Literature Reviews

doi: 10.25005/2074-0581-2018-20-4-455-461
GESTATIONAL DIABETES MELLITUS: A MODERN VIEW ON THE ACTUAL PROBLEM

M.F. Dodkhoeva, D.A. Pirmatova

Department of Obstetrics and Gynecology № 1, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

A review of world literature has shown that gestational diabetes mellitus (GDM) is the most frequently encountered extra genital pathology of gestation and represents a serious medical and social problem, increasing the incidence of unwanted pregnancy outcomes for both the mother and the fetus. Significant variability of opinions on the frequency of GDM, its etiology and pathogenesis, screening methods and diagnostics of impaired carbon-water metabolism revealed during the pregnancy. Considering the diverse scientific data, constantly changing bio ecological environmental conditions that drastically affect the development of pregnancy, it is necessary to note the need for early detection of GDM in order, to adequately correct glycaemia to prevent an adverse course of pregnancy and childbirth. The lack of universal diagnostic criteria, on the one hand, and the clinical course of GDM without obvious manifestations, on the other hand, subsequently increase the risk of diabetes, obesity, carbohydrate metabolism disorders and cardiovascular complications in both mother and child. Consequently, this pathology requires the development of uniform standards for the diagnosis and treatment of disorders of carbohydrate metabolism during the pregnancy.

Keywords: Gestational diabetes mellitus, pregnancy, prevalence, complications, diabetic fetopathy, diagnostic criteria.

