Gestational diabetes
Gestational diabetes is pregnancy-related hyperglycaemia diagnosed by risk-factor-based OGTT when maternal insulin secretion cannot compensate for placental insulin resistance; treatment aims to reduce fetal overgrowth and neonatal hypoglycaemia while protecting maternal and fetal safety.
Definition
Gestational diabetes is hyperglycaemia first recognised during pregnancy, diagnosed by a risk-factor-based 75-g oral glucose tolerance test. It usually improves after placental delivery but identifies increased future risk of type 2 diabetes and recurrence.
First principles
Placental hormones increase insulin resistance
As pregnancy progresses, placental and maternal hormones reduce insulin sensitivity so glucose remains available for the fetus. Most pancreatic beta cells compensate by increasing insulin secretion. Gestational diabetes occurs when the compensatory response is insufficient and maternal plasma glucose rises.
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