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Sample records for prevention gestational diabetes

  1. Gestational diabetes

    Science.gov (United States)

    ... right for you. Low-impact exercises, such as swimming, brisk walking, or using an elliptical machine are ... chap 45. Moyer VA; US Preventive Services Task Force. Screening for gestational diabetes mellitus: US Preventive Services ...

  2. Mothers After Gestational Diabetes in Australia Diabetes Prevention Program (MAGDA-DPP) post-natal intervention

    DEFF Research Database (Denmark)

    Shih, Sophy T F; Davis-Lameloise, Nathalie; Janus, Edward D.

    2014-01-01

    Background: The Mothers After Gestational Diabetes in Australia Diabetes Prevention Program (MAGDA-DPP) is a randomized controlled trial (RCT) that aims to assess the effectiveness of a structured diabetes prevention intervention for women who had gestational diabetes.Methods/Design: The original...

  3. Gestational diabetes

    OpenAIRE

    Dragoš, Andreja

    2014-01-01

    Gestational diabetes is diabetes that occurs for the first time during pregnancy. In Slovenia, between 2.8 and 4.5 percent of pregnant women are affected by this disease. The number of women with gestational diabetes is increasing due to unhealthy lifestyle and most of all due to increasing occurrence of obesity. Gestational diabetes is a growing problem in Slovenia, as well as in the world. The purpose of the thesis is to establish the main risk factors for gestational diabetes and determ...

  4. Mothers After Gestational Diabetes in Australia Diabetes Prevention Program (MAGDA-DPP) post-natal intervention

    DEFF Research Database (Denmark)

    Shih, Sophy T.F.; Davis-Lameloise, Nathalie; Janus, Edward D.

    2013-01-01

    Background: Gestational diabetes mellitus (GDM) is defined as glucose intolerance with its onset or first recognition during pregnancy. Post-GDM women have a life-time risk exceeding 70% of developing type 2 diabetes mellitus (T2DM). Lifestyle modifications reduce the incidence of T2DM by up to 58......% for high-risk individuals. Methods/Design: The Mothers After Gestational Diabetes in Australia Diabetes Prevention Program (MAGDA-DPP) is a randomized controlled trial aiming to assess the effectiveness of a structured diabetes prevention intervention for post-GDM women. This trial has an intervention...... group participating in a diabetes prevention program (DPP), and a control group receiving usual care from their general practitioners during the same time period. The 12-month intervention comprises an individual session followed by five group sessions at two-week intervals, and two follow-up telephone...

  5. Prescribing physical activity to prevent and manage gestational diabetes

    OpenAIRE

    Colberg, Sheri R; Castorino, Kristin; Jovanovič, Lois

    2013-01-01

    Gestational diabetes mellitus (GDM) is the most prevalent metabolic disorder during pregnancy. Women diagnosed with GDM have a substantially greater risk of developing type 2 diabetes within 5-10 years after delivery, and the risk is increased by excess body weight. Uncontrolled hyperglycemia during pregnancy is potentially harmful to both mother and fetus, resulting in a greater need for Caesarian-section deliveries, delivery of larger infants with more excess body fat, a greater risk of inf...

  6. Gestational diabetes

    African Journals Online (AJOL)

    ::wercome the pregnancy-related decline in insulin sensitivity. Gestational diabetes mellitus (GDM) is defined as impaired glucose tolerance presenting during pregnancy; it is usual for GDM to abate after delivery.7 A number of diagnostic criteria have been used to define GDM since its recognrtion by Bennewitz and its fuller ...

  7. Combined diet and exercise interventions for preventing gestational diabetes mellitus.

    Science.gov (United States)

    Shepherd, Emily; Gomersall, Judith C; Tieu, Joanna; Han, Shanshan; Crowther, Caroline A; Middleton, Philippa

    2017-11-13

    Gestational diabetes mellitus (GDM) is associated with a wide range of adverse health consequences for women and their infants in the short and long term. With an increasing prevalence of GDM worldwide, there is an urgent need to assess strategies for GDM prevention, such as combined diet and exercise interventions. This is an update of a Cochrane review that was first published in 2015. To assess the effects of diet interventions in combination with exercise interventions for pregnant women for preventing GDM, and associated adverse health consequences for the mother and her infant/child. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (27 November 2016) and reference lists of retrieved studies. We included randomised controlled trials (RCTs) and cluster-RCTs, comparing combined diet and exercise interventions with no intervention (i.e. standard care), that reported on GDM diagnosis as an outcome. Quasi-RCTs were excluded. Cross-over trials were not eligible for inclusion. We planned to include RCTs comparing two or more different diet/exercise interventions, however none were identified. Two review authors independently assessed study eligibility, extracted data, assessed the risk of bias of the included trials and assessed quality of evidence for selected maternal and infant/child outcomes using the GRADE approach. We checked data for accuracy. In this update, we included 23 RCTs (involving 8918 women and 8709 infants) that compared combined diet and exercise interventions with no intervention (standard care). The studies varied in the diet and exercise programs evaluated and health outcomes reported. None reported receiving funding from a drug manufacturer or agency with interests in the results. Overall risk of bias was judged to be unclear due to the lack of methodological detail reported. Most studies were undertaken in high-income countries.For our primary review outcomes, there was a possible reduced risk of GDM in the diet and

  8. Genetics Home Reference: gestational diabetes

    Science.gov (United States)

    ... percent of all pregnancies are affected by gestational diabetes . The prevalence of gestational diabetes has been increasing rapidly over the past few ... Pregnancy (PDF) U.S. Preventive Services Task Force: Gestational Diabetes Mellitus ... Formal Treatment/Management Guidelines (4 links) Joslin Diabetes Center and ...

  9. Prevention of Type 2 diabetes after gestational diabetes directed at the family context

    DEFF Research Database (Denmark)

    Kragelund Nielsen, K; Grunnet, L Groth; Maindal, H Terkildsen

    2018-01-01

    for future research. A narrative review of the symposium presentations and related literature is given. GDM is associated with increased short- and long-term adverse outcomes including Type 2 diabetes for both mother and offspring. Interestingly, women's partners are also at higher risk of Type 2 diabetes....... Thus, although GDM is diagnosed in pregnant women, the implications seem to affect the whole family. Structured lifestyle intervention can prevent or delay the onset of Type 2 diabetes. In this review, we show how numerous challenges are present in the target group, when such interventions are sought......In this review, we aim to summarize knowledge about gestational diabetes (GDM) after delivery; with special focus on the potential of preventing Type 2 diabetes in a family context. The review expands on the key messages from a symposium held in Copenhagen in May 2017 and highlights avenues...

  10. Screening for gestational diabetes mellitus : US preventive services task force recommendation statement

    NARCIS (Netherlands)

    Calonge, Ned; Petitti, Diana B.; DeWitt, Thomas G.; Gordis, Leon; Gregory, Kimberly D.; Harris, Russell; Isham, George; LeFevre, Michael L.; Loveland-Cherry, Carol; Marion, Lucy N.; Moyer, Virginia A.; Ockene, Judith K.; Sawaya, George F.; Siu, Albert L.; Teutsch, Steven M.; Yawn, Barbara P.

    2008-01-01

    Description: Update of 2003 U. S. Preventive Services Task Force (USPSTF) recommendation about screening for gestational diabetes. Methods: The USPSTF weighed the evidence on maternal and neonatal benefits (reduction in preeclampsia, mortality, brachial plexus injury, clavicular fractures, admission

  11. Diabetes and Pregnancy: Gestational Diabetes

    Centers for Disease Control (CDC) Podcasts

    2007-11-14

    Gestational diabetes happens in a woman who develops diabetes during pregnancy. This podcast discusses its potential effects and action steps to avoid complications.  Created: 11/14/2007 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Diabetes Translation (DDT) and National Center on Birth Defects and Developmental Disabilities (NCBDDD), Prevention Research Branch.   Date Released: 11/27/2007.

  12. Prevention of type 2 diabetes mellitus in women with previous gestational diabetes mellitus.

    Science.gov (United States)

    Moon, Joon Ho; Kwak, Soo Heon; Jang, Hak C

    2017-01-01

    Gestational diabetes mellitus (GDM), defined as any degree of glucose intolerance with onset or first recognition during pregnancy, is characterized by underlying maternal defects in the β-cell response to insulin during pregnancy. Women with a previous history of GDM have a greater than 7-fold higher risk of developing postpartum diabetes compared with women without GDM. Various risk factors for postpartum diabetes have been identified, including maternal age, glucose levels in pregnancy, family history of diabetes, pre-pregnancy and postpartum body mass index, dietary patterns, physical activity, and breastfeeding. Genetic studies revealed that GDM shares common genetic variants with type 2 diabetes. A number of lifestyle interventional trials that aimed to ameliorate modifiable risk factors, including diet, exercise, and breastfeeding, succeeded in reducing the incidence of postpartum diabetes, weight retention, and other obesity-related morbidities. The present review summarizes the findings of previous studies on the incidence and risk factors of postpartum diabetes and discusses recent lifestyle interventional trials that attempted to prevent postpartum diabetes.

  13. Prevention of type 2 diabetes mellitus in women with previous gestational diabetes mellitus

    Science.gov (United States)

    Moon, Joon Ho; Kwak, Soo Heon; Jang, Hak C.

    2017-01-01

    Gestational diabetes mellitus (GDM), defined as any degree of glucose intolerance with onset or first recognition during pregnancy, is characterized by underlying maternal defects in the β-cell response to insulin during pregnancy. Women with a previous history of GDM have a greater than 7-fold higher risk of developing postpartum diabetes compared with women without GDM. Various risk factors for postpartum diabetes have been identified, including maternal age, glucose levels in pregnancy, family history of diabetes, pre-pregnancy and postpartum body mass index, dietary patterns, physical activity, and breastfeeding. Genetic studies revealed that GDM shares common genetic variants with type 2 diabetes. A number of lifestyle interventional trials that aimed to ameliorate modifiable risk factors, including diet, exercise, and breastfeeding, succeeded in reducing the incidence of postpartum diabetes, weight retention, and other obesity-related morbidities. The present review summarizes the findings of previous studies on the incidence and risk factors of postpartum diabetes and discusses recent lifestyle interventional trials that attempted to prevent postpartum diabetes. PMID:28049284

  14. Thiamine supplementation to prevent induction of low birth weight by conventional therapy for gestational diabetes mellitus

    NARCIS (Netherlands)

    Bakker, SJL; ter Maaten, JC; Gans, ROB

    Conventional treatment for gestational diabetes mellitus increases the proportion of infants born with a low birth weight, a risk factor for cardiovascular disease and diabetes mellitus in later life. Thiamine supplementation during pregnancy may be shown to be a safe preventive measure. During

  15. Gestational Diabetes and Pregnancy

    Science.gov (United States)

    ... Pregnant Avoiding Pregnancy Zika and Pregnancy Articles Gestational Diabetes and Pregnancy Language: English (US) Español (Spanish) Recommend ... diabetes must also take insulin. Problems of Gestational Diabetes in Pregnancy Blood sugar that is not well ...

  16. Interventions for preventing gestational diabetes mellitus: A systematic review and meta-analysis

    NARCIS (Netherlands)

    Oostdam, N.; Poppel, M.N.M. van; Wouters, M.G.A.J.; Mechelen, W. van

    2011-01-01

    Background: The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. GDM is associated with increased risks for mother and child during pregnancy and in later life. The aim of this article is to systematically review literature on the effectiveness of interventions to prevent

  17. Interventions for preventing gestational diabetes mellitus: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Oostdam, N.; van Poppel, M.N.M.; Wouters, M.G.A.J.; van Mechelen, W.

    2011-01-01

    Background: The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. GDM is associated with increased risks for mother and child during pregnancy and in later life. The aim of this article is to systematically review literature on the effectiveness of interventions to prevent

  18. The cost-effectiveness of gestational diabetes screening including prevention of type 2 diabetes

    DEFF Research Database (Denmark)

    Marseille, Elliot; Lohse, Nicolai; Jiwani, Aliya

    2013-01-01

    Gestational diabetes mellitus (GDM) is associated with elevated risks of perinatal complications and type 2 diabetes mellitus, and screening and intervention can reduce these risks. We quantified the cost, health impact and cost-effectiveness of GDM screening and intervention in India and Israel,...

  19. SPRING: an RCT study of probiotics in the prevention of gestational diabetes mellitus in overweight and obese women

    Directory of Open Access Journals (Sweden)

    Nitert Marloes Dekker

    2013-02-01

    Full Text Available Abstract Background Obesity is increasing in the child-bearing population as are the rates of gestational diabetes. Gestational diabetes is associated with higher rates of Cesarean Section for the mother and increased risks of macrosomia, higher body fat mass, respiratory distress and hypoglycemia for the infant. Prevention of gestational diabetes through life style intervention has proven to be difficult. A Finnish study showed that ingestion of specific probiotics altered the composition of the gut microbiome and thereby metabolism from early gestation and decreased rates of gestational diabetes in normal weight women. In SPRING (the Study of Probiotics IN the prevention of Gestational diabetes, the effectiveness of probiotics ingestion for the prevention of gestational diabetes will be assessed in overweight and obese women. Methods/design SPRING is a multi-center, prospective, double-blind randomized controlled trial run at two tertiary maternity hospitals in Brisbane, Australia. Five hundred and forty (540 women with a BMI > 25.0 kg/m2 will be recruited over 2 years and receive either probiotics or placebo capsules from 16 weeks gestation until delivery. The probiotics capsules contain > 1x109 cfu each of Lactobacillus rhamnosus GG and Bifidobacterium lactis BB-12 per capsule. The primary outcome is diagnosis of gestational diabetes at 28 weeks gestation. Secondary outcomes include rates of other pregnancy complications, gestational weight gain, mode of delivery, change in gut microbiome, preterm birth, macrosomia, and infant body composition. The trial has 80% power at a 5% 2-sided significance level to detect a >50% change in the rates of gestational diabetes in this high-risk group of pregnant women. Discussion SPRING will show if probiotics can be used as an easily implementable method of preventing gestational diabetes in the high-risk group of overweight and obese pregnant women.

  20. SPRING: an RCT study of probiotics in the prevention of gestational diabetes mellitus in overweight and obese women.

    Science.gov (United States)

    Nitert, Marloes Dekker; Barrett, Helen L; Foxcroft, Katie; Tremellen, Anne; Wilkinson, Shelley; Lingwood, Barbara; Tobin, Jacinta M; McSweeney, Chris; O'Rourke, Peter; McIntyre, H David; Callaway, Leonie K

    2013-02-25

    Obesity is increasing in the child-bearing population as are the rates of gestational diabetes. Gestational diabetes is associated with higher rates of Cesarean Section for the mother and increased risks of macrosomia, higher body fat mass, respiratory distress and hypoglycemia for the infant. Prevention of gestational diabetes through life style intervention has proven to be difficult. A Finnish study showed that ingestion of specific probiotics altered the composition of the gut microbiome and thereby metabolism from early gestation and decreased rates of gestational diabetes in normal weight women. In SPRING (the Study of Probiotics IN the prevention of Gestational diabetes), the effectiveness of probiotics ingestion for the prevention of gestational diabetes will be assessed in overweight and obese women. SPRING is a multi-center, prospective, double-blind randomized controlled trial run at two tertiary maternity hospitals in Brisbane, Australia. Five hundred and forty (540) women with a BMI > 25.0 kg/m(2) will be recruited over 2 years and receive either probiotics or placebo capsules from 16 weeks gestation until delivery. The probiotics capsules contain > 1x10(9) cfu each of Lactobacillus rhamnosus GG and Bifidobacterium lactis BB-12 per capsule. The primary outcome is diagnosis of gestational diabetes at 28 weeks gestation. Secondary outcomes include rates of other pregnancy complications, gestational weight gain, mode of delivery, change in gut microbiome, preterm birth, macrosomia, and infant body composition. The trial has 80% power at a 5% 2-sided significance level to detect a >50% change in the rates of gestational diabetes in this high-risk group of pregnant women. SPRING will show if probiotics can be used as an easily implementable method of preventing gestational diabetes in the high-risk group of overweight and obese pregnant women.

  1. Strategies to optimize participation in diabetes prevention programs following gestational diabetes: a focus group study.

    Directory of Open Access Journals (Sweden)

    Kaberi Dasgupta

    Full Text Available OBJECTIVE: We performed a qualitative study among women within 5 years of Gestational Diabetes (GDM diagnosis. Our aim was to identify the key elements that would enhance participation in a type 2 diabetes (DM2 prevention program. RESEARCH DESIGN AND METHODS: Potential participants received up to three invitation letters from their GDM physician. Four focus groups were held. Discussants were invited to comment on potential facilitators/barriers to participation and were probed on attitudes towards meal replacement and Internet/social media tools. Recurring themes were identified through qualitative content analysis of discussion transcripts. RESULTS: Among the 1,201 contacted and 79 eligible/interested, 29 women attended a focus group discussion. More than half of discussants were overweight/obese, and less than half were physically active. For DM2 prevention, a strong need for social support to achieve changes in dietary and physical activity habits was expressed. In this regard, face-to-face interactions with peers and professionals were preferred, with adjunctive roles for Internet/social media. Further, direct participation of partners/spouses in a DM2 prevention program was viewed as important to enhance support for behavioural change at home. Discussants highlighted work and child-related responsibilities as potential barriers to participation, and emphasized the importance of childcare support to allow attendance. Meal replacements were viewed with little interest, with concerns that their use would provide a poor example of eating behaviour to children. CONCLUSIONS: Among women within 5 years of a GDM diagnosis who participated in a focus group discussion, participation in a DM2 prevention program would be enhanced by face-to-face interactions with professionals and peers, provision of childcare support, and inclusion of spouses/partners.

  2. Strategies to optimize participation in diabetes prevention programs following gestational diabetes: a focus group study.

    Science.gov (United States)

    Dasgupta, Kaberi; Da Costa, Deborah; Pillay, Sabrina; De Civita, Mirella; Gougeon, Réjeanne; Leong, Aaron; Bacon, Simon; Stotland, Stephen; Chetty, V Tony; Garfield, Natasha; Majdan, Agnieszka; Meltzer, Sara

    2013-01-01

    We performed a qualitative study among women within 5 years of Gestational Diabetes (GDM) diagnosis. Our aim was to identify the key elements that would enhance participation in a type 2 diabetes (DM2) prevention program. Potential participants received up to three invitation letters from their GDM physician. Four focus groups were held. Discussants were invited to comment on potential facilitators/barriers to participation and were probed on attitudes towards meal replacement and Internet/social media tools. Recurring themes were identified through qualitative content analysis of discussion transcripts. Among the 1,201 contacted and 79 eligible/interested, 29 women attended a focus group discussion. More than half of discussants were overweight/obese, and less than half were physically active. For DM2 prevention, a strong need for social support to achieve changes in dietary and physical activity habits was expressed. In this regard, face-to-face interactions with peers and professionals were preferred, with adjunctive roles for Internet/social media. Further, direct participation of partners/spouses in a DM2 prevention program was viewed as important to enhance support for behavioural change at home. Discussants highlighted work and child-related responsibilities as potential barriers to participation, and emphasized the importance of childcare support to allow attendance. Meal replacements were viewed with little interest, with concerns that their use would provide a poor example of eating behaviour to children. Among women within 5 years of a GDM diagnosis who participated in a focus group discussion, participation in a DM2 prevention program would be enhanced by face-to-face interactions with professionals and peers, provision of childcare support, and inclusion of spouses/partners.

  3. Gestational Diabetes and Women

    Centers for Disease Control (CDC) Podcasts

    2009-05-12

    This women's health podcast focuses on gestational diabetes (GDM) to help educate women who may have been diagnosed with GDM now or in the past. GDM is a condition that can lead to pregnancy complications.  Created: 5/12/2009 by Office of Women’s Health (OWH) and National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 5/12/2009.

  4. Prescribing exercise for prevention and treatment of gestational diabetes: review of suggested recommendations.

    Science.gov (United States)

    Bianchi, Cristina; Battini, Lorella; Aragona, Michele; Lencioni, Cristina; Ottanelli, Serena; Romano, Matilde; Calabrese, Maria; Cuccuru, Ilaria; De Bellis, Alessandra; Mori, Mary Liana; Leopardi, Anna; Sabbatini, Gigliola; Bottone, Pietro; Miccoli, Roberto; Trojano, Giuseppe; Salerno, Maria Giovanna; Del Prato, Stefano; Bertolotto, Alessandra

    2017-04-01

    Exercise has been proved to be safe during pregnancy and to offer benefits for both mother and fetus; moreover, physical activity may represent a useful tool for gestational diabetes prevention and treatment. Therefore, all women in uncomplicated pregnancy should be encouraged to engage in physical activity as part of a healthy lifestyle. However, exercise in pregnancy needs a careful medical evaluation to exclude medical or obstetric contraindications to exercise, and an appropriate prescription considering frequency, intensity, type and duration of exercise, to carefully balance between potential benefits and potential harmful effects. Moreover, some precautions related to anatomical and functional adaptations observed during pregnancy should be taken into consideration. This review summarized the suggested recommendations for physical activity among pregnant women with focus on gestational diabetes.

  5. How to Treat Gestational Diabetes

    Science.gov (United States)

    ... A Listen En Español How to Treat Gestational Diabetes Be sure to see the latest Diabetes Forecast ... and a healthy start for your baby. Gestational Diabetes – Looking Ahead Gestational diabetes usually goes away after ...

  6. Behavior modification techniques used to prevent gestational diabetes: a systematic review of the literature.

    Science.gov (United States)

    Skouteris, Helen; Morris, Heather; Nagle, Cate; Nankervis, Alison

    2014-04-01

    The prevalence of gestational diabetes mellitus (GDM) and obesity is increasing in developed countries, presenting significant challenges to acute care and public health. The aim of this study is to systematically review published controlled trials evaluating behavior modification interventions to prevent the development of GDM. Nine studies were identified involving such techniques as repetition of information, use of verbal and written educational information, goal setting, and planning, in addition to group and individual counseling sessions. Of the 3 trials with GDM incidence as a primary outcome, only 1 showed a significant reduction. GDM was a secondary outcome in 6 studies where the prevention of excessive gestational weight gain was the primary outcome and only 1 trial study determined an effective intervention. The small number of effective interventions highlights a significant gap in evidence to inform maternity health policy and practice.

  7. The Prevention of Gestational Diabetes Mellitus With Antenatal Oral Inositol Supplementation: A Randomized Controlled Trial.

    Science.gov (United States)

    Farren, Maria; Daly, Niamh; McKeating, Aoife; Kinsley, Brendan; Turner, Michael J; Daly, Sean

    2017-06-01

    This study investigated if inositol in a combination of myo -inositol and D -chiro-inositol would prevent gestational diabetes mellitus (GDM) in women with a family history of diabetes. This was a randomized controlled trial that examined whether inositol from the first antenatal visit prevents GDM. The trial was carried out in a single-center tertiary referral center. Women with a family history of diabetes were enrolled at the first antenatal visit. They were randomized to the intervention group, which received a combination of 1,100 mg myo -inositol, 27.6 mg D -chiro-inositol, and 400 μg folic acid, or to the control group, which received 400 μg folic acid only. All women had an oral glucose tolerance test between 24 and 28 weeks' gestation. The primary end point was the incidence of GDM. Statistical analysis was carried out using SPSS Statistical Package version 20. Two hundred forty women, 120 in each arm, were recruited between January 2014 and July 2015. There were no differences in characteristics between the groups. The incidence of GDM was 23.3% ( n = 28) in the intervention group compared with 18.3% ( n = 22) in the control group ( P = 0.34). The mean fasting plasma glucose at the glucose tolerance test was 81 mg/dL in both groups. Commencing an inositol combination in early pregnancy did not prevent GDM in women with a family history of diabetes. Further studies are required to examine whether inositol supplements at varying doses may prevent GDM. © 2017 by the American Diabetes Association.

  8. What I Need to Know about Gestational Diabetes

    Science.gov (United States)

    ... Diabetes? Type 1 Diabetes Type 2 Diabetes Prediabetes & Insulin Resistance Gestational Diabetes Definition & Facts Symptoms & Causes Tests & Diagnosis Management & Treatment Prevention After Your Baby is Born Monogenic ...

  9. A Randomised Controlled Trial to Delay or Prevent Type 2 Diabetes after Gestational Diabetes: Walking for Exercise and Nutrition to Prevent Diabetes for You

    OpenAIRE

    Peacock, A. S.; Bogossian, F. E.; Wilkinson, S. A.; Gibbons, K. S.; Kim, C.; McIntyre, H. D.

    2015-01-01

    Aims. To develop a program to support behaviour changes for women with a history of Gestational Diabetes Mellitus (GDM) and a Body Mass Index (BMI) > 25?kg/m2 to delay or prevent Type 2 Diabetes Mellitus. Methods. Women diagnosed with GDM in the previous 6 to 24 months and BMI > 25 kg/m2 were randomized to an intervention (I) (n = 16) or a control (C) (n = 15) group. The intervention was a pedometer program combined with nutrition coaching, with the primary outcome increased weight loss in th...

  10. Educational Intervention on Preventive Behaviors on Gestational Diabetes in Pregnant Women: Application of Health Belief Model

    Directory of Open Access Journals (Sweden)

    Zahra Khiyali

    2017-05-01

    Full Text Available Background Unfortunately, gestational diabetes with its demanding health cares and increasing economic costs is globally prevailing. Therefore, preventive measures against this difficulty are highly significant. The aim of the present study was to evaluate the effects of training interventions on behaviors of pregnant women for prevention of gestational diabetes. Materials and Methods This quasi-experimental study was conducted on 91 pregnant women (n=45 in intervention group, n=46 in control group, whom were chosen through multi-stage random sampling, and three training sessions with weekly intervals were offered for the intervention group. The data was collected in two stages including before the intervention and three months after intervention through interview as well as filling in questionnaire forms. The collected data was analyzed through independent sample t-test and paired t-test by considering 0.05 confidence level using SPSS software (version19.0. Results The results of present study showed a direct and significant correlation between age and preventive behaviors (r=0.22, P

  11. Gestational diabetes: A clinical update

    DEFF Research Database (Denmark)

    Kampmann, Ulla; Madsen, Lene Ring; Skajaa, Gitte Oeskov

    2015-01-01

    Gestational diabetes mellitus (GDM) is increasing in prevalence in tandem with the dramatic increase in the prevalence of overweight and obesity in women of childbearing age. Much controversy surrounds the diagnosis and management of gestational diabetes, emphasizing the importance and relevance...... an overview of clinical issues related to GDM, including the challenges of screening and diagnosis, the pathophysiology behind GDM, the treatment and prevention of GDM and the long and short term consequences of gestational diabetes for both mother and offspring....... of clarity and consensus. If newly proposed criteria are adopted universally a significantly growing number of women will be diagnosed as having GDM, implying new therapeutic challenges to avoid foetal and maternal complications related to the hyperglycemia of gestational diabetes. This review provides...

