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Gestational diabetes mellitus: a modern view on the actual problem

A review of world literature has shown that gestational diabetes mellitus (GDM) is the most frequently encountered extra genital pathology of gestation and represents a serious medical and social problem, increasing the inc >pregnancy outcomes for both the mother and the fetus. Significant variability of opinions on the frequency of GDM, its etiology and pathogenesis, screening methods and diagnostics of impaired carbon-water metabolism revealed during the pregnancy . Cons >pregnancy , it is necessary to note the need for early detection of GDM in order, to adequately correct glycaemia to prevent an adverse course of pregnancy and childbirth. The lack of universal diagnostic criteria , on the one hand, and the clinical course of GDM without obvious manifestations, on the other hand, subsequently increase the risk of diabetes, obesity, carbohydrate metabolism disorders and cardiovascular complications in both mother and child. Consequently, this pathology requires the development of uniform standards for the diagnosis and treatment of disorders of carbohydrate metabolism during the pregnancy .

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■ : , . : . . 2018;20(4):455-61. Available from: http://dx.doi.org/10.25005/2074-0581-2018-20-4-455-461

GESTATIONAL DIABETES MELLITUS: A MODERN VIEW ON THE ACTUAL PROBLEM

M.F. DoDKHoEvA, D.A. PIRMATovA

Department of obstetrics and Gynecology 1, avicenna Tajik state Medical university, Dushanbe, Republic of Tajikistan

A review of world literature has shown that gestational diabetes mellitus (GDM) is the most frequently encountered extra genital pathology of gestation and represents a serious medical and social problem, increasing the incidence of unwanted pregnancy outcomes for both the mother and the fetus. Significant variability of opinions on the frequency of GDM, its etiology and pathogenesis, screening methods and diagnostics of impaired carbon-water metabolism revealed during the pregnancy. Considering the diverse scientific data, constantly changing bio ecological environmental conditions that drastically affect the development of pregnancy, it is necessary to note the need for early detection of GDM in order, to adequately correct glycaemia to prevent an adverse course of pregnancy and childbirth. The lack of universal diagnostic criteria, on the one hand, and the clinical course of GDM without obvious manifestations, on the other hand, subsequently increase the risk of diabetes, obesity, carbohydrate metabolism disorders and cardiovascular complications in both mother and child. Consequently, this pathology requires the development of uniform standards for the diagnosis and treatment of disorders of carbohydrate metabolism during the pregnancy.

Keywords: Gestational diabetes mellitus, pregnancy, prevalence, complications, diabetic fetopathy, diagnostic criteria.

I For citation: Dodkhoeva MF, Pirmatova DA. Gestatsionnyy sakharnyy diabet: sovremennyy vzglyad na aktual'nuyu problemu [Gestational diabetes mellitus: a modern view on the actual problem]. Vestnik Avitsenny [Avicenna Bulletin]. 2018;20(4):455-61. Available from: http://dx.doi.org/10.25005/2074-0581-2018-20-4-455-461

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1. Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Research and Clinical Practice. 2014;103:137-49. Available from http://dx.doi.org/10.10167j.diabres.2013.11.002.

2. International Diabetes Federation. IDF Diabetes Atlas, 8th ed. Brussels, Belgium: International Diabetes Federation; 2017.

3. , , . . , : ; 2017. 112 .

1. Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Research and Clinical Practice. 2014;103:137-49. Available from http://dx.doi.org/10.1016/j.diabres.2013.11.002.

2. International Diabetes Federation. IDF Diabetes Atlas, 8th ed. Brussels, Belgium: International Diabetes Federation; 2017.

3. Dedov II, Shestakova MV, Mayorov AYu. Algoritmy spetsializirovannoy meditsinskoy pomoshchi bol'nym sakharnym diabetom [Standards of specialized diabetes care]. Moscow, RF: Meditsina; 2017. 112 p.

4. American Diabetes Association. Position statement: diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33:62-9. Available from http://dx.doi.org/10.2337/dc10-S062.

5. Hadden DR, Hillebrand B. The first recorded case of diabetic pregnancy (Bennewitz HG, 1824, University of Berlin). Diabetologia. 1989;32(8):625.

6. , . : , , . . 2014;10:109-15.

7. O'Sullivan JB, Mahan CM. Criteria for the oral glucose tolerance test in pregnancy. Diabetes. 1964;285:278.

8. Sacks DA, Metzger BE. Classification of diabetes in pregnancy. Obstetrics & Gynecology. 2013;121(2):345-8. Available from http://dx.doi.org/ http://10.1097/A0G.0b013e31827f09b5.

9. , . , : . . 2008;6:36-42.

10. Kharroubi AT, Darwish HM. Diabetes mellitus: The epidemic of the century. World J Diabetes. 2015;6(6):850-67.

11. International Diabetes Federation. IDF Diabetes Atlas, 7th ed. Brussels, Belgium: International Diabetes Federation, 2016.

12. , , , , . : . . 2012;4:81-4.

