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Gestational Diabetes Management

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61. Diagnosis a posteriori? Assessing gestational diabetes screening and management in Morocco (PubMed)

Diagnosis a posteriori? Assessing gestational diabetes screening and management in Morocco In Morocco, gestational diabetes affects 1 in 10 pregnant women, but knowledge about screening and management practices outside university settings is limited.To provide a comprehensive picture about the current situation of screening and management of gestational diabetes at different levels of care and to highlight existing challenges.We conducted a descriptive mixed methods study in the districts of Al (...) for the management of non-pregnant diabetic patients.Decentralization of screening for gestational diabetes and initial management of uncomplicated cases at the primary level of care could ease access to care and reduce the number of mothers who are diagnosed after a complication occurred.

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2016 Global health action

62. Postpartum glucose follow-up and lifestyle management after gestational diabetes mellitus: general practitioner and patient perspectives (PubMed)

Postpartum glucose follow-up and lifestyle management after gestational diabetes mellitus: general practitioner and patient perspectives Incidence of type 2 diabetes is high after gestational diabetes mellitus (GDM). We aimed to evaluate the adherence to follow-up six-weeks postpartum visits in secondary care after GDM and glucose monitoring in primary care longer than 12-14 months after delivery and the years thereafter. In addition, we examined the women's lifestyle after delivery.A cross (...) postpartum visit at the diabetes outpatient clinic and in 145 (93%) of these women glucose testing was performed. In total 77 (39%) women responded to the invitation to participate in this study and filled in the lifestyle questionnaire. About one third of the women met the recommendations for sufficient physical activity. A majority of them did not fulfil the Dutch guidelines on healthy diet - fruit intake 35.1%, vegetables intake 7.8%. Of the 74 invited GP's, 61 responded (82%), only 12 (20%) reported

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2016 Journal of diabetes and metabolic disorders

63. Could Metformin Manage Gestational Diabetes Mellitus instead of Insulin? (PubMed)

Could Metformin Manage Gestational Diabetes Mellitus instead of Insulin? Gestational diabetes mellitus (GDM) complicates a significant number of pregnancies. Blood glucose control improves perinatal outcomes. Medical nutrition therapy is the foundation in management. Aim of This Study. To evaluate efficacy of metformin in comparison to insulin for managing GDM. Methods. In prospective randomized comparative study, 150 antenatal women whose pregnancies had been complicated by GDM and did

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2016 International journal of reproductive medicine Controlled trial quality: uncertain

64. Effectiveness of cognitive-behavioral stress management on psychological stress and glycemic control in gestational diabetes: a randomized controlled trial. (PubMed)

Effectiveness of cognitive-behavioral stress management on psychological stress and glycemic control in gestational diabetes: a randomized controlled trial. This study was conducted to determine the effect of cognitive-behavioral stress management (CBT) on reducing psychological stress in diabetic pregnant women.This randomized controlled trial applied through pretest and post-test with control group was conducted on 88 eligible women with gestational diabetes. Women who had a stress score more (...) , the stress scores were significantly different before and after the intervention and women had a significant increase in the stress scores (p = 0.028). There was a significant difference between two groups in stress scores, two weeks after intervention (p = 0.001).Cognitive-behavioral stress management reduces stress in women with gestational diabetes and reducing stress may also improve the pregnancy outcomes, especially whose glycemic along with stress is not adequately controlled by medication.

2016 The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians Controlled trial quality: uncertain

65. Trial protocol to compare the efficacy of a smartphone-based blood glucose management system with standard clinic care in the gestational diabetic population. (PubMed)

Trial protocol to compare the efficacy of a smartphone-based blood glucose management system with standard clinic care in the gestational diabetic population. The prevalence of gestational diabetes mellitus (GDM) is rising in the UK. Good glycaemic control improves maternal and neonatal outcomes. Frequent clinical review of patients with GDM by healthcare professionals is required owing to the rapidly changing physiology of pregnancy and its unpredictable course. Novel technologies that allow (...) and neonatal outcomes compared to standard clinic care in a single large publicly funded (National Health Service (NHS)) maternity unit.Women with confirmed gestational diabetes in a current pregnancy are individually randomised to either the GDm-health system and half the normal clinic visits or normal clinic care. Primary outcome is mean BG in each group from recruitment to delivery calculated, with adjustments made for number of BG measurements, proportion of preprandial and postprandial readings

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2016 BMJ open Controlled trial quality: uncertain

66. Immediate delivery or expectant management in gestational diabetes at term: the GINEXMAL randomised controlled trial. (PubMed)

Immediate delivery or expectant management in gestational diabetes at term: the GINEXMAL randomised controlled trial. To evaluate maternal and perinatal outcomes after induction of labour versus expectant management in pregnant women with gestational diabetes at term.Multicentre open-label randomised controlled trial.Eight teaching hospitals in Italy, Slovenia, and Israel.Singleton pregnancy, diagnosed with gestational diabetes by the International Association of Diabetes and Pregnancy Study (...) diabetes, without other maternal or fetal conditions, no difference was detected in birth outcomes regardless of the approach used (i.e. active versus expectant management). Although the study was underpowered, the magnitude of the between-group difference was very small and without clinical relevance.Immediate delivery or expectant management in gestational diabetes at term?© 2016 Royal College of Obstetricians and Gynaecologists.

