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Preventing progression from gestational diabetes mellitus to diabetes: A thought‐filled review
Author(s) -
KasherMeron Michal,
Grajower Martin M.
Publication year - 2017
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.2909
Subject(s) - medicine , gestational diabetes , diabetes mellitus , liraglutide , metformin , type 2 diabetes , pregnancy , obstetrics , pioglitazone , incidence (geometry) , psychological intervention , intensive care medicine , gestation , endocrinology , nursing , genetics , physics , optics , biology
Summary Women with a history of gestational diabetes are at high risk for developing type 2 diabetes mellitus. In studies with long periods of follow‐up, diabetes incidence of up to 70% has been reported. The appropriate follow‐up of women following a pregnancy complicated by gestational diabetes has not been studied. Published guidelines recommend that obstetrician/gynaecologists, who are often the de facto primary care physicians for these otherwise healthy young women, incorporate glucose monitoring in the post‐partum period into their annual examinations. In reality, reported rates of screening have been low. There is also no clear evidence for any beneficial interventions to prevent diabetes in patients with prior history of gestational diabetes. Lifestyle intervention programmes for diabetes prevention among these patients yielded disappointing results. Metformin, pioglitazone, liraglutide, and bariatric surgery are possible options but based on inadequate data. There remains a need for randomized, placebo‐controlled studies to evaluate various pharmacologic treatments, with and without lifestyle interventions, to prevent type 2 diabetes mellitus in women with a history of gestational diabetes.