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Latest & greatest articles for gestational diabetes
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Regular Exercise to Prevent the Recurrence of GestationalDiabetes Mellitus: A Randomized Controlled Trial To investigate the effect of a supervised home-based exercise program on the recurrence and severity of gestationaldiabetes mellitus (GDM) together with other aspects of maternal health and obstetric and neonatal outcomes.This randomized controlled trial allocated women with a history of GDM to an exercise intervention (14-week supervised home-based stationary cycling program (...) ) or to a control group (standard care) at 13±1 weeks of gestation. The primary outcome was a diagnosis of GDM. Secondary outcomes included maternal fitness, psychological well-being, and obstetric and neonatal outcomes. A sample size of 180 (90 in each group) was required to attain 80% power to detect a 40% reduction in the incidence of GDM.Between June 2011 and July 2014, 205 women provided written consent and completed baseline assessments. Of these, 33 (16%) were subsequently excluded as a result
Dietary supplementation with myo-inositol in women during pregnancy for treating gestationaldiabetes. Gestationaldiabetes mellitus (GDM) is any degree of glucose intolerance that first presents and is recognised during pregnancy and usually resolves after the birth of the baby. GDM is associated with increased short- and long-term morbidity for the mother and her baby. Treatment usually includes lifestyle modification and/or pharmacological therapy (oral antidiabetic agents or insulin (...) of myo-inositol for the treatment of gestationaldiabetes, with no data to examine the majority of outcomes in this review. There do not appear to be any benefits for the infant associated with exposure to myo-inositol such as reduced risk of being born large-for-gestational age. Although the risk of neonatal hypoglycaemia is reduced for the myo-inositol group, there is evidence of imprecision. Evidence from two studies suggested that myo-inositol was associated with a reduced change in maternal BMI
Risk perception and unrecognized type 2 diabetes in women with previous gestationaldiabetes mellitus. Women with a history of gestationaldiabetes mellitus (GDM) have a high chance of developing type 2 diabetes mellitus (T2DM) following the index pregnancy, however, little is known of women's perception of this risk. The objectives were to (1) determine women's perception of risk of future development of T2DM following a GDM pregnancy and (2) describe the prevalence of undetected dysglycaemia (...) in a Canadian population. The study was designed as a 9-11 year follow-up study of women previously enrolled in a randomized controlled trial of tight versus minimal intervention for GDM. Women's perception of future risk of diabetes was determined by questionnaire. Fasting lipid profile, height and weight were performed on all participants. Oral glucose tolerance tests were performed on all women without prior history of diabetes mellitus type 2 (DM2). The study was conducted at Ottawa Hospital General
External validation of prognostic models to predict risk of gestationaldiabetes mellitus in one Dutch cohort: prospective multicentre cohort study. To perform an external validation and direct comparison of published prognostic models for early prediction of the risk of gestationaldiabetes mellitus, including predictors applicable in the first trimester of pregnancy. External validation of all published prognostic models in large scale, prospective, multicentre cohort study. 31 independent (...) midwifery practices and six hospitals in the Netherlands. Women recruited in their first trimester (<14 weeks) of pregnancy between December 2012 and January 2014, at their initial prenatal visit. Women with pre-existing diabetes mellitus of any type were excluded. Discrimination of the prognostic models was assessed by the C statistic, and calibration assessed by calibration plots. 3723 women were included for analysis, of whom 181 (4.9%) developed gestationaldiabetes mellitus in pregnancy. 12
Lactation and Progression to Type 2 Diabetes Mellitus After GestationalDiabetes Mellitus 27538169 2017 12 07 2018 12 02 1539-3704 165 4 2016 08 16 Annals of internal medicine Ann. Intern. Med. Lactation and Progression to Type 2 Diabetes Mellitus After GestationalDiabetes Mellitus. 299-300 10.7326/L16-0106 Gunderson Erica P EP Study of Women, Infant Feeding and Type 2 Diabetes After GDM Pregnancy Investigators eng R01 HD050625 HD NICHD NIH HHS United States Journal Article Comment United (...) States Ann Intern Med 0372351 0003-4819 AIM IM Ann Intern Med. 2015 Dec 15;163(12):889-98 26595611 Ann Intern Med. 2016 Aug 16;165(4):299 27538168 Breast Feeding Diabetes Mellitus, Type 2 Diabetes, Gestational Disease Progression Female Humans Lactation Pregnancy 2016 8 19 6 0 2016 8 19 6 0 2017 12 8 6 0 ppublish 27538169 2544588 10.7326/L16-0106 PMC5613933 NIHMS906750 Am J Psychiatry. 2001 Jun;158(6):848-56 11384888 Matern Child Health J. 2009 May;13(3):334-42 18473131 BMC Public Health. 2011 Dec