2016 BJOG Controlled trial quality: predicted high

67. Reducing risk of type 2 diabetes after gestational diabetes: a qualitative study to explore the potential of technology in primary care. (PubMed)

Reducing risk of type 2 diabetes after gestational diabetes: a qualitative study to explore the potential of technology in primary care. Despite the seven-fold increased risk of type 2 diabetes mellitus (T2DM) among females previously diagnosed with gestational diabetes (GD), annual rates of follow-up in primary care are low. There is a need to consider how to reduce the incidence of progression to T2DM among this high-risk group.To examine the views of females diagnosed with GD to ascertain (...) by providing information, enabling flexible and personalised self-management, and facilitating social support.A more tailored approach for females previously diagnosed with GD may help reduce the risk of progression to T2DM. A need for future research to test the efficacy of using technology as an adjunct to current care was identified.© British Journal of General Practice 2018.

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2018 British Journal of General Practice

68. Research Gaps in Gestational Diabetes Mellitus: Executive Summary of a National Institute of Diabetes and Digestive and Kidney Diseases Workshop. (PubMed)

Research Gaps in Gestational Diabetes Mellitus: Executive Summary of a National Institute of Diabetes and Digestive and Kidney Diseases Workshop. The National Institute of Diabetes and Digestive and Kidney Diseases convened a workshop on research gaps in gestational diabetes mellitus (GDM) with a focus on 1) early pregnancy diagnosis and treatment and 2) pharmacologic treatment strategies. This article summarizes the proceedings of the workshop. In early pregnancy, the appropriate diagnostic (...) criteria for the diagnosis of GDM remain poorly defined, and an effect of early diagnosis and treatment on the risk of adverse outcomes has not been demonstrated. Despite many small randomized controlled trials of glucose-lowering medication treatment in GDM, our understanding of medication management of GDM is incomplete as evidenced by discrepancies among professional society treatment guidelines. The comparative effectiveness of insulin, metformin, and glyburide remains uncertain, particularly

2018 Obstetrics and Gynecology

69. Gestational Diabetes Mellitus Screening & Diagnosis 2011

Gestational Diabetes Mellitus Screening & Diagnosis 2011 April 2014 Please be informed that the PSBC guideline you are looking for; Obstetric Guideline Gestational Diabetes Mellitus Screening and Diagnosis is under revision but still available by request. An updated clinical practice guideline is available through the: Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada – see Chapter 36 for Diabetes and Pregnancy at http (...) ://guidelines.diabetes.ca/Browse/Chapter36 The PSBC guideline for Diabetes Mellitus and Pregnancy Type 1 & 2 is also being revised. West Tower, 350-555 West 12th Avenue Vancouver, BC V5Z 3X7 Main Line: 604.877.2121 Fax: 604.872.1987 www.perinatalservicesbc.ca

2014 British Columbia Perinatal Health Program

70. Diabetes in Pregnancy and Gestational Diabetes Mellitus (GDM); Antidepressants in Pregnancy and Lactation

Diabetes in Pregnancy and Gestational Diabetes Mellitus (GDM); Antidepressants in Pregnancy and Lactation RxFiles Q&A Summary www.RxFiles.ca - April 2012 Lynette Kosar BSP, MSc Are Antidepressants Safe during Pregnancy & Breastfeeding? Up to ~25% of pregnant women will suffer from depression while pregnant. 1 The decision on how to treat depression and/or anxiety during & after pregnancy requires careful consideration of benefits and harms & collaborative discussions with the patient. SHOULD (...) and/or use other substances), and are less likely to take prenatal vitamins. ? There is a higher risk of spontaneous abortions, miscarriages, gestational hypertension, preeclampsia, preterm deliveries, low birth weight, small for gestational age, cesarean section, low Apgar scores, need for neonatal intensive care & ? length of hospital stay. - Some antidepressant studies have found these same risks, but most were unable to control for underlying depression. 1 ? Postpartum depression can impact

