الفهرس 
Gestational DiabetesOnly 14 pages are availabe for public view
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Abstract
Gestational diabetes is a growing health problem in pregnancy. The prevalence has been variable from 2.2% to 8.8% and may increase to 14% depending on the ethnic mix of criteria used for diagnosis and population (Fernandez-Morera et al., 2010).
The pregnancy is a physiological situation of progressive insulin resistance. Insulin resistance and impaired beta cell function, both contribute to GDM (Singh et al., 2008).
Insulin resistance includes 2 main contributors, increased maternal adiposity and insulin desensitizing effect of pregnancy hormones (Di Cianni et al., 2003).
GDM is associated with fetal and maternal complications. Screening, diagnosis and management of hyperglycemia are important.
Screening of GDM is recommended for all women between 24-28 weeks of pregnancy. The diagnosis is based on OGTT.
Dietary restriction and suitable physical exercise help in control of GDM. Fasting and post-prandial glucose testing is necessary for monitoring and guidance of therapy.
When dietary measures are inadequate to achieve glycemic targets, insulin should be introduced. Oral hypoglycemic agents are not been proved to be teratogenic and their safety has not widely accepted.
Elevated uric acid is accompanied with cardiovascular disease events and risk factors such as hypertension, metabolic syndrome, chronic kidney disease, obesity, and diabetes in non-pregnant adults (Feig et al., 2008).
Hyperuricemia is a risk factor for developing type 2 diabetes (Dehghan et al., 2008) (Nakanishi et al., 2003).
It was a prospective observational study included 200 pregnant patients who were regularly attending the out-patient clinic for routine antenatal care to find if the elevated first trimester uric acid is associated with development of GDM or not.
In this study:
• Elevated first-trimester uric acid concentration was correlated with an increased risk of developing GDM. The risk of developing GDM was higher if first-trimester uric acid was < 3.1 mg/dI.
• Women who developed GDM were significantly older when they compared to women who did not develop GDM [Normal with Mean + SD 24.53 + 4.40 years, Abnormal with Mean + SD 32.78 + 8.18 years, p-value 0.016].
• It was found that, the mean BMI was significantly higher in women who developed GDM when compared to women who did not develop GDM [Normal 115 cases of total sample and no one developed GD with Mean + SD, 95.57 + 12.32, Overweight 59 cases, 56 cases (29.3%) were normal and 3 cases (33.3%) had GD with Mean + SD 106.29 + 26.62, Obese 26 cases, 20 cases (10.5%) were normal and 6 cases (66.7%) had GD with Mean + SD 124.27 + 39.78, p-value 0.000].
• Women who developed GDM had significantly more number of children [Nullipara were 85 cases (44.5%) of total sample size and no one had GD with Mean + SD 97.61 + 13.20, 1–2 children were 73 cases of total sample size, 72 cases (37.7%) were normal and 1 case (11.1%) had GD with Mean + SD 98.23 + 16.87, 3 or more were 42 cases of total sample size, 38 cases (17.8%) were normal and 8 cases (88.9%) had GD with Mean + SD 119.62 + 40.08] with p-value 0.000.