Gestational diabetes mellitus: Screening, diagnosis and non-pharmacological therapy
DOI:
https://doi.org/10.33448/rsd-v13i11.47423Keywords:
Gestacional Diabetes; Screening; Diagnosis; Diet therapy.Abstract
Gestational Diabetes Mellitus (GDM) is a condition in the spectrum of hyperglycemia during pregnancy resulting from physiological changes during pregnancy in a predisposed mother. This condition has serious consequences for the mother-fetus binomial, such as preeclampsia and prematurity, which points to the importance of management. This study aimed to elucidate the aspects of screening, diagnosis, and non-pharmacological treatment of Gestational Diabetes Mellitus through a review of the existing literature, using original articles and books published between 2015 and 2024, in English, German, and Portuguese. The search was carried out in the National Library of Medicine (PubMed MEDLINE), Scientific Electronic Library Online (Scielo), Google Scholar, Virtual Health Library (VHL), and EBSCO Information Services databases, between September and October 2024, using the keywords: “Gestational Diabetes”, “screening”, “diagnosis”, and “diet therapy”. After selection and critical reading, 25 studies were included in the review. It was observed that screening and diagnosis vary in terms of criteria and indications at the international level. In Brazil, there is a structured recommendation to carry out universal screening in order to identify pregnant women with hyperglycemia from the first prenatal visit. With regard to non-pharmacological treatment, nutritional therapy, physical activity and glycemic monitoring are recommended. This study contributes to the literature by promoting the formatting of concepts related to Gestational Diabetes Mellitus (GDM), in terms of screening, diagnosis and non-pharmacological treatment.
References
ACOG. (2018). ACOG Practice Bulletin No. 190. Obstetrics & Gynecology, 131(2), e49–e64. https://doi.org/10.1097/aog.0000000000002501
Alfadhli, E. (2015). Gestational diabetes mellitus. Saudi Medical Journal, 36(4), 399–406. https://doi.org/10.15537/smj.2015.4.10307
Chiefari, E., Arcidiacono, B., Foti, D., & Brunetti, A. (2017). Gestational diabetes mellitus: an updated overview. Journal of Endocrinological Investigation, 40(9), 899–909. https://doi.org/10.1007/s40618-016-0607-5
Cordeiro, A. M., Oliveira, G. M. de, Rentería, J. M., & Guimarães, C. A. (2007). Revisão sistemática: uma revisão narrativa. Revista Do Colégio Brasileiro de Cirurgiões, 34(6), 428–431. https://doi.org/10.1590/s0100-69912007000600012
Guardo, F. D., Currò, J. M., Valenti, G., Rossetti, P., Di Gregorio, L. M., Conway, F., Chiofalo, B., Garzon, S., Bruni, S., & Rizzo, G. (2019). Non-pharmacological management of gestational diabetes: The role of myo-inositol. Journal of Complementary and Integrative Medicine, 17(2). https://doi.org/10.1515/jcim-2019-0111
Igwesi-Chidobe, C. N., Okechi, P. C., Emmanuel, G. N., & Ozumba, B. C. (2022). Community-based non-pharmacological interventions for pregnant women with gestational diabetes mellitus: a systematic review. BMC Women’s Health, 22(1). https://doi.org/10.1186/s12905-022-02038-9
Johns, E. C., Denison, F. C., Norman, J. E., & Reynolds, R. M. (2018). Gestational Diabetes Mellitus: Mechanisms, Treatment, and Complications. Trends in Endocrinology & Metabolism, 29(11), 743–754. https://doi.org/10.1016/j.tem.2018.09.004
Kautzky-Willer, A., Winhofer, Y., Kiss, H., Falcone, V., Berger, A., Lechleitner, M., Weitgasser, R., & Harreiter, J. (2023). [Gestational diabetes mellitus (Update 2023)]. Wiener Klinische Wochenschrift, 135(Suppl 1), 115–128. https://doi.org/10.1007/s00508-023-02181-9
Mack, L. R., & Tomich, P. G. (2017). Gestational Diabetes: Diagnosis, Classification, and Clinical Care. Obstetrics and Gynecology Clinics of North America, 44(2), 207–217. https://doi.org/10.1016/j.ogc.2017.02.002
Marconi, M.D. A., & Lakatos, E. M. (2022). Metodologia Científica (8th ed.). Grupo GEN.
