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Research Gaps in Gestational Diabetes Mellitus: Executive Summary of a National Institute of Diabetes and Digestive and Kidney Diseases Workshop

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  • Deborah J Wexler
  • Camille E Powe
  • Linda A Barbour
  • Thomas Buchanan
  • Donald R Coustan
  • Rosa Corcoy
  • Peter Damm
  • Fidelma Dunne
  • Denice S Feig
  • Assiamira Ferrara
  • Lorie M Harper
  • Mark B Landon
  • Sara J Meltzer
  • Boyd E Metzger
  • Hilary Roeder
  • Janet A Rowan
  • David A Sacks
  • David Simmons
  • Jason G Umans
  • Patrick M Catalano
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The National Institute of Diabetes and Digestive and Kidney Diseases convened a workshop on research gaps in gestational diabetes mellitus (GDM) with a focus on 1) early pregnancy diagnosis and treatment and 2) pharmacologic treatment strategies. This article summarizes the proceedings of the workshop. In early pregnancy, the appropriate diagnostic criteria for the diagnosis of GDM remain poorly defined, and an effect of early diagnosis and treatment on the risk of adverse outcomes has not been demonstrated. Despite many small randomized controlled trials of glucose-lowering medication treatment in GDM, our understanding of medication management of GDM is incomplete as evidenced by discrepancies among professional society treatment guidelines. The comparative effectiveness of insulin, metformin, and glyburide remains uncertain, particularly with respect to long-term outcomes. Additional topics in need of further research identified by workshop participants included phenotypic heterogeneity in GDM and novel and individualized treatment approaches. Further research on these topics is likely to improve our understanding of the pathophysiology and treatment of GDM to improve both short- and long-term outcomes for mothers and their children.

Original languageEnglish
JournalObstetrics and Gynecology
Volume132
Issue number2
Pages (from-to)496-505
Number of pages10
ISSN0029-7844
DOIs
Publication statusPublished - Aug 2018

ID: 56321355