13. Mirghani Dirar A, Doupis J. Gestational diabetes from A to Z. World J Diabetes. 2017;8(12):489-506. Available from http://dx.doi.org/10.4239/ wjd.v8.i12.489.

14. Bener A, Saleh NM, Al-Hamaq A. Prevalence of gestational diabetes and associated maternal and neonatal complications in a fast-developing community: global comparisons. Int J Womens Health. 2011;3:367-373. Available from http://dx.doi.org/10.2147/IJWH. S26094.

15. Nguyen CL, Pham NM, Colin WB, Duong DV, Lee AH. Prevalence of Gestational diabetes mellitus in Eastern and Southeastern Asia: A systematic review and meta-Analysis. Diabetes Research. 2018:1-10. Available from http://dx.doi. org/10.1155/2018/6536974.

16. , , . . 2009;7:348-51.

17. , , . - . . 2010;2:3-6.

18. , . . . .. . 2014;1:48-51.

19. Parhofer KG, Hasbargen U, Ulugberdiyewa A, Abdullayewa M, Melebayewa B, Annamuhammedov A, et al. Gestational diabetes in Turkmenistan: implementation of a screening program and first results. Arch Gynecol Obstet. 2014;289:293-8. Available from http://dx.doi.org/10.1007/s00404-013-2961-2.

20. Xu T, He Y, Dainelli L, Yu K, Detzel P, Silva-Zollezzi I, et al. Healthcare interventions for the prevention and control of gestational diabetes mellitus in China: a scoping review. BMC Pregnancy and Childbirth. 2017; 17:171. Available from http://dx.doi.org/10.1186/s12884-017-1353-1.

21. Morampudi S, Balasubramanian G, Gowda A, Zomorodi B, Patil AS. The challenges and recommendations for GDM care in India: a review. Frontiers in Endocrinology. 2017;8(56):1-10. Available from http://dx.doi.org/10.3389/ fendo.2017.00056.

22. . . . 2012;1:72-8.

23. Kuo CH, Chen SC, Fang CT, Nien FJ, Wu ET, Lin SY, et al. Screening gestational diabetes mellitus: The role of maternal age. PLoS ONE. 2017;12:3. Available from http://dx.doi.org/10.1371/journal.pone.0173049.

24. . (, ). . 2011;3:78-90.

25. , , , , . - . -

4. American Diabetes Association. Position statement: diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33:62-9. Available from http://dx.doi.org/10.2337/dc10-S062.

5. Hadden DR, Hillebrand B. The first recorded case of diabetic pregnancy (Bennewitz HG, 1824, University of Berlin). Diabetologia. 1989;32(8):625.

6. Burumkulova FF, Petrukhin VA. Gestatsionnyy sakharnyy diabet: vchera, segodnya, zavtra [Gestational diabetes mellitus: yesterday, today, and tomorrow]. Terapevticheskiy arkhiv. 2014;10:109-15.

7. O'Sullivan JB, Mahan CM. Criteria for the oral glucose tolerance test in pregnancy. Diabetes. 1964;285:278.

8. Sacks DA, Metzger BE. Classification of diabetes in pregnancy. Obstetrics & Gynecology. 2013;121(2):345-8. Available from http://dx.doi.org/ http://10.1097/AOG.0b013e31827f09b5.

9. Medved VI, Bychkova EA. Opredelenie, klassifikatsiya i diagnosticheskie kriterii gestatsionnogo diabeta: evolyutsiya i sovremennoe sostoyanie [Definition, classification and diagnostic criteria of gestational diabetes: evolution and modern condition]. Liki Ukrainy. 2008;6:36-42.

10. Kharroubi AT, Darwish HM. Diabetes mellitus: The epidemic of the century. World J Diabetes. 2015;6(6):850-67.

11. International Diabetes Federation. IDF Diabetes Atlas, 7th ed. Brussels, Belgium: International Diabetes Federation, 2016.

12. Petrukhin VA, Burumkulova FF, Titova TV, Golovchenko MA, Kotov YuB. Rasprostranyonnost' gestatsionnogo sakharnogo diabeta v Moskovskoy oblasti: rezul'taty skrininga [Prevalence of gestational diabetes mellitus in Moscow region: results of screening]. Rossiyskiy vestnik akushera ginekologa. 2012;4:81-4.

13. Mirghani Dirar A, Doupis J. Gestational diabetes from A to Z. World J Diabetes. 2017;8(12):489-506. Available from http://dx.doi.org/10.4239/ wjd.v8.i12.489.

14. Bener A, Saleh NM, Al-Hamaq A. Prevalence of gestational diabetes and associated maternal and neonatal complications in a fast-developing community: global comparisons. Int J Womens Health. 2011;3:367-373. Available from http://dx.doi.org/10.2147/IJWH. S26094.

15. Nguyen CL, Pham NM, Colin WB, Duong DV, Lee AH. Prevalence of Gestational diabetes mellitus in Eastern and Southeastern Asia: A systematic review and meta-Analysis. Diabetes Research. 2018:1-10. Available from http://dx.doi. org/10.1155/2018/6536974.