  12. DALI: Vitamin D and lifestyle intervention for gestational diabetes mellitus (GDM) prevention: an European multicentre, randomised trial - study protocol

    OpenAIRE

    Jelsma, Judith G. M.; van Poppel, Mireille N. M.; Galjaard, Sander; Desoye, Gernot; Corcoy, Rosa; Devlieger, Roland; van Assche, Andre; Timmerman, Dirk; Jans, Goele; Harreiter, Jurgen; Kautzky-Willer, Alexandra; Damm, Peter; Mathiesen, Elisabeth R.; Jensen, Dorte M.; Andersen, Liselotte

    2013-01-01

    Background Gestational diabetes mellitus (GDM) is an increasing problem world-wide. Lifestyle interventions and/or vitamin D supplementation might help prevent GDM in some women. Methods/design Pregnant women at risk of GDM (BMI?29 (kg/m2)) from 9 European countries will be invited to participate and consent obtained before 19+6 weeks of gestation. After giving informed consent, women without GDM will be included (based on IADPSG criteria: fasting glucose

  13. Antenatal dietary supplementation with myo-inositol in women during pregnancy for preventing gestational diabetes.

    Science.gov (United States)

    Crawford, Tineke J; Crowther, Caroline A; Alsweiler, Jane; Brown, Julie

    2015-12-17

    Gestational diabetes, glucose intolerance with onset or first recognition during pregnancy, is a rising problem worldwide. Both non-pharmacological and pharmacological approaches to the prevention of gestational diabetes have been, and continue to be explored. Myo-inositol, an isomer of inositol, is a naturally occurring sugar commonly found in cereals, corn, legumes and meat. It is one of the intracellular mediators of the insulin signal and correlated with insulin sensitivity in type 2 diabetes. The potential beneficial effect on improving insulin sensitivity suggests that myo-inositol may be useful for women in preventing gestational diabetes. To assess if antenatal dietary supplementation with myo-inositol is safe and effective, for the mother and fetus, in preventing gestational diabetes. We searched the Pregnancy and Childbirth Group's Trials Register, ClinicalTrials.gov, WHO ICTRP (2 November 2015) and reference lists of retrieved studies. We sought published and unpublished randomised controlled trials, including conference abstracts, assessing the effects of myo-inositol for the prevention of gestational diabetes mellitus (GDM). Quasi-randomised and cross-over trials were not eligible for inclusion, but cluster designs were eligible. Participants in the trials were pregnant women. Women with pre-existing type 1 or type 2 diabetes were excluded. Trials that compared the administration of any dose of myo-inositol, alone or in a combination preparation were eligible for inclusion. Trials that used no treatment, placebo or another intervention as the comparator were eligible for inclusion. Two review authors independently assessed trials for inclusion, risk of bias and extracted the data. Data were checked for accuracy. We included four randomised controlled trials (all conducted in Italy) reporting on 567 women who were less than 11 weeks' to 24 weeks' pregnant at the start of the trials. The trials had small sample sizes and one trial only reported an

  14. The important role of physical activity in the prevention and management of gestational diabetes mellitus.

    Science.gov (United States)

    Ruchat, Stephanie-May; Mottola, Michelle F

    2013-07-01

    The actual pathophysiology behind gestational diabetes mellitus (GDM) is still unclear, but a deterioration in insulin resistance beyond that induced by pregnancy, combined with beta cell dysfunction, plays a key role. Interventions that help improve glucose tolerance by attenuating pregnancy-induced insulin resistance or achieve glycaemic control may therefore help in preventing and managing GDM. In non-pregnant populations, physical activity has been associated with an improvement in glucose homeostasis and insulin sensitivity and a risk reduction for type 2 diabetes mellitus (T2DM) and is a cornerstone for T2DM treatment. However, there is still controversy regarding the benefits of physical activity in preventing and managing GDM. The objective of this review is therefore to provide a comprehensive overview of the effect of prenatal physical activity-based interventions on (1) glucose tolerance, insulin sensitivity and GDM prevention and (2) glycaemic control and insulin use in GDM women. On the basis of the available literature, there is a lack of consistent evidence regarding the benefits of physical activity on improving glucose tolerance and insulin sensitivity and preventing GDM. However, it appears that physical activity may help to achieve good glycaemic control and limit insulin use in GDM women. Compliance appears to be a major problem in physical activity-based intervention studies aimed at GDM prevention. Rigorous scientific research is still required to make an informed decision about the role of physical activity in the prevention and management of GDM and to develop evidence-based physical activity guidelines for GDM prevention and management. Copyright © 2013 John Wiley & Sons, Ltd.

  15. Effect of exercise during pregnancy to prevent gestational diabetes mellitus: a systematic review and meta-analysis.

    Science.gov (United States)

    Yu, Ying; Xie, Rongrong; Shen, Cainuo; Shu, Lianting

    2018-06-01

    Exercise showed some potential in preventing gestational diabetes mellitus. However, the results remained controversial. We conducted a systematic review and meta-analysis to evaluate the impact of exercise during pregnancy on gestational diabetes mellitus. PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the influence of exercise during pregnancy on gestational diabetes mellitus were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome was the incidence of gestational diabetes mellitus. Meta-analysis was performed using random-effect model. Six RCTs involving 2164 patients were included in the meta-analysis. Compared with control intervention, exercise intervention was associated with significantly decreased incidence of gestational diabetes mellitus (Std. mean difference = 0.59; 95%CI = 0.39-.88; p = .01), but had no effect on gestational age at birth (Std. mean difference = -0.03; 95%CI = -0.12 to 0.07; p = .60), the number of preterm birth (OR = 0.85; 95%CI = 0.43-1.66; p = .63), glucose 2-h post-OGTT (Std. mean difference = -1.02; 95%CI = -2.75 to 0.71; p = .25), birth weight (Std. mean difference = -0.13; 95%CI = -0.26 to 0.01; p = .06), and Apgar score less than 7 (OR = .78; 95%CI = 0.21-2.91; p = .71). Compared to control intervention, exercise intervention could significantly decrease the risk of gestational diabetes mellitus, but showed no impact on gestational age at birth, preterm birth, glucose 2-h post-OGTT, birth weight, and Apgar score less than 7.

  16. Healthcare interventions for the prevention and control of gestational diabetes mellitus in China: a scoping review.

    Science.gov (United States)

    Xu, Tingting; He, Yasheng; Dainelli, Livia; Yu, Kai; Detzel, Patrick; Silva-Zolezzi, Irma; Volger, Sheri; Fang, Hai

    2017-06-05

    Gestational Diabetes Mellitus (GDM) is a type of diabetes which occurs during pregnancy. Women with GDM are at greater risk of complications during pregnancy and delivery, while babies born from mothers with GDM are at greater risk of post-natal complications. Using the most updated diagnosis criteria, the GDM prevalence is estimated at 9.3-25.5% worldwide and 9.3-18.9% in China. Our objective was to identify healthcare interventions aimed at GDM prevention and control in China. A best-evidence synthesis was performed based on a systematic search of literature published between 1997 and October 2015 in PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Wan-fang databases using keywords "Gestational Diabetes Mellitus", "GDM", "Intervention" "Medical Intervention" "Early Medical Intervention", "Dietary Intervention", "Exercise Intervention", "Lifestyle Intervention", "Therapy", "Treatment" and "China". Inclusion criteria were studies conducted in China, reporting GDM healthcare interventions, and published in either Chinese or English. Two reviewers independently assessed eligibility and quality of the studies and extracted the data. Treatment efficacy was examined with weighted pooled odds ratio (OR) meta-analyses. The search resulted in 5961 articles (published in 276 different Chinese language journals and 6 English language journals), of which 802 were included in this synthesis. While 39.4% (n = 316) failed to report the GDM diagnostic criteria used, the remaining studies classified GDM with various international (n = 5) or Chinese (n = 7) diagnostic standards. Treatment interventions were categorized into 6 types: dietary (18.6%), exercise (1.6%), medication (20.7%), health education (9.0%), psychological (2.6%) and combination (47.4%). No interventions aimed at GDM prevention were identified. Meta-analyses demonstrated a statistically significant overall benefit of GDM treatment strategies in reducing the odds of maternal and

  17. Regular Exercise to Prevent the Recurrence of Gestational Diabetes Mellitus: A Randomized Controlled Trial.

    Science.gov (United States)

    Guelfi, Kym J; Ong, Ming Jing; Crisp, Nicole A; Fournier, Paul A; Wallman, Karen E; Grove, J Robert; Doherty, Dorota A; Newnham, John P

    2016-10-01

    To investigate the effect of a supervised home-based exercise program on the recurrence and severity of gestational diabetes mellitus (GDM) together with other aspects of maternal health and obstetric and neonatal outcomes. This randomized controlled trial allocated women with a history of GDM to an exercise intervention (14-week supervised home-based stationary cycling program) or to a control group (standard care) at 13±1 weeks of gestation. The primary outcome was a diagnosis of GDM. Secondary outcomes included maternal fitness, psychological well-being, and obstetric and neonatal outcomes. A sample size of 180 (90 in each group) was required to attain 80% power to detect a 40% reduction in the incidence of GDM. Between June 2011 and July 2014, 205 women provided written consent and completed baseline assessments. Of these, 33 (16%) were subsequently excluded as a result of an elevated baseline oral glucose tolerance test (OGTT), leaving 172 randomized to exercise (n=85) or control (n=87). Three women miscarried before the assessment of outcome measures (control=2; exercise=1). All remaining women completed the postintervention OGTT. The recurrence rate of GDM was similar between groups (control 40% [n=34]; exercise 40.5% [n=34]; P=.95) and the severity of GDM at diagnosis was unaffected by the exercise program with similar glucose and insulin responses to the OGTT (glucose 2 hours post-OGTT 7.7±1.5 compared with 7.6±1.6 mmol/L; P>.05). Maternal fitness was improved by the exercise program (P.05). Supervised home-based exercise started at 14 weeks of gestation did not prevent the recurrence of GDM; however, it was associated with important benefits for maternal fitness and psychological well-being. ClinicalTrials.gov, https://clinicaltrials.gov, NCT01283854.

  18. Gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Jiwani, Aliya; Marseille, Elliot; Lohse, Nicolai

    2012-01-01

    Objective: The association between gestational diabetes mellitus (GDM), perinatal complications and long-term morbidity is gaining increased attention. However, the global burden of GDM and the existing responses are not fully understood. We aimed to assess country prevalence and to summarize...

  19. Gestational Diabetes Mellitus

    DEFF Research Database (Denmark)

    McIntyre, H David; Jensen, Dorte M; Jensen, Richard C

    2018-01-01

    OBJECTIVE: To define the prevalence and pregnancy outcomes related to elevated fasting venous plasma glucose (FVPG) in a Danish pregnancy cohort. RESEARCH DESIGN AND METHODS: This was an observational cohort study including 1,516 women without gestational diabetes mellitus (GDM) by Danish criteria...

  20. The efficacy of myo-inositol supplementation to prevent gestational diabetes onset: a meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Zhang, Haifeng; Lv, You; Li, Zhuo; Sun, Lin; Guo, Weiying

    2018-02-06

    The efficacy of myo-inositol supplementation to prevent gestational diabetes onset remains controversial. We conducted a systematic review and meta-analysis to explore the influence of myo-inositol supplementation on the incidence of gestational diabetes. We search PubMed, Embase, Web of science, EBSCO, and Cochrane Library databases through November 2017 for randomized controlled trials (RCTs) assessing the effect of myo-inositol supplementation on gestational diabetes onset. This meta-analysis is performed using the random-effect model. Five randomized controlled trials (RCTs) are included in the meta-analysis. Compared with control group in pregnant women, myo-inositol supplementation is associated with significantly reduced incidence of gestational diabetes (risk ratio (RR) = 0.43; 95%CI = 0.21-0.89; p = .02), and preterm delivery (RR = 0.36; 95%CI = 0.17-0.73; p = .005), but has no substantial impact on 2-h glucose oral glucose tolerance test (OGTT) (mean difference (MD) = -6.90; 95%CI = -15.07 to 1.27; p = .10), gestational age at birth (MD = 0.74; 95%CI = -1.06 to 2.54; p = .42), birth weight (MD = -5.50; 95%CI = -116.99 to 105.99; p = .92), and macrosomia (RR = 0.65; 95%CI = 0.20-2.11; p = .47). Myo-inositol supplementation has some ability to reduce the incidence of gestational diabetes and preterm delivery in pregnant women.

  1. Reasons for participation and non-participation in a diabetes prevention trial among women with prior gestational diabetes mellitus (GDM).

    Science.gov (United States)

    Infanti, Jennifer J; O'Dea, Angela; Gibson, Irene; McGuire, Brian E; Newell, John; Glynn, Liam G; O'Neill, Ciaran; Connolly, Susan B; Dunne, Fidelma P

    2014-01-24

    Gestational diabetes mellitus (GDM) is a risk factor for the development of type 2 diabetes. Lifestyle intervention can prevent progression to type 2 diabetes in high risk populations. We designed a randomised controlled trial (RCT) to evaluate the effectiveness of an established lifestyle intervention compared to standard care for delaying diabetes onset in European women with recent GDM. Recruitment into the RCT was more challenging than anticipated with only 89 of 410 (22%) women agreeing to participate. This paper identifies factors that could enhance participation of the target population in future interventions. We hypothesised that women who agreed to participate would have higher diabetes risk profiles than those who declined, and secondly that it would be possible to predict participation on the bases of those risk factors. To test our hypothesis, we identified the subset of women for whom we had comprehensive data on diabetes risks factors 3-5 years following GDM, reducing the sample to 43 participants and 73 decliners. We considered established diabetes risk factors: smoking, daily fruit and vegetable intake, participation in exercise, family history of diabetes, glucose values and BMI scores on post-partum re-screens, use of insulin during pregnancy, and age at delivery. We also analysed narrative data from 156 decliners to further understand barriers to and facilitators of participation. Two factors differentiated participants and decliners: age at delivery (with women older than 34 years being more likely to participate) and insulin use during pregnancy (with women requiring the use of insulin in pregnancy less likely to participate). Binary logistic regression confirmed that insulin use negatively affected the odds of participation. The most significant barriers to participation included the accessibility, affordability and practicality of the intervention. Women with recent GDM face multiple barriers to lifestyle change. Intervention designers

  2. Increasing incidence of diabetes after gestational diabetes

    DEFF Research Database (Denmark)

    Lauenborg, Jeannet; Hansen, Torben; Jensen, Dorte Møller

    2004-01-01

    To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes....

  3. Increasing incidence of diabetes after gestational diabetes

    DEFF Research Database (Denmark)

    Lauenborg, Jeannet; Hansen, Torben; Jensen, Dorte Møller

    2004-01-01

    To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes.......To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes....

  4. How to prevent type 2 diabetes in women with previous gestational diabetes?

    DEFF Research Database (Denmark)

    Pedersen, Anne Louise Winkler; Terkildsen Maindal, Helle; Juul, Lise

    2017-01-01

    of RCTs in several databases in March 2016. RESULTS: No specific intervention or intervention components were found superior. The pooled effect on diabetes incidence (four trials) was estimated to: -5.02 per 100 (95% CI: -9.24; -0.80). CONCLUSIONS: This study indicates that intervention is superior...

  5. Mothers after Gestational Diabetes in Australia (MAGDA: A Randomised Controlled Trial of a Postnatal Diabetes Prevention Program.

    Directory of Open Access Journals (Sweden)

    Sharleen L O'Reilly

    2016-07-01

    Full Text Available Gestational diabetes mellitus (GDM is an increasingly prevalent risk factor for type 2 diabetes. We evaluated the effectiveness of a group-based lifestyle modification program in mothers with prior GDM within their first postnatal year.In this study, 573 women were randomised to either the intervention (n = 284 or usual care (n = 289. At baseline, 10% had impaired glucose tolerance and 2% impaired fasting glucose. The diabetes prevention intervention comprised one individual session, five group sessions, and two telephone sessions. Primary outcomes were changes in diabetes risk factors (weight, waist circumference, and fasting blood glucose, and secondary outcomes included achievement of lifestyle modification goals and changes in depression score and cardiovascular disease risk factors. The mean changes (intention-to-treat [ITT] analysis over 12 mo were as follows: -0.23 kg body weight in intervention group (95% CI -0.89, 0.43 compared with +0.72 kg in usual care group (95% CI 0.09, 1.35 (change difference -0.95 kg, 95% CI -1.87, -0.04; group by treatment interaction p = 0.04; -2.24 cm waist measurement in intervention group (95% CI -3.01, -1.42 compared with -1.74 cm in usual care group (95% CI -2.52, -0.96 (change difference -0.50 cm, 95% CI -1.63, 0.63; group by treatment interaction p = 0.389; and +0.18 mmol/l fasting blood glucose in intervention group (95% CI 0.11, 0.24 compared with +0.22 mmol/l in usual care group (95% CI 0.16, 0.29 (change difference -0.05 mmol/l, 95% CI -0.14, 0.05; group by treatment interaction p = 0.331. Only 10% of women attended all sessions, 53% attended one individual and at least one group session, and 34% attended no sessions. Loss to follow-up was 27% and 21% for the intervention and control groups, respectively, primarily due to subsequent pregnancies. Study limitations include low exposure to the full intervention and glucose metabolism profiles being near normal at baseline.Although a 1-kg weight

  6. Gestational diabetes mellitus screening and outcomes.

    Science.gov (United States)

    Aktün, Hale Lebriz; Uyan, Derya; Yorgunlar, Betül; Acet, Mustafa

    2015-01-01

    To verify the usefulness of the World Health Organization criteria for the diagnosis of gestational diabetes mellitus in pregnant women and its effectiveness in the prevention of maternal and neonatal adverse results in women younger than 35 years without apparent risk factors for gestational diabetes mellitus. This is a retrospective study based on population involving 1360 pregnant women who delivered and who were followed-up in a university hospital in Istanbul. All women underwent the 75-g oral glucose tolerance test screening, usually in between the 24(th)-28(th) weeks of pregnancy. In all cases, the identification of gestational diabetes mellitus was determined in accordance with the World Health Organization criteria. Approximately 28% of the pregnant women aged younger than 35 years with no risk factors for gestational diabetes mellitus were diagnosed with the oral glucose tolerance test in this study. In the gestational diabetes mellitus group, the primary cesarean section rate was importantly higher than that in the non-gestational diabetes mellitus group. Preterm delivery was also associated with gestational diabetes mellitus. The diagnosis of gestational diabetes mellitus was strongly associated with admittance to the neonatal intensive care unit. Neonatal respiratory problems didn't showed any significant deviation between the groups. There was a moderate association between gestational diabetes mellitus and metabolic complications. Pregnant women with no obvious risk factors were diagnosed with gestational diabetes mellitus using the World Health Organization criteria. The treatment of these women potentially reduced their risk of adverse maternal and neonatal hyperglycemia-related events, such as cesarean section, polyhydramnios, preterm delivery, admission to neonatal intensive care unit, large for gestational age, and higher neonatal weight.

  7. Screening for gestational diabetes mellitus

    NARCIS (Netherlands)

    van Leeuwen, M.

    2012-01-01

    Gestational diabetes mellitus is associated with increased risk of complications for mother and child. Along with the growing epidemic of obesity and type 2 diabetes, the prevalence of gestational diabetes is expected to rise. With adequate and timely treatment, the risk of complications is reduced.

  8. Metformin for Preventing Gestational Diabetes in Women with Polycystic Ovarian Syndrome

    International Nuclear Information System (INIS)

    Ainuddin, J. A.; Kazi, A.; Aftab, S.; Kamran, A.

    2015-01-01

    Objective:To assess the effect of metformin in controlling Gestational Diabetes Mellitus (GDM) in women with Polycystic Ovarian Syndrome (PCOS). Study Design: Comparative cohort study. Place and Duration of Study: Gynecology Clinics of Mamji Hospital, Karachi, from 2008 to 2010. Methodology: Patients who had been diagnosed Polycystic Ovarian Syndrome (PCOS) with hyperinsulinemia and conceived and continued pregnancy, were divided in two groups; 50 patients received metformin throughout pregnancy and 32 did not. Development of GDM was ascertained in both groups. The patients were followed throughout pregnancy and in puerperium with OGTT as per WHO criteria. Primary outcome measure was development of gestational diabetes mellitus. Comparison of continuous variables was done using student 't' test. For categorical variables, frequency and percentages are reported while, odds ratio is also estimated for GDM during pregnancy. Results: A total of 82 women with PCOS were included in this study, out of whom, 50 patients received metformin treatment while 32 patients did not. Pregnant women with PCOS in both groups were comparable in age, weight, parity and BMI. Mean fasting insulin levels at beginning of study entry were 17.22 ± 2.3 mIU/L and 16.93 ± 2.28 mIU/L in metformin and no metformin group respectively (p=0.589). Mean fasting blood sugar levels were 94.54 mg/dl in metformin and 99.59 mg/dl in no metformin group p < 0.001. A total of 5 (10%) patients in metformin group developed GDM while 11 (34.37% OR 4.71, p = 0.01) developed GDM in no metformin group. Patients not receiving metformin were 4.7 times likely to have GDM (OR: 4.71) compared to those who received it. Conclusion: The frequency of gestational diabetes, was significantly higher in patients with PCOS who had not received metformin compared to those who did. (author)

  9. Metformin for preventing gestational diabetes in women with polycystic ovarian syndrome.

    Science.gov (United States)

    Ainuddin, Jahan Ara; Kazi, Sarah; Aftab, Shazia; Kamran, Ayesha

    2015-04-01

    To assess the effect of metformin in controlling Gestational Diabetes Mellitus (GDM) in women with Polycystic Ovarian Syndrome (PCOS). Comparative cohort study. Gynecology Clinics of Mamji Hospital, Karachi, from 2008 to 2010. Patients who had been diagnosed Polycystic Ovarian Syndrome (PCOS) with hyperinsulinemia and conceived and continued pregnancy, were divided in two groups; 50 patients received metformin throughout pregnancy and 32 did not. Development of GDM was ascertained in both groups. The patients were followed throughout pregnancy and in puerperium with OGTT as per WHO criteria. Primary outcome measure was development of gestational diabetes mellitus. Comparison of continuous variables was done using student 't' test. For categorical variables, frequency and percentages are reported while, odds ratio is also estimated for GDM during pregnancy. A total of 82 women with PCOS were included in this study, out of whom, 50 patients received metformin treatment while 32 patients did not. Pregnant women with PCOS in both groups were comparable in age, weight, parity and BMI. Mean fasting insulin levels at beginning of study entry were 17.22 ± 2.3 mIU/L and 16.93 ± 2.28 mIU/L in metformin and no metformin group respectively (p=0.589). Mean fasting blood sugar levels were 94.54 mg/dl in metformin and 99.59 mg/dl in no metformin group p metformin group developed GDM while 11 (34.37% OR 4.71, p = 0.01) developed GDM in no metformin group. Patients not receiving metformin were 4.7 times likely to have GDM (OR: 4.71) compared to those who received it. The frequency of gestational diabetes, was significantly higher in patients with PCOS who had not received metformin compared to those who did.

  10. A Randomised Controlled Trial to Delay or Prevent Type 2 Diabetes after Gestational Diabetes: Walking for Exercise and Nutrition to Prevent Diabetes for You

    Directory of Open Access Journals (Sweden)

    A. S. Peacock

    2015-01-01

    Full Text Available Aims. To develop a program to support behaviour changes for women with a history of Gestational Diabetes Mellitus (GDM and a Body Mass Index (BMI > 25 kg/m2 to delay or prevent Type 2 Diabetes Mellitus. Methods. Women diagnosed with GDM in the previous 6 to 24 months and BMI > 25 kg/m2 were randomized to an intervention (I (n=16 or a control (C (n=15 group. The intervention was a pedometer program combined with nutrition coaching, with the primary outcome increased weight loss in the intervention group. Secondary outcomes included decreased waist and hip measurements, improved insulin sensitivity and body composition, increased physical activity, and improved self-efficacy in eating behaviours. Results. Median (IQR results were as follows: weight: I −2.5 (2.3 kg versus C +0.2 (1.6 kg (P=0.009, waist: I −3.6 (4.5 cm versus C −0.1 (3.6 cm (P=0.07, and hip: I −5.0 (3.3 cm versus C −0.2 (2.6 cm (P=0.002. There was clinical improvement in physical activity and eating behaviours and no significant changes in glucose metabolism or body composition. Conclusion. A pedometer program and nutrition coaching proved effective in supporting weight loss, waist circumference, physical activity, and eating behaviours in women with previous GDM.

  11. Identifying postpartum intervention approaches to prevent type 2 diabetes in women with a history of gestational diabetes

    Directory of Open Access Journals (Sweden)

    Abdul-Rahim Zainab S

    2011-03-01

    Full Text Available Abstract Background Women who develop gestational diabetes mellitus (GDM have an increased risk for the development of type 2 diabetes. Despite this "window of opportunity," few intervention studies have targeted postpartum women with a history of GDM. We sought perspectives of women with a history of GDM to identify a barriers and facilitators to healthy lifestyle changes postpartum, and b specific intervention approaches that would facilitate participation in a postpartum lifestyle intervention program. Methods We used mixed methods to gather data from women with a prior history of GDM, including focus groups and informant interviews. Analysis of focus groups relied on grounded theory and used open-coding to categorize data by themes, while frequency distributions were used for the informant interviews. Results Of 38 women eligible to participate in focus groups, only ten women were able to accommodate their schedules to attend a focus group and 15 completed informant interviews by phone. We analyzed data from 25 women (mean age 35, mean pre-pregnancy BMI 28, 52% Caucasian, 20% African American, 12% Asian, 8% American Indian, 8% refused to specify. Themes from the focus groups included concern about developing type 2 diabetes, barriers to changing diet, and barriers to increasing physical activity. In one focus group, women expressed frustration about feeling judged by their physicians during their GDM pregnancy. Cited barriers to lifestyle change were identified from both methods, and included time and financial constraints, childcare duties, lack of motivation, fatigue, and obstacles at work. Informants suggested facilitators for lifestyle change, including nutrition education, accountability, exercise partners/groups, access to gyms with childcare, and home exercise equipment. All focus group and informant interview participants reported access to the internet, and the majority expressed interest in an intervention program delivered

  12. Achieving penetration and participation in Diabetes After Pregnancy prevention interventions following gestational diabetes

    DEFF Research Database (Denmark)

    Dasgupta, Kaberi; Terkildsen Maindal, Helle; Kragelund Nielsen, Karoline

    2018-01-01

    and/or telephone contact CONCLUSIONS: Although penetration and participation reporting is sub-optimal, penetration generally is high while participation is variable. Leveraging and structuring recruitment within standard GDM care and settings appears to be important to engage women in DAP prevention...... (enrolled/invited) rates were calculated after data extraction. RESULTS: Among 2,859 records, 33 intervention studies were identified, among which 16 had sufficient information to calculate penetration or participation. Penetration proportion (n=9 studies) was between 85-100% for two-thirds of studies...... included. Participation proportion (n=16 studies) varied substantially; when recruitment occurred during pregnancy or early postpartum participation was 40% or more, especially if face-to-face contact was used within the GDM care setting, compared to under 15% in mid/late postpartum with mailed invitation...

