Gestational diabetes mellitus(GDM) is one of the most common metabolic disorders complicating pregnancy. It is associated with adverse outcome of pregnancy including obstetrical complications such as increased rate of cesarean section,
preeclampsia, and
birth trauma, and perinatal morbidities, such as macrosomia, hypoglycemia, hypocalcemia, and hyperbilirubinemia. Women with GDM are at higher risk for non-insulin dependent diabetes mellitus later in life and have a predisposition to dyslipidemia
and
cardiovascular disease. GDM may also have long-term implications for the offspring. The offspring of mothers with pregestational and gestational diabetes have been reported to have a higher frequency of obesity in childhood, impaired, glucose
tolerance
or non-insulin dependent diabetes in adolescence or later, and if poorly controlled, may be at risk of impariment of intellectual and neurobehavioral development.
The reported prevalence of GDM in Korea women is 2~3%, which is very similar to that in the Caucasian and African-American women in North America. The frequencies of obstetrical complications and adverse perinatal outcomes observed in Korean
women
with
GDM are also similar to that in other reports. Therfore, identifying with GDM is very important in Korean women.
The Second and Third International Workshop-Conference on Gestational Diabetes Melltus and the American College of Obstetrician and Gynecologists recommend screening with a 50g oral glucose challenge followed 1 hour later by a plasma glucose
measurement. The 1-h, 50-g oral glucose challenge test can be performed without regard to time or amount of
last meal. The test procedure is simple and convenient for patients and doctors. Selective screening based on clinical or historic risk factors has been reported ineffective to identify the women with GDM. Universal screening with 135 mg/dl as a
threshold offeres a cost-effective protocol to identify women with GDM in the Korean population.
|