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## Meet the editor

Miroslav Radenković, MD, graduated from the Faculty of Medicine, University of Belgrade (FMUB), Serbia, in 1995, where he also obtained an MS in Pharmacology, board certification in Clinical Pharmacology, a Ph.D. in Medical Sciences, and sub-specialization in Pharmacotherapy in 1999, 2000, 2004, and 2016, respectively. He has worked in the Department of Pharmacology at FMUB since 1996. Dr. Radenković also obtained an MS

in Bioethics from Clarkson University, NYC, USA, in 2021. He has participated in several scientific projects supported by the Ministry of Science, Serbia; the Austrian Science Fund; and the NIH Fogarty International Center Project, USA. Dr. Radenković is a member of the Ethics Committee of Serbia.

Contents

**Section 1**

**Section 2**

*by Samar Banerjee*

*by Temitope Sanusi-Olubowale*

to Improve Glucose Regulation

Current Recommendations

*and Elisabet Børsheim*

**Section 3**

Impairment

*by Cristian Espinoza*

*by Radiana Staynova and Vesselina Yanachkova*

Pharmacotherapy of Gestational Diabetes Mellitus:

*by Miroslav Radenković and Ana Jakovljević*

**Preface III**

Ethology of Gestational Diabetes Mellitus **1**

**Chapter 1 3**

**Chapter 2 25**

**Chapter 3 37**

Management of Gestational Diabetes Mellitus **57**

**Chapter 4 59**

**Chapter 5 69**

**Chapter 6 85**

Consequences of Gestational Diabetes Mellitus **101**

**Chapter 7 103**

GDM-Induced Vascular Injury and Its Relationship with Fetal Metabolic

Improving Gestational Diabetes Management through Patient Education

Using Resistance Training in Women with Gestational Diabetes Mellitus

*by Brittany R. Allman, Samantha McDonald, Linda May, Amber W. Kinsey* 

Biomarkers in GDM, Role in Early Detection and Prevention

Epigenetic: New Insight in Gestational Diabetes Mellitus *by Maria Grazia Dalfrà, Silvia Burlina and Annunziara Lapolla*

The Interaction between the Gut Microbiota and Chronic Diseases

## Contents



Preface

Gestational diabetes mellitus is defined as diabetes diagnosed in the second or third trimester of pregnancy, with no evidence of pre-existing type 1 or type 2 diabetes. Although gestational diabetes normally disappears after delivery, this pathological condition may have long-term medical consequences for both mother and offspring. In accordance, increased risk of miscarriage, macrosomia, complications around delivery, and stillbirth have been clearly connected with diabetes developed during pregnancy.

Although much knowledge has been acquired regarding the prevention, diagnosis, implications, and management of gestational diabetes mellitus, the exact mechanisms of its development are still under investigation. In that way, we can recognize recent efforts in a deeper understanding of the adverse genetic background and the epigenetic modifications linked to nutritional and environmental factors in affecting hyperglycemia

Pharmacological and non-pharmacological treatments of gestational diabetes are aimed at maintaining euglycemia with regular glucose monitoring, dietary modifications,

This book provides a comprehensive overview of recent advances in gestational diabetes mellitus. It includes three major sections directing the reader's attention to the etiology, management, and consequences of the disorder. Chapters present the latest information regarding biomarkers and their promising role in early detection and prevention of gestational diabetes mellitus as well as up-to-date knowledge linked to genetic and epigenetic factors, including gut microbiota. Improving gestational diabetes management through patient education, resistance training throughout pregnancy, and the prudent use of drugs leading to the optimal control of glucose level represent the major components of contemporary management of gestational diabetes mellitus. Unfortunately, despite all medical efforts, gestational diabetes is still connected to some major consequences that may affect both mothers and their offspring. Hence, the closing chapters provided pivotal information regarding vascular injury induced by gestational diabetes mellitus and its relationship with fetal metabolic impairment, maternal microbiome alterations, and finally current

data about future risks for children born to mothers with gestational diabetes.

and update existing knowledge on diabetes-related to pregnancy.

This book is a useful resource for both clinicians and basic investigators to further explore

**Dr. Miroslav Radenković**

Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Professor,

We express sincere appreciation to all the chapter authors for their enthusiasm and expertise, as well as IntechOpen for their highly professional and unconditional support.

of pregnant women and future fetal metabolism.

lifestyle changes, exercise, and appropriate pharmacotherapy.
