Additional Information
Book Details
Abstract
Gestational diabetes mellitus (GDM) is classically seen in about 5–8% of the pregnant women. The condition appears to be caused by the same broad spectrum of physiological and genetic peculiarities that characterize diabetes outside of pregnancy. These women with GDM are also otherwise at high risk of having or developing diabetes even when not pregnant. The controversies regarding the diagnosis, management, and prevention of diabetes in pregnancy pose specific problems in clinical practice such as how to clinch the diagnosis, when to introduce therapy, what therapy to introduce, and how to predict the future course of the condition. This book is designed to address such questions with supportive typical clinical scenarios, with which all readers will be able to identify. Thus it provides an excellent opportunity to widen one’s perspective in this area.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover\r | Front Cover | ||
| Front Matter\r | 1a | ||
| ECAB Clinical Update:Diabetology | 1c | ||
| Copyright | 1e | ||
| About the Authors | 1f | ||
| Contents | 1h | ||
| ECAB Clinical Update InformationDiabetes in Pregnancy | i | ||
| ELSEVIER CLINICAL ADVISORY BOARD (ECAB)INDIA | i | ||
| STATEMENT OF NEED | i | ||
| DIABETES IN PREGNANCY | ii | ||
| TARGET AUDIENCE | ii | ||
| EDUCATIONAL OBJECTIVES | ii | ||
| ACCREDITATION INFORMATION | ii | ||
| DISCLAIMER | ii | ||
| DISCLOSURE OF UNLABELED USES | iii | ||
| DISCLOSURE OF FINANCIAL RELATIONSHIPSWITH ANY COMMERCIAL INTEREST | iii | ||
| RESOLUTION OF CONFLICT OF INTEREST | iii | ||
| CONTENT DEVELOPMENT COMMITTEE | iv | ||
| ENQUIRIES | iv | ||
| Introduction | 1 | ||
| Diagnosis of Diabetes in Pregnancy: Controversies and Consensus | 5a | ||
| Abstract | 5a | ||
| Keywords 1 | 5a | ||
| Definition of gdm | 6 | ||
| Detection and diagnosis | 7 | ||
| How to Screen | 8 | ||
| Whom to Screen for GDM | 10 | ||
| Diagnosis of GDM | 14 | ||
| Three-hour 100-g OGTT | 14 | ||
| Criteria for Diagnosis of GDM | 15 | ||
| Two-Hour 75-g GTT | 18 | ||
| Indian scenario | 22 | ||
| Summary | 23 | ||
| Ada recommendations for gdm screening and diagnosis | 23 | ||
| Case study i | 28 | ||
| History | 28 | ||
| Evaluation | 28 | ||
| Management | 29 | ||
| Discussion | 29 | ||
| Case study ii | 30 | ||
| History | 30 | ||
| Evaluation | 30 | ||
| Management | 30 | ||
| Discussion | 31 | ||
| Case Study Iii | 33 | ||
| History | 33 | ||
| Evaluation | 33 | ||
| Management | 33 | ||
| Discussion | 34 | ||
| Prevention and Management of Diabetes in Pregnancy | 35a | ||
| Abstract | 35a | ||
| Keywords | 35a | ||
| Management of Diabetes in Pregnancy | 36 | ||
| Pregestational Type 1 and Type 2 Diabetic Women | 36 | ||
| Insulin Requirement in Pre-GDM | 37 | ||
| Pregestational Type 1 Diabetic Women | 38 | ||
| Pregestational Type 2 DM Patients | 39 | ||
| Management of Gdm | 40 | ||
| Medical Nutrition Therapy | 40 | ||
| Insulin Administration in GDM | 43 | ||
| Target Blood Glucose Levels | 45 | ||
| Insulin Analogs in Pregnancy | 46 | ||
| Oral Antidiabetic Drugs | 46 | ||
| Glibenclamide | 47 | ||
| Metformin | 48 | ||
| Monitoring Glycemic Control | 48 | ||
| Measuring other Parameters | 49 | ||
| A1c Levels | 49 | ||
| Blood Pressure, Fundoscopy, and Microalbuminuria | 49 | ||
| Ultrasound Fetal Measurement | 50 | ||
