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Pre-gestational diabetes can be classified as Type 1 or Type 2 depending on the physiological mechanism. Type 1 diabetes mellitus is an autoimmune disorder leading to destruction of insulin-producing cell in the pancreas; type 2 diabetes mellitus is associated with obesity and results from a combination of insulin resistance and insufficient insulin production.
Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy. [2] Gestational diabetes generally results in few symptoms; [2] however, obesity increases the rate of pre-eclampsia, cesarean sections, and embryo macrosomia, as well as gestational diabetes. [2]
Pregnant women fall at a similar rate (27%) to women over age of 70 years (28%). Most of the falls (64%) occur during the second trimester. Additionally, two-thirds of falls are associated with walking on slippery floors, rushing, or carrying an object. [38] The root causes for these falls are not well known.
There are several non-modifiable and modifiable risk factors that predispose women to development of this condition such as female fetus, psychiatric illness history, high or low BMI pre-pregnancy, young age, African American or Asian ethnicity, type I diabetes, multiple pregnancies, and history of pregnancy affected by hyperemesis gravidarum.
With a prevalence of 6-20% among pregnant women globally, gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance developing or initially recognized during pregnancy. [67] Neutral protamine Hagedorn (NPH) insulin has been the cornerstone of insulin therapy during pregnancy, administered two to four times per day.
The guidelines attempt to address the prevention and management of obesity at both the individual and population levels in both children and adults. [5] The European Union published clinical practice guidelines in 2008 in an effort to address the rising rates of obesity in Europe. [107] Australia came out with practice guidelines in 2004. [106]
[2] [10] This test measures the average amount of diabetic control over a period of about 3 months. [10] In non-diabetic people, the HbA1c level ranges from 4.0 to 5.7%. [ 10 ] Regular 6 monthly laboratory testing of HbA1c (glycated hemoglobin) provides some assurance of long-term control and allows the adjustment of the patient's routine ...
Both circulating and placental levels of soluble fms-like tyrosine kinase-1 (sFlt-1) are higher in women with pre-eclampsia than in women with normal pregnancy. [ 26 ] sFlt-1 is an anti-angiogenic protein that antagonizes vascular endothelial growth factor (VEGF) and placental growth factor (PIGF), both of which are proangiogenic factors. [ 15 ]