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Gestational Diabetes Management

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1. Fetal biometry for guiding the medical management of women with gestational diabetes mellitus for improving maternal and perinatal health. (Abstract)

Fetal biometry for guiding the medical management of women with gestational diabetes mellitus for improving maternal and perinatal health. Gestational diabetes mellitus (GDM) is a common medical condition that complicates pregnancy and causes adverse maternal and fetal outcomes. At present, most treatment strategies focus on normalisation of maternal blood glucose values with use of diet, lifestyle modification, exercise, oral anti-hyperglycaemics and insulin. This has been shown to reduce (...) the incidence of adverse outcomes, such as birth trauma and macrosomia. However, this involves intensive monitoring and treatment of all women with GDM. We propose that using medical imaging to identify pregnancies displaying signs of being affected by GDM could help to target management, allowing low-risk women to be spared excessive intervention, and facilitating better resource allocation.We wanted to address the following question: in women with gestational diabetes, does the use of fetal imaging plus

2019 Cochrane

2. Oral anti-diabetic agents for women with established diabetes/impaired glucose tolerance or previous gestational diabetes planning pregnancy, or pregnant women with pre-existing diabetes. Full Text available with Trip Pro

of oral anti-diabetic agents for the management of gestational diabetes in a current pregnancy is evaluated in a separate Cochrane Review.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 October 2016) and reference lists of retrieved studies.Randomised controlled trials (RCTs) and quasi-RCTs assessing the effects of oral anti-diabetic agents in women with established diabetes, impaired glucose tolerance or previous gestational diabetes who were planning a pregnancy (...) Oral anti-diabetic agents for women with established diabetes/impaired glucose tolerance or previous gestational diabetes planning pregnancy, or pregnant women with pre-existing diabetes. While most guidance recommends the use of insulin in women whose pregnancies are affected by pre-existing diabetes, oral anti-diabetic agents may be more acceptable to women. The effects of these oral anti-diabetic agents on maternal and infant health outcomes need to be established in pregnant women with pre

2017 Cochrane

3. Health app: GDm-Health for people with gestational diabetes

this information to prioritise users for review. Improved communication using the app could potentially reduce the workload for healthcare professionals and the number of outpatient appointments. This would depend on current local protocols for managing gestational diabetes. Blood glucose and other information are recorded electronically, which allows for efficient data auditing. Current care pathway The NICE guideline on diabetes in pregnancy recommends that people with gestational diabetes should have (...) . All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 8 of 14Adopting GDm-Health may need changes to local protocols for managing gestational diabetes. These could include introducing protocols for responding to users, remote monitoring, communication between users and other members of the healthcare team, training and data storage, and management and security. Implementing and managing GDm-Health may need additional staff

2017 National Institute for Health and Clinical Excellence - Advice

4. Planned birth at or near term for improving health outcomes for pregnant women with gestational diabetes and their infants. Full Text available with Trip Pro

of the included study. The quality of the evidence was assessed using the GRADE approach.The findings of this review are based on a single trial involving 425 women with gestational diabetes. The trial compared induction of labour with expectant management (waiting for the spontaneous onset of labour in the absence of any maternal or fetal issues that may necessitate birth) in pregnant women with gestational diabetes at term. We assessed the overall risk of bias as being low for most domains, apart from (...) Planned birth at or near term for improving health outcomes for pregnant women with gestational diabetes and their infants. Gestational diabetes is a type of diabetes that occurs during pregnancy. Women with gestational diabetes are more likely to experience adverse health outcomes such as pre-eclampsia or polyhydramnios (excess amniotic fluid). Their babies are also more likely to have health complications such as macrosomia (birthweight > 4000 g) and being large-for-gestational age

2018 Cochrane

5. Treatments for women with gestational diabetes mellitus: an overview of Cochrane systematic reviews. Full Text available with Trip Pro

(hypertensive disorders of pregnancy, pregnancy-induced hypertension, death or serious morbidity composite, insulin versus oral therapy (development of type 2 diabetes); intensive management versus routine care (IOL, large-for-gestational age); post- versus pre-prandial glucose monitoring (large-for-gestational age). The evidence ranged from moderate-, low- and very low-quality.Currently there is insufficient high-quality evidence about the effects on health outcomes of relevance for women with GDM (...) Treatments for women with gestational diabetes mellitus: an overview of Cochrane systematic reviews. Successful treatments for gestational diabetes mellitus (GDM) have the potential to improve health outcomes for women with GDM and their babies.To provide a comprehensive synthesis of evidence from Cochrane systematic reviews of the benefits and harms associated with interventions for treating GDM on women and their babies.We searched the Cochrane Database of Systematic Reviews (5 January 2018

