tract hyperglycosylation and impaired immune adaptation to pregnancy. Sci Rep 2018; 8 (01) 2114
- 5 Sudasinghe BH, Wijeyaratne CN, Ginige PS. Long and short-term outcomes of Gestational Diabetes Mellitus (GDM) among South Asian women - a community-based study. Diabetes Res Clin Pract 2018; 145: 93-101
- 6 Damm P, Houshmand-Oeregaard A, Kelstrup L, Lauenborg J, Mathiesen ER, Clausen TD. Gestational diabetes mellitus and long-term consequences for mother and offspring: a view from Denmark. Diabetologia 2016; 59 (07) 1396-1399
- 7 The Medical Encyclopaedia. U.S. National Library of Medicine. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/002398.htm. Accessed June 28, 2021
- 8 Pantaleon M, Tan HY, Kafer GR, Kaye PL. Toxic effects of hyperglycemia are mediated by the hexosamine signaling pathway and o-linked glycosylation in early mouse embryos. Biol Reprod 2010; 82 (04) 751-758
- 9 Frank LA, Sutton-McDowall ML, Gilchrist RB, Thompson JG. The effect of peri-conception hyperglycaemia and the involvement of the hexosamine biosynthesis pathway in mediating oocyte and embryo developmental competence. Mol Reprod Dev 2014; 81 (05) 391-408
- 10 Hernandez TL, Friedman JE, Van Pelt RE, Barbour LA. Patterns of glycemia in normal pregnancy: should the current therapeutic targets be challenged?. Diabetes Care 2011; 34 (07) 1660-1668
- 11 Khan N. et al. Early age at onset and high frequency of associated complications in maternally transmitted type 2 diabetes mellitus. Int J Diabetes Dev Ctries 2004; 24: 36-39
- 12 Damm P. Future risk of diabetes in mother and child after gestational diabetes mellitus. Int J Gynaecol Obstet 2009; 104 (Suppl. 01) S25-S26
- 13 Dabelea D, Hanson RL, Bennett PH, Roumain J, Knowler WC, Pettitt DJ. Increasing prevalence of type II diabetes in American Indian children. Diabetologia 1998; 41 (08) 904-910
- 14 Adam PA, Teramo K, Raiha N, Gitlin D, Schwartz R. Human fetal insulin metabolism early in gestation. Response to acute elevation of the fetal glucose concentration and placental transfer of human insulin-I-131. Diabetes 1969; 18 (06) 409-416
- 15 Reiher H, Fuhrmann K, Noack S. et al. Age-dependent insulin secretion of the endocrine pancreas in vitro from fetuses of diabetic and nondiabetic patients. Diabetes Care 1983; 6 (05) 446-451
- 16 Desoye G, Nolan CJ. The fetal glucose steal: an underappreciated phenomenon in diabetic pregnancy. Diabetologia 2016; 59 (06) 1089-1094
- 17 Schwartz R, Gruppuso PA, Petzold K, Brambilla D, Hiilesmaa V, Teramo KA. Hyperinsulinemia and macrosomia in the fetus of the diabetic mother. Diabetes Care 1994; 17 (07) 640-648
- 18 Tisi DK, Burns DH, Luskey GW, Koski KG. Fetal exposure to altered amniotic fluid glucose, insulin, and insulin-like growth factor-binding protein 1 occurs before screening for gestational diabetes mellitus. Diabetes Care 2011; 34 (01) 139-144
- 19 Maegawa Y, Sugiyama T, Kusaka H, Mitao M, Toyoda N. Screening tests for gestational diabetes in Japan in the 1st and 2nd trimester of pregnancy. Diabetes Res Clin Pract 2003; 62 (01) 47-53
- 20 Seshiah V, Balaji V, Balajiet MS. et al. GDM manifests in all trimesters of pregnancy. Diabetes Res Clin Pract 2007; 77 (03) 482-484
- 21 Veeraswamy S, Divakar H, Gupte S, Datta M, Kapur A, Vijayam B. Need for testing glucose tolerance in the early weeks of pregnancy. Indian J Endocrinol Metab 2016; 20 (01) 43-46
- 22 Anjalakshi C, Balaji V, Balaji MS. et al. A single test procedure to diagnose gestational diabetes mellitus. Acta Diabetol 2009; 46 (01) 51-54
- 23 Maternal Health Division Ministry of Health & Family Welfare Government of India. www.mohfw.gov.in &www.nhm.gov.in. February 2018. Accessed June 28, 2021
- 24 Colagiuri S, Falavigna M, Agarwal MM. et al. Strategies for implementing the WHO diagnostic criteria and classification of hyperglycaemia first detected in pregnancy. Diabetes Res Clin Pract 2014; 103 (03) 364-372
- 25 Hod M, Kapur A, Sacks DA. et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on gestational diabetes mellitus; a pragmatic guide for diagnosis, management and care. Int J Gynaecol Obstet 2015; 131 (Suppl. 03) S173-S211
- 26 Chittaranjan N. Purandare(FIGO), Shaukat Sadikot(IDF), Nam Cho Han(IDF) et al. FIGO-IDF Joint Statement and Declaration on Hyperglycemia in Pregnancy. IDF Congress. Abu Dhabi, 6th December 2017. www.diabetesatlas.org/atlas@idf.org. Accessed June 28, 2021
- 27 Bartha JL, Martinez-Del-Fresno P, Comino-Delgado R. Early diagnosis of gestational diabetes mellitus and prevention of diabetes-related complications. Eur J Obstet Gynecol Reprod Biol 2003; 109 (01) 41-44
- 28 Li M, Hinkle SN, Grantz KL. et al. Glycaemic status during pregnancy and longitudinal measures of fetal growth in a multi-racial US population: a prospective cohort study. Lancet Diabetes Endocrinol 2020; 8 (04) 292-300
- 29 Barker DJ, Thornburg KL. The obstetric origins of health for a lifetime. Clin Obstet Gynecol 2013; 56 (03) 511-519
- 30 Combs CA, Gunderson E, Kitzmiller JL, Gavin LA, Main EK. Relationship of fetal macrosomia to maternal postprandial glucose control during pregnancy. Diabetes Care 1992; 15 (10) 1251-1257
- 31 Jovanovic-Peterson L, Peterson CM, Reed GF. et al. Maternal postprandial glucose levels and infant birth weight: the diabetes in early pregnancy study. Am J Obstet Gynecol 1991; 164 (1 Pt 1) 103-111
- 32 Jovanovic L. Point: Oral hypoglycemic agents should not be used to treat diabetic pregnant women. Diabetes Care 2007; 30 (11) 2976-2979
- 33 You and Your Hormones: An Education Resource for the Society of Endocrinology. https://www.yourhormones.info/about. Accessed June 28, 2021
- 34 Savona-Ventura C, Chircop M. Birth weight influence on the subsequent development of gestational diabetes mellitus. Acta Diabetol 2003; 40 (02) 101-104
- 35 Catalano Patrick M. Fetal growth in normal and diabetic pregnancies. Textbook of Diabetes and pregnancy. Second. edition, Publishers Informa Healthcare 2008. Informa UK Ltd;