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References
  1. Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Research and Clinical Practice. 2014;103:137-49. Available from http://dx.doi.org/10.1016/j.diabres.2013.11.002.
  2. International Diabetes Federation. IDF Diabetes Atlas, 8th ed. Brussels, Belgium: International Diabetes Federation; 2017.
  3. Dedov II, Shestakova MV, Mayorov AYu. Algoritmy spetsializirovannoy meditsinskoy pomoshchi bol’nym sakharnym diabetom [Standards of specialized diabetes care]. Moscow, RF: Meditsina; 2017. 112 p.
  4. American Diabetes Association. Position statement: diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33:62-9. Available from http://dx.doi.org/10.2337/dc10-S062.
  5. Hadden DR, Hillebrand B. The first recorded case of diabetic pregnancy (Bennewitz HG, 1824, University of Berlin). Diabetologia. 1989;32(8):625.
  6. Burumkulova FF, Petrukhin VA. Gestatsionnyy sakharnyy diabet: vchera, segodnya, zavtra [Gestational diabetes mellitus: yesterday, today, and tomorrow]. Terapevticheskiy arkhiv. 2014;10:109-15.
  7. O’Sullivan JB, Mahan CM. Criteria for the oral glucose tolerance test in pregnancy. Diabetes. 1964;285:278.
  8. Sacks DA, Metzger BE. Classification of diabetes in pregnancy. Obstetrics & Gynecology. 2013;121(2):345-8. Available from http://dx.doi.org/ http://10.1097/AOG.0b013e31827f09b5.
  9. Medved VI, Bychkova EA. Opredelenie, klassifikatsiya i diagnosticheskie kriterii gestatsionnogo diabeta: evolyutsiya i sovremennoe sostoyanie [Definition, classification and diagnostic criteria of gestational diabetes: evolution and modern condition]. Liki Ukrainy. 2008;6:36-42.
  10. Kharroubi AT, Darwish HM. Diabetes mellitus: The epidemic of the century. World J Diabetes. 2015;6(6):850-67.
  11. International Diabetes Federation. IDF Diabetes Atlas, 7th ed. Brussels, Belgium: International Diabetes Federation, 2016.
  12. Petrukhin VA, Burumkulova FF, Titova TV, Golovchenko MA, Kotov YuB. Rasprostranyonnost’ gestatsionnogo sakharnogo diabeta v Moskovskoy oblasti: rezul’taty skrininga [Prevalence of gestational diabetes mellitus in Moscow region: results of screening]. Rossiyskiy vestnik akushera ginekologa. 2012;4:81-4.
  13. Mirghani Dirar A, Doupis J. Gestational diabetes from A to Z. World J Diabetes. 2017;8(12):489-506. Available from http://dx.doi.org/10.4239/ wjd.v8.i12.489.
  14. Bener A, Saleh NM, Al-Hamaq A. Prevalence of gestational diabetes and associated maternal and neonatal complications in a fast-developing community: global comparisons. Int J Womens Health. 2011;3:367-373. Available from http://dx.doi.org/10.2147/IJWH. S26094
  15. Nguyen CL, Pham NM, Colin WB, Duong DV, Lee AH. Prevalence of Gestational diabetes mellitus in Eastern and Southeastern Asia: A systematic review and meta-Analysis. Diabetes Research. 2018:1-10. Available from http://dx.doi. org/10.1155/2018/6536974.
  16. Vedmed AA, Shaposhnikova EV. Osobennosti techeniya beremennosti, rodov i sostoyaniya novorozhdyonnykh u patsientok s gestatsionnym sakharnym diabetom [Peculiarities of pregnancy, delivery and newborn condition in patients with gestational diabetes mellitus]. Vestnik RUDN. 2009;7:348-51.
  17. Krasnopolskiy VI, Petrukhin VA, Burumkulova FF. Gestatsionniy sakharnyy diabet – novyy vzglyad na staruyu problemu [Gestational diabetes mellitus – new view to the old problem]. Akusherstvo i ginekologiya. 2010;2:3-6.
  18. Petrukhin VA, Burumkulova FF. Gestatsionnyy diabet [Gestational diabetes mellitus]. Arkhiv akusherstva i ginekologii im. V.F. Snegiryova. 2014;1:48-51.
  19. Parhofer KG, Hasbargen U, Ulugberdiyewa A, Abdullayewa M, Melebayewa B, Annamuhammedov A, et al. Gestational diabetes in Turkmenistan: implementation of a screening program and first results. Arch Gynecol Obstet. 2014;289:293-8. Available from http://dx.doi.org/10.1007/s00404- 013-2961-2.
  20. Xu T, He Y, Dainelli L, Yu K, Detzel P, Silva-Zollezzi I, et al. Healthcare interventions for the prevention and control of gestational diabetes mellitus in China: a scoping review. BMC Pregnancy and Childbirth. 2017; 17:171. Available from http://dx.doi.org/10.1186/s12884-017-1353-1.