Different intensities of glycaemic control for women with gestationaldiabetes mellitus. Gestationaldiabetes mellitus (GDM) has major short- and long-term implications for both the mother and her baby. GDM is defined as a carbohydrate intolerance resulting in hyperglycaemia or any degree of glucose intolerance with onset or first recognition during pregnancy from 24 weeks' gestation onwards and which resolves following the birth of the baby. Rates for GDM can be as high as 25% depending (...) diagnosed with GDM. Data from 171 of the 180 women were published as a conference abstract and no full report has been identified. The overall risk of bias of the single included study was judged to be unclear.The included trial did not report on any of this review's primary outcomes. For the mother, these were hypertension disorders of pregnancy or subsequent development of type 2 diabetes. For the infant, our primary outcomes were (perinatal (fetal and neonatal) mortality; large-for-gestational age
Short-term risk of cancer among women with previous gestationaldiabetes: a population-based study To evaluate the relationship between gestationaldiabetes (GDM) and incidence of cancer in women within the first decade postpartum.This population-based retrospective cohort study compared the risk of cancer in women with GDM with that of a matched control group comprising pregnant women without diabetes. We included women from Ontario, Canada aged 20-50 years with no history of cancer who had (...) given birth between 1995 and 2008 (N = 149 049). Women with GDM (N = 49 684) were matched on age and year of giving birth, in a ratio of 1:2, to pregnant women without diabetes (N = 99 365).Over a median 8-year follow-up, there were a total of 2927 (1.5%) cancers. After adjustment for covariates, we found no significant difference in overall risk of cancer between women with GDM and matched control subjects; however, GDM was associated with a significantly greater risk of thyroid cancer (adjusted
Pre-pregnancy potato consumption and risk of gestationaldiabetes mellitus: prospective cohort study. What is the association between potato consumption before pregnancy and the risk of gestationaldiabetes mellitus (GDM)?This prospective cohort study included 15,632 women from the Nurses' Health Study II (1991-2001). They had no previous GDM or chronic diseases before pregnancy. Consumption of potatoes and other foods was assessed every four years. Incident first time GDM was ascertained from (...) % lower risk of GDM. Consumption and diabetes were self reported, and severity of diabetes was unknown. More than 90% of women were white. A causal association cannot be assumed.Higher levels of potato consumption before pregnancy are associated with greater risk of GDM, and substitution of potatoes with other vegetables, legumes, or whole grain foods might lower the risk.Funding was received from the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health
The Comparative Effectiveness of Diabetes Prevention Strategies to Reduce Postpartum Weight Retention in Women With GestationalDiabetes Mellitus: The GestationalDiabetes' Effects on Moms (GEM) Cluster Randomized Controlled Trial To compare the effectiveness of diabetes prevention strategies addressing postpartum weight retention for women with gestationaldiabetes mellitus (GDM) delivered at the health system level: mailed recommendations (usual care) versus usual care plus a Diabetes (...) Prevention Program (DPP)-derived lifestyle intervention.This study was a cluster randomized controlled trial of 44 medical facilities (including 2,280 women with GDM) randomized to intervention or usual care. The intervention included mailed gestational weight gain recommendations plus 13 telephone sessions between 6 weeks and 6 months postpartum. Primary outcomes included the following: proportion meeting the postpartum goals of 1) reaching pregravid weight if pregravid BMI <25.0 kg/m(2) or 2) losing 5
Antenatal dietary supplementation with myo-inositol in women during pregnancy for preventing gestationaldiabetes. Gestationaldiabetes, glucose intolerance with onset or first recognition during pregnancy, is a rising problem worldwide. Both non-pharmacological and pharmacological approaches to the prevention of gestationaldiabetes have been, and continue to be explored. Myo-inositol, an isomer of inositol, is a naturally occurring sugar commonly found in cereals, corn, legumes and meat (...) . It is one of the intracellular mediators of the insulin signal and correlated with insulin sensitivity in type 2 diabetes. The potential beneficial effect on improving insulin sensitivity suggests that myo-inositol may be useful for women in preventing gestational diabetes.To assess if antenatal dietary supplementation with myo-inositol is safe and effective, for the mother and fetus, in preventing gestational diabetes.We searched the Pregnancy and Childbirth Group's Trials Register, ClinicalTrials.gov