  13. Myo-inositol may prevent gestational diabetes onset in overweight women: a randomized, controlled trial.

    Science.gov (United States)

    Santamaria, Angelo; Di Benedetto, Antonino; Petrella, Elisabetta; Pintaudi, Basilio; Corrado, Francesco; D'Anna, Rosario; Neri, Isabella; Facchinetti, Fabio

    2016-10-01

    To evaluate whether myo-inositol supplementation may reduce gestational diabetes mellitus (GDM) rate in overweight women. In an open-label, randomized trial, myo-inositol (2 g plus 200 μg folic acid twice a day) or placebo (200 μg folic acid twice a day) was administered from the first trimester to delivery in pregnant overweight non-obese women (pre-pregnancy body mass index ≥ 25 and inositol and 110 to placebo. The incidence of GDM was significantly lower in the myo-inositol group compared to the placebo group (11.6% versus 27.4%, respectively, p = 0.004). Myo-inositol treatment was associated with a 67% risk reduction of developing GDM (OR 0.33; 95% CI 0.15-0.70). Myo-inositol supplementation, administered since early pregnancy, reduces GDM incidence in overweight non-obese women.

  14. Mothers After Gestational Diabetes in Australia Diabetes Prevention Program (MAGDA-DPP) post-natal intervention: study protocol for a randomized controlled trial

    Science.gov (United States)

    2013-01-01

    Background Gestational diabetes mellitus (GDM) is defined as glucose intolerance with its onset or first recognition during pregnancy. Post-GDM women have a life-time risk exceeding 70% of developing type 2 diabetes mellitus (T2DM). Lifestyle modifications reduce the incidence of T2DM by up to 58% for high-risk individuals. Methods/Design The Mothers After Gestational Diabetes in Australia Diabetes Prevention Program (MAGDA-DPP) is a randomized controlled trial aiming to assess the effectiveness of a structured diabetes prevention intervention for post-GDM women. This trial has an intervention group participating in a diabetes prevention program (DPP), and a control group receiving usual care from their general practitioners during the same time period. The 12-month intervention comprises an individual session followed by five group sessions at two-week intervals, and two follow-up telephone calls. A total of 574 women will be recruited, with 287 in each arm. The women will undergo blood tests, anthropometric measurements, and self-reported health status, diet, physical activity, quality of life, depression, risk perception and healthcare service usage, at baseline and 12 months. At completion, primary outcome (changes in diabetes risk) and secondary outcome (changes in psychosocial and quality of life measurements and in cardiovascular disease risk factors) will be assessed in both groups. Discussion This study aims to show whether MAGDA-DPP leads to a reduction in diabetes risk for post-GDM women. The characteristics that predict intervention completion and improvement in clinical and behavioral measures will be useful for further development of DPPs for this population. Trial registration Australian New Zealand Clinical Trials Registry ANZCTRN 12610000338066 PMID:24135085

  15. Integrated Intervention for Diabetes Risk After Gestational Diabetes ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Reducing the risk, improving women's health Research has shown that increasing physical activity, eating a healthier diet, and losing weight, can prevent the progression to long-term diabetes. Researchers will develop and evaluate an approach that will help prevent women with previous gestational diabetes from ...

  16. The management of gestational diabetes

    Directory of Open Access Journals (Sweden)

    N Wah Cheung

    2009-01-01

    Full Text Available N Wah CheungCentre for Diabetes and Endocrinology Research, Westmead Hospital, and University of Sydney, NSW, AustraliaAbstract: The incidence of gestational diabetes is increasing. As gestational diabetes is associated with adverse pregnancy outcomes, and has long-term implications for both mother and child, it is important that it is recognized and appropriately managed. This review will examine the pharmacological options for the management of gestational diabetes, as well as the evidence for blood glucose monitoring, dietary and exercise therapy. The medical management of gestational diabetes is still evolving, and recent randomized controlled trials have added considerably to our knowledge in this area. As insulin therapy is effective and safe, it is considered the gold standard of pharmacotherapy for gestational diabetes, against which other treatments have been compared. The current experience is that the short acting insulin analogs lispro and aspart are safe, but there are only limited data to support the use of long acting insulin analogs. There are randomized controlled trials which have demonstrated efficacy of the oral agents glyburide and metformin. Whilst short-term data have not demonstrated adverse effects of glyburide and metformin on the fetus, and they are increasingly being used in pregnancy, there remain long-term concerns regarding their potential for harm.Keywords: gestational diabetes, insulin, oral antidiabetic agents, pregnancy, type 2 diabetes

  17. Effectiveness of physical activity interventions on preventing gestational diabetes mellitus and excessive maternal weight gain: a meta-analysis.

    Science.gov (United States)

    Sanabria-Martínez, G; García-Hermoso, A; Poyatos-León, R; Álvarez-Bueno, C; Sánchez-López, M; Martínez-Vizcaíno, V

    2015-08-01

    It is commonly accepted that pregnancy-related physiological changes (circulatory, respiratory, and locomotor) negatively influence the daily physical activity of pregnant women. The aim of this study is to conduct a meta-analysis of randomised controlled trials (RCTs) for assessing the effectiveness of physical exercise interventions during pregnancy to prevent gestational diabetes mellitus and excessive maternal weight gain. Keywords were used to conduct a computerised search in six databases: Cochrane Library Plus, Science Direct, EMBASE, PubMed, Web of Science, and ClinicalTrials.gov. Healthy pregnant women who were sedentary or had low levels of physical activity were selected for RCTs that included an exercise programme. Two independent reviewers extracted data and assessed the quality of the included studies. Of 4225 articles retrieved, 13 RCTs (2873 pregnant women) met the inclusion criteria. Pooled relative risk (RR) or weighted mean differences (WMDs) (depending on the outcome measure) were calculated using a random-effects model. Overall, physical exercise programmes during pregnancy decreased the risk of gestational diabetes mellitus (RR = 0.69; P = 0.009), particularly when the exercise programme was performed throughout pregnancy (RR = 0.64; P = 0.038). Furthermore, decreases were also observed in maternal weight (WMD = -1.14 kg; 95% CI -1.50 to -0.78; P physical exercise programmes during pregnancy decrease the risk of gestational diabetes mellitus and diminish maternal weight gain, and seem to be safe for the mother and the neonate; however, further studies are needed to establish recommendations. © 2015 Royal College of Obstetricians and Gynaecologists.

  18. A 12-week exercise program performed during the second trimester does not prevent gestational diabetes in healthy pregnant women.

    Science.gov (United States)

    Ramírez-Vélez, Robinson

    2012-01-01

    Does a 12-week exercise program prevent gestational diabetes and improve insulin resistance in healthy pregnant women with normal body mass index (BMI)? Randomised, controlled trial with concealed allocation and blinded outcome assessment. Two University hospitals in Norway. White adult women with a single fetus. High-risk pregnancies or diseases that would interfere with participation were exclusion criteria. Randomisation of 855 participants allocated 429 to the exercise group and 426 to a control group. Both groups received written advice on pelvic floor muscle exercises, diet, and lumbo-pelvic pain. In addition, the intervention group participated in a standardised group exercise program led by a physiotherapist, once a week for 12 weeks, between 20 and 36 weeks gestation. The program included 30-35 minutes low impact aerobics, 20-25 minutes of strength exercises using body weight as resistance and 5-10 minutes of stretching, breathing, and relaxation exercises. They were also encouraged to follow a 45-minute home exercise program at least twice a week. The control group received standard antenatal care and the customary information given by their midwife or general practitioner. The primary outcomes were the prevalence of gestational diabetes, insulin resistance estimated by the homeostasis model assessment method (HOMA-IR), and fasting insulin and oral glucose tolerance tests at baseline and at the end of the training period. Fasting and 2-hour glucose levels were measured in serum by the routine methods. Gestational diabetes was diagnosed as fasting glucose level 2-hour value ≥7.8mmol/L. Secondary outcome measures were weight, BMI, and pregnancy complications and outcomes. 702 participants completed the study. At the end of the 12-week program, there was no difference in the prevalence of gestational diabetes (25 (7%) of intervention group compared with 18 (6%) of control group), HOMA-IR (-0.15, 95% CI -0.33 to 0.03), or oral glucose tolerance tests at 2

  19. The Impact of Health Education Intervention for Prevention and Early Detection of Type 2 Diabetes in Women with Gestational Diabetes.

    Science.gov (United States)

    Tawfik, Mirella Youssef

    2017-06-01

    This study aims to investigate the impact of a health belief model (HBM)-based educational intervention on knowledge, beliefs, self-reported practices, gestational and postpartum weight in women with gestational diabetes mellitus (GDM). A cluster randomized controlled trial was performed, with randomization at the level of Primary Health Care centers in three Egyptian cities. Eligible women with GDM were enrolled at 24 weeks pregnancy. The intervention group (n = 103) received health education intervention based on the HBM construct. Control subjects (n = 98) received the usual care. The outcomes measured were: women's knowledge, beliefs, self-reported practices, gestational weight gain (GWG), and postpartum weight retention. Patients were investigated at baseline, at end of pregnancy, and at 6 weeks postpartum. After the intervention, percentages of women who had high knowledge and beliefs scores had significantly increased from less than 50 % to more than 70 % in the intervention group (p < 0.001). More women in the intervention group reported practicing exclusive breast feeding (85.4 %) and screening for T2DM (43.7 %) at 6 weeks postpartum compared to the control group (63.3 and 19.4 % respectively) (p < 0.001). More women with excessive body mass index in the intervention group (65 %) compared to the control group (11.6 %) were meeting recommended GWG (p < 0.001), and postpartum weight (37.7, and 20.3 % respectively) (p < 0.01). This intervention significantly improved knowledge, beliefs, self-reported practices, and gestational and postpartum weight in patients with GDM. Further research is needed for investigating the effectiveness of applying early, multi-phase, and longer intervention.

  20. Gestational Diabetes Screening During Pregnancy

    Directory of Open Access Journals (Sweden)

    Cihan Cetin

    2015-09-01

    Full Text Available Gestational diabetes is a type of diabetes that is diagnosed during pregnancy in patients who do not have pregestational diabetes. Unless diagnosed and treated on time, it may cause various maternal, fetal and neonatal complications like macrosomia, polyhydramniosis, preterm labor, in utero ex fetus, infections, neonatal metabolic complications. The diagnosis of gestational diabetes stands on single-step or two-step screening/diagnosis strategies. These screening and diagnosis tests should be well known by physicians who are taking care of pregnants. [Archives Medical Review Journal 2015; 24(3.000: 348-354

  1. Gestational diabetes insipidus. Case Report.

    Science.gov (United States)

    Ejmocka-Ambroziak, Anna; Grzechocińska, Barbara; Jastrzebska, Helena; Kochman, Magdalena; Cyganek, Anna; Wielgoś, Mirosław; Zgliczyński, Wojciech

    2015-01-01

    Gestational diabetes insipidus is a very rare complication. However, undiagnosed and untreated may lead to serious complications in both mother and fetus. In this study, a case of 34-year-old female patient with diabetes insipidus associated with pregnancy was reported. We discussed process of diagnosis and treatment with particular emphasis on the monitoring of water-electrolyte imbalance during labor.

  2. Relationship between the adoption of preventive practices and the metabolic profile of women with prior gestational diabetes mellitus.

    Science.gov (United States)

    Gingras, Véronique; Paradis, Ann-Marie; Tchernof, André; Weisnagel, S John; Robitaille, Julie

    2012-12-01

    Women with prior gestational diabetes mellitus (GDM) are encouraged to adopt healthy lifestyle behaviours to prevent or delay type 2 diabetes. The objective was to examine the association between the adoption of preventive practices and the metabolic profile of women with prior GDM. Analyses included 181 women who had GDM between 2003 and 2010. The preventive practices examined included (i) regular physical activity (≥150 min·week(-1)) assessed with the International Physical Activity Questionnaire; (ii) a healthy diet (score derived from the Alternate Healthy Eating Index and associated with a lower metabolic risk) evaluated from a food frequency questionnaire; and (iii) exclusive breastfeeding (≥6 months). Women were classified according to the number of preventive practices adopted. Waist circumference, weight, and height were measured and body mass index (BMI) was calculated. Fasting insulinemia and glycemia were obtained and Matsuda index for insulin sensitivity was calculated. Nearly one-third of women adopted none of the listed preventive practices. For each increase of 1 preventive practice adopted, women were 30% less likely to have a BMI ≥ 25 kg·m(-2) (odds ratio (OR): 0.70, 95% confidence interval (CI) (0.50-0.98)), they were 34% less likely to have a waist circumference ≥ 88 cm (OR: 0.66, 95%CI (0.47-0.92)) and they were 33% less likely to have a Matsuda index for insulin sensitivity practices in the years following delivery are less likely to have lower insulin sensitivity, less likely to be overweight-obese, and less likely to be characterized by abdominal obesity.

  3. Postnatal Prevention of Childhood Obesity in Offspring Prenatally Exposed to Gestational Diabetes mellitus: Where Are We Now

    Directory of Open Access Journals (Sweden)

    Camille Dugas

    2017-08-01

    Full Text Available Children exposed to gestational diabetes mellitus (GDM in utero are at high risk of developing many health problems such as obesity. There is an urgent need to find new strategies to prevent obesity development among high-risk populations such as those children. Accordingly, the aim of this review was to summarize current knowledge on the postnatal prevention of childhood obesity in offspring born from mothers with GDM. Specifically, this review addresses the impact of breastfeeding, complementary feeding practices as well as dietary intake and physical activity during childhood on obesity risk of children exposed to GDM in utero. Furthermore, breast milk composition of diabetic mothers and its potential impact on growth is discussed. According to the available literature, breastfeeding may reduce obesity risk in children exposed to GDM in utero but a longer duration seems necessary to achieve its protective effect against obesity. Detailed analysis of breast milk composition of mothers with GDM will be necessary to fully understand the relationship between breastfeeding and obesity in this specific population. This review highlights the need for more studies addressing the impact of complementary feeding practices and lifestyle habits during childhood on obesity risk of children exposed to GDM in utero.

  4. Primary prevention of gestational diabetes mellitus and large-for-gestational-age newborns by lifestyle counseling: a cluster-randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Riitta Luoto

    2011-05-01

    Full Text Available BACKGROUND: Our objective was to examine whether gestational diabetes mellitus (GDM or newborns' high birthweight can be prevented by lifestyle counseling in pregnant women at high risk of GDM. METHOD AND FINDINGS: We conducted a cluster-randomized trial, the NELLI study, in 14 municipalities in Finland, where 2,271 women were screened by oral glucose tolerance test (OGTT at 8-12 wk gestation. Euglycemic (n = 399 women with at least one GDM risk factor (body mass index [BMI] ≥ 25 kg/m(2, glucose intolerance or newborn's macrosomia (≥ 4,500 g in any earlier pregnancy, family history of diabetes, age ≥ 40 y were included. The intervention included individual intensified counseling on physical activity and diet and weight gain at five antenatal visits. Primary outcomes were incidence of GDM as assessed by OGTT (maternal outcome and newborns' birthweight adjusted for gestational age (neonatal outcome. Secondary outcomes were maternal weight gain and the need for insulin treatment during pregnancy. Adherence to the intervention was evaluated on the basis of changes in physical activity (weekly metabolic equivalent task (MET minutes and diet (intake of total fat, saturated and polyunsaturated fatty acids, saccharose, and fiber. Multilevel analyses took into account cluster, maternity clinic, and nurse level influences in addition to age, education, parity, and prepregnancy BMI. 15.8% (34/216 of women in the intervention group and 12.4% (22/179 in the usual care group developed GDM (absolute effect size 1.36, 95% confidence interval [CI] 0.71-2.62, p = 0.36. Neonatal birthweight was lower in the intervention than in the usual care group (absolute effect size -133 g, 95% CI -231 to -35, p = 0.008 as was proportion of large-for-gestational-age (LGA newborns (26/216, 12.1% versus 34/179, 19.7%, p = 0.042. Women in the intervention group increased their intake of dietary fiber (adjusted coefficient 1.83, 95% CI 0.30-3.25, p = 0.023 and

  5. Gestational diabetes mellitus in Greenland

    DEFF Research Database (Denmark)

    Pedersen, Michael Lynge; Olesen, Jesper; Jørgensen, M. E.

    2016-01-01

    Background. Within the last 20 years, the prevalence of gestational diabetes mellitus (GDM) has been reported to be increasing worldwide in correlation with ethnic and geographic variations. The actual prevalence of GDM throughout all of Greenland remains unknown. Objective. The aim of this study...

  6. Postpartum Lifestyle Interventions to Prevent Type 2 Diabetes Among Women with History of Gestational Diabetes: A Systematic Review of Randomized Clinical Trials.

    Science.gov (United States)

    Guo, Jia; Chen, Jyu-Lin; Whittemore, Robin; Whitaker, Evans

    2016-01-01

    Women with a history of gestational diabetes mellitus (GDM) are at a higher risk of developing type 2 diabetes. Several postpartum lifestyle intervention studies have been conducted for this high-risk group; however, the randomized clinical trials have not been evaluated systematically. Thus, the aim of this article is to evaluate the outcomes of clinical trials that focus on diabetes prevention among women with DGM. This systematic review utilized Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Chinese and US databases were searched. Randomized controlled trials of postpartum lifestyle interventions to prevent type 2 diabetes in women with prior GDM were reviewed. Outcomes included in this review are type 2 diabetes incidences, insulin insistence, and weight-related measures. The effect size of these outcomes in each study was computed. Data on intervention components were extracted, including type (in-person vs. technology-based), content (diet or physical activity or both), form (individual session vs. group session), duration, intensity, evaluation time point, and program delivery. A total of 12 studies met the inclusion criteria. The mean annual type 2 diabetes mellitus (T2DM) incidence of the intervention group was lower than that of the comparison group (6.0% vs. 9.3%), although there was no statistical difference between the two groups. About 50% of these studies and two-thirds of studies, respectively, reported a significant decrease in insulin resistance-related measures and weight-related measures in the intervention group compared with the comparison group. The median intervention duration and study length were 6 months. Postpartum lifestyle interventions can be effective in reducing T2DM development and insulin resistance, and decrease weight in women with GDM history, regardless of the intervention types (technology-based or in-person). Effective interventions typically include dietary changes while some physical

  7. Optimizing postpartum care for the patient with gestational diabetes mellitus.

    Science.gov (United States)

    Martinez, Noelle G; Niznik, Charlotte M; Yee, Lynn M

    2017-09-01

    Gestational diabetes mellitus poses well-established risks to both the mother and infant. As >50% of women with gestational diabetes mellitus will develop type 2 diabetes mellitus in their lifetime, performing postpartum oral glucose tolerance testing is paramount to initiation of appropriate lifestyle interventions and pharmacologic therapy. Nonetheless, test completion among women with gestational diabetes mellitus is estimated to be diabetes mellitus. Based on existing evidence, we propose best practices for the postpartum care of women with gestational diabetes mellitus: (1) enhanced patient support for identifying long-term health care providers, (2) patient-centered medical home utilization when possible, (3) patient and provider test reminders, and (4) formalized obstetrician-primary care provider hand offs using the Situation Background Assessment Recommendation (SBAR) mnemonic. These strategies deserve future investigation to solidify a multilevel approach for identifying and preventing the continuum of diabetes. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Metformin, the aspirin of the 21st century: its role in gestational diabetes mellitus, prevention of preeclampsia and cancer, and the promotion of longevity.

    Science.gov (United States)

    Romero, Roberto; Erez, Offer; Hüttemann, Maik; Maymon, Eli; Panaitescu, Bogdan; Conde-Agudelo, Agustin; Pacora, Percy; Yoon, Bo Hyun; Grossman, Lawrence I

    2017-09-01

    Metformin is everywhere. Originally introduced in clinical practice as an antidiabetic agent, its role as a therapeutic agent is expanding to include treatment of prediabetes mellitus, gestational diabetes mellitus, and polycystic ovarian disease; more recently, experimental studies and observations in randomized clinical trials suggest that metformin could have a place in the treatment or prevention of preeclampsia. This article provides a brief overview of the history of metformin in the treatment of diabetes mellitus and reviews the results of metaanalyses of metformin in gestational diabetes mellitus as well as the treatment of obese, non-diabetic, pregnant women to prevent macrosomia. We highlight the results of a randomized clinical trial in which metformin administration in early pregnancy did not reduce the frequency of large-for-gestational-age infants (the primary endpoint) but did decrease the frequency of preeclampsia (a secondary endpoint). The mechanisms by which metformin may prevent preeclampsia include a reduction in the production of antiangiogenic factors (soluble vascular endothelial growth factor receptor-1 and soluble endoglin) and the improvement of endothelial dysfunction, probably through an effect on the mitochondria. Another potential mechanism whereby metformin may play a role in the prevention of preeclampsia is its ability to modify cellular homeostasis and energy disposition, mediated by rapamycin, a mechanistic target. Metformin has a molecular weight of 129 Daltons and therefore readily crosses the placenta. There is considerable evidence to suggest that this agent is safe during pregnancy. New literature on the role of metformin as a chemotherapeutic adjuvant in the prevention of cancer and in prolonging life and protecting against aging is reviewed briefly. Herein, we discuss the mechanisms of action and potential benefits of metformin. Published by Elsevier Inc.

  9. Exercise: An Alternative Therapy for Gestational Diabetes.

    Science.gov (United States)

    Artal, Raul

    1996-01-01

    Exercise is encouraged in the management of pregnant women with gestational diabetes or women with Type II diabetes who become pregnant. Although non-weight-bearing exercises may be best for sedentary women, moderate workouts appear to be safe for most women with gestational diabetes. The role of exercise, risk factors, warning signs, and examples…

  10. Mothers after Gestational Diabetes in Australia (MAGDA)

    DEFF Research Database (Denmark)

    O’Reilly, Sharleen L.; Dunbar, James A.; Versace, Vincent

    2016-01-01

    Background: Gestational diabetes mellitus (GDM) is an increasingly prevalent risk factor for type 2 diabetes. We evaluated the effectiveness of a group-based lifestyle modification program in mothers with prior GDM within their first postnatal year. Methods and Findings: In this study, 573 women...... were randomised to either the intervention (n = 284) or usual care (n = 289). At baseline, 10% had impaired glucose tolerance and 2% impaired fasting glucose. The diabetes prevention intervention comprised one individual session, five group sessions, and two telephone sessions. Primary outcomes were...... changes in diabetes risk factors (weight, waist circumference, and fasting blood glucose), and secondary outcomes included achievement of lifestyle modification goals and changes in depression score and cardiovascular disease risk factors. The mean changes (intention-to-treat [ITT] analysis) over 12 mo...

  11. Vitamin D and gestational diabetes

    DEFF Research Database (Denmark)

    Joergensen, Jan S; Lamont, Ronald F; Torloni, Maria R

    2014-01-01

    PURPOSE OF REVIEW: Vitamin D status (which is involved in glucose homeostasis) is related to gestational diabetes mellitus (GDM). GDM is characterized by increased resistance to and impaired secretion of insulin and results in higher risk of adverse pregnancy outcomes including operative delivery......, macrosomia, shoulder dystocia and neonatal hypoglycemia. Women with GDM and their babies are at increased risk for developing type II diabetes. RECENT FINDINGS: International definitions of vitamin D deficiency and normality are inconsistent. Vitamin D deficiency is common in pregnant women particularly...... those with poor diets and who have dark skins living in temperate climes with lack of exposure to sunlight. SUMMARY: Few interventional studies indicate that supplementation optimizes maternal vitamin D status or improves maternal glucose metabolism. Observational studies about maternal vitamin D status...

  12. Physical activity and gestational diabetes mellitus.

    Science.gov (United States)

    van Poppel, Mireille N M; Ruchat, Stephanie-May; Mottola, Michelle F

    2014-01-01

    Gestational diabetes mellitus (GDM) is defined as 'carbohydrate intolerance resulting in hyperglycemia of variable severity with onset or first recognition during pregnancy'. GDM is associated with several detrimental health consequences during pregnancy and delivery for both mother and baby. The largest public health impact of GDM is through its role on future diabetes in the mother and obesity and diabetes in the offspring. Physical activity (PA) is likely an effective intervention for prevention and treatment of GDM, given its known effectiveness in prevention and treatment of type 2 diabetes. Based on observational studies, PA initiated before and/or during pregnancy has a positive influence on maternal glucose and insulin metabolism and reduces the risk of GDM. However, although PA interventions have been reported to be effective at improving glycemic control in women who already developed GDM, prenatal PA interventions aimed at preventing GDM have shown modest effectiveness in increasing PA levels and thus were not effective in improving glucose/insulin metabolism or reducing GDM incidence. There is therefore a strong need to develop effective strategies for increasing PA levels, especially in women at high risk for GDM who are often obese and inactive. The optimal intervention for preventing or managing GDM is still unknown, and further studies are needed to determine the type, intensity, frequency and duration for the most successful PA intervention. Furthermore, the effects of PA on neonatal outcomes are not clear, and it is highly recommended that future studies examine more specific neonatal outcomes such as body composition.

  13. Management of gestational diabetes mellitus at secondary health ...

    African Journals Online (AJOL)

    Background: Gestational Diabetes Mellitus (GDM) account for the majority of cases of Diabetes complicating pregnancy. It is amenable to risk reduction measures and if properly managed, complications leading to poor pregnancy outcome can be prevented. However, this requires a good knowledge of the disease by the ...

  14. Recurrence of gestational diabetes in primiparous women

    DEFF Research Database (Denmark)

    Kruse, Anne R; Darling, Mette S; Hansen, Mia K L

    2015-01-01

    Introduction Gestational diabetes mellitus (GDM) increases the risk for diabetes in the next pregnancy and later in life. Thus, estimating the risk of GDM in further pregnancies provides a time frame for possible preventive measures. We aimed to calculate the recurrence rate of GDM in primiparous...... women and evaluate the factors involved such as age, body mass index, weight gain, time between pregnancy and postpartum OGTT results. Material and methods We established a prospective cohort during a 5-year period at the Department of Obstetrics at Kolding Hospital. Women with diet-treated GDM...... in their first pregnancy and a subsequent pregnancy constituted our study population. Multiparity and insulin-treated GDM were exclusion criteria. Results Among 15 735 deliveries, 535 women were diagnosed with GDM (3.4%). Of these, 209 (39.1%) were nulliparous women, treated with diet only. Seventy...

  15. The effectiveness of lifestyle intervention in early pregnancy to prevent gestational diabetes mellitus in Chinese overweight and obese women: A quasi-experimental study.

