What is the course of renal disease in gestational diabetes mellitus (GDM)?

Updated: Apr 29, 2020
  • Author: Thomas R Moore, MD; Chief Editor: George T Griffing, MD  more...
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Answer

Answer

The most recent studies indicate that pregnancy does not measurably alter the time course of diabetic renal disease, nor does it increase the likelihood of progression to end-stage renal disease. Regardless of pregnancy, the progression to renal disease in diabetic patients appears to be related to duration of diabetes and degree of glycemic control. A randomized study in 36 patients with insulin-dependent diabetes who had microalbuminuria found that after 2 years, none of the patients who had strict metabolic control with a subcutaneous insulin pump progressed to clinical nephropathy. Among study patients receiving conventional treatment, which was associated with higher mean glucose levels, 5 patients progressed to clinical nephropathy. [23]


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