Large-for-Gestational-Age Ultrasound Diagnosis and Risk for Cesarean Delivery in Women With GestationalDiabetes Mellitus To assess the accuracy of a large-for-gestational-age (LGA) ultrasound diagnosis and the subsequent risk for cesarean delivery associated with ultrasound diagnosis of LGA among women with gestationaldiabetes mellitus.This was a retrospective cohort study of 903 women with GDM who delivered after 36 weeks of gestation with an ultrasound-estimated fetal weight within 31 days (...) delivery (adjusted odds ratio [OR] 3.13, 95% confidence interval [CI] 2.10-4.67, P<.001) after adjusting for relevant covariates. Stratified analyses demonstrated that ultrasound diagnosis of LGA was associated with an increased risk for cesarean delivery whether the birth weight was between 2,500 and 3,499 g (OR 2.82, 95% CI 1.62-4.84, P<.001) or between 3,500 and 4,500 g (OR 3.47, 95% CI 2.06-5.88, P<.001).Ultrasonography significantly overestimates the prevalence of LGA in women with gestational
Lifestyle intervention for gestationaldiabetes mellitus prevention: AÂ cluster-randomized controlled study The study was to examine whether gestationaldiabetes mellitus (GDM) can be prevented by early trimester lifestyle counseling in a high-risk population.From September 2012 to January 2013, 1664 pregnancies in the Department of Obstetrics and Gynecology of First Hospital of Peking University were enrolled in the study during their first prenatal care visit before the 8 gestational weeks (...) on maternal anthropometrics were offered. Both groups were followed until 75 g oral glucose tolerance test (OGTT) testing at 24-28 gestational weeks. The weight gain after intervention and the prevalence of GDM were used to evaluate the effect.(1) According to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria, the positive rate of GDM for the intervention group was 17.16% (23/134), lower than the control group which was 23.91% (33/138), P = 0.168. (2) The weight gain
GestationalDiabetes Mellitus Can Be Prevented by Lifestyle Intervention: The Finnish GestationalDiabetes Prevention Study (RADIEL): A Randomized Controlled Trial To assess whether gestationaldiabetes mellitus (GDM) can be prevented by a moderate lifestyle intervention in pregnant women who are at high risk for the disease.Two hundred ninety-three women with a history of GDM and/or a prepregnancy BMI of ≥30 kg/m(2) were enrolled in the study at <20 weeks of gestation and were randomly (...) % in the intervention group and 21.6% in the control group ([95% CI 0.40-0.98%]; P = 0.044, after adjustment for age, prepregnancy BMI, previous GDM status, and the number of weeks of gestation). Gestational weight gain was lower in the intervention group (-0.58 kg [95% CI -1.12 to -0.04 kg]; adjusted P = 0.037). Women in the intervention group increased their leisure time physical activity more and improved their dietary quality compared with women in the control group.A moderate individualized lifestyle
Diet and exercise interventions for preventing gestationaldiabetes mellitus. Gestationaldiabetes mellitus (GDM) is associated with a wide range of adverse health consequences for women and their babies in the short and long term. With an increasing prevalence of GDM worldwide, there is an urgent need to assess strategies for GDM prevention, such as combined diet and exercise interventions.To assess the effects of combined diet and exercise interventions for preventing GDM and associated (...) as being of moderate risk of bias overall.When comparing women receiving a diet and exercise intervention with those receiving no intervention, there was no clear difference in the risk of developing GDM (average risk ratio (RR) 0.92, 95% confidence interval (CI) 0.68 to 1.23; 11 trials, 3744 women), caesarean section (RR 0.92, 95% CI 0.83 to 1.01; seven trials, 3246 women), or large-for-gestational age (RR 0.90, 95% CI 0.77 to 1.05; 2950 infants). Only one trial reported on perinatal mortality
Different strategies for diagnosing gestationaldiabetes to improve maternal and infant health. Gestationaldiabetes mellitus (GDM) is carbohydrate intolerance resulting in hyperglycaemia with onset or first recognition during pregnancy. If untreated, perinatal morbidity and mortality may be increased. Accurate diagnosis allows appropriate treatment. Use of different tests and different criteria will influence which women are diagnosed with GDM.To evaluate and compare different testing (...) strategies for diagnosis of gestationaldiabetes mellitus to improve maternal and infant health while assessing their impact on healthcare service costs.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 October 2014) and reference lists of retrieved studies.We included randomised trials if they evaluated tests carried out to diagnose GDM. We excluded studies that used a quasi-random model.Two review authors independently assessed trials for inclusion and risk of bias