2018 Cochrane

6. Integrated management of type 2 diabetes and gestational diabetes within multi-morbidity conditions in Africa: a systematic review protocol. Full Text available with Trip Pro

Integrated management of type 2 diabetes and gestational diabetes within multi-morbidity conditions in Africa: a systematic review protocol. Multi-morbidity, defined as the co-existence of more than one chronic condition in one person, has been increasing due to comorbid non-communicable and infectious chronic diseases (CNCICDs). Type 2 diabetes (T2D) and gestational diabetes mellitus (GDM) incidences within the CNCICDs conditions are increasing and overwhelming already weak and under-resourced (...) healthcare systems in Africa. There is then an urgent need for the integrated management of CNCICDs. We aim to review the integrated management of T2D and GDM within multi-morbidity conditions in Africa.Studies that have assessed the integrated management of T2D and GDM within multi-morbidity conditions in Africa will be considered based on the Population, Intervention, Comparator and Outcome method: population (adult diagnosed with T2D and GDM, who also have other diseases, non-communicable diseases

2019 BMJ open

7. Gestational diabetes

a comprehensive synthesis of evidence from Cochrane systematic reviews of the benefits and harms associated with interventions for treating GDM on women and their babies. METHODS: We searched the Cochrane Database (...) (hypoglycaemia); metformin versus glibenclamide (hypertensive disorders of pregnancy, pregnancy-induced hypertension, death or serious morbidity composite, insulin versus oral therapy (development of type 2 diabetes ); intensive management versus routine care (IOL, large-for- gestational age (...) to browse the site you (...) are agreeing to our use of cookies. Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here In women with gestational diabetes requiring drug treatment

2018 Trip Latest and Greatest

8. Gestational Diabetes

Alberico S, Erenbourg A, Hod M, et al; GINEXMAL Group. Immediate delivery or expectant management in gestational diabetes at term: the GINEXMAL randomised controlled trial. BJOG. 2017 Mar;124(4):669- 677. Boulvain M, Senat MV, Perrotin F, et al; Groupe de Recherche en Obstétrique et Gynécologie. Induction of labour versus expectant management for large-for-date fetuses: a randomized controlled trial. Lancet. 2015 Jun 27;385(9987):2600-2605. Garrison A. Screening, diagnosis, and management (...) Gestational Diabetes © 2002 Kaiser Foundation Health Plan of Washington. All rights reserved. 1 Gestational Diabetes Screening and Treatment Guideline Major Changes as of April 2018 2 Screening Recommendations and Tests 2 Diagnosis 3 Treatment Goals 3 Lifestyle modifications/non-pharmacologic options 3 Pharmacologic options 4 Additional Testing/Monitoring Antenatal monitoring 7 Follow-up after delivery 7 Referral 7 Evidence Summary 8 References 11 Guideline Development Process and Team 12 Last

2018 Kaiser Permanente Clinical Guidelines

9. Dietary supplementation for prevention and management of gestational diabetes: a meta-analysis of randomized controlled trials

Dietary supplementation for prevention and management of gestational diabetes: a meta-analysis of randomized controlled trials Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any

2019 PROSPERO

10. Detection and initial management of gestational diabetes through primary health care services in Morocco: An effectiveness-implementation trial. Full Text available with Trip Pro

Detection and initial management of gestational diabetes through primary health care services in Morocco: An effectiveness-implementation trial. Gestational Diabetes Mellitus (GDM) testing and management in Morocco is associated with delays resulting in late commencement of treatment. To reduce delays and to increase access of women to GDM care, a country-adapted intervention targeting primary health care providers was designed to test the hypothesis that detection and initial management of GDM (...) a delivery complication whereas more newborn complications were observed in women from intervention facilities. No difference between the two groups existed regarding mode of delivery and mean gestational age at delivery. One of the main limitations of the study was the Hawthorn-effect at control sites that might have led to an underestimation of the effect size.A high GDM prevalence in Morocco calls for a context-adapted screening and management approach to enable early interventions. GDM detection