2012 RxFiles

71. Implementing a best-practice model of gestational diabetes mellitus care in dietetics: a qualitative study. (PubMed)

Implementing a best-practice model of gestational diabetes mellitus care in dietetics: a qualitative study. Translating research into clinical practice is challenging for health services. Emerging approaches in implementation science recognise the need for a theory-driven approach to identify and overcome barriers to guideline adherence. However, many clinicians do not have the capacity, confidence, or expertise to realise change in their local settings. Recently, two regional sites (...) participated in a facilitated implementation project of an evidence-based model of gestational diabetes mellitus (GDM) care in dietetics, supported by a team at a metropolitan centre. This study describes (i) stakeholder experiences', and (ii) learnings to inform implementation of the model of care (MOC) across Queensland.This qualitative descriptive study utilised semi-structured telephone interviews with staff involved in implementation of the MOC project at two regional sites. Eight participants were

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2019 BMC health services research

72. Higher rates of large-for-gestational-age newborns mediated by excess maternal weight gain in pregnancies with Type 1 diabetes and use of continuous subcutaneous insulin infusion vs multiple dose insulin injection. (PubMed)

Higher rates of large-for-gestational-age newborns mediated by excess maternal weight gain in pregnancies with Type 1 diabetes and use of continuous subcutaneous insulin infusion vs multiple dose insulin injection. To compare glycaemic control, maternal and neonatal outcomes in pregnancies with Type 1 diabetes, managed either by continuous subcutaneous insulin infusion, multiple daily insulin injection or switch from multiple daily insulin injection (MDI) to continuous subcutaneous insulin (...) infusion (CSII) in early pregnancy.Data from 339 singleton pregnancies were retrospectively reviewed. HbA1c values were measured preconception and in each trimester. In a secondary analysis, use of CSII pre-pregnancy was compared with initiation of CSII during pregnancy.MDI was used in 140 pregnancies (41.3%) and CSII was used in 199 (58.7%), including 34 pregnancies (10.0%) during which the women switched to CSII. In pregnancies during which CSII was used duration of diabetes [median (interquartile

2019 Diabetic Medicine

73. Pregnancy outcomes of early detected gestational diabetes: a retrospective comparison cohort study, Qatar. (PubMed)

Pregnancy outcomes of early detected gestational diabetes: a retrospective comparison cohort study, Qatar. To compare pregnancy outcomes in patients with early versus usual gestational diabetes mellitus (GDM).A retrospective cohort study.The Women's Hospital, Hamad Medical Corporation, Qatar.GDM women who attended and delivered in the Women's Hospital, between January and December 2016. GDM was diagnosed based on the 2013-WHO criteria. The study included 801 patients; of which, 273 E-GDM (...) and 528 U-GDM. Early GDM (E-GDM) and usual GDM (U-GDM) were defined as GDM detected before and after 24 weeks' gestation, respectively.Maternal and neonatal outcomes and the impact of timing of GDM-diagnosis on pregnancy outcomes.At conception, E-GDM women were older (mean age 33.5±5.4 vs 32.0±5.4 years, p<0.001) and had higher body mass index (33.0±6.3 vs 31.7±6.1 kg/m2, p=0.0059) compared with U-GDM. The mean fasting, and 1-hour blood glucose levels were significantly higher in E-GDM vs U-GDM

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2019 BMJ open

74. The Effectiveness of Regular Exercise Programs in the Prevention of Gestational Diabetes Mellitus-A Systematic Review. (PubMed)

The Effectiveness of Regular Exercise Programs in the Prevention of Gestational Diabetes Mellitus-A Systematic Review. Physical activity is recognized as one of the most important tools in the management of gestational diabetes mellitus (GDM).The aim of this review was to compare and analyze regular prenatal exercise programs and examine their effectiveness in the prevention of GDM.The following databases were used: Academic Search Complete, Health Source-Consumer Edition, Health Source-Nursing

2019 Obstetrical & Gynecological Survey

75. Prevalence of gestational diabetes according to commonly used data sources: an observational study. (PubMed)

Prevalence of gestational diabetes according to commonly used data sources: an observational study. It is well recognized that prevalence of gestational diabetes mellitus (GDM) varies depending on the population studied and the diagnostic criteria used. The data source used also can lead to substantial differences in the reporting of GDM prevalence but is considered less frequently. Accurate estimation of GDM prevalence is important for service planning and evaluation, policy development (...) on diabetes status were collected from regional health boards and the Ministry of Health's National Minimum Dataset, plasma glucose results were collected from laboratories servicing the recruitment catchment area and coded according to the New Zealand Society for the Study of Diabetes diagnostic criteria, and self-reported diabetes status collected via interview administered questionnaires. Agreement between data sources was calculated using the proportion of agreement with 95% confidence intervals

