DETERMINANTS OF RECURRENCE IN GESTATIONAL DIABETES MELLITUS

Gestational Diabetes Mellitus is any degree of glucose intolerance that is diagnosed for the first time during pregnancy or starts during pregnancy. Gestational Diabetes Mellitus adversely affects maternal and fetus health. It is very important to know the causes of recurrence of Gestational Diabetes Mellitus and to take preventive measures. The recurrence rate of GDM in the next pregnancy is in a wide range of one-third to threequarters. However, in general, this ratio is half. Many studies have found a relationship between pre-pregnancy high body mass index and recurrence of GDM. High body mass index increases insulin resistance. Existing insulin resistance increases further during pregnancy. Therefore, the risk of GDM formation increases. GDM recurrence increases with maternal age. Advanced maternal age increases the risk of GDM in index pregnancy and subsequent pregnancies. Recurrence of GDM also appears to be directly related to age. A decrease in the number of beta cells and an increase in insulin resistance may explain this relationship. There is a linear relationship between weight gain between two pregnancies and GDM recurrence. Weight gain between pregnancies increases the insulin resistance and facilitates recurrence of GDM. In many studies, recurrence of GDM was found to be at least 3 times higher in multiparous women than in primiparous women. The diabetogenic effect of pregnancy and the frequent recurrence of this effect in multiparious may explain the high risk of GDMrecurrence. It is also possible that each pregnancy may cause some beta cell loss. GDM recurrence more frequently in subsequent pregnancies of women who have macrosomic babies. The majority of GDMs are treated with diet. Insulin therapy is used in patients with unresponsive to diet therapy. This indicates the severity of the disease. The need for insulin during pregnancy is a very good marker for GDM recurrence. It is even possible to predict persistent diabetes. The relationship between recurrence and short time interval is that found to be more frequent. There are also studies that long time interval and GDMrecurrence. These findings suggest that the pathophysiological causes of GDM recurrence may be increased age and weight gain due to pregnancy. Recurrence of GDM in the next pregnancy is associated with advanced maternal age, maternal obesity, weight gain up to the next pregnancy, insulin use in previous pregnancy, multiparity, inter-pregnancy interval, macrosomic infant birth, postprandial glucose elevation and non-Caucasian ethnicity. © 2020 by Nova Science Publishers, Inc. All rights reserved.