    Science.gov (United States)

    Sun, Yu; Zhao, Hong

    2016-05-01

    Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and is associated with substantially elevated risk of adverse health outcomes for both mothers and offspring. This quasi-experimental trial was conducted to assess whether a lifestyle intervention in early pregnancy can reduce the incidence of GDM and excessive gestational weight (GWG) gain among Chinese overweight women. Convenience samples of 74 women in gestational weeks 8-12 with a BMI ≥ 24 kg/m(2) were enrolled. They were divided into intervention (N=37) or control group (N=37) according to the time sequence of seeing the doctor. The intervention group was provided with exercise, dietary, weight gain counseling and detailed plans at weeks 8-12 and every month in the second trimester. In addition, each counseling session included a personalized feedback based on their 5-day-records. Follow-up phone calls or emails were conducted every week between antenatal visits. The control group was just provided with exercise, dietary and weight gain counseling at weeks 8-12, besides the usual health education provided at the O&G outpatient department. The lifestyle intervention resulted in a lower incidence of gestational diabetes in the intervention group (9/32, 28.1%) compared with the control group (19/34, 55.9%), p=0.023. Women in the intervention group gained much less weight (6.86 ± 2.31 versus 10.08 ± 3.84 kg, p=0.000) at the end of second trimester. Lifestyle intervention in early pregnancy can reduce the incidence of GDM and prevent excessive maternal weight gain in overweight and obese pregnant women. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Gestational diabetes mellitus: Non-insulin management

    Directory of Open Access Journals (Sweden)

    Navneet Magon

    2011-01-01

    Full Text Available Gestational diabetes mellitus (GDM complicates a substantial number of pregnancies. There is consensus that in patients of GDM, excellent blood glucose control, with diet and, when necessary, oral hypoglycemics and insulin results in improved perinatal outcomes, and appreciably reduces the probability of serious neonatal morbidity compared with routine prenatal care. Goals of metabolic management of a pregnancy complicated with GDM have to balance the needs of a healthy pregnancy with the requirements to control glucose level. Medical nutrition therapy is the cornerstone of therapy for women with GDM. Surveillance with daily self-monitoring of blood glucose has been found to help guide management in a much better way than blood glucose checking in labs and clinics, which tends to be less frequent. Historically, insulin has been the therapeutic agent of choice for controlling hyperglycemia in pregnant women. However, difficulty in medication administration with multiple daily injections, potential for hypoglycemia, and increase in appetite and weight make this therapeutic option cumbersome for many pregnant patients. Use of oral hypogycemic agents (OHAs in pregnancy has opened new vistas for GDM management. At present, there is a growing acceptance of glyburide (glibenclamide use as the primary therapy for GDM. Glyburide and metformin have been found to be safe, effective and economical for the treatment of gestational diabetes. Insulin, however, still has an important role to play in GDM. GDM is a window of opportunity, which needs to be seized, for prevention of diabetes in future life. Goal of our educational programs should be not only to improve pregnancy outcomes but also to promote healthy lifestyle changes for the mother that will last long after delivery. Team effort on part of obstetricians and endocrinologists is required to make " the diabetes capital of the world" into " the diabetes care capital of the world".

  17. [Gestational diabetes insipidus during a twin pregnancy].

    Science.gov (United States)

    De Mesmay, M; Rigouzzo, A; Bui, T; Louvet, N; Constant, I

    2013-02-01

    Gestational diabetes insipidus is an uncommon clinical disease whose prevalence is approximately two to three pregnancies per 100,000. It may be isolated or associated with preeclampsia. We report a case of gestational diabetes insipidus in a twin pregnancy, originally isolated during two months, and secondarily complicated by HELLP-syndrome. We recall the specific pathophysiology of polyuric-polydipsic syndrome during pregnancy and summarize its various causes. Finally, we discuss the indications, in case of isolated gestational diabetes insipidus, of treatment by dDAVP. Copyright © 2013. Published by Elsevier SAS.

  18. Myo-inositol Supplementation for Prevention of Gestational Diabetes in Obese Pregnant Women: A Randomized Controlled Trial.

    Science.gov (United States)

    DʼAnna, Rosario; Di Benedetto, Antonino; Scilipoti, Angela; Santamaria, Angelo; Interdonato, Maria Lieta; Petrella, Elisabetta; Neri, Isabella; Pintaudi, Basilio; Corrado, Francesco; Facchinetti, Fabio

    2015-08-01

    To evaluate whether myo-inositol supplementation, an insulin sensitizer, reduces the rate of gestational diabetes mellitus (GDM) and lowers insulin resistance in obese pregnant women. In an open-label, randomized trial, myo-inositol (2 g plus 200 micrograms folic acid twice a day) or placebo (200 micrograms folic acid twice a day) was administered from the first trimester to delivery in pregnant obese women (prepregnancy body mass index 30 or greater. We calculated that 101 women in each arm would be required to demonstrate a 65% GDM reduction in the myo-inositol group with a statistical power of 80% (α=0.05). The primary outcomes were the incidence of GDM and the change in insulin resistance from enrollment until the diagnostic oral glucose tolerance test. From January 2011 to April 2014, 220 pregnant women at 12-13 weeks of gestation were randomized at two Italian university hospitals, 110 to myo-inositol and 110 to placebo. Most characteristics were similar between groups. The GDM rate was significantly reduced in the myo-inositol group compared with the control group, 14.0% compared with 33.6%, respectively (P=.001; odds ratio 0.34, 95% confidence interval 0.17-0.68). Furthermore, women treated with myo-inositol showed a significantly greater reduction in the homeostasis model assessment of insulin resistance compared with the control group, -1.0±3.1 compared with 0.1±1.8 (P=.048). Myo-inositol supplementation, started in the first trimester, in obese pregnant women seems to reduce the incidence in GDM through a reduction of insulin resistance. ClinicalTrials.gov, www.clinicaltrials.gov, NCT01047982.

  19. Diabetes risk in women with gestational diabetes mellitus and a history of polycystic ovary syndrome: a retrospective cohort study.

    Science.gov (United States)

    Bond, R; Pace, R; Rahme, E; Dasgupta, K

    2017-12-01

    To investigate whether polycystic ovary syndrome further increases postpartum diabetes risk in women with gestational diabetes mellitus and to explore relationships between polycystic ovary syndrome and incident diabetes in women who do not develop gestational diabetes. This retrospective cohort study (Quebec Physician Services Claims; Hospitalization Discharge Databases; Birth and Death registries) included 34 686 women with gestational diabetes during pregnancy (live birth), matched 1:1 to women without gestational diabetes by age group, year of delivery and health region. Diagnostic codes were used to define polycystic ovary syndrome and incident diabetes. Cox regression models were used to examine associations between polycystic ovary syndrome and incident diabetes. Polycystic ovary syndrome was present in 1.5% of women with gestational diabetes and 1.2% of women without gestational diabetes. There were more younger mothers and mothers who were not of white European ancestry among those with polycystic ovary syndrome. Those with polycystic ovary syndrome more often had a comorbidity and a lower proportion had a previous pregnancy. Polycystic ovary syndrome was associated with incident diabetes (hazard ratio 1.52; 95% CI 1.27, 1.82) among women with gestational diabetes. No conclusive associations between polycystic ovary syndrome and diabetes were identified (hazard ratio 0.94; 95% CI 0.39, 2.27) in women without gestational diabetes. In women with gestational diabetes, polycystic ovary syndrome confers additional risk for incident diabetes postpartum. In women without gestational diabetes, an association between PCOS and incident diabetes was not observed. Given the already elevated risk of diabetes in women with a history of gestational diabetes, a history of both polycystic ovary syndrome and gestational diabetes signal a critical need for diabetes surveillance and prevention. © 2017 Diabetes UK.

  20. Am I at Risk for Gestational Diabetes?

    Science.gov (United States)

    ... sugar level is high after an hour, your health care provider will give you an oral glucose tolerance test (OGTT) to determine if you have gestational diabetes or another problem. For the OGTT, you will ...

  1. Fetal programming and gestational diabetes mellitus.

    Science.gov (United States)

    Monteiro, Lara J; Norman, Jane E; Rice, Gregory E; Illanes, Sebastián E

    2016-12-01

    Gestational diabetes mellitus is defined by new-onset glucose intolerance during pregnancy. About 2-5% of all pregnant women develop gestational diabetes during their pregnancies and the prevalence has increased considerably during the last decade. This metabolic condition is manifested when pancreatic β-cells lose their ability to compensate for increased insulin resistance during pregnancy, however, the pathogenesis of the disease remains largely unknown. Gestational diabetes is strongly associated with adverse pregnancy outcome as well as with long-term adverse effects on the offspring which likely occurs due to epigenetic modifications of the fetal genome. In the current review we address gestational diabetes and the short and long term complications for both mothers and offspring focusing on the importance of fetal programming in conferring risk of developing diseases in adulthood. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Early detection of diabetes after pregnancy complicated by gestational diabetes

    DEFF Research Database (Denmark)

    Nielsen, Jane Hyldgård; Overgaard, Charlotte; Olesen, Christinna Rebecca

    Title: Early detection of diabetes after pregnancy complicated by gestational diabetes Background: Women whose pregnancy was complicated by gestational diabetes have a 7-fold higher risk of developing diabetes, primarily type 2. 40% of women with a history gestational diabetes mellitus (GDM...... of health consequences for women. Aims: Examine the extent of participation in follow-up screening in the Danish Region of North Jutland, and the possible consequences of nonattendance. Methods: A register based study. In Danish national registers 2171 birthing women whose pregnancy was complicated by GDM...

  3. Prevalence of gestational diabetes mellitus among women born in Greenland

    DEFF Research Database (Denmark)

    Jacobsen, Jytte Lindskov; Jørgensen, Marit Eika

    2010-01-01

    OBJECTIVES: To estimate the prevalence of gestational diabetes mellitus (GDM) among Greenlanders and to evaluate the quality of the current screening procedure for gestational diabetes. STUDY DESIGN: Observational retrospective study of consecutive birth-log data and medical records on pregnant....... However, only 54% of those women were screened. The prevalence of gestational diabetes was calculated to be 4.3% among high-risk Greenlandic pregnant women (2/46) (95% CI 0-10.0%). CONCLUSIONS: Despite a suboptimal screening rate, the prevalence of GDM among Greenlanders seems to be relatively low...... to find and treat all women with GDM. The number of screened women compared to the number of births occurring annually could be used as an indicator of screening efficacy. Diabetes prevention initiatives should be given high priority to avoid high rates of GDM in the future, as increasing prevalence...

  4. Diabetes Prevention Program (DPP)

    Science.gov (United States)

    ... Recruiting Patients & Families Consortia, Networks & Centers Reports & Planning Diabetes Prevention Program (DPP) The NIDDK-sponsored Diabetes Prevention ... Diabetes Prevention Program for those who are eligible. Diabetes Prevention Program (DPP) DPP Goal The DPP looked ...

  5. Role of Exercise in Reducing Gestational Diabetes Mellitus.

    Science.gov (United States)

    Mottola, Michelle F; Artal, Raul

    2016-09-01

    Exercise plays an important role in reducing the prevalence of gestational diabetes mellitus (GDM) in women with or without risk factors. GDM risk factors include obesity, family history of diabetes, high-risk ethnicity, increased maternal age, history of GDM, delivering a macrosomic infant, excessive gestational weight gain early in pregnancy (before glucose screening), sedentary behavior, low physical activity, and vitamin D deficiency. Most GDM patients can be managed with lifestyle modifications that include medical nutrition therapy and physical activity. When adherence is high and women are fully engaged in the exercise program, GDM can be effectively managed and prevented.

  6. Nutritional risk factors for gestational diabetes mellitus

    OpenAIRE

    Sakshi Singh; T K Ray; Ranjan Das; Abha Singh

    2014-01-01

    Background: Gestational diabetes mellitus (GDM) has been observed to be associated with increased perinatal morbidity and mortality. GDM is becoming a public health concern globally as well as in India with fast increasing trend. It affects approximately 14% of all pregnancies. Studies on the association of food items having high glycaemic index with GDM risk are sparse. Most of the literature has focused on typical risk factors like advanced maternal age, family history of diabetes mellitus,...

  7. Iron, Oxidative Stress and Gestational Diabetes

    Directory of Open Access Journals (Sweden)

    Taifeng Zhuang

    2014-09-01

    Full Text Available Both iron deficiency and hyperglycemia are highly prevalent globally for pregnant women. Iron supplementation is recommended during pregnancy to control iron deficiency. The purposes of the review are to assess the oxidative effects of iron supplementation and the potential relationship between iron nutrition and gestational diabetes. High doses of iron (~relative to 60 mg or more daily for adult humans can induce lipid peroxidation in vitro and in animal studies. Pharmaceutical doses of iron supplements (e.g., 10× RDA or more for oral supplements or direct iron supplementation via injection or addition to the cell culture medium for a short or long duration will induce DNA damage. Higher heme-iron intake or iron status measured by various biomarkers, especially serum ferritin, might contribute to greater risk of gestational diabetes, which may be mediated by iron oxidative stress though lipid oxidation and/or DNA damage. However, information is lacking about the effect of low dose iron supplementation (≤60 mg daily on lipid peroxidation, DNA damage and gestational diabetes. Randomized trials of low-dose iron supplementation (≤60 mg daily for pregnant women are warranted to test the relationship between iron oxidative stress and insulin resistance/gestational diabetes, especially for iron-replete women.

  8. an alternative therapy for gestational diabetes mellitus

    African Journals Online (AJOL)

    Toxic effects of glibenclamide in fetuses of normoglycemic rats: an alternative therapy for gestational diabetes mellitus. ... However, GLIB animals presented a light brownish precipitate into the center-lobular veins and in the liver parenchyma among the hepatocytes. These results indicated a possible passage of the drug ...

  9. Maternal and foetal outcome in gestational diabetes.

    Science.gov (United States)

    Qadir, Saima Yasmin; Yasmin, Tayyaba; Fatima, Iffat

    2012-01-01

    Gestational diabetes is impaired carbohydrate metabolism first diagnosed in pregnancy. Knowledge of diabetes dates back to centuries before Christ. Objective was to describe maternal complications during antenatal period and Maternal and neonatal outcome in gestational diabetes mellitus. This Descriptive observational study was conducted at Department of Obstetrics and Gynaecology, Alhada Military Hospital, Taif, KSA. It was done during January-December 2009 to measure maternal and neonatal outcome. Hundred pregnant women diagnosed through glucose tolerance test as diabetic were enrolled as study subjects. All the subjects were enrolled and followed regularly at Obstetric and Gynaecology out-patient Department of Alhada Military Hospital, Taif. Blood glucose level was controlled either by diet or by diet and insulin. Study subjects were hospitalised for adjustment of dose of insulin and for management of complications. Foetal well being was assessed by kick count, cardiotocography and ultrasound. Time and mode of delivery was decided at 36 week of gestation. Intra-partum maternal blood glucose level was monitored and foetal monitoring was done by cardiotocography. Total numbers of women delivered were 2,858. Hundred cases of diabetes mellitus during pregnancy were studied. Eighty-eight patients were above 25 years of age, multiparous ladies with gestational diabetes in 76% of cases. Insulin was required in 64% of patients. Polyhydramnios was most common maternal complication. Two out of 100 had spontaneous miscarriage; 14 underwent preterm delivery while 84 reached term with two intrauterine death. Caesarean section was carried out in 58 patients. Total number of babies delivered alive were 92. There were 4 neonatal deaths. Hyperbilirubinemia was the most common neonatal complication. It was concluded that early detection, constant supervision, strict glycaemic control, delivery with intensive intrapartum monitoring and facilities of expert neonatologist can result

  10. A Daily Snack Containing Leafy Green Vegetables, Fruit, and Milk before and during Pregnancy Prevents Gestational Diabetes in a Randomized, Controlled Trial in Mumbai, India.

    Science.gov (United States)

    Sahariah, Sirazul A; Potdar, Ramesh D; Gandhi, Meera; Kehoe, Sarah H; Brown, Nick; Sane, Harshad; Coakley, Patsy J; Marley-Zagar, Ella; Chopra, Harsha; Shivshankaran, Devi; Cox, Vanessa A; Jackson, Alan A; Margetts, Barrie M; Fall, Caroline Hd

    2016-07-01

    Prospective observational studies suggest that maternal diets rich in leafy green vegetables and fruit may help prevent gestational diabetes mellitus (GDM). Our objective was to test whether increasing women's dietary intake of leafy green vegetables, fruit, and milk before conception and throughout pregnancy reduced their risk of GDM. Project SARAS ("excellent") (2006-2012) was a nonblinded, individually randomized, controlled trial in women living in slums in the city of Mumbai, India. The interventions included a daily snack made from leafy green vegetables, fruit, and milk for the treatment group or low-micronutrient vegetables (e.g., potato and onion) for the control group, in addition to the usual diet. Results for the primary outcome, birth weight, have been reported. Women were invited to take an oral-glucose-tolerance test (OGTT) at 28-32 wk gestation to screen for GDM (WHO 1999 criteria). The prevalence of GDM was compared between the intervention and control groups, and Kernel density analysis was used to compare distributions of 120-min plasma glucose concentrations between groups. Of 6513 women randomly assigned, 2291 became pregnant; of these, 2028 reached a gestation of 28 wk, 1008 (50%) attended for an OGTT, and 100 (9.9%) had GDM. In an intention-to-treat analysis, the prevalence of GDM was reduced in the treatment group (7.3% compared with 12.4% in controls; OR: 0.56; 95% CI: 0.36, 0.86; P = 0.008). The reduction in GDM remained significant after adjusting for prepregnancy adiposity and fat or weight gain during pregnancy. Kernel density analysis showed that this was explained by the fact that fewer women in the treatment group had a 2-h glucose concentration in the range 7.5-10.0 mmol/L. In low-income settings, in which women have a low intake of micronutrient-rich foods, improving dietary micronutrient quality by increasing intake of leafy green vegetables, fruit, and/or milk may have an important protective effect against the development of GDM

  11. Nutritional risk factors for gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Sakshi Singh

    2014-12-01

    Full Text Available Background: Gestational diabetes mellitus (GDM has been observed to be associated with increased perinatal morbidity and mortality. GDM is becoming a public health concern globally as well as in India with fast increasing trend. It affects approximately 14% of all pregnancies. Studies on the association of food items having high glycaemic index with GDM risk are sparse. Most of the literature has focused on typical risk factors like advanced maternal age, family history of diabetes mellitus, history of abortions, previous history of GDM. Objective: To assess the risk of developing GDM in pregnant women consuming food items with high glycemic index. Material and Methods: A hospital based case control study was conducted in Lady Hardinge Medical College and associated hospital with a sample size of 104 (52 cases & 52 controls. For dietary history a validated quantitative food frequency questionnaire was used. The usual pattern of eating during days, weeks and months were asked. The data was compiled and analysed in SPSS version 12. Results: Total 30.8% cases and 13.5% controls gave history of consuming food items having high glycaemic index more frequently (at least once daily. The odds ratio of developing GDM was 2.86(CI -1.06-7.70 among the cases who were taking high glycaemic foods more frequently in comparison to those who were taking occasionally. Conclusions: Risk of developing GDM in high glycemic foods consumers is high. Simple measures like changing dietary patterns, consuming food items with low glycaemic load can contribute significantly in prevention of GDM. 

  12. Preventing Type 2 Diabetes

    Science.gov (United States)

    ... Sexual & Urologic Problems Clinical Trials Preventing Type 2 Diabetes Perhaps you have learned that you have a ... I lower my chances of developing type 2 diabetes? Research such as the Diabetes Prevention Program shows ...

  13. Preventing Diabetes Problems

    Science.gov (United States)

    ... Problems Diabetes & Sexual & Urologic Problems Clinical Trials Preventing Diabetes Problems View or Print All Sections Heart Disease & ... prevent or delay sexual and urologic problems. Depression & Diabetes Depression is common among people with a chronic, ...

  14. Gestational Diabetes Mellitus and Future Cardiovascular Risk: An Update

    OpenAIRE

    Burlina, S.; Dalfr?, M. G.; Chilelli, N. C.; Lapolla, A.

    2016-01-01

    The prevalence of gestational diabetes mellitus is increasing in parallel with the rising prevalence of type 2 diabetes and obesity around the world. Current evidence strongly suggests that women who have had gestational diabetes mellitus are at greater risk of cardiovascular disease later in life. Given the growing prevalence of gestational diabetes mellitus, it is important to identify appropriate reliable markers of cardiovascular disease and specific treatment strategies capable of contai...

  15. A randomized clinical trial of exercise during pregnancy to prevent gestational diabetes mellitus and improve pregnancy outcome in overweight and obese pregnant women.

    Science.gov (United States)

    Wang, Chen; Wei, Yumei; Zhang, Xiaoming; Zhang, Yue; Xu, Qianqian; Sun, Yiying; Su, Shiping; Zhang, Li; Liu, Chunhong; Feng, Yaru; Shou, Chong; Guelfi, Kym J; Newnham, John P; Yang, Huixia

    2017-04-01

    Obesity and being overweight are becoming epidemic, and indeed, the proportion of such women of reproductive age has increased in recent times. Being overweight or obese prior to pregnancy is a risk factor for gestational diabetes mellitus, and increases the risk of adverse pregnancy outcome for both mothers and their offspring. Furthermore, the combination of gestational diabetes mellitus with obesity/overweight status may increase the risk of adverse pregnancy outcome attributable to either factor alone. Regular exercise has the potential to reduce the risk of developing gestational diabetes mellitus and can be used during pregnancy; however, its efficacy remain controversial. At present, most exercise training interventions are implemented on Caucasian women and in the second trimester, and there is a paucity of studies focusing on overweight/obese pregnant women. We sought to test the efficacy of regular exercise in early pregnancy to prevent gestational diabetes mellitus in Chinese overweight/obese pregnant women. This was a prospective randomized clinical trial in which nonsmoking women age >18 years with a singleton pregnancy who met the criteria for overweight/obese status (body mass index 24≤28 kg/m 2 ) and had an uncomplicated pregnancy at exercise or a control group. Patients did not have contraindications to physical activity. Patients allocated to the exercise group were assigned to exercise 3 times per week (at least 30 min/session with a rating of perceived exertion between 12-14) via a cycling program begun within 3 days of randomization until 37 weeks of gestation. Those in the control group continued their usual daily activities. Both groups received standard prenatal care, albeit without special dietary recommendations. The primary outcome was incidence of gestational diabetes mellitus. From December 2014 through July 2016, 300 singleton women at 10 weeks' gestational age and with a mean prepregnancy body mass index of 26.78 ± 2.75 kg/m 2 were

  16. Risk Factors for Gestational Diabetes Mellitus in a Large Population of Women Living in Spain: Implications for Preventative Strategies

    Directory of Open Access Journals (Sweden)

    Ana M. Ramos-Leví

    2012-01-01

    Full Text Available The aim of this study is to establish a risk appraisal model for GDM by identifying modifiable factors that can help predict the risk of GDM in a large population of 2194 women living in Spain. They were recruited between 2009-2010 when screening for GDM was performed. Participants completed a questionnaire on socio-demographic, anthropomorphic and behavioral characteristics, and reproductive and medical history. A total of 213 (9.7% women were diagnosed as having GDM. Age, pregestational body weight (BW and body mass index (BMI, and number of events of medical, obstetric and family history were significantly associated with GDM. After logistic regression model, biscuits and pastries intake 30 minutes/day, and 30 minutes/day of sports at least 2 days/week, compared with opposite consumption, was associated with less GDM risk. Our study identified several pregestational modifiable lifestyle risk factors associated with an increase in the risk of developing GDM. This may represent a promising approach for the prevention of GDM and subsequent complications. Further intervention studies are needed to evaluate if this appraisal model of risk calculation can be useful for prevention and treatment of GDM.

  17. The diagnosis of gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Metzger, Boyd E; Gabbe, Steven G; Persson, Bengt

    2012-01-01

    . In this review, we provide details regarding some points that were considered by the IADPSG Consensus Panel but not published and address the following issues: 1) what should be the frequency of gestational diabetes mellitus (GDM); 2) were appropriate outcomes and odds ratios used to define diagnostic thresholds......The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study showed significant perinatal risks at levels of maternal hyperglycemia below values that are diagnostic for diabetes. A Consensus Panel of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) reviewed HAPO Study...... for GDM; 3) to improve perinatal outcome, should the focus be on GDM, obesity, or both; 4) should results of randomized controlled trials of treatment of mild GDM influence recommendations for diagnostic thresholds; and, 5) other issues related to diagnosis of GDM. Other groups are independently...

  18. Attitudes towards gestational diabetes among a multiethnic cohort in Australia.

    Science.gov (United States)

    Carolan, Mary; Steele, Cheryl; Margetts, Heather

    2010-09-01

    This study aimed to examine the attitudes and beliefs towards gestational diabetes of a multiethnic sample of pregnant women with gestational diabetes. Women from non-Caucasian background are disproportionately represented in gestational diabetes statistics. This is of particular importance in multicultural Australia, where increasing numbers of non-Caucasian women give birth. Cross-sectional survey. The Diabetes Attitude Scale, version 3 was administered to 200 women with gestational diabetes from Vietnamese, Indian, Filipino and Caucasian backgrounds. A total of 143 questionnaires were returned indicating a response rate of 71·5%. There were significant between group differences in terms of educational level (p = 0·001) and English fluency (p = 0·001). Lower educational level, though not English language fluency, was associated with poorer appreciation of gestational diabetes as a serious condition and also with a lower valuing of tight glucose control. This effect was seen irrespective of ethnic group. Indian and Vietnamese women indicated a lower valuing of patient autonomy and also reported less negative psychological effects than Caucasian and Filipino women. Women from non-Caucasian ethnicities may be at risk of poorer self-management of gestational diabetes related to lower education, lower health literacy and a lower appreciation of gestational diabetes as a serious condition. Nurses and midwives provide information and advice to women with gestational diabetes. Knowledge about factors that impact on attitude towards gestational diabetes among multiethnic populations is important for developing educational programmes to address their needs. © 2010 Blackwell Publishing Ltd.

  19. COMPLICATIONS AND OUTCOMES OF PREGNANCY IN GESTATIONAL DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    I. A. Bondar

    2014-01-01

    Full Text Available The aim of the study was to analyze the complications and examine the outcomes of pregnancy in women with compensated gestational diabetes mellitus.We studied outcomes and complications of pregnancy in 50 pregnant women with gestational diabetes mellitus, the effects of gestational diabetes on the fetus.The average age of pregnant women was (33.7 ± 5.7 years. The incidence of gestoses and placental insufficiency in compensated gestational diabetes mellitus was 84%, polyhydramnios – 36%, the fetus fetopathy – 48% of cases. Births in period occurred in 96% of cases, the frequency of fetal malformations consistent with population-based indicators.Gestational diabetes mellitus affects the development of gestosis and fetoplacental insufficiency, even when the compensation of carbohydrate metabolism after the diagnosis of gestational diabetes mellitus.

