Management of Gestational Diabetes Mellitus and Pharmacists' Role in Patient Education

Emily Evans; Roland Patry

Am J Health Syst Pharm. 2004;61(14) 

In This Article

Pathophysiology

During early pregnancy, increases in estrogens, progestins, and other pregnancy-related hormones lead to lower glucose levels, promotion of fat deposition, delayed gastric emptying, and increased appetite. As gestation progresses, however, postprandial glucose levels steadily increase as insulin sensitivity steadily decreases.[5] For glucose control to be maintained in pregnancy, it is necessary for maternal insulin secretion to increase sufficiently to counteract the fall in insulin sensitivity.[6] GDM occurs when there is insufficient insulin secretion to counteract the pregnancy-related decrease in insulin sensitivity.[7]

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