High Fasting Plasma Glucose during Early Pregnancy: A Review about Early Gestational Diabetes Mellitus
Fasting plasma glucose (FPG) is nowadays routinely measured during early pregnancy to detect preexisting diabetes (FPG ≥ 7 mmol/L). This screening has concomitantly led to identify early intermediate hyperglycemia, defined as FPG in the 5.1 to 6.9 mmol/L range, also early gestational diabetes mellit...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2017/8921712 |
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| author | E. Cosson L. Carbillon P. Valensi |
| author_facet | E. Cosson L. Carbillon P. Valensi |
| author_sort | E. Cosson |
| collection | DOAJ |
| description | Fasting plasma glucose (FPG) is nowadays routinely measured during early pregnancy to detect preexisting diabetes (FPG ≥ 7 mmol/L). This screening has concomitantly led to identify early intermediate hyperglycemia, defined as FPG in the 5.1 to 6.9 mmol/L range, also early gestational diabetes mellitus (eGDM). Early FPG has been associated with poor pregnancy outcomes, but the recommendation by the IADPSG to refer women with eGDM for immediate management is more pragmatic than evidence based. Although eGDM is characterized by insulin resistance and associated with classical risk factors for type 2 diabetes and incident diabetes after delivery, it is not necessarily associated with preexisting prediabetes. FPG ≥ 5.1 mmol/L in early pregnancy is actually poorly predictive of gestational diabetes mellitus diagnosed after 24 weeks of gestation. An alternative threshold should be determined but may vary according to ethnicity, gestational age, and body mass index. Finally, observational data suggest that early management of intermediate hyperglycemia may improve prognosis, through reduced gestational weight gain and potential early introduction of hypoglycemic agents. Considering all these issues, we suggest an algorithm for the management of eGDM based on early FPG levels that would be measured in case of risk factors. Nevertheless, interventional randomized trials are still missing. |
| format | Article |
| id | doaj-art-3fbf24110b514514acd31ad6d1732397 |
| institution | Kabale University |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-3fbf24110b514514acd31ad6d17323972025-02-03T06:11:25ZengWileyJournal of Diabetes Research2314-67452314-67532017-01-01201710.1155/2017/89217128921712High Fasting Plasma Glucose during Early Pregnancy: A Review about Early Gestational Diabetes MellitusE. Cosson0L. Carbillon1P. Valensi2Department of Endocrinology-Diabetology-Nutrition, AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bondy, FranceDepartment of Gynecology-Obstetrics, AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Bondy, FranceDepartment of Endocrinology-Diabetology-Nutrition, AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bondy, FranceFasting plasma glucose (FPG) is nowadays routinely measured during early pregnancy to detect preexisting diabetes (FPG ≥ 7 mmol/L). This screening has concomitantly led to identify early intermediate hyperglycemia, defined as FPG in the 5.1 to 6.9 mmol/L range, also early gestational diabetes mellitus (eGDM). Early FPG has been associated with poor pregnancy outcomes, but the recommendation by the IADPSG to refer women with eGDM for immediate management is more pragmatic than evidence based. Although eGDM is characterized by insulin resistance and associated with classical risk factors for type 2 diabetes and incident diabetes after delivery, it is not necessarily associated with preexisting prediabetes. FPG ≥ 5.1 mmol/L in early pregnancy is actually poorly predictive of gestational diabetes mellitus diagnosed after 24 weeks of gestation. An alternative threshold should be determined but may vary according to ethnicity, gestational age, and body mass index. Finally, observational data suggest that early management of intermediate hyperglycemia may improve prognosis, through reduced gestational weight gain and potential early introduction of hypoglycemic agents. Considering all these issues, we suggest an algorithm for the management of eGDM based on early FPG levels that would be measured in case of risk factors. Nevertheless, interventional randomized trials are still missing.http://dx.doi.org/10.1155/2017/8921712 |
| spellingShingle | E. Cosson L. Carbillon P. Valensi High Fasting Plasma Glucose during Early Pregnancy: A Review about Early Gestational Diabetes Mellitus Journal of Diabetes Research |
| title | High Fasting Plasma Glucose during Early Pregnancy: A Review about Early Gestational Diabetes Mellitus |
| title_full | High Fasting Plasma Glucose during Early Pregnancy: A Review about Early Gestational Diabetes Mellitus |
| title_fullStr | High Fasting Plasma Glucose during Early Pregnancy: A Review about Early Gestational Diabetes Mellitus |
| title_full_unstemmed | High Fasting Plasma Glucose during Early Pregnancy: A Review about Early Gestational Diabetes Mellitus |
| title_short | High Fasting Plasma Glucose during Early Pregnancy: A Review about Early Gestational Diabetes Mellitus |
| title_sort | high fasting plasma glucose during early pregnancy a review about early gestational diabetes mellitus |
| url | http://dx.doi.org/10.1155/2017/8921712 |
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