  21. Morampudi S, Balasubramanian G, Gowda A, Zomorodi B, Patil AS. The challenges and recommendations for GDM care in India: a review. Frontiers in Endocrinology. 2017;8(56):1-10. Available from http://dx.doi.org/10.3389/ fendo.2017.00056.
  22. Nazarova SI. Akusherskie i perinatal’nye iskhody pri gestatsionnom sakharnom diabete [Obstetrical and perinatal outcomes at gestational diabetes mellitus]. Vestnik Avitsenny [Avicenna Bulletin]. 2012;1:72-8.
  23. Kuo CH, Chen SC, Fang CT, Nien FJ, Wu ET, Lin SY, et al. Screening gestational diabetes mellitus: The role of maternal age. PLoS ONE. 2017;12:3. Available from http://dx.doi.org/10.1371/journal.pone.0173049.
  24. Burumkulova FF. Gestatsionnyy sakharnyy diabet (Endokrinologicheskie, akusherskie i perinatal’nye aspekty) [Gestational diabetes mellitus (Endocrinal, obstetrical and perinatal aspects)]. Mezhdunarodnyy endokrinologicheskiy zhurnal. 2011;3:78-90.
  25. Nekrasova KR, Van AV, Galkina AS, Dzhobova EM, Dobrokhotova YuE. Gestatsionnyy sakharnyy diabet – bolezn’ populyatsii. Medikamentoznaya terapiya ugrozy prerivaniya beremennosti i uglevodnyy obmen [Gestational diabetes mellitus – diseases of population. Medical therapy of threatening miscarriage and carbohydrate exchange]. Akusherstvo, ginekologiya, reproduktsiya. 2013;7(1):31-5.
  26. Nikonova LV, Tishkovkiy SV, Gadomskaya VI, Davydchik EV, Gulinskaya OV. Sakharnyy diabet i beremennost’. Chast’ I. Vliyanie narusheniy uglevodnogo obmena na formirovanie platsenty i ploda. Planirovanie beremennosti pri sakharnom diabete [Diabetes mellitus and pregnancy. Chapter I. Influence of carbohydrate metabolism to formation of placenta and fetus. Planning of pregnancy in diabetes mellitus]. GGMU. 2017;15(3):255-6
  27. Angueira AR, Ludvik AE, Reddy TE. New insights into gestational glucose metabolism: lessons learned from 21st century approaches. Diabetes. 2015;64(2):327-34. Available from http://dx.doi.org/10.2337/db14-0877.
  28. Wu L, Cui L, Tam WH. Genetic variants associated with gestational diabetes mellitus: a meta-analysis and subgroup analysis. Sci Rep. 2016;6:30539. Available from http://dx.doi.org/10.1038/srep30539.
  29. Kwak SH, Jang HC, Park KS. Finding genetic risk factors of gestational diabetes. Genomics Inform. 2012;10(4):239-43. Available from http://dx.doi. org/10.5808/GI.2012.10.4.239.
  30. Zhang C, Bao W, Rong Y, Yang H, Bowers K, Yeung E, et al. Genetic variants and the risk of gestational diabetes mellitus: a systematic review. Hum Reprod Update. 2013;19:376-90. Available from http://dx.doi.org/10.1093/ humupd/dmt013.
  31. Kuraeva TL, Zilberman LI, Titovich EV, Peterkova VA. Genetika monogennykh form sakharnogo diabeta [Genetics of monegenic forms of diabetes mellitus]. Sakharnyy diabet. 2011;14(1):20-7. Available from http://dx.doi. org/10.14341/2072-0351-6246.
  32. Murphy R. Monogenic diabetes and pregnancy. Obstet Med. 2015;8(3):114- 20. Available from http://dx.doi.org/10.1177/1753495X15590713.
  33. Colom C, Corcoy R. Maturity onset diabetes of the young and pregnancy. Best Pract Res Clin Endocrinol Metab. 2010;24(4):605-15. Available from http:// dx.doi.org/10.1016/j.beem.2010.05.008.
  34. Bingley PJ. Clinical applications of diabetes antibody testing. J Clin Endocrinol Metab. 2010;95(1):25-33. Available from http://dx.doi.org/10.1210/ jc.2009-1365.
  35. Law KP, Zhang H. The pathogenesis and pathophysiology of gestational diabetes mellitus: Deductions from three-part longitudinal metabolomics study in China. Clinica Chimica Acta. 2017;468:60-70. Available from http:// dx.doi.org/10.1016/j.cca.2017.02.008.
  36. Ordynskiy VF, Makarov OV. Sakharnyy diabet i beremennost’. Perinatal‘naya ul’trazvukovaya diagnostika [Diabetes mellitus and pregnancy. Perinatal ultrasound diagnostic]. Moscow, RF: Vidar-M; 2010. 212 p.
  37. Arzhanova ON, Kvetnoy IM, Polyakova VO, Kapustin RV, Rulyova AV. Akusherskie i patomorfologicheskie osobennosti techeniya beremennosti u zhenshchin s gestatsionnym sakharnym diabetom [Obstetrical and pathomorfological courses of pregnancy in women with gestational diabetes]. Akusherstvo i zhenskie bolezni. 2011;3:44-8.
