BACKGROUND Gestational diabetes mellitus(GDM)has emerged as a global public health cha-llenge,fueled by increasing maternal age,rising obesity rates,and lifestyle shifts.It is linked to substantial short-and long-term...BACKGROUND Gestational diabetes mellitus(GDM)has emerged as a global public health cha-llenge,fueled by increasing maternal age,rising obesity rates,and lifestyle shifts.It is linked to substantial short-and long-term health risks for both mothers and their offspring,offering a critical opportunity for intergenerational prevention of metabolic disorders.AIM To synthesize current evidence on the pathophysiology,diagnosis,management,complications,and individualized treatment strategies of GDM.METHODS We conducted a narrative review in accordance with PRISMA guidelines.Pub-Med,Scopus,Web of Science,and EMBASE were searched for English-language articles(2017-2025)using terms such as“GDM”,“pregnancy”,“insulin resis-tance”,and“maternal outcomes”.After removing duplicates,512 records were screened;102 full texts were assessed for eligibility,and 55 studies were included based on methodological quality,clinical relevance,and alignment with the review objectives.RESULTS GDM results from a complex interplay among progressive insulin resistance,β-cell dysfunction,immune dysregulation,and placental inflammation.Emerging evidence indicates that hyperglycemia before formal diagnosis can impair fetal programming via epigenetic mechanisms.GDM increases a mother’s risk of developing type 2 diabetes mellitus seven-to tenfold and raises the incidence of cardiovascular disease,preeclampsia,and cesarean delivery.Offspring are at higher risk of macrosomia,neonatal hypoglycemia,and future metabolic and cardiovascular disorders.Lifestyle modification remains the cornerstone of therapy and,when necessary,can be supplemented with pharmacologic agents such as metformin or insulin.Postpartum follow-up,breastfeeding support,and preconception counseling are vital to long-term metabolic health.CONCLUSION GDM requires precision-based,life-course care.Future priorities include early risk detection,biomarker validation,unified diagnosis,and culturally sensitive interventions to improve maternal-child outcomes.展开更多
Previous literature has demonstrated that low-income people are more likely to settle for poor health choices in developed countries. By using income as a budget constraint and signal for future wellbeing in a life-co...Previous literature has demonstrated that low-income people are more likely to settle for poor health choices in developed countries. By using income as a budget constraint and signal for future wellbeing in a life-course utility model, we examine the association amongst income and overweight. The data used for this study are from the China Health and Nutrition Survey(CHNS). Estimations are conducted for overweight initiation, cessation, and participation mirroring a decision to begin and a past decision to not terminate. Our findings propose that body weight and the likelihood of overweight commencement rise with additional income but at a diminishing degree, representing a concave relation;while the likelihood of overweight discontinuance declines with additional income but at an accelerating degree, suggesting a convex relation.We presume that, as opposed to developed countries, low-income people are less inclined to be overweight in China, a country in transition. This could be explained by an income constraint for unhealthy foodstuff. Nevertheless, it will switch when income surpasses the critical threshold of the concave or inverted U-shape curve indicating that low-income people appear to receive not as much utility from future health. Specifically, this adjustment seems to occur earlier for females and inhabitants of urban areas.展开更多
文摘BACKGROUND Gestational diabetes mellitus(GDM)has emerged as a global public health cha-llenge,fueled by increasing maternal age,rising obesity rates,and lifestyle shifts.It is linked to substantial short-and long-term health risks for both mothers and their offspring,offering a critical opportunity for intergenerational prevention of metabolic disorders.AIM To synthesize current evidence on the pathophysiology,diagnosis,management,complications,and individualized treatment strategies of GDM.METHODS We conducted a narrative review in accordance with PRISMA guidelines.Pub-Med,Scopus,Web of Science,and EMBASE were searched for English-language articles(2017-2025)using terms such as“GDM”,“pregnancy”,“insulin resis-tance”,and“maternal outcomes”.After removing duplicates,512 records were screened;102 full texts were assessed for eligibility,and 55 studies were included based on methodological quality,clinical relevance,and alignment with the review objectives.RESULTS GDM results from a complex interplay among progressive insulin resistance,β-cell dysfunction,immune dysregulation,and placental inflammation.Emerging evidence indicates that hyperglycemia before formal diagnosis can impair fetal programming via epigenetic mechanisms.GDM increases a mother’s risk of developing type 2 diabetes mellitus seven-to tenfold and raises the incidence of cardiovascular disease,preeclampsia,and cesarean delivery.Offspring are at higher risk of macrosomia,neonatal hypoglycemia,and future metabolic and cardiovascular disorders.Lifestyle modification remains the cornerstone of therapy and,when necessary,can be supplemented with pharmacologic agents such as metformin or insulin.Postpartum follow-up,breastfeeding support,and preconception counseling are vital to long-term metabolic health.CONCLUSION GDM requires precision-based,life-course care.Future priorities include early risk detection,biomarker validation,unified diagnosis,and culturally sensitive interventions to improve maternal-child outcomes.
基金the National Institute of Nutrition and Food Safety, China Center for Disease Control and Prevention, Carolina Population Center (5 R24 HD050924)the University of North Carolina at Chapel Hill, the NIH (R01-HD30880, DK056350, R24 HD050924, and R01HD38700)+2 种基金the Fogarty International Center, NIH for financial support for the CHNS data collection and analysis files from 1989 to 2011 and future surveysthe China-Japan Friendship Hospital, Ministry of Health for support for CHNS 2009financial support from the China Scholarship Council for conducting this research
文摘Previous literature has demonstrated that low-income people are more likely to settle for poor health choices in developed countries. By using income as a budget constraint and signal for future wellbeing in a life-course utility model, we examine the association amongst income and overweight. The data used for this study are from the China Health and Nutrition Survey(CHNS). Estimations are conducted for overweight initiation, cessation, and participation mirroring a decision to begin and a past decision to not terminate. Our findings propose that body weight and the likelihood of overweight commencement rise with additional income but at a diminishing degree, representing a concave relation;while the likelihood of overweight discontinuance declines with additional income but at an accelerating degree, suggesting a convex relation.We presume that, as opposed to developed countries, low-income people are less inclined to be overweight in China, a country in transition. This could be explained by an income constraint for unhealthy foodstuff. Nevertheless, it will switch when income surpasses the critical threshold of the concave or inverted U-shape curve indicating that low-income people appear to receive not as much utility from future health. Specifically, this adjustment seems to occur earlier for females and inhabitants of urban areas.
