A Review of Gestational Diabetes Mellitus and Ademolus Classification of Hypoglycaemia

Abstract

According to the World Health Organization, hyperglycaemia first detected at any time during pregnancy should be classified as either diabetes mellitus in pregnancy, or gestational diabetes mellitus. Current definitions of gestational diabetes include women with diabetes and women with intermediate hyperglycaemia impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) as defined in non-pregnant adults. The use of insulin in gestational diabetes mellitus is a category B level of recommendation while the use of oral hypoglycaemic agent is category C. Whichever glucose lowering agent is used whether injectable or oral, the risk of hypoglycaemia in both mother and fetus and in the immediate neonatal period cannot be overemphasized, this fact is what makes Ademolus Classification of Hypoglycaemia (ACH) a valuable tool in evaluating hypoglycaemia complicating the management of gestational diabetes mellitus. It is noticed that studies reported on maternal hypoglycaemia had varying results due, in part, to differences in the definition of hypoglycaemia. This is one of the gap in knowledge and controversies that will be addressed usefully by Ademolus Classification of Hypoglycemia in gestational diabetes mellitus management complication worldwide, it will helps to unify definition of hypoglycaemia irrespective of race and also allow for comparing of data objectively.ACH will make interpretation of continuous glucose monitoring easier. The more we use ACH, the more we will see the gap in our existing knowledge, the more insight we will get in hypoglycaemia complicating gestational diabetes mellitus and the more scientifically knowledgeable we will become as it will open up new path of scientific understanding of fetomaternal pathophysiology for the benefit of mankind.