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Gestational diabetes (or gestational diabetes mellitus, GDM) is a condition in which women without previously diagnosed diabetes exhibit high blood glucose (blood sugar) levels during pregnancy (especially during their third trimester). Gestational diabetes is caused when insulin receptors do not function properly. This is likely due to pregnancy-related factors such as the presence of human placental lactogen that interferes with susceptible insulin receptors. This in turn causes inappropriately elevated blood sugar levels. Gestational diabetes generally has few symptoms and it is most commonly diagnosed by screening during pregnancy. Diagnostic tests detect inappropriately high levels of glucose in blood samples. Gestational diabetes affects 3-10% of pregnancies, depending on the population studied.〔Thomas R Moore, MD et al. Diabetes Mellitus and Pregnancy. . Version: Jan 27, 2005 update.〕 As with diabetes mellitus in pregnancy in general, babies born to mothers with untreated gestational diabetes are typically at increased risk of problems such as being large for gestational age (which may lead to delivery complications), low blood sugar, and jaundice. If untreated, it can also cause seizures or stillbirth. Gestational diabetes is a treatable condition and women who have adequate control of glucose levels can effectively decrease these risks. The food plan is often the first recommended target for strategic management of GDM. Women with unmanaged gestational diabetes are at increased risk of developing type 2 diabetes mellitus (or, very rarely, latent autoimmune diabetes or Type 1) after pregnancy, as well as having a higher incidence of pre-eclampsia and Caesarean section; their offspring are prone to developing childhood obesity, with type 2 diabetes later in life. Most women are able to manage their blood glucose levels with a modified diet and the introduction of moderate exercise, but some require antidiabetic drugs, including insulin.〔 ==Classification== Gestational diabetes is formally defined as "any degree of glucose intolerance with onset or first recognition during pregnancy".〔 And the rest of the issue B1–B167.〕 This definition acknowledges the possibility that a woman may have previously undiagnosed diabetes mellitus, or may have developed diabetes coincidentally with pregnancy. Whether symptoms subside after pregnancy is also irrelevant to the diagnosis. A woman is diagnosed with gestational diabetes when glucose intolerance continues beyond 24–28 weeks of gestation. The White classification, named after Priscilla White, who pioneered research on the effect of diabetes types on perinatal outcome, is widely used to assess maternal and fetal risk. It distinguishes between gestational diabetes (type A) and pregestational diabetes (diabetes that existed prior to pregnancy). These two groups are further subdivided according to their associated risks and management.〔Gabbe S.G., Niebyl J.R., Simpson J.L. OBSTETRICS: Normal and Problem Pregnancies. Fourth edition. Churchill Livingstone, New York, 2002. ISBN 0-443-06572-1〕 The two subtypes of gestational diabetes under this classification system are: * Type A1: abnormal oral glucose tolerance test (OGTT), but normal blood glucose levels during fasting and two hours after meals; diet modification is sufficient to control glucose levels * Type A2: abnormal OGTT compounded by abnormal glucose levels during fasting and/or after meals; additional therapy with insulin or other medications is required Diabetes which existed prior to pregnancy is also split up into several subtypes under this system: * Type B: onset at age 20 or older and duration of less than 10 years. * Type C: onset at age 10-19 or duration of 10–19 years. * Type D: onset before age 10 or duration greater than 20 years. * Type E: overt diabetes mellitus with calcified pelvic vessels. * Type F: diabetic nephropathy. * Type R: proliferative retinopathy. * Type RF: retinopathy and nephropathy. * Type H: ischemic heart disease. * Type T: prior kidney transplant. An early age of onset or long-standing disease comes with greater risks, hence the first three subtypes. Two other sets of criteria are available for diagnosis of gestational diabetes, both based on blood-sugar levels. Criteria for diagnosis of gestational diabetes, using the 100 gram Glucose Tolerance Test, according to Carpenter and Coustan: * Fasting 95 mg/dl * 1 hour 180 mg/dl * 2 hours 155 mg/dl * 3 hour 140 mg/dl Criteria for diagnosis of gestational diabetes according to National Diabetes Data Group: * Fasting 105 mg/dl * 1 hour 190 mg/dl * 2 hours 165 mg/dl * 3 hour 145 mg/dl 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「gestational diabetes」の詳細全文を読む スポンサード リンク
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