  20. Potential Mechanisms of Exercise in Gestational Diabetes

    Directory of Open Access Journals (Sweden)

    Saeid Golbidi

    2013-01-01

    Full Text Available Gestational diabetes mellitus (GDM is defined as glucose intolerance first diagnosed during pregnancy. This condition shares same array of underlying abnormalities as occurs in diabetes outside of pregnancy, for example, genetic and environmental causes. However, the role of a sedentary lifestyle and/or excess energy intake is more prominent in GDM. Physically active women are less likely to develop GDM and other pregnancy-related diseases. Weight gain in pregnancy causes increased release of adipokines from adipose tissue; many adipokines increase oxidative stress and insulin resistance. Increased intramyocellular lipids also increase cellular oxidative stress with subsequent generation of reactive oxygen species. A well-planned program of exercise is an important component of a healthy lifestyle and, in spite of old myths, is also recommended during pregnancy. This paper briefly reviews the role of adipokines in gestational diabetes and attempts to shed some light on the mechanisms by which exercise can be beneficial as an adjuvant therapy in GDM. In this regard, we discuss the mechanisms by which exercise increases insulin sensitivity, changes adipokine profile levels, and boosts antioxidant mechanisms.

  1. Neighbourhood food environment and gestational diabetes in New York City

    OpenAIRE

    Janevic, Teresa; Borrell, Luisa N.; Savitz, David A.; Herring, Amy H.; Rundle, Andrew

    2010-01-01

    The association between neighbourhood characteristics and gestational diabetes has not been examined previously. We investigated the relationship between the number of healthy food outlets (supermarkets; fruit/vegetable and natural food stores), and unhealthy food outlets (fast food; pizza; bodegas; bakeries; convenience, candy/nut and meat stores) in census tract of residence, and gestational diabetes in New York City. Gestational diabetes, census tract and individual-level covariates were a...

  2. A random plasma glucose method for screening for gestational diabetes.

    OpenAIRE

    Maheshwari J; Mataliya M

    1989-01-01

    Low renal threshold for glucose during pregnancy renders glycosuria less specific for the diagnosis of gestational diabetes. Screening for gestational diabetes was done by utilising random plasma glucose (RPG). RPG was done at the first antenatal visit. In 12,623 patients who registered for antenatal care at the N.W.M. Hospital, 1371 patients had a RPG more than 100 mg%. An oral glucose tolerance test was advised in these patients. The pick-up rate of gestational diabetes correlated wi...

  3. Screening for gestational diabetes mellitus and its prevalence in Bangladesh.

    Science.gov (United States)

    Jesmin, Subrina; Akter, Shamima; Akashi, Hidechika; Al-Mamun, Abdullah; Rahman, Md Arifur; Islam, Md Majedul; Sohael, Farzana; Okazaki, Osamu; Moroi, Masao; Kawano, Satoru; Mizutani, Taro

    2014-01-01

    The prevalence of gestational diabetes mellitus (GDM) has important health complications for both mother and child and is increasing all over the world. Although prevalence estimates for GDM are not new in developed and many developing countries, data are lacking for many low-income countries like Bangladesh. To evaluate the prevalence of GDM in Bangladesh. This cross-sectional study included 3447 women who consecutively visited the antenatal clinics with an average gestation age of 26 weeks. GDM was defined according to WHO criteria (fasting plasma glucose [FPG] ≥7.0 mmol/L or 2-h ≥7.8 mmol/L) and the new ADA criteria (FPG ≥5.3 mmol/L or 2-h ≥8.6 mmol/L OGTT). We also calculated overt diabetes as FPG ≥7.0 mmol/L. Prevalence of GDM was 9.7% according to the WHO criteria and 12.9% according to the ADA criteria in this study population. Prevalence of overt diabetes was 1.8%. Women with GDM were older, higher educated, had higher household income, higher parity, parental history of diabetes, and more hypertensive, compared with non-GDM women. This study demonstrates a high prevalence of GDM in Bangladesh. These estimates for GDM may help to formulate new policies to prevent and manage diabetes. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  4. Exercise and its role in gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Chen Wang

    2016-12-01

    Full Text Available Gestational diabetes mellitus (GDM refers to diabetes diagnosed in the second or third trimester of pregnancy that is not clearly either type 1 or type 2 diabetes. GDM is a common medical complication in pregnancy that has been rapidly increasing worldwide. GDM is associated with both short- and long-term health issues for both mothers and offspring. Consistent with type 2 diabetes, peripheral insulin resistance contributes to the hyperglycemia associated with GDM. Accordingly, it is important to identify strategies to reduce the insulin resistance associated with GDM. To date, observational studies have shown that exercise can be a non-invasive therapeutic option for preventing and managing GDM that can be readily applied to the antenatal population. However, the relevant mechanisms for these outcomes are yet to be fully elucidated. The present review aimed to explain the potential mechanisms of exercise from the perspective of reducing the insulin resistance, which is the root cause of GDM. Exercise recommendations and opinions of exercise during pregnancy are briefly summarized. Keywords: Exercise, Gestational diabetes mellitus, Insulin resistance, Pregnancy

  5. Perceived psychosocial stress and gestational weight gain among women with gestational diabetes.

    Directory of Open Access Journals (Sweden)

    Ai Kubo

    Full Text Available Growing evidence links perceived stress-a potentially modifiable psychosocial risk factor-with health behaviors and obesity. Yet little is known about the relationship between stress during pregnancy and gestational weight gain, particularly among women with pregnancy complications. We conducted a cross-sectional analysis to examine associations between psychosocial stress during pregnancy and gestational weight gain among women with gestational diabetes. We used baseline data from the Gestational Diabetes's Effects on Moms (GEM study: 1,353 women with gestational diabetes who delivered a term singleton within Kaiser Permanente Northern California were included. Perceived stress near the time of gestational diabetes diagnosis was measured using the validated Perceived Stress Scale (PSS10. Gestational weight gain was categorized according to the 2009 Institute of Medicine recommendations. Binomial regression analyses adjusted for gestational age and maternal age at the time of gestational diabetes diagnosis, and race/ethnicity and estimated rate ratios (RR and their 95% confidence interval (CI. Among women with a normal pregravid Body Mass Index (BMI 18.5-24.9 kg/m2, there was a significant association between high (Q4 PSS score and risk of both exceeding and gaining below the Institute of Medicine recommendations compared to those with lower stress (Q1 [adjusted RR = 2.16 95% CI 1.45-3.21; RR = 1.39 95% CI 1.01-1.91, respectively.] Among women with pregravid overweight/obesity (BMI≥25 kg/m2, there was no association. Although the temporal relationship could not be established from this study, there may be a complex interplay between psychosocial stress and gestational weight gain among women with gestational diabetes. Further studies examining stress earlier in pregnancy, risk of developing gestational diabetes and excess/inadequate gestational weight gain are warranted to clarify these complex relationships.

  6. Perceived psychosocial stress and gestational weight gain among women with gestational diabetes.

    Science.gov (United States)

    Kubo, Ai; Ferrara, Assiamira; Brown, Susan D; Ehrlich, Samantha F; Tsai, Ai-Lin; Quesenberry, Charles P; Crites, Yvonne; Hedderson, Monique M

    2017-01-01

    Growing evidence links perceived stress-a potentially modifiable psychosocial risk factor-with health behaviors and obesity. Yet little is known about the relationship between stress during pregnancy and gestational weight gain, particularly among women with pregnancy complications. We conducted a cross-sectional analysis to examine associations between psychosocial stress during pregnancy and gestational weight gain among women with gestational diabetes. We used baseline data from the Gestational Diabetes's Effects on Moms (GEM) study: 1,353 women with gestational diabetes who delivered a term singleton within Kaiser Permanente Northern California were included. Perceived stress near the time of gestational diabetes diagnosis was measured using the validated Perceived Stress Scale (PSS10). Gestational weight gain was categorized according to the 2009 Institute of Medicine recommendations. Binomial regression analyses adjusted for gestational age and maternal age at the time of gestational diabetes diagnosis, and race/ethnicity and estimated rate ratios (RR) and their 95% confidence interval (CI). Among women with a normal pregravid Body Mass Index (BMI 18.5-24.9 kg/m2), there was a significant association between high (Q4) PSS score and risk of both exceeding and gaining below the Institute of Medicine recommendations compared to those with lower stress (Q1) [adjusted RR = 2.16 95% CI 1.45-3.21; RR = 1.39 95% CI 1.01-1.91, respectively.] Among women with pregravid overweight/obesity (BMI≥25 kg/m2), there was no association. Although the temporal relationship could not be established from this study, there may be a complex interplay between psychosocial stress and gestational weight gain among women with gestational diabetes. Further studies examining stress earlier in pregnancy, risk of developing gestational diabetes and excess/inadequate gestational weight gain are warranted to clarify these complex relationships.

  7. Gestational diabetes mellitus results in a higher prevalence of small for gestational age babies

    LENUS (Irish Health Repository)

    Avalos, G

    2011-09-01

    Background and aims: Gestational Diabetes Mellitus (GDM) is associated with increased foetal and maternal morbidity and mortality. Previous studies have shown that babies of diabetic mothers are more likely to be large for gestational age (LGA). This retrospective study aimed to assess whether the converse may also be true, that there may also a higher rate of small for gestational age (SGA) amongst babies of mothers with GDM.\\r\

  8. Perceived psychosocial stress and gestational weight gain among women with gestational diabetes

    OpenAIRE

    Kubo, Ai; Ferrara, Assiamira; Brown, Susan D.; Ehrlich, Samantha F.; Tsai, Ai-Lin; Quesenberry, Charles P.; Crites, Yvonne; Hedderson, Monique M.

    2017-01-01

    Growing evidence links perceived stress-a potentially modifiable psychosocial risk factor-with health behaviors and obesity. Yet little is known about the relationship between stress during pregnancy and gestational weight gain, particularly among women with pregnancy complications. We conducted a cross-sectional analysis to examine associations between psychosocial stress during pregnancy and gestational weight gain among women with gestational diabetes. We used baseline data from the Gestat...

  9. Gestational Diabetes Mellitus and Future Cardiovascular Risk: An Update

    Directory of Open Access Journals (Sweden)

    S. Burlina

    2016-01-01

    Full Text Available The prevalence of gestational diabetes mellitus is increasing in parallel with the rising prevalence of type 2 diabetes and obesity around the world. Current evidence strongly suggests that women who have had gestational diabetes mellitus are at greater risk of cardiovascular disease later in life. Given the growing prevalence of gestational diabetes mellitus, it is important to identify appropriate reliable markers of cardiovascular disease and specific treatment strategies capable of containing obesity, diabetes, and metabolic syndrome in order to reduce the burden of cardiovascular disease in the women affected.

  10. Gestational diabetes mellitus in Europe: prevalence, current screening practice and barriers to screening.

    LENUS (Irish Health Repository)

    Buckley, B S

    2011-12-12

    Background:  Gestational diabetes mellitus is a potentially serious condition that affects many pregnancies and its prevalence is increasing. Evidence suggests early detection and treatment improves outcomes, but this is hampered by continued disagreement and inconsistency regarding many aspects of its diagnosis. Methods:  The Vitamin D and Lifestyle Intervention for Gestational Diabetes Mellitus Prevention (DALI) research programme aims to promote pan-European standards in the detection and diagnosis of gestational diabetes and to develop effective preventive interventions. To provide an overview of the context within which the programme will be conducted and its findings interpreted, systematic searching and narrative synthesis have been used to identify and review the best available European evidence relating to the prevalence of gestational diabetes, current screening practices and barriers to screening. Results:  Prevalence is most often reported as 2-6% of pregnancies. Prevalence may be lower towards the Northern Atlantic seaboard of Europe and higher in the Southern Mediterranean seaboard. Screening practice and policy is inconsistent across Europe, hampered by lack of consensus on testing methods, diagnostic glycaemic thresholds and the value of routine screening. Poor clinician awareness of gestational diabetes, its diagnosis and local clinical guidelines further undermine detection of gestational diabetes. Conclusions:  Europe-wide agreement on screening approaches and diagnostic standards for gestational diabetes could lead to better detection and treatment, improved outcomes for women and children and a strengthened evidence base. There is an urgent need for well-designed research that can inform decisions on best practice in gestational diabetes mellitus screening and diagnosis. © 2011 The Authors. Diabetic Medicine© 2011 Diabetes UK.

  11. Gestational diabetes mellitus in Tanzania : public health perspectives

    NARCIS (Netherlands)

    Mwanri, A.W.

    2015-01-01

    Gestational diabetes mellitus in Tanzania – public health perspectives

    Abstract

    Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance resulting in hyperglycaemia of variable severity with onset or

  12. Screening for gestational diabetes: examining a breakfast meal test ...

    African Journals Online (AJOL)

    Objective: This study was performed to analyse the carbohydrate quantity of the non-standardised breakfast meal test consumed as part of a screening test for gestational diabetes. Design: A prospective descriptive design was utilised. Setting: Screening for gestational diabetes was performed in the High-Risk Antenatal ...

  13. Risk factors for gestational diabetes mellitus in Sudanese pregnant ...

    African Journals Online (AJOL)

    McRoy

    Background: The prevalence of gestational diabetes mellitus (GDM) in. Sudan is ... glucosuria, followed by proteinuria, family history of DM, BMI ≥ 25 Kg/m2 and age ≥ 30 ..... Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med 2005;352:2477-86. 5. The Guideline Development Group.

  14. Gestational diabetes mellitus in Tanzania : public health perspectives

    NARCIS (Netherlands)

    Mwanri, A.W.

    2015-01-01

    Gestational diabetes mellitus in Tanzania – public health perspectives Abstract Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance resulting in hyperglycaemia of variable severity with onset or first

  15. Maternal serum adiponectin multimers in gestational diabetes.

    Science.gov (United States)

    Mazaki-Tovi, Shali; Romero, Roberto; Vaisbuch, Edi; Erez, Offer; Mittal, Pooja; Chaiworapongsa, Tinnakorn; Kim, Sun Kwon; Pacora, Percy; Yeo, Lami; Gotsch, Francesca; Dong, Zhong; Yoon, Bo Hyun; Hassan, Sonia S; Kusanovic, Juan Pedro

    2009-01-01

    Adiponectin, an adipokine with profound insulin-sensitizing effect, consists of heterogeneous species of multimers. These oligomeric complexes circulate as low-molecular-weight (LMW) trimers, medium-molecular-weight (MMW) hexamers and high-molecular-weight (HMW) isoforms and can exert differential biological effects. The aims of this study were to determine whether there is a change in circulating adiponectin multimers in the presence of gestational diabetes mellitus (GDM), overweight/obesity or with a treatment with sulfonylurea or insulin in patients with GDM. This cross-sectional study included women with: 1) normal pregnancy (n=149); and 2) patients with GDM (n=72). Thirty-three patients with GDM were managed with diet alone. Among the others 39 diabetic patients, 17 were treated with Glyburide and 22 with insulin. The study population was further stratified by first trimester body mass index (BMI) (normal weight or =25 kg/m(2)). Serum adiponectin multimers (total, HMW, MMW and LMW) concentrations were determined by ELISA. 1) The median maternal serum of total, HMW, MMW and LMW were lower in patients with GDM than in those with normal pregnancies (Pdiet, and those who were treated with pharmacological agents. 1) GDM is characterized by a distinctive pattern of concentrations and relative distribution of adiponectin multimers akin to Type 2 diabetes mellitus; 2) dysregulation of adiponectin multimeres can provide a mechanistic basis for the association between adiposity and GDM.

  16. Pregnancy outcome in undiagnosed gestational diabetes

    International Nuclear Information System (INIS)

    Dehdashtian, M.; Aletayeb, S.M.H.; Kajbaf, T.Z.; Taheri, M.; Aminzadeh, M.

    2012-01-01

    Objective: To investigate the outcomes of macrosomia and compare the risk factors associated with neonatal and maternal complications between mothers with gestational diabetes (GDM) and Non-GDM mothers, and determine whether it is important to screen for GDM before birth. Methodology: We sampled the venous blood of the mothers of 120 macrosomic neonates in the was based on a HbA1c>5.9%. Results: Twenty-three (19%) mothers had an HgbA1c>5.9%. Maternal and neonatal complications mother's age, parity, and BMI, other risk factors for the development of GDM didn't differ significantly between the two groups. Conclusions: The frequency of neonatal and maternal complications associated with the birth macrosonic neonates are significantly different between GDM and non-GDM mothers. Hence, of the universal screening of pregnant women for GDM is not recommended. (author)

  17. Maternal outcome of gestational diabetes mellitus.

    Science.gov (United States)

    Beucher, G; Viaris de Lesegno, B; Dreyfus, M

    2010-12-01

    To estimate maternal outcome of treated or untreated gestational diabetes mellitus (GDM). French and English publications were searched using PubMed and the Cochrane library. The diagnosis of GDM includes a high risk population for preeclampsia and Caesarean sections (EL3). The risks are positively correlated with the level of hyperglycaemia in a linear way (EL2). Intensive treatment of mild GDM compared with routine care reduces the risk of pregnancy-induced hypertension (preeclampsia, gestational hypertension). Moreover, it does not increase the risk of operative vaginal delivery, Caesarean section and postpartum haemorrhage (EL1). Being overweight, obesity and maternal hyperglycaemia are independent risk factors for preeclampsia (EL2). Their association with GDM increases the risk of preeclampsia and Caesarean section compared to diabetic women with a normal body mass index (EL3). The association of several risk factors (such as advanced maternal age, pre-existing chronic hypertension, pre-existing nephropathy, obesity, suboptimal glycaemic control) increases the risk of preeclampsia. In that case, the classic follow-up (blood pressure measurement, proteinuria) should be more frequent than monthly (professional consensus). The risk of Caesarean section is increased by macrosomia, whether suspected prenatally or not, but this increased risk remains whatever the birth weight (EL3). Diagnosis and treatment of GDM do not reduce the risk of severe perineal lesions, operative vaginal delivery and postpartum haemorrhage (EL2). Some psychological symptoms, such as anxiety and alteration of self-perception, can occur upon diagnosis of GDM (EL3). The treatment of GDM appears to reduce the risk of postpartum depression symptoms (EL2). Most of the information published on GDM covers the risks of preeclampsia and Caesarean section; intensive care of GDM reduces these risks. Pregnancy care should be adjusted to the risk factors.

  18. Postpartum care and contraception provided to women with gestational and preconception diabetes in California's Medicaid program.

    Science.gov (United States)

    Schwarz, Eleanor Bimla; Braughton, Monica Y; Riedel, Julie Cross; Cohen, Susannah; Logan, Julia; Howell, Mike; Thiel de Bocanegra, Heike

    2017-12-01

    To compare rates of postpartum care and contraception provided to women with gestational or preconception diabetes mellitus to women with no known diabetes mellitus. A retrospective cohort study of 199,860 women aged 15-44 years who were continuously enrolled in California's Medicaid program, Medi-Cal, from 43 days prior to 99 days after delivering in 2012. Claims for postpartum clinic visits and contraceptive supplies were compared for 11,494 mothers with preconception diabetes, 17,970 mothers with gestational diabetes, and 170,396 mothers without diabetes. Multivariable logistic regression was used to control for maternal age, race/ethnicity, primary language, residence in a primary care shortage area, state-funded healthcare program and Cesarean delivery, when examining the effects of diabetes on postpartum care and contraception. Although postpartum clinic visits were more common with diabetes (55% preconception, 55% gestational, 48% no diabetes, p=contraception than women without diabetes (preconception diabetes, aOR: 1.39, 95% CI: 1.31-1.47; gestational diabetes, aOR: 1.20, 95% CI: 1.14-1.27). However, among women without permanent contraception, less than half received any reversible contraception within 99 days of delivery (44% preconception, 43% gestational, 43% no diabetes) and less effective, barrier contraceptives were more commonly provided to women with preconception diabetes than women without diabetes (aOR: 1.24, 95% CI:1.16-1.33). Low-income Californian women with pregnancies complicated by diabetes do not consistently receive postpartum care or contraception that may prevent complication of future pregnancies. Efforts are needed to improve rates of provision of postpartum care and high quality contraceptive services to low income women in California, particularly following pregnancies complicated by diabetes. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Gestational diabetes mellitus in 13 dogs.

    Science.gov (United States)

    Fall, T; Johansson Kreuger, S; Juberget, A; Bergström, A; Hedhammar, A

    2008-01-01

    There are few reports on the clinical appearance, prognosis, and risk factors for gestational diabetes mellitus (GDM) in dogs. To describe the clinical characteristics of GDM in dogs. Thirteen dogs with GDM. Retrospective study. Medical records were reviewed and owners and referring veterinarians were contacted for follow-up information. Nordic Spitz breeds (11/13 dogs) were overrepresented in the case material. Diagnosis was established at a median of 50 days after mating (range, 32-64). Median glucose concentration at diagnosis was 340 mg/dL (18.9 mmol/L) (range, 203-587). One dog was euthanized at diagnosis, 5 bitches were treated with insulin until whelping, and in 7 dogs, pregnancy was terminated within 4 days of diagnosis. One dog died after surgery. Tight glycemic control was not achieved in any of the insulin-treated dogs during pregnancy. Diabetes mellitus (DM) resolved in 7 dogs at a median of 9 days after the end of their pregnancies and DM was permanent in 4 dogs. Puppy mortality was increased compared with offspring of healthy dams. This report suggests that GDM affects mainly middle-aged bitches in the 2nd half of pregnancy with a breed predisposition toward Nordic Spitz breeds. GDM may resolve within days to weeks after pregnancy has ended. Further research is needed to investigate optimal treatment regimens for dogs with GDM and risk factors for unsuccessful outcome.

  20. Gestational diabetes: risks, management, and treatment options

    Directory of Open Access Journals (Sweden)

    Catherine Kim

    2010-10-01

    Full Text Available Catherine KimDepartments of Medicine and Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USAAbstract: Gestational diabetes mellitus (GDM is commonly defined as glucose intolerance first recognized during pregnancy. Diagnostic criteria for GDM have changed over the decades, and several definitions are currently used; recent recommendations may increase the prevalence of GDM to as high as one of five pregnancies. Perinatal complications associated with GDM include hypertensive disorders, preterm delivery, shoulder dystocia, stillbirths, clinical neonatal hypoglycemia, hyperbilirubinemia, and cesarean deliveries. Postpartum complications include obesity and impaired glucose tolerance in the offspring and diabetes and cardiovascular disease in the mothers. Management strategies increasingly emphasize optimal management of fetal growth and weight. Monitoring of glucose, fetal stress, and fetal weight through ultrasound combined with maternal weight management, medical nutritional therapy, physical activity, and pharmacotherapy can decrease comorbidities associated with GDM. Consensus is lacking on ideal glucose targets, degree of caloric restriction and content, algorithms for pharmacotherapy, and in particular, the use of oral medications and insulin analogs in lieu of human insulin. Postpartum glucose screening and initiation of healthy lifestyle behaviors, including exercise, adequate fruit and vegetable intake, breastfeeding, and contraception, are encouraged to decrease rates of future glucose intolerance in mothers and offspring.Keywords: glucose intolerance, pregnancy, perinatal complications

  1. Metformin in gestational diabetes: An emerging contender

    Directory of Open Access Journals (Sweden)

    Awadhesh Kumar Singh

    2015-01-01

    Full Text Available Gestational diabetes mellitus (GDM is defined as any degree of glucose intolerance occurring first time during pregnancy. Its prevalence is simultaneously increasing with the global rise of diabesity. GDM commonly develops, when maternal glucose metabolism is unable to compensate for the progressive development of insulin resistance, arising primarily from the consistently rising diabetogenic placental hormones. It classically develops during the second or third trimester. Theoretically, insulin sensitizers should have been the ideal agent in its treatment, given the insulin resistance, the major culprit in its pathogenesis. Fortunately, majority of women can be treated satisfactorily with lifestyle modification, and approximately 20% requires more intensive treatment. For several decades, insulin has been the most reliable treatment strategy and the gold standard in GDM. Metformin is effective insulin sensitizing agent and an established first line drug in type 2 diabetes currently. As it crosses the placenta, a safety issue remains an obstacle and, therefore, metformin is currently not recommended in the treatment of GDM. Nevertheless, given the emerging clinically equivalent safety and efficacy data of metformin compared to insulin, it appears that it may perhaps open a rather new door in managing GDM. The aim of this review is to critically analyze, the safety and efficacy data of metformin regarding its use in GDM and pregnant mothers with polycystic ovarian disease, which has emerged in past decades.

  2. Fasting glycaemia to simplify screening for gestational diabetes.

    Science.gov (United States)

    Ryser Rüetschi, J; Jornayvaz, F R; Rivest, R; Huhn, E A; Irion, O; Boulvain, M

    2016-12-01

    Recommendations in Switzerland on screening for gestational diabetes endorse the International Association of Diabetes in Pregnancy Study Group consensus. As universal testing is time consuming and glucose loading is unpleasant, the recommendations include a simplification, not performing the glucose loading in women with fasting glycaemia fasting glycaemia was fasting glycaemia. The prevalence of gestational diabetes was 10.9% in our population. Among 251 women with gestational diabetes, fasting glycaemia was ≥5.1 mmol/l in 119 women (47.4%), between 4.4 and fasting glycaemia between 4.4 and fasting glycaemia is an attractive alternative to universal screening with the complete 75-g glucose tolerance test. This strategy is, however, slightly less sensitive than previously reported in higher-risk populations. Fasting glycaemia can be considered as an alternative to the complete test for gestational diabetes screening. © 2016 Royal College of Obstetricians and Gynaecologists.

  3. Predictive factors for the development of diabetes in women with previous gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Damm, P.; Kühl, C.; Bertelsen, Aksel

    1992-01-01

    OBJECTIVES: The purpose of this study was to determine the incidence of diabetes in women with previous dietary-treated gestational diabetes mellitus and to identify predictive factors for development of diabetes. STUDY DESIGN: Two to 11 years post partum, glucose tolerance was investigated in 241...... women with previous dietary-treated gestational diabetes mellitus and 57 women without previous gestational diabetes mellitus (control group). RESULTS: Diabetes developed in 42 (17.4%) women with previous gestational diabetes mellitus (3.7% insulin-dependent diabetes mellitus and 13.7% non......-insulin-dependent diabetes mellitus). Diabetes did not develop in any of the controls. Predictive factors for diabetes development were fasting glucose level at diagnosis (high glucose, high risk), preterm delivery, and an oral glucose tolerance test result that showed diabetes 2 months post partum. In a subgroup...

  4. Uric acid and diabetes risk among Chinese women with a history of gestational diabetes mellitus.

    Science.gov (United States)

    Leng, Junhong; Wang, Leishen; Wang, Jing; Li, Weiqin; Liu, Huikun; Zhang, Shuang; Li, Lili; Tian, Huiguang; Xun, Pengcheng; Yang, Xilin; Yu, Zhijie; Hu, Gang

    2017-12-01

    To assess the association of uric acid (UA) with the risks of postpartum type 2 diabetes and prediabetes among women with prior gestational diabetes mellitus (GDM). We performed a cross-sectional study of 1262 GDM women at 1-5 years after delivery using the baseline data from the Tianjin Gestational Diabetes Mellitus Prevention Program. Logistic regression models were used to estimate the association of different levels of serum UA with the risks of type 2 diabetes and prediabetes. The multivariable-adjusted odds ratios (ORs) across quartiles of serum UA were 1.00, 1.23 (95% confidence interval [CI] 0.55-2.78), 2.05 (95% CI 0.96-4.39), and 3.17 (95% CI 1.54-6.55) (P trend  diabetes, and 1.00, 1.50 (95% CI 1.03-2.19), 2.28 (95% CI 1.58-3.30), and 2.88 (95% CI 1.99-4.17) (P trend  diabetes and prediabetes. This positive association was significant when stratified by healthy weight and overweight participants. Serum UA levels have a graded positive association with the risks of type 2 diabetes and prediabetes among Chinese with a history of GDM. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. The prevalence of gestational diabetes mellitus in Aba, South ...

