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 of pregnant women and future fetal metabolism.

Pharmacological and non-pharmacological treatments of gestational diabetes are aimed at maintaining euglycemia with regular glucose monitoring, dietary modifications, lifestyle changes, exercise, and appropriate pharmacotherapy.

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.

This book is a useful resource for both clinicians and basic investigators to further explore and update existing knowledge on diabetes-related to pregnancy.

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.

#### **Dr. Miroslav Radenković** Professor, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Section 1