2018 PLoS ONE Controlled trial quality: uncertain

11. Different types of dietary advice for women with gestational diabetes mellitus. Full Text available with Trip Pro

Different types of dietary advice for women with gestational diabetes mellitus. Dietary advice is the main strategy for managing gestational diabetes mellitus (GDM). It remains unclear what type of advice is best.To assess the effects of different types of dietary advice for women with GDM for improving health outcomes for women and babies.We searched Cochrane Pregnancy and Childbirth's Trials Register (8 March 2016), PSANZ's Trials Registry (22 March 2016) and reference lists of retrieved (...) studies.Randomised controlled trials comparing the effects of different types of dietary advice for women with GDM.Two authors independently assessed study eligibility, risk of bias, and extracted data. Evidence quality for two comparisons was assessed using GRADE, for primary outcomes for the mother: hypertensive disorders of pregnancy; caesarean section; type 2 diabetes mellitus; and child: large-for-gestational age; perinatal mortality; neonatal mortality or morbidity composite; neurosensory disability

2017 Cochrane

12. Flowchart: Intrapartum management for gestational diabetes mellitus requiring Insulin and/or Metformin

Flowchart: Intrapartum management for gestational diabetes mellitus requiring Insulin and/or Metformin Document Number: F15.33--2-V1-R20 Department of Health Queensland Clinical Guidelines State of Queensland (Queensland Health) 2015 http://creativecommons.org/licenses/by-nc-nd/3.0/au/deed.en Queensland Clinical Guidelines, Guidelines@health.qld.gov.au Intrapartum management for GDM requiring Insulin and/or Metformin Metformin • Cease when labour established Insulin • Cease when labour

2015 Queensland Health

13. Self-management Intervention Program Based on the Health Belief Model (HBM) among Women with Gestational Diabetes Mellitus: A Quazi-Experimental Study. (Abstract)

Self-management Intervention Program Based on the Health Belief Model (HBM) among Women with Gestational Diabetes Mellitus: A Quazi-Experimental Study. The Health Belief Model (HBM) as a conceptual framework in health behavior research was applied to improve self-management. This study aimed to determine the effect of theory-based intervention program among women with gestational diabetes mellitus (GDM).This quazi-experimental study was conducted on 110 women 17-41 years old which were divided (...) randomly into intervention (n = 55) and control (n = 55) groups. The intervention group received a self-management education for four sessions lasting 35-40 minutes accompanied with a phone call as a booster. Both intervention and control groups attended a routine GDM education program at outpatient health centers. A multi-section instrument included demographics, 28 items in HBM (CVI and CVR were 0.83, 0.87, respectively) and self-management sections. All participants were invited to complete

2019 Archives of Iranian medicine Controlled trial quality: uncertain

14. Intrapartum Glucose Management in Women With Gestational Diabetes Mellitus: A Randomized Controlled Trial. (Abstract)

Intrapartum Glucose Management in Women With Gestational Diabetes Mellitus: A Randomized Controlled Trial. To assess the effect of tight compared with liberalized intrapartum maternal glucose management on neonatal hypoglycemia risk in pregnancies complicated by gestational diabetes mellitus (GDM).This was a randomized controlled trial of women with singleton gestations and GDM attempting vaginal delivery. After written informed consent, women were randomly allocated to one of two intrapartum (...) maternal glucose management protocols: tight control (glucose measurements hourly and treatment for maternal glucose levels lower than 60 mg/dL or greater than 100 mg/dL) or liberalized control (glucose measurements every 4 hours and treatment for maternal glucose levels lower than 60 mg/dL or greater than 120 mg/dL). The primary outcome was the first neonatal blood glucose level; a total sample size of 74 was necessary to have 80% power to detect a mean difference of 10 mg/dL between groups. Secondary

2019 Obstetrics and Gynecology Controlled trial quality: predicted high

15. Current guidelines on the management of gestational diabetes mellitus: a content analysis and appraisal. Full Text available with Trip Pro

Current guidelines on the management of gestational diabetes mellitus: a content analysis and appraisal. Despite many guidelines for the management of gestational diabetes available internationally, little work has been done to summarize and assess the content of existing guidelines. A paucity of analysis guidelines within in a unified system may be one explanatory factor. So this study aims to analyze and evaluate the contents of all available guidelines for the management of gestational (...) of evidence, between selected evidence and interpretation, and between interpretation and resulting recommendations were analyzed.Fourteen documents were analyzed, and a total of 361 original recommendations for gestational diabetes mellitus (GDM) management were assessed. In all guidelines included, the recommendations were developed in five domains, namely, diagnosis of GDM, prenatal care, intrapartum care, neonatal care and postpartum care. Different guidelines appeared to have significant discrepancy

2019 BMC Pregnancy and Childbirth

16. Management of postprandial hyperglycaemia and weight gain in women with gestational diabetes mellitus using a novel telemonitoring system. Full Text available with Trip Pro

