Exploration of the shared pathophysiological mechanisms of gestational diabetes and large for gestational age offspring
Exploration of the shared pathophysiological mechanisms of gestational diabetes and large for gestational age offspring作者机构：The Royal Children’s Hospital Melbourne Parkville VIC 3052 Australia Department of Endocrinology Austin Health Repatriation Campus Heidelberg West Melbourne VIC 3081 Australia Department of Medicine Austin Health and the University of Melbourne (Austin Campus) Parkville Melbourne VIC 3084 Australia
出 版 物：《World Journal of Diabetes》 (世界糖尿病杂志（英文版）（电子版）)
年 卷 期：2019年第10卷第6期
页 面：333-340页
核心收录：
主 题：Gestational diabetes mellitus Large for gestational age Metabolism Biomarkers Glucose Lipids
摘 要：Gestational diabetes mellitus (GDM) and large for gestational age (LGA) offspring are two common pregnancy complications. Connections also exist between the two conditions, including mutual maternal risk factors for the conditions and an increased prevalence of LGA offspring amongst pregnancies affected by GDM. Thus, it is important to elucidate potential shared underlying mechanisms of both LGA and GDM. One potential mechanistic link relates to macronutrient metabolism. Indeed, derangement of carbohydrate and lipid metabolism is present in GDM, and maternal biomarkers of glucose and lipid control are associated with LGA neonates in such pregnancies. The aim of this paper is therefore to reflect on the existing nutritional guidelines for GDM in light of our understanding of the pathophysiological mechanisms of GDM and LGA offspring. Lifestyle modification is first line treatment for GDM, and while there is some promise that nutritional interventions may favourably impact outcomes, there is a lack of definitive evidence that changing the macronutrient composition of the diet reduces the incidence of either GDM or LGA offspring. The quality of the available evidence is a major issue, and rigorous trials are needed to inform evidence-based treatment guidelines.
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