    African Journals Online (AJOL)

    Background: Any degree of glucose intolerance with onset or first recognition during pregnancy is regarded as Gestational Diabetes Mellitus (GDM). The incidence of diabetes in pregnancy in any obstetric population will vary according to whether diabetic screening is done routinely or not in these populations. Objective: To ...

  6. A random plasma glucose method for screening for gestational diabetes.

    Science.gov (United States)

    Maheshwari, J R; Mataliya, M V

    1989-01-01

    Low renal threshold for glucose during pregnancy renders glycosuria less specific for the diagnosis of gestational diabetes. Screening for gestational diabetes was done by utilising random plasma glucose (RPG). RPG was done at the first antenatal visit. In 12,623 patients who registered for antenatal care at the N.W.M. Hospital, 1371 patients had a RPG more than 100 mg%. An oral glucose tolerance test was advised in these patients. The pick-up rate of gestational diabetes correlated with RPG level. Thirty-six cases of gestational diabetes were picked up. The pick up rate is significantly higher as compared to that which would have been detected utilising conventional screening criteria.

  7. Strategy to improve the burden of gestational diabetes in African ...

    African Journals Online (AJOL)

    Strategy to improve the burden of gestational diabetes in African women: Rwandan perspective. Herbert T. Mapira, David K. Tumusiime, Kevin Yarasheski, Nadine Rujeni, Todd W. Cade, Eugene Mutimura ...

  8. Decreased plasma chemerin levels in women with gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Hare, K J; Bonde, L; Svare, J A

    2014-01-01

    AIMS: To evaluate fasting and post-prandial serum chemerin levels in pregnant women with and without gestational diabetes, and again following delivery when normal glucose homeostasis is re-established. METHODS: Chemerin levels were measured in serum from nine women with gestational diabetes......, and from eight age- and BMI-matched pregnant women with normal glucose tolerance during two meal tests: in the third trimester and 3-4 months post partum. All women with gestational diabetes re-established normal glucose tolerance after delivery. RESULTS: Meal intake did not affect serum chemerin levels....... The group with gestational diabetes had lower mean serum chemerin levels during the third trimester compared with the group with normal glucose tolerance (28 ± 1.3 vs. 88 ± 3.5 ng/ml, P

  9. A random plasma glucose method for screening for gestational diabetes.

    Directory of Open Access Journals (Sweden)

    Maheshwari J

    1989-01-01

    Full Text Available Low renal threshold for glucose during pregnancy renders glycosuria less specific for the diagnosis of gestational diabetes. Screening for gestational diabetes was done by utilising random plasma glucose (RPG. RPG was done at the first antenatal visit. In 12,623 patients who registered for antenatal care at the N.W.M. Hospital, 1371 patients had a RPG more than 100 mg%. An oral glucose tolerance test was advised in these patients. The pick-up rate of gestational diabetes correlated with RPG level. Thirty-six cases of gestational diabetes were picked up. The pick up rate is significantly higher as compared to that which would have been detected utilising conventional screening criteria.

  10. Serum YKL-40 and gestational diabetes - an observational cohort study

    DEFF Research Database (Denmark)

    Gybel-Brask, Dorte; Johansen, Julia S; Christiansen, Ib J

    2016-01-01

    To examine serum YKL-40 in women developing gestational diabetes mellitus (GDM). In the present large observational cohort study of 1179 pregnant women, we determined serum YKL-40 four times during pregnancy (at gestational age 12, 20, 25, and 32 weeks). Pregnancy outcome was obtained from medical...

  11. Exercise guidelines for gestational diabetes mellitus

    Science.gov (United States)

    Padayachee, Cliantha; Coombes, Jeff S

    2015-01-01

    The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. This disease has many detrimental consequences for the woman, the unborn foetus and child. The management of GDM aims to mediate the effects of hyperglycaemia by controlling blood glucose levels. Along with pharmacology and dietary interventions, exercise has a powerful potential to assist with blood glucose control. Due to the uncertainty of risks and benefits of exercise during pregnancy, women tend to avoid exercise. However, under adequate supervision exercise is both safe and beneficial in the treatment of GDM. Therefore it is vital that exercise is incorporated into the continuum of care for women with GDM. Medical doctors should be able to refer to competently informed exercise professionals to aid in GDM treatment. It is important that exercise treatment is informed by research. Hence, the development of evidence-based guidelines is important to inform practice. Currently there are no guidelines for exercise in GDM. This review aims to assess the efficacy of exercise for the management of GDM in order to establish an exercise prescription guideline specific to the condition. It is recommended that women with GDM should do both aerobic and resistance exercise at a moderate intensity, a minimum of three times a week for 30-60 min each time. PMID:26240700

  12. Does First Nations ancestry modify the association between gestational diabetes and subsequent diabetes: a historical prospective cohort study among women in Manitoba, Canada.

    Science.gov (United States)

    Shen, G X; Shafer, L A; Martens, P J; Sellers, E; Torshizi, A A; Ludwig, S; Phillips-Beck, W; Heaman, M; Prior, H J; McGavock, J; Morris, M; Dart, A B; Campbell, R; Dean, H J

    2016-09-01

    Over the past 30 years, the prevalence of diabetes has steadily increased among Canadians, and is particularly evident among First Nations (FN) women. The interplay between FN ancestry, gestational diabetes and the development of subsequent diabetes among mothers remains unclear. After excluding known pre-existing diabetes, we explored whether FN ancestry may modify the association between gestational diabetes and post-partum diabetes among women in Manitoba (1981-2011) via a historical prospective cohort database study. We analysed administrative data in the Population Health Research Data Repository using Kaplan-Meier survival analysis and Cox proportional hazards regression. Gestational diabetes was diagnosed in 11 906 of 404 736 deliveries (2.9%), 6.7% of FN and 2.2% of non-FN pregnant women (P women than among non-FN women (P women with gestational diabetes within the follow-up period. The hazard ratio of gestational diabetes for post-partum diabetes was 10.6 among non-FN women and 5.4 among FN women. Other factors associated with a higher risk of diabetes included lower family income among FN and non-FN women and rural/remote residences among FN women. Among non-FN women, urban residence was associated with a higher risk of diabetes. Gestational diabetes increases post-partum diabetes in FN and non-FN women. FN women had substantially more gestational diabetes or post-partum diabetes than non-FN women, partially due to socio-economic and environmental barriers. Reductions in gestational diabetes and socio-economic inequalities are required to prevent diabetes in women, particularly in FN population. © 2015 Diabetes UK.

  13. Diagnosing gestational diabetes mellitus in the Danish National Birth Cohort.

    Science.gov (United States)

    Olsen, Sjurdur F; Houshmand-Oeregaard, Azedeh; Granström, Charlotta; Langhoff-Roos, Jens; Damm, Peter; Bech, Bodil H; Vaag, Allan A; Zhang, Cuilin

    2017-05-01

    The Danish National Birth Cohort (DNBC) contains comprehensive information on diet, lifestyle, constitutional and other major characteristics of women during pregnancy. It provides a unique source for studies on health consequences of gestational diabetes mellitus. Our aim was to identify and validate the gestational diabetes mellitus cases in the cohort. We extracted clinical information from hospital records for 1609 pregnancies included in the Danish National Birth Cohort with a diagnosis of diabetes during or before pregnancy registered in the Danish National Patient Register and/or from a Danish National Birth Cohort interview during pregnancy. We further validated the diagnosis of gestational diabetes mellitus in 2126 randomly selected pregnancies from the entire Danish National Birth Cohort. From the individual hospital records, an expert panel evaluated gestational diabetes mellitus status based on results from oral glucose tolerance tests, fasting blood glucose and Hb1c values, as well as diagnoses made by local obstetricians. The audit categorized 783 pregnancies as gestational diabetes mellitus, corresponding to 0.89% of the 87 792 pregnancies for which a pregnancy interview for self-reported diabetes in pregnancy was available. From the randomly selected group the combined information from register and interviews could correctly identify 96% (95% CI 80-99.9%) of all cases in the entire Danish National Birth Cohort population. Positive predictive value, however, was only 59% (56-61%). The combined use of data from register and interview provided a high sensitivity for gestational diabetes mellitus diagnosis. The low positive predictive value, however, suggests that systematic validation by hospital record review is essential not to underestimate the health consequences of gestational diabetes mellitus in future studies. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

  14. A Mediterranean diet with additional extra virgin olive oil and pistachios reduces the incidence of gestational diabetes mellitus (GDM: A randomized controlled trial: The St. Carlos GDM prevention study.

    Directory of Open Access Journals (Sweden)

    Carla Assaf-Balut

    Full Text Available Gestational diabetes mellitus (GDM prevalence is increasing and becoming a major public health concern. Whether a Mediterranean diet can help prevent GDM in unselected pregnant women has yet to be studied.We conducted a prospective, randomized controlled trial to evaluate the incidence of GDM with two different dietary models. All consecutive normoglycemic (<92 mg/dL pregnant women at 8-12 gestational weeks (GW were assigned to Intervention Group (IG, n = 500: MedDiet supplemented with extra virgin olive oil (EVOO and pistachios; or Control Group (CG, n = 500: standard diet with limited fat intake. Primary outcome was to assess the effect of the intervention on GDM incidence at 24-28 GW. Gestational weight gain (GWG, pregnancy-induced hypertension, caesarean section (CS, preterm delivery, perineal trauma, small and large for gestational age (SGA and LGA and admissions to neonatal intensive care unit were also assessed. Analysis was by intention-to-treat.A total of 874 women completed the study (440/434, CG/IG. According to nutritional questionnaires and biomarker analysis, women in the IG had a good adherence to the intervention. 177/874 women were diagnosed with GDM, 103/440 (23.4% in CG and 74/434(17.1% in IG, p = 0.012. The crude relative risk (RR for GDM was 0.73 (95% CI: 0.56-0.95; p = 0.020 IG vs CG and persisted after adjusted multivariable analysis, 0.75(95% CI: 0.57-0.98; p = 0.039. IG had also significantly reduced rates of insulin-treated GDM, prematurity, GWG at 24-28 and 36-38 GW, emergency CS, perineal trauma, and SGA and LGA newborns (all p<0.05.An early nutritional intervention with a supplemented MedDiet reduces the incidence of GDM and improves several maternal and neonatal outcomes.

  15. Gestational diabetes mellitus and long-term consequences for mother and offspring

    DEFF Research Database (Denmark)

    Damm, Peter; Houshmand-Øregaard, Azadeh; Kelstrup, Louise

    2016-01-01

    Gestational diabetes mellitus (GDM) is defined as glucose intolerance of varying severity and is present in about 2-6% of all pregnancies in Europe, making it one of the most common pregnancy disorders. Aside from the short-term maternal, fetal and neonatal consequences associated with GDM...... diabetes after GDM, and that approximately 50% of mothers with GDM will develop diabetes within 10 years, making GDM one of the strongest predictors of type 2 diabetes. In women with previous GDM, development of type 2 diabetes can be prevented or delayed by lifestyle intervention and/or medical treatment...... are implicated. Animal studies indicate that treatment can prevent long-term metabolic complications in offspring, but this remains to be confirmed in humans. Thus, diabetes begets diabetes and it is likely that GDM plays a significant role in the global diabetes epidemic. This review summarises a presentation...

  16. Terapia nutricional no diabetes gestacional Nutritional therapy in gestational diabetes

    Directory of Open Access Journals (Sweden)

    Patricia de Carvalho Padilha

    2010-02-01

    Full Text Available Trata-se de uma revisão da literatura científica sobre a terapia nutricional no Diabetes Mellitus Gestacional, sem restrição de data e com fontes primárias indexadas nas bases de dados SciELO, PubMed, Medline. Os resultados desta revisão apontam a intervenção nutricional como uma importante aliada no controle do Diabetes Mellitus Gestacional, trazendo potenciais benefícios à saúde materno-fetal. Na avaliação do estado nutricional materno devem ser empregados os indicadores antropométricos, dietéticos, bioquímicos, clínicos e funcional. Neste sentido, a avaliação dietética deve ser detalhada, com atenção para o fracionamento e composição das refeições, e grupos de alimentos presentes. No planejamento nutricional a distribuição de macronutrientes em relação ao consumo energético diário deve ser 45-65% de carboidratos, 15-20% de proteínas e 20-35% de lipídeos. Quanto a recomendação dos edulcorantes, são liberados para gestantes acesulfame K, aspartame, neotame, sacarina e sucralose. A atividade física também deve fazer parte da estratégia de tratamento do Diabetes Mellitus Gestacional, embora o impacto do exercício nas complicações neonatais ainda mereça ser rigorosamente testado. Ademais, estudos associam a habilidade de aconselhamento nutricional com a melhorara na adesão ao cuidado nutricional. Diante desses achados, para sucesso no controle do DMG são necessários: a participação da equipe inter e multidisciplinar, o cuidado pré-natal precoce, com assistência nutricional oportuna e a garantia da assistência de qualidade ao longo da gestação.This is a scientific literature review about nutritional therapy in gestational diabetes mellitus, without date restriction and using the SciELO, PubMed and Medline databases. The results of this review show that nutritional intervention is an important tool for managing gestational diabetes mellitus, and potentially benefits the mother's and fetal health

  17. Serum zinc levels in gestational diabetes

    Directory of Open Access Journals (Sweden)

    Rahimi Sharbaf F

    2008-12-01

    Full Text Available "nBackground: Maternal zinc deficiency during pregnancy has been related to adverse pregnancy outcomes. Most studies in which pregnant women have been supplemented with zinc to examine its effects on the outcome of the pregnancy have been carried out in industrialized countries and the results have been inconclusive. It has been shown that women with gestational diabetes (GDM have lower serum zinc levels than healthy pregnant women, and higher rates of macrosomia. Zinc is required for normal glucose metabolism, and strengthens the insulin-induced transportation of glucose into cells by its effect on the insulin signaling pathway. The purpose of this study was to assess the serum zinc levels of GDM patients and evaluate the effect of zinc supplementation. "nMethods: In the first stage of this prospective controlled study, we enrolled 70 women who were 24-28 weeks pregnant at the Prenatal Care Center of Mirza Kochak Khan Hospital, Tehran, Iran. The serum zinc level of each subject was determined. In the second stage, among these 70 subjects, the diabetics receiving insulin were divided into two groups, only one of which received a zinc supplement and the other group was the control group. Birth weight of neonates and insulin dosages were recorded. "nResults: The mean serum zinc level in the GDM group was lower than that of the control group (94.83 vs. 103.49mg/dl, respectively and the mean birth weight of neonates from the GDM women who received the zinc supplement was lower than that of the control group (3849g vs. 4136g. The rate of macrosomia was lower in the zinc supplemented group (20% vs. 53%. The mean of increase of insulin after receiving the zinc supplement was lower (8.4u vs. 13.53. "nConclusion: Maternal insulin resistance is associated with the accumulation of maternal fat tissue during early stages of pregnancy and greater fetoplacental nutrient availability in later stages, when 70% of fetal growth occurs, resulting in macrosomia. In

  18. Strategy to improve the burden of gestational diabetes in African ...

    African Journals Online (AJOL)

    The global prevalence of gestational diabetes (GDM) in pregnant 20-49 year old women has increased to 16.9%, although data from Africa on GDM are scarce, and ... laboratory diagnostic tests (Glucose Oxidase method), questionnaire ... BMI, body mass index; T2D, type 2 diabetes mellitus; HTN, hypertension. Discussion.

  19. Gestational Diabetes Mellitus in a Nigerian Antenatal Population ...

    African Journals Online (AJOL)

    Context: Gestational Diabetes Mellitus (GDM) is defined as carbohydrate intolerance of variable severity, with onset or first recognition during the index pregnancy. Previous studies of the problem of pregnancy and diabetes in parts of Nigeria failed to distinguish between GDM (as defined) and pregnancy occurring in a ...

  20. Relation of maternal vitamin D status with gestational diabetes ...

    African Journals Online (AJOL)

    metabolic syndrome10,11. Pregnancy is another condition associated with insulin resistance and hyperinsulinemia. During pregnancy, the effects of diabetogenic hormones cannot be handled in women with insufficient pancreatic reserve, thus ges- tational diabetes occurs. Gestational diabetes is an im- portant health issue ...

  1. Diabetes mellitus prevention.

    Science.gov (United States)

    Allende-Vigo, Myriam Zaydee

    2015-01-01

    The aim of this study was to review lifestyle modification interventions and pharmacological clinical studies designed to prevent diabetes and provide evidence-based recommendations for the prevention of Diabetes Mellitus. A review of relevant literature compiled via a literature search (PUBMED) of English-language publications between 1997 and 2010 was conducted. It is found that people at increased risk of developing type 2 diabetes mellitus can halt the development of the disease. Lifestyle modification intervention with reduction of 5%-10% of excess body weight and increase in moderate physical activity by 150 min/wk has consistently proven to reduce the appearance of diabetes in different at-risk populations. Pharmacologic interventions have also demonstrated the prevention of the appearance of diabetes in persons at risk. Bariatric surgery has decreased the appearance of diabetes patients in a select group of individuals. The progression from prediabetes to diabetes mellitus can be prevented. Lifestyle modification intervention changes with weight loss and increased physical activity are currently recommended for the prevention of diabetes.

  2. Role of probiotics in reducing the risk of gestational diabetes.

    Science.gov (United States)

    Isolauri, E; Rautava, S; Collado, M C; Salminen, S

    2015-08-01

    Overweight and obesity currently constitute a major threat to human well-being. Almost half of the female population are currently overweight. Pregnant overweight women are at risk of gestational diabetes affecting the health of the mother and the child, in both the short and long term. Notwithstanding the extensive scientific interest centred on the problem, research efforts have thus far been unable to devise preventive strategies. Recent scientific advances point to a gut microbiota dysbiosis, with ensuing low-grade inflammation as a contributing element, in obesity and its comorbidities. Such findings would suggest a role for specific probiotics in the search for preventive and therapeutic adjunct applications in gestational diabetes. The aim of the present paper was to critically review recent demonstrations of the role of intestinal microbes in immune and metabolic regulation, which could be exploited in nutritional management of pregnant women by probiotic bacteria. By modulating specific target functions, probiotic dietary intervention may exert clinical effects beyond the nutritional impact of food. As this approach in pregnancy is new, an overview of the role of gut microbiota in shaping host metabolism, together with the definition of probiotics are presented, and finally, specific targets and potential mechanisms for probiotics in pregnancy are discussed. Pregnancy appears to be the most critical stage for interventions aiming to reduce the risk of non-communicable disease in future generations, beyond the immediate dangers attributable to the health of the mother, labour and the neonate. Specific probiotic interventions during pregnancy provide an opportunity, therefore, to promote the health not only of the mother but also of the child. © 2015 John Wiley & Sons Ltd.

  3. Maternal Moderate Physical Training during Pregnancy Attenuates the Effects of a Low-Protein Diet on the Impaired Secretion of Insulin in Rats: Potential Role for Compensation of Insulin Resistance and Preventing Gestational Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Carol Góis Leandro

    2012-01-01

    Full Text Available The effects of pregestational and gestational low-to-moderate physical training on insulin secretion in undernourished mothers were evaluated. Virgin female Wistar rats were divided into four groups as follows: control (C, n=5; trained (T, n=5; low-protein diet (LP, n=5; trained with a low-protein diet (T + LP, n=5. Trained rats ran on a treadmill over a period of 4 weeks before mate (5 days week−1 and 60 min day−1, at 65% of VO2max. At pregnancy, the intensity and duration of the exercise were reduced. Low-protein groups were provided with an 8% casein diet, and controls were provided with a 17% casein diet. At third day after delivery, mothers and pups were killed and islets were isolated by collagenase digestion of pancreas and incubated for a further 1 h with medium containing 5.6 or 16.7 mM glucose. T mothers showed increased insulin secretion by isolated islets incubated with 16.7 mM glucose, whereas LP group showed reduced secretion of insulin by isolated islets when compared with both C and LP + T groups. Physical training before and during pregnancy attenuated the effects of a low-protein diet on the secretion of insulin, suggesting a potential role for compensation of insulin resistance and preventing gestational diabetes mellitus.

  4. Pregnancy outcomes in pregnant women with previous history of gestational diabetes

    Directory of Open Access Journals (Sweden)

    Masomeh Rezaie

    2016-11-01

    Full Text Available The aim of this study was to determine the pregnancy outcomes in pregnant women with a history of previous gestational diabetes and its related recurrence risk factors. This study was conducted on 180 pregnant women with history of gestational diabetes in previous pregnancy that referred to Besat hospital, Sanandaj, Iran. They were divided into two groups (recurrence of gestational diabetes group and non-recurrence of gestational diabetes group .The data were recorded in the check list and analyzed using SPSS software Ver.18. To analyze quantitative variables such as mother`s age, mother`s BMI, interval between pregnancies, Apgar score and neonatal hypoglycemia independent t-tests was used and to compare qualitative variables between the two groups chi square test was used. The results showed that there was no statistically significant difference between the two groups in terms of mother`s age (P = 0.22. In terms of mother’s BMI and interval between pregnancies there was statistically significant difference between the two groups (p<0.05. In terms of mode of delivery, after excluding 61 mothers who were replicate Cesarean section the percentage of Caesarean section in recurrence of gestational diabetes group was 15.4%4 and in non- recurrence of gestational diabetes group it was2.4% which difference was statistically significant (P <0.05. In terms of incidence of macrosomia (P <0.001 and neonatal hypoglycemia (p <0.05 there were statistically significant differences between two groups. The recurrence rate of diabetes was 66.6%.Regarding the results of this study in order to prevent maternal and fetal complications, monitoring and giving extra care to mothers with diabetes is recommended.

  5. Diagnosis of gestational diabetes mellitus in Nigerian pregnant ...

    African Journals Online (AJOL)

    Key Words: Gestational diabetes mellitus, Plasma glucose response, Fetal macrosomia. Résumé Objectif d'étude:- Comparer des performances diagnostiques de 75g et 100g test de la tolérance du glucose oral dans la détection du diabète pancréatiques gestational chez des femmes enceintes nigerianes. Matériels et ...

  6. Neonatal outcomes according to different therapies for gestational diabetes mellitus,

    Directory of Open Access Journals (Sweden)

    Amanda L. da Silva

    Full Text Available Abstract: Objectives: To compare different neonatal outcomes according to the different types of treatments used in the management of gestational diabetes mellitus. Methods: This was a retrospective cohort study. The study population comprised pregnant women with gestational diabetes treated at a public maternity hospital from July 2010 to August 2014. The study included women aged at least 18 years, with a singleton pregnancy, who met the criteria for gestational diabetes mellitus. Blood glucose levels, fetal abdominal circumference, body mass index and gestational age were considered for treatment decision-making. The evaluated neonatal outcomes were: type of delivery, prematurity, weight in relation to gestational age, Apgar at 1 and 5 min, and need for intensive care unit admission. Results: The sample consisted of 705 pregnant women. The neonatal outcomes were analyzed based on the treatment received. Women treated with metformin were less likely to have children who were small for gestational age (95% CI: 0.09-0.66 and more likely to have a newborn adequate for gestational age (95% CI: 1.12-3.94. Those women treated with insulin had a lower chance of having a preterm child (95% CI: 0.02-0.78. The combined treatment with insulin and metformin resulted in higher chance for a neonate to be born large for gestational age (95% CI: 1.14-11.15 and lower chance to be born preterm (95% CI: 0.01-0.71. The type of treatment did not affect the mode of delivery, Apgar score, and intensive care unit admission. Conclusions: The pediatrician in the delivery room can expect different outcomes for diabetic mothers based on the treatment received.

  7. ¿Puede el ejercicio físico moderado durante el embarazo actuar como un factor de prevención de la Diabetes Gestacional? (Can moderate physical exercise during pregnancy act as a factor in preventing Gestational Diabetes?

    Directory of Open Access Journals (Sweden)

    Yaiza Cordero Rodríguez

    2012-01-01

    Full Text Available The aim of the present study was to know the effectiveness of exercise of a moderate program developed during pregnancy in the excessive maternal weight gain and development of Gestational Diabetes (GD. We performed a clinical trial, randomized, unmatched, not masked by mean the collaboration between the Department of Gynecology and Obstetrics of Health Center of Torrelodones (Madrid and the Polytechnic University of Madrid. 55 pregnant women without obstetric contraindications were studied, (age= 32,9±3,9 years, all of them caucasian, 25 in the treatment group and 30 in the control group. A physical exercise program was developed (land/water three times per week during pregnancy. According to our resultats, treatment group showed a lower maternal weight gain than in the control group (12.820±3.682 g and 14.780 g ± 3.427 g respectively, p=0.03. The values in the O'Sullivan test are lower in the treatment group than in the control group (102,9±17,7 gr/dL vs 125,6±30,8 gr/dL respectively, p=0,002. Not diagnosed any cases of GD in the treatment group while the control group 2 cases were diagnosed. The exercise done during the pregnancy reduces maternal weight gain, values of O’Sullivan score and apparently acts as a preventive factor of the GD.ResumenEl presente trabajo pretende conocer la eficacia de un programa de ejercicio f��sico moderado desarrollado durante todo el embarazo en la excesiva ganancia de peso materno y el desarrollo de la Diabetes Gestacional (DG. Se realizó un ensayo clínico, aleatorizado, no apareado, no enmascarado mediante una colaboración entre el Servicio de Ginecología y Obstetricia del Centro de Salud de Torrelodones y la Universidad Politécnica de Madrid. 55 gestantes sin contraindicaciones obstétricas fueron estudiadas, (edad=32,9±3,9 años, todas ellas caucásicas, 25 en el grupo de tratamiento y 30 en el de control. Se desarrolló un programa de ejercicio físico (seco/agua durante todo el embarazo

  8. Plasma YKL-40 during pregnancy and gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Rinnov, Anders R; Rathcke, Camilla N; Bonde, Lisbeth

    2015-01-01

    Gestational diabetes mellitus (GDM) is characterised by hyperglycaemia during pregnancy. The clinical circumstances involved in the development of GDM leaves the patient at a high risk of the subsequent development of type 2 diabetes. Plasma levels of the inflammation marker YKL-40 are elevated...... in type 2 diabetes and correlate with fasting plasma glucose levels and insulin resistance in patients with type 2 diabetes. With the present study we aimed to determine if pregnancy (and associated insulin resistance) with or without GDM affects plasma YKL-40 levels. Plasma from women diagnosed with GDM...