Management of postprandial hyperglycaemia and weight gain in women with gestational diabetes mellitus using a novel telemonitoring system. The purpose of this study was to investigate the effect of remotely delivered telemedicine dietary advice on monitoring of blood glucose levels and weight gain of women with gestational diabetes mellitus (GDM).Women with GDM were recruited and randomly allocated into two groups: a Tele-GDM group that received a telemonitoring device, and a control group

2019 The Journal of international medical research

17. Can Nurse-Based Management Screening Ensure Adequate Outcomes in Patients With Gestational Diabetes? A Comparison of 2 Organizational Models. (Abstract)

Can Nurse-Based Management Screening Ensure Adequate Outcomes in Patients With Gestational Diabetes? A Comparison of 2 Organizational Models. Gestational diabetes mellitus (GDM) is an impaired glucose tolerance with onset or first recognition during pregnancy. The purpose of this study is to evaluate the clinical outcomes of a blood glucose monitoring protocol implemented by nurses and dietitians in a diabetes team to the previously established protocol of direct monitoring of GDM patients (...) therapy (OR: 0.066 vs 0.34). In group P1 and group P2, a correlation was observed between insulin therapy and a family history of diabetes (OR: 2.20 vs 2.27), and a body mass index of greater than 30 kg/m in group P2 (OR: 3.0 vs 1.47).The data we collected show that creating a structured protocol for GDM management reduces the number of medical visits required by patients without increasing the risk of hypoglycemia, macrosomia, or hyperweight gain during pregnancy.

2019 Quality Management in Health Care

18. Assessment of the methodological quality of local clinical practice guidelines on the identification and management of gestational diabetes. Full Text available with Trip Pro

Assessment of the methodological quality of local clinical practice guidelines on the identification and management of gestational diabetes. Gestational diabetes is the most common metabolic disorder of pregnancy, and it is important that well-written clinical practice guidelines (CPGs) are used to optimise healthcare delivery and improve patient outcomes. The aim of the study was to assess the methodological quality of hospital-based CPGs on the identification and management of gestational (...) diabetes.We conducted an assessment of local clinical guidelines in English for gestational diabetes using the Appraisal of Guidelines for Research and Evaluation (AGREE II) to assess and validate methodological quality.We sought a representative selection of local CPGs accessible by the internet. Criteria for inclusion were (1) identified as a guideline, (2) written in English, (3) produced by or for the hospital in a Western country, (4) included diagnostic criteria and recommendations concerning

2019 BMJ open

19. SMFM Statement Pharmacological treatment of gestational diabetes Full Text available with Trip Pro

. and others x 4 Nankervis, A. and Conn, J. Gestational diabetes mellitus: negotiating the confusion. Aust Fam Physician . 2013 ; 42 : 528–531 | , x 5 Hod, M., Kapur, A., Sacks, D.A. 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 : S173–S211 | | support the use of oral hypoglycemic agents as first-line therapy. Despite U.S. providers’ decades (...) ., and Feng, L. Metformin vs insulin in the management of gestational diabetes: a meta-analysis. PloS One . 2013 ; 8 : e64585 | | | Maternal side effects of metformin are largely gastrointestinal and include transient anorexia, nausea, and loose stools, causing 2% of pregnant women to discontinue use in one study. x 13 Rowan, J.A., Hague, W.M., Gao, W., Battin, M.R., Moore, M.P., and MiG Trial Investigators. Metformin versus insulin for the treatment of gestational diabetes. N Engl J Med . 2008 ; 358

2018 Society for Maternal-Fetal Medicine

20. Associations of sedentary time and self-reported television time during pregnancy with incident gestational diabetes and plasma glucose levels in women at risk of gestational diabetes in the UK. Full Text available with Trip Pro

Associations of sedentary time and self-reported television time during pregnancy with incident gestational diabetes and plasma glucose levels in women at risk of gestational diabetes in the UK. Sedentary time is associated with increased risk of type 2 diabetes, but the association between objectively measured sedentary time and incident gestational diabetes mellitus (GDM) has not been tested. The purpose of this paper is to test associations between objectively measured sedentary time (...) and self-reported television time during pregnancy with incident GDM and plasma glucose levels among women at high risk for GDM.At 20 weeks' gestation, pregnant women (n = 188) in the North East of England with a risk factor for GDM wore an activPAL accelerometer and reported their usual television time. Participants underwent a standard oral glucose tolerance test at 24-28 weeks' gestation. Regression analyses were used to test for associations of total and prolonged sedentary time, breaks

2019 BMC Public Health

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