Abstract
Screening for gestational diabetes is commonly recommended despite the absence of a common definition of gestational diabetes. Furthermore, there is no consensus about management or treatment. Those who recommend screening do so largely on the basis of fetal morbidity, which seems to be predominantly "macrosomia"--another term without an agreed definition. The implications of macrosomia in terms of actual morbidity are also not clear. R J Jarrett reviews the history of the subject and concludes that gestational diabetes is simply impaired glucose tolerance temporally associated with pregnancy. Its main importance is as a predictor of subsequent non-insulin dependent diabetes, but it fails the major tests for a condition suitable for a screening programme.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Barker D. J., Martyn C. N. The maternal and fetal origins of cardiovascular disease. J Epidemiol Community Health. 1992 Feb;46(1):8–11. doi: 10.1136/jech.46.1.8. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Coustan D. R., Lewis S. B. Insulin therapy for gestational diabetes. Obstet Gynecol. 1978 Mar;51(3):306–310. doi: 10.1097/00006250-197803000-00010. [DOI] [PubMed] [Google Scholar]
- GILBERT J. A. L., DUNLOP D. M. Diabetic fertility, maternal mortality, and foetal loss rate. Br Med J. 1949 Jan 8;1(4592):48–51. doi: 10.1136/bmj.1.4592.48. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Green J. R., Schumacher L. B., Pawson I. G., Partridge J. C., Kretchmer N. Influence of maternal body habitus and glucose tolerance on birth weight. Obstet Gynecol. 1991 Aug;78(2):235–240. [PubMed] [Google Scholar]
- Hadden D. R. Screening for abnormalities of carbohydrate metabolism in pregnancy 1966-1977: the Belfast experience. Diabetes Care. 1980 May-Jun;3(3):440–446. doi: 10.2337/diacare.3.3.440. [DOI] [PubMed] [Google Scholar]
- Hales C. N., Barker D. J., Clark P. M., Cox L. J., Fall C., Osmond C., Winter P. D. Fetal and infant growth and impaired glucose tolerance at age 64. BMJ. 1991 Oct 26;303(6809):1019–1022. doi: 10.1136/bmj.303.6809.1019. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Harris M. I. Gestational diabetes may represent discovery of preexisting glucose intolerance. Diabetes Care. 1988 May;11(5):402–411. doi: 10.2337/diacare.11.5.402. [DOI] [PubMed] [Google Scholar]
- Multicentre randomised clinical trial of chorion villus sampling and amniocentesis. First report. Canadian Collaborative CVS-Amniocentesis Clinical Trial Group. Lancet. 1989 Jan 7;1(8628):1–6. [PubMed] [Google Scholar]
- O'SULLIVAN J. B., MAHAN C. M. CRITERIA FOR THE ORAL GLUCOSE TOLERANCE TEST IN PREGNANCY. Diabetes. 1964 May-Jun;13:278–285. [PubMed] [Google Scholar]
- O'Sullivan J. B., Gellis S. S., Tenney B. O. Gestational blood glucose levels in normal and potentially diabetic women related to the birth weight of their infants. Diabetes. 1966 Jul;15(7):466–470. doi: 10.2337/diab.15.7.466. [DOI] [PubMed] [Google Scholar]