| Obstetric Considerations | 50 | ||
| Fetal Evaluation | 51 | ||
| Mid Pregnancy (16-20 Weeks) To Detect Fetal Anomalies | 52 | ||
| Late Pregnancy (28 Weeks To Delivery) To Assess Fetal Well-Being | 52 | ||
| Intrapartum Diabetic Management | 52 | ||
| Follow-Up of Gdm | 53 | ||
| Prevention | 55 | ||
| Summary | 56 | ||
| The Diabetes in Pregnancy Study Group India (Dipsi) Practice Guidelines For Gdm in The Indian Environment | 59 | ||
| Screening | 59 | ||
| Management | 59 | ||
| Target Blood Glucose Levels | 60 | ||
| Conclusion | 60 | ||
| Case Studies Prevention and Management of Diabetes in Pregnancy | 64 | ||
| Case Study I | 64 | ||
| Obstetric History | 64 | ||
| Family History | 64 | ||
| Investigation Visit 1 | 64 | ||
| Treatment Advised | 65 | ||
| Discussion | 66 | ||
| Case Study ii | 67 | ||
| Obstetric History | 67 | ||
| Family History | 67 | ||
| Investigations | 67 | ||
| Diagnosis | 67 | ||
| Management | 67 | ||
| Case Study iii | 69 | ||
| Obstetric History | 69 | ||
| Family History | 69 | ||
| Investigations | 69 | ||
| Diagnosis | 69 | ||
| Management | 69 | ||
| Discussion | 70 | ||
| Case Study iv | 71 | ||
| Obstetric History | 71 | ||
| Diagnosis | 71 | ||
| Management | 71 | ||
| Follow-up | 72 | ||
| Case Study V | 73 | ||
| Obstetric History | 73 | ||
| Family History | 73 | ||
| Investigations | 73 | ||
| Diagnosis | 73 | ||
| Management | 73 | ||
| Gestational Diabetes Mellitus: A Forerunner of Future Diabetes Mellitus | 75a | ||
| Abstract | 75a | ||
| Keywords | 75a | ||
| Indian Scenario | 76 | ||
| Blood sugar values | 76 | ||
| Global scenario | 77 | ||
| Diagnostic criteria and follow-up diabetes | 78 | ||
| Degree of glycaemia and insulin status | 81 | ||
| Postprandial 1-hour blood glucose | 81 | ||
| Ethnicity and geographical position | 75a | ||
| Age | 82 | ||
| Early gdm diagnosis | 82 | ||
| Degree of glycaemia in early postpartum | 82 | ||
| Single abnormal glucose tolerance value | 83 | ||
| HbA1c As a predictive factor | 83 | ||
| Bedtime insulin | 83 | ||
| Macrosomia | 84 | ||
| Obesity during index pregnancy | 84 | ||
| Multiple pregnancy before and after index pregnancy | 84 | ||
| Family history of dm | 85 | ||
| Post-gdm obesity | 85 | ||
| Diet | 85 | ||
| Physical activity | 85 | ||
| Preterm delivery | 86 | ||
| Hyperhomocysteinemia | 86 | ||
| Asymmetric dimethyl arginine | 86 | ||
| Cardiovascular diseases after gdm | 86 | ||
| Immunological markers | 87 | ||
| Genetic predisposition | 88 | ||
| Features of insulin resistance | 89 | ||
| Prevention of diabetes after gdm | 89 | ||
| Recommendations for postpartum care | 91 | ||
| Algorithm to detect diabetes after gdm | 93 | ||
| Conclusion | 93 | ||
| Case study i | 100 | ||
| History | 100 | ||
| Evaluation | 100 | ||
| Follow-up and Management | 101 | ||
| Discussion | 101 | ||
| Case study ii | 102 | ||
| History | 102 | ||
| Evaluation | 102 | ||
| Physical examination | 102 | ||
| Investigations | 102 | ||
| Follow-Up and Management | 102 | ||
| Discussion | 103 | ||
| Summary | 105 | ||
| Diagnosis of Diabetes in Pregnancy: Controversies And Consensus | 105 | ||
| Prevention and Management of Diabetes in Pregnancy | 106 | ||
| Gestational Diabetes Mellitus: A Forerunner of Future Diabetes | 108 | ||
| ECAB Update Series:\rDiabetology\rForthcoming Books\r | 109 |