2019 BMC Pregnancy and Childbirth

76. Management of Type 2 Diabetes Mellitus

Management of Type 2 Diabetes Mellitus Quality Department Guidelines for Clinical Care Ambulatory Diabetes Mellitus Guideline Team Team Leaders Connie J Standiford, MD General Internal Medicine Sandeep Vijan, MD General Internal Medicine Team Members Hae Mi Choe, PharmD College of Pharmacy R Van Harrison, PhD Medical Education Caroline R Richardson, MD Family Medicine Jennifer A Wyckoff, MD Metabolism, Endocrinology & Diabetes Consultants Martha M Funnell, MS, RN, CDE Diabetes Research (...) proper methods of care or excluding other acceptable methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding any specific clinical procedure or treatment must be made by the physician in light of the circumstances presented by the patient. Management of Type 2 Diabetes Mellitus Patient population. Adults Objectives. To reduce morbidity and mortality by improving adherence to important recommendations for preventing, detecting, and managing diabetic

2017 University of Michigan Health System

77. Management of Diabetes Mellitus in Primary Care

. The insulin resistance resulting in T2DM is thought to be due to excess adiposity, especially central distribution of adiposity, but can be due to other factors, such as corticosteroid treatment or Cushing’s syndrome. Gestational diabetes (GDM) is DM present during pregnancy. Other more unusual types of DM also exist, such as maturity onset diabetes of the young (MODY), latent VA/DoD Clinical Practice Guideline for the Management of Type 2 Diabetes Mellitus in Primary Care April 2017 Page 6 of 160 (...) Management of Diabetes Mellitus in Primary Care VA/DoD CLINICAL PRACTICE GUIDELINE FOR THE MANAGEMENT OF TYPE 2 DIABETES MELLITUS IN PRIMARY CARE Department of Veterans Affairs Department of Defense QUALIFYING STATEMENTS The Department of Veterans Affairs and the Department of Defense guidelines are based upon the best information available at the time of publication. They are designed to provide information and assist decision-making. They are not intended to define a standard of care

2017 VA/DoD Clinical Practice Guidelines

78. Development of a model to assess the cost-effectiveness of gestational diabetes mellitus screening and lifestyle change for the prevention of type 2 diabetes mellitus

mellitus Lohse N, Marseille E, Kahn JG Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary The study examined the cost-effectiveness of gestational diabetes mellitus screening and management using a mathematical model (GDModel). The authors (...) concluded that a universal screening programme to identify gestational diabetes mellitus was highly cost-effective in both India and Israel. The study was based on a validated model and appropriate methodology, although some clinical sources were not fully described. The authors’ conclusions appear robust. Type of economic evaluation Cost-utility analysis Study objective The study examined the cost-effectiveness of gestational diabetes mellitus (GDM) screening and postpartum lifestyle management using

2011 NHS Economic Evaluation Database.

79. Metformin versus Insulin in the Management of Pre-Gestational Diabetes Mellitus in Pregnancy and Gestational Diabetes Mellitus at the Korle Bu Teaching Hospital: A Randomized Clinical Trial. (PubMed)

Metformin versus Insulin in the Management of Pre-Gestational Diabetes Mellitus in Pregnancy and Gestational Diabetes Mellitus at the Korle Bu Teaching Hospital: A Randomized Clinical Trial. To determine if metformin monotherapy or metformin in combination with insulin is equally effective as insulin monotherapy at glycemic control in diabetes mellitus in pregnancy among Ghanaians.This was a study involving 104 pregnant women with type 2 diabetes mellitus (T2DM) or gestational diabetes mellitus (...) weeks.The two hour post prandial blood glucose (2HPG) levels were significantly lower in the metformin group than the insulin group (p= 0.004).The findings of this study suggest that metformin monotherapy is effective in achieving glycemic targets in the management of diabetes in pregnancy. It is more effective than insulin in lowering the 2HPG level.Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12614000942651.

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2015 PloS one Controlled trial quality: uncertain

80. Diabetes in pregnancy: management from preconception to the postnatal period

guideline replaces CG63. This guideline is the basis of QS109. Ov Overview erview This guideline covers managing diabetes and its complications in women who are planning pregnancy or are already pregnant. It aims to improve the diagnosis of gestational diabetes and help women with diabetes to self-manage their blood glucose levels before and during pregnancy. In August 2015, changes were made to recommendations 1.1.17, 1.1.29, 1.1.34 and 1.3.28 for consistency with other NICE guidelines. Who (...) is it for? Healthcare professionals Commissioners and providers Women with diabetes who are planning a pregnancy or are pregnant and women at risk of, or diagnosed with, gestational diabetes Diabetes in pregnancy: management from preconception to the postnatal period (NG3) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 5 of 55Introduction Introduction This guideline updates and replaces 'Diabetes in pregnancy' (NICE guideline CG63

2015 National Institute for Health and Clinical Excellence - Clinical Guidelines

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