I'm doing a report on GDM for my class. I'm finding myself in shock reading medical journals that say that induction for macrosomia causes c/s when every woman I know with GD was induced! Do MDs just not READ medical journals or follow the ACOG recommendations? Majority ending in c/s. I have read Henci Goer's article as well. Actually, I have 3 chapters from different medical texts and about 30, not exaggerating articles from the last 5 years from medical and midwifical sources. I am really interested in your perspectives. Is there really such a thing as GDM? If so, is it just insulin resistance which is at a higher level in some women? Do you think many of the cases of supposed GDM are just sugar spill from a LGA baby? In the case of plus size pregnancy, is the insulin resistance and future diabetes specifically poor diet/larger woman related? When you have a GDM mom, how do you treat her, or do you risk her out? Also, can you think of some good alternative sources for info from the last five years on GDM for me?
I hope this was enough to generate some discussion, my head is spinning form all the reading I have done.
I'm also interested in your perspective on macrosomia. Having known a few women who have given birth to one or more 11 pound babies, I feel like macrosomia is way over diagnosed. Some kids are just big, maybe like their families. TIA!
I do not have the most recent edition of Anne Freye's Guide to Diagnostic Tests, but in the edition I do have (5th? published in the mid-90's?) She has some excellent points (imho) regarding the validity of GD as a diagnosis--specifically the inherent flaws in the way GD is screened.
Something that I am continually reminding myself of is that maternity care in the US is actually *not* evidence based...but you don't have to take my word for it, check it out with the World Health Organization....
Oh totally, in one medical journal it said that there wasn't a lot of evidence for GD, but that much of medicine wasn't evidence based. Or specifically, that there hadn't been enough testing to establish the evidence. :