Gestational diabetes mellitus (GDM) is a controversial subject in obstetrics. It is defined by the National Diabetes Data Group in 1985 as carbohydrate intolerance of variable severity with onset or first recognition during pregnancy.1 The first case report of GDM appeared in 1824, which described a mother with thirst, polyuria and glycosuria and the death of a macrosomic infant from shoulder impaction. Historically, there has been a lot of controversy over most aspects of GDM, including screening, diagnosis, risks, treatment, and the relationship between GDM and type 2 diabetes mellitus. Recently, several major studies have substantially resolved these areas of controversy, eg, the Hyperglycaemia and Adverse Pregnancy Outcomes (HAPO) study,2 the Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS),3 and the Maternal-Fetal Medicine Units Network treatment of mild gestational diabetes (MFMUN-GDM)4 clinical trials, which will be discussed further in this article.
Menopause is a health milestone, signalling a new phase in a woman’s life. It is a natural event characterized by the permanent cessation of menstruation due to loss of ovarian follicular function. Many women breeze through this life stage with little or no issues, while some have bothersome menopausal symptoms that require medical intervention.
Infertility generally affects one in seven couples and is a growing problem worldwide.1,2 This is illustrated by the increase in the number of assisted reproductive technology (ART) treatment cycles worldwide in 2009–2010, ranging from an increase of 5.9% to over 100%.3–5 Male subfertility is one of the major causes, as a sole factor accounting for 29.7% and as a contributor for another 10.3–29.7% in the United Kingdom and Hong Kong.3,5 There is some evidence suggesting that there might be a decline in semen concentration of men born in the 1930’s to 1980’s.6–8
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Impaired endothelial-dependent microvascular reactivity appears to be predictive of albuminuria progression in Asian patients with type 2 diabetes (T2D) who have normal urine albumin levels at baseline, but not in those with microalbuminuria, a prospective longitudinal cohort study suggests.