  9. Let's prevent diabetes

    DEFF Research Database (Denmark)

    Gray, Laura J.; Khunti, Kamlesh; Williams, Sian

    2012-01-01

    Background: The prevention of type 2 diabetes is a globally recognised health care priority, but there is a lack of rigorous research investigating optimal methods of translating diabetes prevention programmes, based on the promotion of a healthy lifestyle, into routine primary care. The aim...... of the study is to establish whether a pragmatic structured education programme targeting lifestyle and behaviour change in conjunction with motivational maintenance via the telephone can reduce the incidence of type 2 diabetes in people with impaired glucose regulation (a composite of impaired glucose...... of type 2 diabetes. Secondary outcomes include changes in HbA1c, blood glucose levels, cardiovascular risk, the presence of the Metabolic Syndrome and the cost-effectiveness of the intervention.Methods: The study consists of screening and intervention phases within 44 general practices coordinated from...

  10. Gestational Diabetes Mellitus, Fetal Growth and Vitamin D

    OpenAIRE

    Yoon, Hyun Koo

    2017-01-01

    Vitamin D is an important secosteroid hormone in skeletal and non-skeletal systems. Vitamin D has relevance to muscle and immune function, hypertension, diabetes mellitus, cancer, and pregnancy because vitamin D receptors (VDR) are present in many non-skeletal tissues. Vitamin D acts on target tissues via the binding of its active form to VDR. As vitamin D affects not only bone metabolism but also glucose metabolism, vitamin D deficiency may affect the development of gestational diabetes mell...

  11. Relationship Between Excessive Gestational Weight Gain and Neonatal Adiposity in Women With Mild Gestational Diabetes Mellitus.

    Science.gov (United States)

    Blackwell, Sean C; Landon, Mark B; Mele, Lisa; Reddy, Uma M; Casey, Brian M; Wapner, Ronald J; Varner, Michael W; Rouse, Dwight J; Thorp, John M; Sciscione, Anthony; Catalano, Patrick; Saade, George; Caritis, Steve N; Sorokin, Yoram; Grobman, William A

    2016-12-01

    To evaluate the relationships among excessive gestational weight gain, neonatal adiposity, and adverse obstetric outcomes in women with mild gestational diabetes mellitus. This is a secondary analysis of a multicenter randomized clinical trial of women with mild gestational diabetes mellitus. Based on self-reported prepregnancy body weight, gestational weight gain was categorized as excessive if it was greater than 2009 Institute of Medicine guidelines. Maternal outcomes and neonatal anthropomorphic characteristics were compared between women with excessive weight gain and those without excessive weight gain. Multiple linear and logistic regression analyses were performed to adjust for confounding factors. We studied 841 women who participated in the main trial and had prepregnancy body mass index (BMI) and delivery information available (n=431 treatment group, n=410 no treatment). After adjustment for factors including treatment and prepregnancy BMI, excessive weight gain remained associated with large for gestational age (adjusted odds ratio [OR] 2.94, 95% confidence interval [CI] 1.81-4.93), birth weight greater than 4,000 g (adjusted OR 2.56, 95% CI 1.54-4.40), preeclampsia (adjusted OR 2.96, 95% CI 1.35-7.03), and cesarean delivery for labor arrest (adjusted OR 2.37, 95% CI 1.30-4.44). In addition, excessive weight gain was independently associated with increased total neonatal fat (Pweight (Pweight gain was independently associated with both greater birth weight and adiposity.

  12. Postpartum development of type 1 diabetes in Asian Indian women with gestational diabetes

    Directory of Open Access Journals (Sweden)

    Ranjit Unnikrishnan

    2016-01-01

    Full Text Available Aim: To study the postpartum conversion of gestational diabetes mellitus (GDM to different types of diabetes among Asian Indian women. Materials and Methods: Using data from electronic medical records, 418 women with GDM seen at a tertiary diabetes care center for diabetes in Chennai in South India between 1991 and 2014 were evaluated for development of diabetes postpartum. Results: Of the 418 GDM women followed up postpartum, 388 progressed to diabetes. Of these 359 (92.5% developed type 2 diabetes (T2DM and 29 women (7.5% developed type 1 diabetes (T1DM. The median time to development of T1DM was 2 years (interquartile range 2 [IQR] while for T2DM it was 5 years (IQR 6. Women who developed T1DM had significantly lower mean body mass index (BMI (20.4 ± 2.8 vs. 27.5 ± 4.4 kg/m 2 , P = 0.001, and higher fasting plasma glucose (222 ± 105 vs. 165 ± 62 mg/dl P = 0.008 and glycated hemoglobin levels (10.2 ± 2.7 vs. 8.5 ± 2.1% P < 0.001 compared to those who developed T2DM. Glutamic acid decarboxylase (GAD autoantibodies were present in 24/29 (82.7% of women who developed T1DM. Conclusion: A small but significant proportion of women with GDM progress to T1DM postpartum. Measurement of GAD antibodies in leaner women with more severe diabetes could help to identify women who are likely to develop T1DM and thus prevent their presentation with acute hyperglycemic emergencies after delivery.

  13. Gestational diabetes: How risky are the mothers of rural Bengal,India

    OpenAIRE

    Sonali Sain

    2012-01-01

    Early detection of gestational diabetes in antenatal mothers can improve both pregnancy and fetal outcome. A descriptive, cross-sectional study was conducted to find out the magnitude of gestational diabetes by selective screening using “American Diabetes Association (ADA) risk approach strategy” and distribution of risk factors of gestational diabetes among the mothers attending the antenatal clinic of Singur Rural Hospital. Pregnant women with gestational age between 24-28...

  14. Relation of maternal vitamin D status with gestational diabetes ...

    African Journals Online (AJOL)

    Objective: To investigate the relationship between maternal vitamin D status and glucose intolerance, and its impact on pregnant women and their newborns. Methods: A cohort of pregnant women were divided into three groups: women with gestational diabetes mellitus, ones with normal results both after the 50 gr and 100 ...

  15. Impact of maternal gestational diabetes on neutrophil functions of ...

    African Journals Online (AJOL)

    Ehab

    L-selectin (CD62L), is a cell adhesion molecule found on lymphocytes and the preimplantation embryo. It is a marker of neutrophil activation and an important mediator of neutrophil rolling and adhesion to activated endothelium17. Our results demonstrated that neutrophils from neonates of gestational diabetic mothers had ...

  16. Risk factors for gestational diabetes mellitus in Sudanese pregnant ...

    African Journals Online (AJOL)

    Background: The prevalence of gestational diabetes mellitus (GDM) in Sudan is less compared with international reports. Whether there is concomitant difference in the risk factors for GDM among Sudanese women is uncertain. Aim: This study investigated the common risk factors for GDM among Sudanese pregnant ...

  17. Screening for gestational diabetes mellitus in a South African ...

    African Journals Online (AJOL)

    be screened for GDM with the IADPSG criteria (Z Bayat, personal communication, September 2016). At present, risk factor-based. This open-access article is distributed under. Creative Commons licence CC-BY-NC 4.0. Screening for gestational diabetes mellitus in a. South African population: Prevalence, comparison.

  18. Evolution of diagnostic criteria for gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Houshmand, Azadeh; Jensen, Dorte Møller; Mathiesen, Elisabeth R

    2013-01-01

    The establishment of universal diagnostic guidelines for gestational diabetes mellitus has been a long time coming. The lack of consensus and uniformity in procedures for diagnosing this disease has been a problem ever since its existence was recognized. The USA, European countries, and Australia...

  19. Screening strategies for gestational diabetes mellitus at the Aga ...

    African Journals Online (AJOL)

    Background: Universal screening strategy for gestational diabetes mellitus offers biochemical screening to all women irrespective of risk factor status while selective strategy screens only those with risk factors. The Aga Khan University Hospital adopted a selective screening protocol by consensus. This study compares both ...

  20. Gestational Diabetes Mellitus : current knowledge and unmet needs

    NARCIS (Netherlands)

    Koning, Sarah H.; Hoogenberg, Klaas; Lutgers, Helen L.; Van den Berg, Paul P.; Wolffenbuttel, Bruce H. R.

    2016-01-01

    Gestational diabetes mellitus (GDM) is a global health concern, not only because its prevalence is high and on the increase, but also because of the potential implications for the health of mothers and their offspring. Unfortunately, there is considerable controversy in the literature surrounding

  1. Screening for gestational diabetes: examining a breakfast meal test

    African Journals Online (AJOL)

    as part of a screening test for gestational diabetes. Design: A prospective descriptive design was utilised. ... using a calibrated (one gram) kitchen scale. Estimations of portion size were used for food brought .... twists (50 g) using a crossover design, first in non-pregnant and then pregnant subjects. They found the candy ...

  2. [Family doctor clinical aptitude confronting gestational diabetes patients].

    Science.gov (United States)

    Pivaral, Carlos Enrique Cabrera; Clara, Elizabeth Rivera; Peña, Luz María Adriana Balderas; Centeno, Mayari Cabrera; Reynoso, Carlos Alonso

    2008-02-01

    Gestational diabetes mellitus complicates 7% of all pregnancies. Recognizing and treating this entity result in a diminished number of materno-fetal complications; this study explores the family physician clinical aptitude to identify risk factors, to diagnose and treat gestational diabetes. Identify clinical aptitude level of family physician to the treatment of diabetes gestational patients. Transversal study to describe the level of clinical aptitude in 85 family physicians working in Guadalajara. Were studied: speciality, genre, work condition, working years, working hours, and place of work. The evaluation instrument was designed to this specific purpose and validated by an expert group; were evaluated four indicators: 1) identification of risk factors, 2) diagnosis, 3) use of therapeutic resources and 4) use of paraclinic resources. Confidence coefficient to the assessment instrument was (21 formula from Kuder-Richardson) 0.92 in global evaluation. The global clinical aptitude in the four family medicine units studied was less than 21 points in 41% of physician population and very low (22 a 40 points) in 38% of the evaluated physicians. The clinical aptitude from family physician in gestational diabetes is low, this situation represents an urgent need to design a system to provide to these groups of health providers specialized continuous education to enhance the attention quality to this group of patients in family medicine units.

  3. Diagnosing gestational diabetes mellitus in the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Olsen, Sjurdur F; Houshmand-Oeregaard, Azedeh; Granström, Charlotta

    2017-01-01

    INTRODUCTION: The Danish National Birth Cohort (DNBC) contains comprehensive information on diet, lifestyle, constitutional and other major characteristics of women during pregnancy. It provides a unique source for studies on health consequences of gestational diabetes mellitus. Our aim was to id...

  4. Increasing incidence of diabetes after gestational diabetes: a long-term follow-up in a Danish population

    DEFF Research Database (Denmark)

    Lauenborg, Jeannet; Hansen, Torben; Jensen, Dorte Møller

    2004-01-01

    To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes....

  5. Prepregnancy obesity and the risk of gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Phupong Vorapong

    2011-08-01

    Full Text Available Abstract Background Prepregnancy obesity is associated with increased risk for adverse pregnancy outcome such as gestational diabetes mellitus (GDM, gestational hypertension, preeclampsia, fetal macrosomia and the need for cesarean delivery. The objectives of this study assessed whether Thai women classified as obese according to WHO's recommended body mass index (BMI for Asians were at risk for developing gestational diabetes mellitus (GDM and other complications such as preeclampsia, gestational hypertension and fetal macrosomia. Methods Two hundred and forty women participated in this study and followed prospectively until delivery. Half of the women (n = 120 were obese (BMI ≥ 27.5 kg/m2 and the other half (n = 120 had normal weight (BMI > 18.5-23 kg/m2. Maternal demographic data, obstetric and neonatal outcomes from both groups were compared to each other. Relative risk and 95% confidence interval (CI were calculated. Results Compared to normal weight women, obese Thai women were not at increased risk for gestational diabetes mellitus (RR = 0.9 [95% CI 0.6-1.4]. Relative risk of preeclampsia and fetal macrosomia in obese women were 0.7 [95% CI 0.2-3.3] and 1.4 [95% CI 0.5-4.3], respectively. Relative risk of gestational hypertension in obese women was 12 [95% CI 1.6-90.8]. Conclusion When WHO's classification of obesity was used for Asian populations, prepregnancy obesity without metabolic problems did not increase the risk for GDM, preeclampsia and fetal macrosomia in Thai women. But, prepregnancy obesity continued to increase the risk for developing gestational hypertension.

  6. Glycemic Status During Pregnancy in Gestational Diabetic & Non-Gestational Diabetic Women & its Effect on Maternal & Fetal Outcome

    Directory of Open Access Journals (Sweden)

    A P Sawant

    2012-01-01

    Full Text Available Aims & Objectives: 1.To study the time course of plasma glucose, in gestational diabetic and normal pregnant women. 2.To compare maternal outcome and fetal outcome in gestational diabetic and normal pregnant women. Materials and Methods: Five hundred pregnant individuals visiting the Antenatal Clinic of Rural Medical College, Loni in either half of the gestation were screened and gestational diabetes mellitus was diagnosed according to the WHO criteria. Results: The scope of diabetes and pregnancy encompasses not only diabetics marching through pregnancy but also, any form of abnormal glucose tolerance developing during gestation, termed as gestational diabetes, abnormal glucose tolerance of any etiology recognized or unrecognized starting before pregnancy or revealed during pregnancy, is associated with a high risk of a poor maternal and fetal outcomes. In our study we found a significantly higher incidence of caesarean section in-patients with GDM when compared with the normal group (67% versus 25%, P <0.001. In GDM cases, we observed fetal macrosomia, high birth weight etc. Naturally these are the factors, which add to the pre-existing unfavourable maternal factors affecting the process of labour adversely. We observed a significant difference in the incidence of preterm labour in between the GDM and non-GDM groups (22% Vs 13%, p<0.05. These individuals underwent a process of preterm labour at a gestational age of 32+3 weeks. Hyperglycemia and polyhydramnios are held responsible for preterm labour. The incidence rate of PIH was more in subjects with GDM as compared to the other group. However this difference failed to prove statistically significant at 5% level of significance. Though we did not get a significant difference in occurrence of PIH in between the GDM and non-GDM groups, we do agree with the comment that hyperglycemia earlier in the pregnancy is associated with greater incidence of PIH as three of the four cases who were diagnosed

  7. Reliability and Validity of Measures for Investigating the Determinants of Health Behaviors among Women with a History of Gestational Diabetes

    Science.gov (United States)

    Smith, Ben J.; Cheung, N. Wah; Najnin, Nusrat; Bauman, Adrian; Razee, Husna; Blignault, Ilse; van der Ploeg, Hidde P.

    2018-01-01

    Aim: Assisting women with a history of gestational diabetes mellitus (GDM) to adopt healthy lifestyles is a priority for diabetes prevention. The aim of this study was to develop and evaluate measures that can be used to assess the efficacy of behavior change interventions in this group. Method: Measures of psychosocial influences on physical…

  8. 78 FR 11210 - Notice of NIH Consensus Development Conference: Diagnosing Gestational Diabetes Mellitus

    Science.gov (United States)

    2013-02-15

    ... treatment, how do health outcomes of mothers who meet various criteria for gestational diabetes mellitus and... Development Conference: Diagnosing Gestational Diabetes Mellitus AGENCY: National Institutes of Health, HHS... ``Consensus Development Conference: Diagnosing Gestational Diabetes Mellitus.'' The conference will be open to...

  9. Increasing incidence of diabetes after gestational diabetes: a long-term follow-up in a Danish population

    DEFF Research Database (Denmark)

    Lauenborg, Jeannet; Hansen, Torben; Jensen, Dorte Møller

    2004-01-01

    To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes.......To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes....

  10. Visual Evoked Potential to Assess Retinopathy in Gestational Diabetes Mellitus.

    Science.gov (United States)

    Hari Kumar, K V S; Ahmad, F M H; Sood, Sandeep; Mansingh, Sudhir

    2016-04-01

    We evaluated for early retinopathy using the visual evoked potential (VEP) in patients with gestational diabetes mellitus (GDM) and type 2 diabetes mellitus during pregnancy. All patients with GDM and type 2 diabetes seen between June and October of 2014 were included in this cross-sectional, observational study. Patients with secondary diabetes, ocular or major illness were excluded from the study. VEP was recorded in both eyes to derive prominent positive peak latency (P100), amplitude and initial negative deflection (N75) latency. The data were compared with 10 gestational age-matched controls with normal glucose tolerance. Appropriate statistical methods were used for comparison among the 3 groups. The study participants (40 with GDM, 10 with type 2 diabetes, 10 with normal glucose tolerance) had a median (25th to 75th interquartile range) age of 26 (24.3, 30) years, a gestational age of 24.5 (21, 27) weeks and weights of 66.8 (63.4, 71.5) kg. The P100 latencies were comparable among the 3 groups (p=0.0577). However, patients with any diabetes (GDM and type 2 diabetes) had prolonged P100 latencies (p=0.0139) and low P100 amplitudes (p=0.0391) in comparison to controls. P100 latency showed a direct correlation with hyperglycemia (p=0.0118). Our data showed that VEP abnormalities are detectable even in the short-term hyperglycemia of GDM and type 2 diabetes. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  11. Influence of exercise intervention on gestational diabetes mellitus: a systematic review and meta-analysis.

    Science.gov (United States)

    Zheng, J; Wang, H; Ren, M

    2017-10-01

    Exercise intervention might be a promising approach to prevent gestational diabetes mellitus. However, the results remained controversial. We conducted a systematic review and meta-analysis to explore the effect of exercise intervention on gestational diabetes mellitus. PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of exercise intervention on gestational diabetes mellitus were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome was the incidence of gestational diabetes mellitus, preterm birth, and gestational age at birth. Meta-analysis was performed using random-effect model. Five RCTs involving 1872 patients were included in the meta-analysis. Overall, compared with control intervention, exercise intervention was found to significantly reduce the risk of gestational diabetes mellitus (std. mean difference 0.62; 95% CI 0.43-0.89; P = 0.01), but demonstrated no influence on preterm birth (OR 0.93; 95% CI 0.44-1.99; P = 0.86), gestational age at birth (std. mean difference -0.03; 95% CI -0.12 to 0.07; P = 0.60), glucose 2-h post-OGTT (std. mean difference -1.02; 95% CI -2.75 to 0.71; P = 0.25), birth weight (std. mean difference -0.10; 95% CI -0.25 to 0.04; P = 0.16), Apgar score less than 7 (OR 0.78; 95% CI 0.21-2.91; P = 0.71), and preeclampsia (OR 1.05; 95% CI 0.53-2.07; P = 0.88). Compared to control intervention, exercise intervention was found to significantly reduce the incidence of gestational diabetes mellitus, but had no significant influence on preterm birth, gestational age at birth, glucose 2-h post-OGTT, birth weight, Apgar score less than 7, and preeclampsia.

  12. Maternal and neonatal outcomes in gestational diabetes mellitus.

    Science.gov (United States)

    Ghosh, Shovan; Ghosh, Kusagradhi

    2013-05-01

    To describe maternal complications and neonatal outcomes caused by gestational diabetes mellitus a descriptive observational study was conducted in the department of obstetrics and gynaecology at Ramakrishna Mission Seva Pratisthan and Vivekananda Institute of Medical Sciences, Kolkata, over a period of one year from July 2009 to June 2010. Women diagnosed by oral glucose tolerance test as gestational diabetes mellitus were enrolled as study subjects and were followed regularly at outpatient department. Blood glucose levels controlled by diet or with insulin. Foetal well-being was assessed by ultrasonography, foetal kick count and cardiotocography. Time and mode of delivery were decided on admission depending upon the complications encountered. Intrapartum blood glucose level was monitored and foetal monitoring was done. After delivery all the babies were assessed by the paediatrician. After discharge patients were advised oral glucose tolerance test at 6 weeks postpartum. Out of 644 women delivered, 58 (9%) were diagnosed gestational diabetes mellitus and were studied. Mean age was 30 years and 55.2% were multigravida; 50% were obese (BMI > or = 30 kg/m2); 60.3% required insulin therapy to achieve glycaemic control. Most common maternal and neonatal complications observed were premature prelabour rupture of membrane (10.3%) and jaundice (29.3%) respectively. Caesarean section was done in 60.3% gestational diabetas mellitus mothers. A total of 57 babies (98.2%) were delivered alive.

  13. Postpartum Diabetes Testing Rates after Gestational Diabetes Mellitus in Canadian Women: A Population-Based Study.

    Science.gov (United States)

    Butalia, Sonia; Donovan, Lois; Savu, Anamaria; Johnson, Jeffrey; Edwards, Alun; Kaul, Padma

    2017-12-01

    We assessed the rate and type of postpartum glycemic testing in women with impaired glucose tolerance of pregnancy (IGTp) and gestational diabetes mellitus (GDM). We examined whether the likelihood of testing was modulated by patients' characteristics and pregnancy outcomes. Our population-level cohort study included data from 132,905 pregnancies between October 1, 2008, and December 31, 2011, in Alberta, Canada. Laboratory data within 270 days before and 1 year after delivery were used to identify pregnancies involving IGTp/GDM and postpartum glycemic testing, respectively. Logistic regression was used to identify maternal and pregnancy factors associated with postpartum testing. A total of 8,703 pregnancies were affected by IGTp (n=3669) or GDM (n=5034) as defined by the prevailing Canadian Diabetes Association 2008 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. By 1 year postpartum, 55.1% had undergone glycemic assessments. Of those, 59.7% had had 75 g oral glucose tolerance tests, 17.4% had had glycated hemoglobin tests without oral glucose tolerance tests and 22.9% had had only fasting or random glucose tests. Women with IGTp or GDM, respectively, who were younger, smokers and residing in rural areas and whose labours were not induced were less likely to be tested postpartum. Having large for gestational age infants was also associated with a lower likelihood of postpartum testing in women with GDM. Despite a universal health-care system in Canada, many women with IGTp or GDM do not undergo postpartum glucose testing. Maternal and pregnancy characteristics influence postpartum testing and provide valuable information for creating targeted strategies to improve postpartum testing in this group of high-risk women. Copyright © 2017 Diabetes Canada. Published by Elsevier Inc. All rights reserved.

  14. Menopause and risk of diabetes in the Diabetes Prevention Program.

    Science.gov (United States)

    Kim, Catherine; Edelstein, Sharon L; Crandall, Jill P; Dabelea, Dana; Kitabchi, Abbas E; Hamman, Richard F; Montez, Maria G; Perreault, Leigh; Foulkes, Mary A; Barrett-Connor, Elizabeth

    2011-08-01

    The study objectives were to examine the association between menopause status and diabetes risk among women with glucose intolerance and to determine if menopause status modifies response to diabetes prevention interventions. The study population included women in premenopause (n = 708), women in natural postmenopause (n = 328), and women with bilateral oophorectomy (n = 201) in the Diabetes Prevention Program, a randomized placebo-controlled trial of lifestyle intervention and metformin among glucose-intolerant adults. Associations between menopause and diabetes risk were evaluated using Cox proportional hazard models that adjusted for demographic variables (age, race/ethnicity, family history of diabetes, history of gestational diabetes mellitus), waist circumference, insulin resistance, and corrected insulin response. Similar models were constructed after stratification by menopause type and hormone therapy use. After adjustment for age, there was no association between natural menopause or bilateral oophorectomy and diabetes risk. Differences by study arm were observed in women who reported bilateral oophorectomy. In the lifestyle arm, women with bilateral oophorectomy had a lower adjusted hazard for diabetes (hazard ratio [HR], 0.19; 95% CI, 0.04-0.94), although observations were too few to determine if this was independent of hormone therapy use. No significant differences were seen in the metformin (HR, 1.29; 95% CI, 0.63-2.64) or placebo arms (HR, 1.37; 95% CI, 0.74-2.55). Among women at high risk for diabetes, natural menopause was not associated with diabetes risk and did not affect response to diabetes prevention interventions. In the lifestyle intervention, bilateral oophorectomy was associated with a decreased diabetes risk.

  15. Menopause and risk of diabetes in the Diabetes Prevention Program

    Science.gov (United States)

    Kim, Catherine; Edelstein, Sharon L.; Crandall, Jill P.; Dabelea, Dana; Kitabchi, Abbas E.; Hamman, Richard F.; Montez, Maria G.; Perreault, Leigh; Foulkes, Mary A.; Barrett-Connor, Elizabeth

    2012-01-01

    Objective The study objective was to examine the association between menopause status and diabetes risk among women with glucose intolerance and to determine if menopausal status modifies response to diabetes prevention interventions. Methods The study population included women in premenopause (n=708), natural postmenopause (n=328), and bilateral oophorectomy (n=201) in the Diabetes Prevention Program (DPP), a randomized placebo-controlled trial of lifestyle intervention and metformin among glucose intolerant adults. Associations between menopause and diabetes risk were evaluated using Cox proportional hazard models that adjusted for demographic variables (age, race/ethnicity, family history of diabetes, history of gestational diabetes mellitus), waist circumference, insulin resistance and corrected insulin response. Similar models were constructed after stratification by menopause type and hormone therapy (HT) use. Results After adjustment for age, there was no association between natural menopause or bilateral oophorectomy and diabetes risk. Differences by study arm were observed in women who reported bilateral oophorectomy. In the lifestyle arm, women with bilateral oophorectomy had a lower adjusted hazard for diabetes (HR 0.19, 95% CI 0.04, 0.94), although observations were too few to determine if this was independent of HT use. No significant differences were seen in the metformin (HR 1.29, 95% CI 0.63, 2.64) or placebo arms (HR 1.37, 95% CI 0.74, 2.55). Conclusions Among women at high-risk for diabetes, natural menopause was not associated with diabetes risk and did not affect response to diabetes prevention interventions. In the lifestyle intervention, bilateral oophorectomy was associated with decreased diabetes risk. PMID:21709591

  16. Raspberry Leaf and Hypoglycemia in Gestational Diabetes Mellitus.

    Science.gov (United States)

    Cheang, Kai I; Nguyen, Thanh T; Karjane, Nicole W; Salley, Kelsey E S

    2016-12-01

    Raspberry leaf is commonly consumed by pregnant women. Hypoglycemic effects have been documented with other species within the plant family. Whether raspberry leaf affects glycemic control in gestational diabetes mellitus (GDM) is unknown. A 38-year-old nulliparous woman with GDM developed hypoglycemia requiring lowered insulin dose after consuming raspberry leaf tea at 32 weeks of gestation. The temporal relationship was confirmed by the patient's self-withdrawal and reintroduction of the herb. Fetal surveillance and growth were reassuring. A cesarean delivery was performed at 39 weeks of gestation. The neonate did not experience hypoglycemia or other complications. Placental biopsy revealed normal findings. Consumption of raspberry leaf may lead to reduced insulin requirements in GDM. Women with GDM should be cautioned about its use and their glucose levels more closely monitored.