  38. Kostenko IV, Rogozhina IE, Sukhankina GV, Ryzhina SA. Struktura razvitiya faktorov riska, rasrostranyonnost’, diagnostika i metody lecheniya gestatsionnogo sakharnogo diabeta (obzor) [The developmental structure of risk factors, prevalence, diagnosis and methods of therapy gestational diabetes mellitus (review)]. Saratovskiy nauchno-meditsinskiy zhurnal. 2011;7(2):534-41.
  39. Burumkulova FF. Petrukhin VA. Gestatsionnyy sakharnyy diabet [Gestational diabetes mellitus]. Endokrinologiya. 2013;7:22-8.
  40. Reece EA. The fetal and maternal consequences of gestational diabetes mellitus. Maternal-Fetal & Neonatal Medicine. 2010;23(3):199203. Available from http://dx.doi.org/10.3109/14767050903550659.
  41. Bondar IA, Malysheva AS. Oslozhneniya i iskhody beremennosti pri sakharnom diabete [Complications and outcomes in gestational diabetes mellitus]. Byulleten’ sibirskoy meditsiny. 2014;13(2):5-9.
  42. Esakoff TF, Cheng YW, Sparks TN, Caughey AB. The association between birthweight 4000 g or greater and perinatal outcomes in patients with and without gestational diabetes mellitus. Am J Obstet Gynecol. 2009;200(6):672. e1-4.
  43. Zarifova PG, Kamilova MYa, Aminov KhD. Gestatsionnyy diabet i sostoyanie zdorov’ya novorozhdyonnykh [Gestational diabetes and health condition of newborn]. Vestnik Avitsenny [Avicenna Bulletin]. 2008;1:97-100.
  44. Carpenter MW, Coustan DR. Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol. 1982;144:768-73. Available from http:// dx.doi.org/10.1016/0002-9378(82)90349-0.
  45. International Association of Diabetes and Pregnancy Study Groups Consensus Panel, Metzger BE, Gabbe SG, Dyer AR, Leiva AD, Hod M, Kitzmiler JL, Lowe LP, McIntyre HD, Oats JJ, Omori Y, Schmidt MI. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010; 33:676-82. Available from http://dx.doi.org/10.2337/dc10-0719.
  46. International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. International Association of Diabetes and Pregnancy Study Groups Consensus Panel, B.E. Metzger, S.G. Gabbe, B. Persson, T.A. Buchanan, et al. Diabetes Care. 2010;33(3):676-82.
  47. HAPO Study Cooperative Research Group, Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, Coustan DR, Hadden DR, McCance DR, Hod M, McIntyre HD, Oats JJ, Persson B, Rogers MS, Sacks DA. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008;358: 1991-2002. Available from http://dx.doi.org/10.1056/NEJMoa0707943
  48. Dedov II, Krasnopolskiy VI, Sukhikh GT. Rossiiskiy natsional’nyy konsensus «Gestatsionnyy sakharnyy diabet: diagnostika, lechenie, poslerodovoe nablyudenie» [Russian national consensus «Gestational diabetes mellitus: diagnosis, treatment, postpartum observation»]. Sakharnyy diabet. 2012;4:4-10.
  49. Agarwal MM. Gestational diabetes mellitus: an update on the current international diagnostic criteria. World Journal of Diabetes. 2015;6(6):782-91.
  50. Mack LR, Tomich PG. Gestational diabetes: diagnosis, classification, and clinical care. Obstetrics and Gynecology Clinics of North America. 2017;44(2):207-17.
  51. World Health Organization. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy. WHO/NMH/CHP/CPM: 2013. 62 p.
  52. Use of glycated haemoglobin (HbA1c) in the diagnosis of diabetes mellitus. Abbreviated report of a WHO Consultation. WHO/NMH/CHP/CPM: 2011.

Authors informations:

Dodkhoeva Munavvara Fayzulloevna, Academician of the Academy of Medical Sciences of the Republic of Tajikistan, Doctor of Medical Sciences, Full Professor, Professor of the Department of Obstetrics and Gynecology № 1, Avicenna Tajik State Medical University

Pirmatova Dilnoza Alikhonovna, Postgraduate Student of the Department of Obstetrics and Gynecology № 1, Avicenna Tajik State Medical University

Address for correspondence:

Dodkhoeva Munavvara Fayzulloevna
Academician of the Academy of Medical Sciences of the Republic of Tajikistan, Doctor of Medicine, Full Professor, Professor of the Department of Obstetrics and Gynecology № 1, Avicenna Tajik State Medical University

734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139

Tel.: +992 (918) 612606

E-mail: dodkho2008@mail.ru