16. Vedmed AA, Shaposhnikova EV. Osobennosti techeniya beremennosti, rodov i sostoyaniya novorozhdyonnykh u patsientok s gestatsionnym sakharnym diabetom [Peculiarities of pregnancy, delivery and newborn condition in patients with gestational diabetes mellitus]. Vestnik RUDN. 2009;7:348-51.

17. Krasnopolskiy VI, Petrukhin VA, Burumkulova FF. Gestatsionniy sakharnyy diabet - novyy vzglyad na staruyu problemu [Gestational diabetes mellitus -new view to the old problem]. Akusherstvo i ginekologiya. 2010;2:3-6.

18. Petrukhin VA, Burumkulova FF. Gestatsionnyy diabet [Gestational diabetes mellitus]. Arkhiv akusherstva i ginekologii im. V.F. Snegiryova. 2014;1:48-51.

19. Parhofer KG, Hasbargen U, Ulugberdiyewa A, Abdullayewa M, Melebayewa B, Annamuhammedov A, et al. Gestational diabetes in Turkmenistan: implementation of a screening program and first results. Arch Gynecol Obstet. 2014;289:293-8. Available from http://dx.doi.org/10.1007/s00404-013-2961-2.

20. Xu T, He Y, Dainelli L, Yu K, Detzel P, Silva-Zollezzi I, et al. Healthcare interventions for the prevention and control of gestational diabetes mellitus in China: a scoping review. BMC Pregnancy and Childbirth. 2017; 17:171. Available from http://dx.doi.org/10.1186/s12884-017-1353-1.

21. Morampudi S, Balasubramanian G, Gowda A, Zomorodi B, Patil AS. The challenges and recommendations for GDM care in India: a review. Frontiers in Endocrinology. 2017;8(56):1-10. Available from http://dx.doi.org/10.3389/ fendo.2017.00056.

22. Nazarova SI. Akusherskie i perinatal'nye iskhody pri gestatsionnom sakharnom diabete [Obstetrical and perinatal outcomes at gestational diabetes mellitus]. Vestnik Avitsenny [Avicenna Bulletin]. 2012;1:72-8.

23. Kuo CH, Chen SC, Fang CT, Nien FJ, Wu ET, Lin SY, et al. Screening gestational diabetes mellitus: The role of maternal age. PLoS ONE. 2017;12:3. Available from http://dx.doi.org/10.1371/journal.pone.0173049.

24. Burumkulova FF. Gestatsionnyy sakharnyy diabet (Endokrinologicheskie, akusherskie i perinatal'nye aspekty) [Gestational diabetes mellitus (Endocrinal, obstetrical and perinatal aspects)]. Mezhdunarodnyy endokrinologicheskiy zhurnal. 2011;3:78-90.

25. Nekrasova KR, Van AV, Galkina AS, Dzhobova EM, Dobrokhotova YuE. Gestatsionnyy sakharnyy diabet - bolezn' populyatsii. Medikamentoznaya

. , , . 2013;7(1):31-5.

26. , , , , . . I. . . . 2017;15(3):255-6.

27. Angueira AR, Ludvik AE, Reddy TE. New insights into gestational glucose metabolism: lessons learned from 21st century approaches. Diabetes. 2015;64(2):327-34. Available from http://dx.doi.org/10.2337/db14-0877.

28. Wu L, Cui L, Tam WH. Genetic variants associated with gestational diabetes mellitus: a meta-analysis and subgroup analysis. Sci Rep. 2016;6:30539. Available from http://dx.doi.org/10.1038/srep30539.

29. Kwak SH, Jang HC, Park KS. Finding genetic risk factors of gestational diabetes. Genomics Inform. 2012;10(4):239-43. Available from http://dx.doi. org/10.5808/GI.2012.10.4.239.

30. Zhang C, Bao W, Rong Y, Yang H, Bowers K, Yeung E, et al. Genetic variants and the risk of gestational diabetes mellitus: a systematic review. Hum Reprod Update. 2013;19:376-90. Available from http://dx.doi.org/10.1093/ humupd/dmt013.

31. , , , . . . 2011;14(1):20-7. Available from http://dx.doi.org/10.14341/2072-0351-6246.

32. Murphy R. Monogenic diabetes and pregnancy. Obstet Med. 2015;8(3):114-20. Available from http://dx.doi.org/10.1177/1753495X15590713.

33. Colom C, Corcoy R. Maturity onset diabetes of the young and pregnancy. Best Pract Res Clin Endocrinol Metab. 2010;24(4):605-15. Available from http:// dx.doi.org/10.1016/j.beem.2010.05.008.

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Dodkhoeva Munavvara Fayzulloevna, Academician of the Academy of Medical Sciences of the Republic of Tajikistan, Doctor of Medical Sciences, Full Professor, Professor of the Department of Obstetrics and Gynecology 1, Avicenna Tajik State Medical University

Pirmatova Dilnoza Alikhonovna, Postgraduate Student of the Department of Obstetrics and Gynecology 1, Avicenna Tajik State Medical University

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[X] ADDRESS FOR CORRESPONDENCE: Dodkhoeva Munavvara Fayzulloevna

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