Martis, R., Crowther, C. A., Shepherd, E., Alsweiler, J., Downie, M. R., & Brown, J. (2018). Treatments for Women with Gestational Diabetes mellitus: an Overview of Cochrane Systematic Reviews. Cochrane Database of Systematic Reviews, 8. https://doi.org/10.1002/14651858.cd012327.pub2
McIntyre, H. D., Catalano, P., Zhang, C., Desoye, G., Mathiesen, E. R., & Damm, P. (2019). Gestational Diabetes Mellitus. Nature Reviews Disease Primers, 5(1). https://doi.org/10.1038/s41572-019-0098-8
Moon, J. H., & Jang, H. C. (2022). Gestational Diabetes Mellitus: Diagnostic Approaches and Maternal-Offspring Complications. Diabetes & Metabolism Journal, 46(1), 3–14. https://doi.org/10.4093/dmj.2021.0335
Mukerji, G., & Feig, D. S. (2017). Pharmacological Management of Gestational Diabetes Mellitus. Drugs, 77(16), 1723–1732. https://doi.org/10.1007/s40265-017-0807-0
OPAS. (2016). Organização Pan-Americana da Saúde. Ministério da Saúde. Federação Brasileira das Associações de Ginecologia e Obstetrícia. Sociedade Brasileira de Diabetes. Rastreamento e diagnóstico de diabetes mellitus gestacional no Brasil, 32p. ISBN: 978-85-7967-118-0.
Oskovi-Kaplan, Z. A., & Ozgu-Erdinc, A. S. (2021). Management of Gestational Diabetes Mellitus. Advances in Experimental Medicine and Biology, 1307, 257–272. https://doi.org/10.1007/5584_2020_552
Patti, A. M., Giglio, R. V., Pafili, K., Rizzo, M., & Papanas, N. (2018). Pharmacotherapy for gestational diabetes. Expert Opinion on Pharmacotherapy, 19(13), 1407–1414. https://doi.org/10.1080/14656566.2018.1509955
Plows, J., Stanley, J., Baker, P., Reynolds, C., & Vickers, M. (2018). The pathophysiology of gestational diabetes mellitus. International Journal of Molecular Sciences, 19(11). https://doi.org/10.3390/ijms19113342
Rasmussen, L., Poulsen, C. W., Kampmann, U., Smedegaard, S. B., Ovesen, P. G., & Fuglsang, J. (2020). Diet and Healthy Lifestyle in the Management of Gestational Diabetes Mellitus. Nutrients, 12(10), 3050. https://doi.org/10.3390/nu12103050
Sert, U. Y., & Ozgu-Erdinc, A. S. (2020). Gestational Diabetes Mellitus Screening and Diagnosis. Advances in Experimental Medicine and Biology, 231–255. https://doi.org/10.1007/5584_2020_512
Sweeting, A., Hannah, W., Backman, H., Catalano, P., Feghali, M., Herman, W. H., Marie-France Hivert, Jincy Immanuel, Meek, C., Maria Lucia Oppermann, Nolan, C. J., Ram, U., Maria Inês Schmidt, Simmons, D., Chivese, T., & Katrien Benhalima. (2024). Epidemiology and management of gestational diabetes. Lancet. https://doi.org/10.1016/s0140-6736(24)00825-0
Sweeting, A., Wong, J., Murphy, H. R., & Ross, G. P. (2022). A Clinical Update on Gestational Diabetes Mellitus. Endocrine Reviews, 43(5), 763–793. https://doi.org/10.1210/endrev/bnac003
Szmuilowicz, E. D., Josefson, J. L., & Metzger, B. E. (2019). Gestational Diabetes Mellitus. Endocrinology and Metabolism Clinics of North America, 48(3), 479–493. https://doi.org/10.1016/j.ecl.2019.05.001
Sant’Anna Ramos Vosgerau, D., & Paulin Romanowski, J. (2014). Estudos de revisão: implicações conceituais e metodológicas. Revista Diálogo Educacional, 14(41), 165–189. https://doi.org/10.7213/dialogo.educ.14.041.DS08
Yang, X., Han, R., Xiang, Z., Li, H., Zhao, Q., Chen, L., & Gao, L. (2023). Clinical practice guidelines on physical activity and exercise for pregnant women with gestational diabetes mellitus: A systematic review. International Journal of Nursing Practice. https://doi.org/10.1111/ijn.13141
Ye, W., Luo, C., Huang, J., Li, C., Liu, Z., & Liu, F. (2022). Gestational diabetes mellitus and adverse pregnancy outcomes: systematic review and meta-analysis. BMJ, 377(377), e067946. https://doi.org/10.1136/bmj-2021-067946
Zajdenverg, L., Dualib, P. M., Façanha, C. F., Golbert, A., Negrato, C. A., Forti, A. C. e, & Bertoluci, M. C. (2022). Tratamento farmacológico do diabetes na gestação. Diretriz Oficial Da Sociedade Brasileira de Diabetes. https://doi.org/10.29327/557753.2022-13
Zajdenverg, L., Façanha, C. F. S., Dualib, P. M., Golbert, A., Moisés, E. C. D., Calderon, I. de M. P., Mattar, R., Francisco, R. P. V., Negrato, C. A., & Bertoluci, M. (2022). Rastreamento e diagnóstico da hiperglicemia na gestação. Diretriz Oficial Da Sociedade Brasileira de Diabetes. https://doi.org/10.29327/557753.2022-11
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 João Pedro Arruda Pessoa; Mateus Lopes de Faria
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