  17. Preconception counseling and contraception after gestational diabetes

    DEFF Research Database (Denmark)

    Mølsted-Pedersen, L; Skouby, S O; Damm, P

    1991-01-01

    alternative for women with previous GDM. Of 154 women with GDM, 33% chose IUD, 22% a combination-type oral contraceptive, and 16% barrier methods as their first choice of contraception 2 mo postpartum. We conclude that family planning and qualified contraceptive advice are important in women with previous GDM....... a subsequent pregnancy. Therefore, family planning and contraceptive guidance should follow the lines for women with pregestational diabetes. When low-dose hormonal contraceptives containing ethinyl estradiol and levonorgestrel were given to women with previous GDM, glucose tolerance and lipoprotein levels...

  18. [Gestational diabetes mellitus: importance of blood glucose monitoring].

    Science.gov (United States)

    Flores Le-Roux, Juana A; Benaiges Boix, David; Pedro-Botet, Juan

    2013-01-01

    Gestational diabetes mellitus (GDM) is common during pregnancy, and is frequently associated with maternal and perinatal complications. Intensive treatment of hyperglycaemia during pregnancy has been shown to reduce perinatal morbidity. In women with pregestational type 1 or 2 diabetes, hyperglycaemia during labour and delivery is an important factor in the development of neonatal hypoglycaemia. There are no generally accepted recommendations for women with GDM. Recent studies evaluating patients with GDM show that peripartum glucose control can be achieved in these women without the need for insulin use in the majority of cases. Hyperglycaemia during labour is not related with treatment established during pregnancy but rather with non-compliance of endocrinological follow-up. Factors such as ethnic origin, neonatal hypoxaemia, and large for gestational age seem to play an important role in the development of neonatal hypoglycaemia. Copyright © 2012 Elsevier España, S.L. and SEA. All rights reserved.

  19. Gestational Diabetes Mellitus Management with Oral Hypoglycemic Agents

    Science.gov (United States)

    Ryu, Rachel J.; Hays, Karen E.; Hebert, Mary F.

    2014-01-01

    Oral hypoglycemic agents such as glyburide (second generation sulfonylurea) and metformin (biguanide) are attractive alternatives to insulin due to lower cost, ease of administration, and better patient adherence. The majority of evidence from retrospective and prospective studies suggests comparable efficacy and safety of oral hypoglycemic agents such as glyburide and metformin as compared to insulin when used in the treatment of women with gestational diabetes mellitus (GDM). Glyburide and metformin have altered pharmacokinetics during pregnancy and both agents cross the placenta. In this article, we review the efficacy, safety and dosage of oral hypoglycemic agents for the treatment of gestational diabetes mellitus. Additional research is needed to evaluate optimal dosage for glyburide and metformin during pregnancy. Comparative studies evaluating the effects of glyburide and metformin on long-term maternal and fetal outcomes are also needed. PMID:25315294

  20. Diagnosis of gestational diabetes: falling through the net

    OpenAIRE

    Meek, Claire; Lewis, Hannah B; Patient, Charlotte; Murphy, Helen R; Simmons, David

    2015-01-01

    Aims/hypothesis: Gestational diabetes mellitus (GDM) is associated with increased risks to mother and child, but globally agreed diagnostic criteria remain elusive. Identification of women with GDM is important, as treatment reduces adverse outcomes such as perinatal death, shoulder dystocia and neonatal hypoglycaemia. Recently, the UK’s National Institute for Health and Care Excellence (NICE) recommended new diagnostic thresholds for GDM which are different from the International Associa...

  1. Diagnosis of gestational diabetes mellitus: falling through the net

    OpenAIRE

    Meek, Claire L.; Lewis, Hannah B.; Patient, Charlotte; Murphy, Helen R.; Simmons, David

    2015-01-01

    AIMS/HYPOTHESIS: Gestational diabetes mellitus (GDM) is associated with increased risks to mother and child, but globally agreed diagnostic criteria remain elusive. Identification of women with GDM is important, as treatment reduces adverse outcomes such as perinatal death, shoulder dystocia and neonatal hypoglycaemia. Recently, the UK's National Institute for Health and Care Excellence (NICE) recommended new diagnostic thresholds for GDM which are different from the International Association...

  2. Gestational diabetes: An overview with attention for developing countries

    OpenAIRE

    Schiavone M.; Putoto G.; Laterza F.; Pizzol Damiano

    2016-01-01

    Gestational diabetes mellitus (GDM) is defined as a glucose intolerance that occurs for the first time or it is first identified during pregnancy. The GDM etiology is multifactorial. It has not completely been established yet and several known risk factors may contribute to its onset. To date, there are no shared guidelines on the management and follow-up, especially regarding the low-income countries. In this paper, we describe the state of art about epidemiology, physiopathology, diagnosis,...

  3. Maternal and neonatal outcome in mothers with gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    G Thiruvikrama Prakash

    2017-01-01

    Full Text Available Introduction: Gestational diabetes mellitus (GDM is common and is accompanied with other comorbidities. Challenges to treatment exist at our institute as it serves women with low income. This study assessed the burden of comorbidities and the outcome of GDM. Methods: This was a prospective, observational study of women with gestational diabetes attending the obstetrics department from September 2012 to April 2014. GDM was diagnosed based on the International Association of Diabetes and Pregnancy Study Groups criteria. Medical comorbidities were noted, and lipid profile was done. All the women were followed up till delivery, and the complications were recorded. Age- and parity-matched pregnant women with normal oral glucose tolerance test were recruited as controls. Results: One hundred and thirty-nine women were followed up till delivery. The average age was 28 years. Eighteen percent had bad obstetric history. The average body mass index was 28.8. Twenty-five percent had gestational hypertension (HTN, and 6.4% had chronic HTN. Thirty percent had hypothyroidism. 65% women received insulin. The glucose values were within the recommended range in 60% of the women. Maternal hypoglycemia occurred in 7 (5% women. Forty-four percent of the women required cesarean section and 34% had complications either during pregnancy or labor. Three neonates had macrosomia. Twenty-six neonates (20% required admission to the Neonatal Intensive Care Unit. Four neonates (3% died. Newborns of mothers whose GDM optimally treated had less complications. Conclusion: Gestational diabetes is associated with HTN, hypothyroidism, obesity, and lipid abnormalities. The majority of women required insulin for treatment and optimal control of blood glucose resulted in lower neonatal complications.

  4. Postpartum reversibility of impaired incretin effect in gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Kosinski, M; Knop, F K; Vedtofte, L

    2013-01-01

    The potential reversibility of a reduced incretin effect is unclear. We investigated the incretin effect during third trimester and 3 to 4months postpartum in women with and without gestational diabetes mellitus (GDM). Ten women with GDM (plasma glucose (PG) concentration at 120min after 75g...... with GDM, the incretin effect increased significantly postpartum (31±6 vs. 56±6%, p=0.02), whereas the increment in women with NGT was insignificant (35±12 vs. 56±9%, p=0.08). Similarly, the gastrointestinal-mediated glucose disposal (GIGD=100%×(glucoseOGTT-glucoseIIGI)/glucoseOGTT) was reduced to diabetic...

  5. Fertility problems and risk of gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Holst, Signe; Kjær, Susanne K; Jørgensen, Marit E

    2016-01-01

    OBJECTIVE: To determine whether women with a history of fertility problems have a higher risk of gestational diabetes mellitus (GDM) than women without a history of fertility problems after adjustment for maternal factors. DESIGN: Nationwide population-based cohort study. SETTING: Not applicable...... of diabetes, level of education, and smoking during pregnancy. RESULT(S): In total, 7,433 (2%) pregnant women received a diagnosis of GDM. Multivariate analysis showed that pregnant women with a history of fertility problems had a statistically significantly higher risk of GDM than pregnant women without...

  6. Animal models for clinical and gestational diabetes: maternal and fetal outcomes

    Directory of Open Access Journals (Sweden)

    Kiss Ana CI

    2009-10-01

    Full Text Available Abstract Background Diabetes in pregnant women is associated with an increased risk of maternal and neonatal morbidity and remains a significant medical challenge. Diabetes during pregnancy may be divided into clinical diabetes and gestational diabetes. Experimental models are developed with the purpose of enhancing understanding of the pathophysiological mechanisms of diseases that affect humans. With regard to diabetes in pregnancy, experimental findings from models will lead to the development of treatment strategies to maintain a normal metabolic intrauterine milieu, improving perinatal development by preventing fetal growth restriction or macrosomia. Based on animal models of diabetes during pregnancy previously reported in the medical literature, the present study aimed to compare the impact of streptozotocin-induced severe (glycemia >300 mg/dl and mild diabetes (glycemia between 120 and 300 mg/dl on glycemia and maternal reproductive and fetal outcomes of Wistar rats to evaluate whether the animal model reproduces the maternal and perinatal results of clinical and gestational diabetes in humans. Methods On day 5 of life, 96 female Wistar rats were assigned to three experimental groups: control (n = 16, severe (n = 50 and mild diabetes (n = 30. At day 90 of life, rats were mated. On day 21 of pregnancy, rats were killed and their uterine horns were exposed to count implantation and fetus numbers to determine pre- and post-implantation loss rates. The fetuses were classified according to their birth weight. Results Severe and mild diabetic dams showed different glycemic responses during pregnancy, impairing fetal glycemia and weight, confirming that maternal glycemia is directly associated with fetal development. Newborns from severe diabetic mothers presented growth restriction, but mild diabetic mothers were not associated with an increased rate of macrosomic fetuses. Conclusion Experimental models of severe diabetes during pregnancy

  7. ADVERSE MATERNAL AND PERINATAL OUTCOMES IN GESTATIONAL DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Ambarisha Bhandiwad, Divyasree B, Surakshith L Gowda

    2015-10-01

    Full Text Available Introduction: Women with Gestational Diabetes Mellitus (GDM are at increased risk for many other health concerns with short and long-term implications for both mother and child. They are at higher risk for glucose-mediated macrosomia, hypertension, birth trauma, respiratory distress, hypoglycemia, hyperbilirubinemia with increased neonatal intensive care unit (NICU admissions. Postpartum complications include obesity and impaired glucose tolerance in the offspring and diabetes and cardiovascular disease in the mothers. Objectives: To study the incidence of maternal and fetal co-morbidities associated with GDM. Materials and Methods: This is a retrospective observational study where cases with GDM were analyzed for maternal and fetal complications. Results: 189 cases were detected to be Gestational Diabetes Mellitus, out of which 63.49% cases developed co-morbidities with GDM. 11.11% cases developed preeclampsia, 9.52% had polyhydramnios, 5.8% patients went into preterm labour, 3 cases had Antepartum Haemorrhage and one case had Postpartum Haemorrhage. 19.57% cases developed macrosomia, hypoglycemia was seen in 7.40% babies and hyperbilirubinemia in 3.70% babies. 6 Intra Uterine Deaths and 2 still borns were documented. Conclusion: GDM is a condition which is worth monitoring and treating, since it has been demonstrated that good metabolic control maintained throughout gestation can reduce maternal and fetal complications.

  8. Fast food consumption and gestational diabetes incidence in the SUN project

    OpenAIRE

    Dominguez, L.J. (Ligia J.); Martinez-Gonzalez, M.A. (Miguel Ángel); Basterra-Gortari, F.J. (Francisco Javier); Gea, A. (Alfredo); Barbagallo, M. (Mario); Bes-Rastrollo, M. (Maira)

    2014-01-01

    Background: Gestational diabetes prevalence is increasing, mostly because obesity among women of reproductive age is continuously escalating. We aimed to investigate the incidence of gestational diabetes according to the consumption of fast food in a cohort of university graduates. Methods: The prospective dynamic ‘‘Seguimiento Universidad de Navarra’’ (SUN) cohort included data of 3,048 women initially free of diabetes or previous gestational diabetes who reported at least one pr...

  9. A STUDY ON PLACENTAL MORPHOLOGY IN GESTATIONAL DIABETES

    Directory of Open Access Journals (Sweden)

    Katadi Venkata Sudha Madhuri

    2017-01-01

    Full Text Available BACKGROUND Gestational Diabetes Mellitus (GDM refers to any degree of glucose intolerance with onset or first recognition during pregnancy. Maternal diabetes constitutes an unfavourable environment for embryonic and foetoplacental development. The histomorphological changes in the placenta are associated with increased perinatal morbidity, increased risk of diabetes in the offspring and the mother in the ensuing years of life. Present study aims to study the morphological changes in the placenta along with maternal and foetal outcomes in pregnancies complicated by GDM. MATERIALS AND METHODS A descriptive observational case-controlled study was conducted from January 2013 to November 2016 in King George Hospital, Visakhapatnam. Hundred and sixty four women diagnosed with GDM and hundred women with normal gestation were enrolled in the study. Foetal surveillance was done by Doppler ultrasound and kick count technique during the gestation. Foetal and maternal outcome was evaluated and compared to the outcome of normal gestation. Placental specimens from term gestations (38-42 weeks diagnosed with GDM and normal full-term gestations were studied to assess the morphological parameters. Statistical analysis was done using descriptive statistical measures. RESULTS In the present study, 62.19% of the GDM cases terminated as normal gestations. Recurrent UTI was the most common complication (14.02% during the antenatal period. 17.68% of the foetuses from GDM mothers presented with macrosomia, however, there were no cases of congenital anomalies or shoulder dystocia. Placental tissue from the GDM cases was larger, heavier and more cotyledonous as compared to placenta from normal subjects. The umbilical cord showed eccentric and central attachment in all the controls and most of the cases and 5.48% of the cases showed marginal attachment of the umbilical cord. CONCLUSION The study describes the various maternal, foetal and placental outcomes in pregnancies

  10. [Prevention of diabetic foot].

    Science.gov (United States)

    Metelko, Zeljko; Brkljacić Crkvencić, Neva

    2013-10-01

    Diabetic foot (DF) is the most common chronic complication, which depends mostly on the duration and successful treatment of diabetes mellitus. Based on epidemiological studies, it is estimated that 25% of persons with diabetes mellitus (PwDM) will develop the problems with DF during lifetime, while 5% do 15% will be treated for foot or leg amputation. The treatment is prolonged and expensive, while the results are uncertain. The changes in DF are influenced by different factors usually connected with the duration and regulation of diabetes mellitus. The first problems with DF are the result of misbalance between nutritional, defensive and reparatory mechanisms on the one hand and the intensity of damaging factors against DF on the other hand. Diabetes mellitus is a state of chronic hyperglycemia, consisting of changes in carbohydrate, protein and fat metabolism. As a consequence of the long duration of diabetes mellitus, late complications can develop. Foot is in its structure very complex, combined with many large and small bones connected with ligaments, directed by many small and large muscles, interconnected with many small and large blood vessels and nerves. Every of these structures can be changed by nutritional, defensive and reparatory mechanisms with consequential DE Primary prevention of DF includes all measures involved in appropriate maintenance of nutrition, defense and reparatory mechanisms.First, it is necessary to identify the high-risk population for DF, in particular for macrovascular, microvascular and neural complications. The high-risk population of PwDM should be identified during regular examination and appropriate education should be performed. In this group, it is necessary to include more frequent and intensified empowerment for lifestyle changes, appropriate diet, regular exercise (including frequent breaks for short exercise during sedentary work), regular self control of body weight, quit smoking, and appropriate treatment of glycemia

  11. Beliefs, Barriers, and Preferences of European Overweight Women to Adopt a Healthier Lifestyle in Pregnancy to Minimize Risk of Developing Gestational Diabetes Mellitus : An Explorative Study

    NARCIS (Netherlands)

    Jelsma, Judith G M; van Leeuwen, Karen M; Oostdam, Nicolette; Bunn, Christopher; Simmons, David; Desoye, Gernot; Corcoy, Rosa; Adelantado, Juan M; Kautzky-Willer, Alexandra; Harreiter, Jürgen; van Assche, Frans Andre; Devlieger, Roland; Timmerman, Dirk; Hill, David; Damm, Peter; Mathiesen, Elisabeth R; Wender-Ozegowska, Ewa; Zawiejska, Agnieszka; Rebollo, Pablo; Lapolla, Annunziata; Dalfrà, Maria G; Del Prato, Stefano; Bertolotto, Alessandra; Dunne, Fidelma; Jensen, Dorte M; Andersen, Lise Lotte T; Snoek, Frank J; van Poppel, Mireille Nm

    2016-01-01

    INTRODUCTION: We explored beliefs, perceived barriers, and preferences regarding lifestyle changes among overweight European pregnant women to help inform the development of future lifestyle interventions in the prevention of gestational diabetes mellitus. METHODS: An explorative mixed methods,

  12. The role of continuing metformin therapy during pregnancy in the reduction of gestational diabetes and improving pregnancy outcomes in women with polycystic ovary syndrome

    Directory of Open Access Journals (Sweden)

    Azza A. Abd El Hameed

    2011-09-01

    Conclusion: Continuous metformin therapy throughout pregnancy in women with PCOS improves pregnancy outcomes by decreasing spontaneous miscarriage rates and prevention of gestational diabetes mellitus with its co morbidity and mortality.

  13. Gestational diabetes and gestational impaired glucose tolerance in 1653 teenage pregnancies: prevalence, risk factors and pregnancy outcomes.

    Science.gov (United States)

    Karcaaltincaba, Deniz; Buyukkaragoz, Bahar; Kandemir, Omer; Yalvac, Serdar; Kıykac-Altınbaş, Sadiman; Haberal, Ali

    2011-04-01

    The aim of this study was to determine the prevalence of gestational diabetes mellitus (GDM) and gestational impaired glucose tolerance (GIGT) in adolescent pregnancies, associated risk factors, and pregnancy complications. Retrospective study. Community-based teaching hospital. Results of 1653 pregnant women age ≤ 19 years in 2005-2007 were reviewed. All pregnant women screened with 50-g glucose challenge test (GCT) and patients with a GCT result ≥ 140 mg/dl underwent a 3-hour 100-g oral glucose tolerance test (OGTT). GDM was diagnosed with at least two abnormal results and GIGT was diagnosed with one abnormal result. GDM and GIGT cases were evaluated for the presence of any associated risk factors and effects of presence of risk factors on pregnancy outcomes. The prevalence of GDM was 0.85% (95% CI, 0.41-1.29), GIGT was 0.5% (95% CI, 0.15-0.81) and GDM+GIGT was 1.35% (95% CI, 0.78-1.88) by Carpenter and Coustan criteria. 68% of patients had at least one of the risk factors including body mass index ≥ 25, family history of diabetes and polycystic ovary syndrome (PCOS). Only 9.1% (n = 2) of them required insulin for glucose regulation during pregnancy with 9.1% (n = 2) macrosomia rate. All patients were primiparous and cesarean delivery rate was 27.3% (n = 6). We could not find any effect of presence of risk factors on pregnancy outcomes in GDM and GIGT cases. We demonstrated that GDM and GIGT are strongly associated with high BMI before pregnancy, PCOS, and family history of diabetes. Since GDM is a state of prediabetes, it is important to diagnose in adolescent pregnancies considering their life expectancy to take preventive measures to avoid diabetes mellitus. Copyright © 2011 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  14. [Risks factors for the development of diabetes in women with history of gestational diabetes mellitus].

    Science.gov (United States)

    Cypryk, Katarzyna; Szymczak, Wiesław; Pertyńska-Marczewska, Magdalena; Zawodniak-Szałapska, Małgorzata; Lewiński, Andrzej

    2005-01-01

    Women who suffered from impaired carbohydrate metabolism during pregnancy are more likely to develop different types of diabetes later in their lives. The aim of this paper was to study the risk factors for the development of diabetes in group of women with gestational diabetes mellitus (GDM) in anamnesis. 200 women took part in this study, who had gestational diabetes diagnosed between 1980-1998. All women were divided into 4 groups depending on the type of disorders occurring at the moment of examination: DM1 - women diagnosed with type I diabetes, DM2 - women diagnosed with type 2 diabetes, IGT-women with glucose levels in OGTT, which applied to impaired glucose tolerance (acc. to WHO criteria), NDM - women with no clinical signs of diabetes, with normal result of OGTT. The risk of diabetes development is significantly higher (independently of the clinical type) in women who had had GDM include: high glucose levels at the time of GDM diagnosis, early onset of symptoms - related to weeks of gestation, and the insulin treatment during pregnancy. However multifactor analysis indicates that the only significant risk factors for DM 1 are early onset of diabetes during pregnancy and high glucose levels 2 hours after OGTT during pregnancy (p women who suffered from diabetes during pregnancy.

  15. Participation in physical activity: perceptions of women with a previous history of gestational diabetes mellitus.

    Science.gov (United States)

    Graco, Marnie; Garrard, Jan; Jasper, Andrea E

    2009-04-01

    Women with a history of gestational diabetes mellitus (GDM) have an increased risk of developing type 2 diabetes mellitus (T2DM). Regular physical activity plays an important role in preventing T2DM. This study aimed to explore the perceptions of physical activity among women with previous GDM, in the context of preventing T2DM. Individual semi-structured interviews were conducted with 10 women with previous GDM who had not been diagnosed with T2DM. Data were analysed using a modified grounded theory approach. Women perceived diet to be significantly more important for the prevention of T2DM than physical activity. They underestimated the role of physical activity in preventing diabetes, which may have resulted from the lack of information they received following their pregnancy. Women consistently placed the needs of their families before their own, despite acknowledging their future health risks. The most commonly cited constraints on physical activity participation were lack of time, partner support, and appropriate childcare. They identified a need for 'family-friendly' community-based physical activity programs for mothers, more accessible childcare, and more information about the role of physical activity in diabetes prevention. Awareness of the role of physical activity for the prevention of diabetes was low. Physical activity promotion for women with previous GDM needs to be shaped around the opportunities and constraints identified by this population group.

  16. Metformin for diabetes prevention: insights gained from the Diabetes Prevention Program/Diabetes Prevention Program Outcomes Study.

    Science.gov (United States)

    Aroda, Vanita R; Knowler, William C; Crandall, Jill P; Perreault, Leigh; Edelstein, Sharon L; Jeffries, Susan L; Molitch, Mark E; Pi-Sunyer, Xavier; Darwin, Christine; Heckman-Stoddard, Brandy M; Temprosa, Marinella; Kahn, Steven E; Nathan, David M

    2017-09-01

    The largest and longest clinical trial of metformin for the prevention of diabetes is the Diabetes Prevention Program/Diabetes Prevention Program Outcomes Study (DPP/DPPOS). In this review, we summarise data from the DPP/DPPOS, focusing on metformin for diabetes prevention, as well as its long-term glycaemic and cardiometabolic effects and safety in people at high-risk of developing diabetes. The DPP (1996-2001) was a RCT of 3234 adults who, at baseline, were at high-risk of developing diabetes. Participants were assigned to masked placebo (n = 1082) or metformin (n = 1073) 850 mg twice daily, or intensive lifestyle intervention (n = 1079). The masked metformin/placebo intervention phase ended approximately 1 year ahead of schedule because of demonstrated efficacy. Primary outcome was reported at 2.8 years. At the end of the DPP, all participants were offered lifestyle education and 88% (n = 2776) of the surviving DPP cohort continued follow-up in the DPPOS. Participants originally assigned to metformin continued to receive metformin, unmasked. The DPP/DPPOS cohort has now been followed for over 15 years with prospective assessment of glycaemic, cardiometabolic, health economic and safety outcomes. After an average follow-up of 2.8 years, metformin reduced the incidence of diabetes by 31% compared with placebo, with a greater effect in those who were more obese, had a higher fasting glucose or a history of gestational diabetes. The DPPOS addressed the longer-term effects of metformin, showing a risk reduction of 18% over 10 and 15 years post-randomisation. Metformin treatment for diabetes prevention was estimated to be cost-saving. At 15 years, lack of progression to diabetes was associated with a 28% lower risk of microvascular complications across treatment arms, a reduction that was no different among treatment groups. Recent findings suggest metformin may reduce atherosclerosis development in men. Originally used for the treatment of type 2

  17. Diabetes Prevention and Treatment Strategies

    OpenAIRE

    Backholer, Kathryn; Peeters, Anna; Herman, William H.; Shaw, Jonathan E.; Liew, Danny; Ademi, Zanfina; Magliano, Dianna J.

    2013-01-01

    OBJECTIVE Effective interventions to prevent, delay, or remit diabetes are currently available. However, their impact on the prevalence of diabetes at the population level is unknown. This study aimed to estimate the impact of a range of diabetes interventions on the population prevalence of diabetes for Australian adults between 2010 and 2025. RESEARCH DESIGN AND METHODS We used the Australian Diabetes Projection Model to estimate the impact of a population-wide strategy, high-risk preventio...

  18. Future risk of diabetes in mother and child after gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Damm, Peter; Damm, Peter

    2009-01-01

    Gestational diabetes mellitus (GDM) is a common pregnancy complication with increased maternal and perinatal morbidity. However, significant long-term morbidity also exists for the mother and offspring. Women with previous GDM have a very high risk of developing overt diabetes, primarily type 2...... diabetes, later in life. Moreover, the risk of the metabolic syndrome is increased 3-fold in these women. Their offspring have an 8-fold risk of diabetes/prediabetes at 19-27 years of age. Thus, GDM is part of a vicious circle which increases the development of diabetes in the coming generations....

  19. 77 FR 38844 - Notice of NIH Consensus Development Conference: Diagnosing Gestational Diabetes Mellitus

    Science.gov (United States)

    2012-06-29

    ... treatment modify the health outcomes of mothers who meet various criteria for gestational diabetes mellitus... Development Conference: Diagnosing Gestational Diabetes Mellitus SUMMARY: The National Institutes of Health... Diabetes Mellitus.'' The conference will be open to the public. DATES: The conference will be held October...

  20. Gestational diabetes mellitus and subsequent development of overt diabetes mellitus

    DEFF Research Database (Denmark)

    Damm, P

    1998-01-01

    to subsequent development of diabetes and also to identify predictive factors for the development of overt diabets in these women. A follow-up study of diet treated GDM women diagnosed during 1978 to 1985 at the Rigshospital, Copenhagen was performed. Glucose tolerance was evaluated in 241 women (81% of the GDM...... of women with GDM. However, previous studies, in populations quite different from a Danish population, have shown that women with previous GDM have a high risk of developing overt diabetes mellitus later in life. Hence, we aimed to investigate the prognosis of women with previous GDM with respect...... population) 2-11 years after pregnancy. Abnormal glucose tolerance was found in 34.4% of the women (3.7% IDDM, 13.7% NIDDM, 17% IGT) in contrast to a control group where none had diabetes and 5.3% had IGT. Logistic regression analysis identified the following independent risk factors for later development...

  1. Gestational diabetes mellitus and subsequent development of overt diabetes mellitus

    DEFF Research Database (Denmark)

    Damm, P

    1998-01-01

    of women with GDM. However, previous studies, in populations quite different from a Danish population, have shown that women with previous GDM have a high risk of developing overt diabetes mellitus later in life. Hence, we aimed to investigate the prognosis of women with previous GDM with respect...... to subsequent development of diabetes and also to identify predictive factors for the development of overt diabets in these women. A follow-up study of diet treated GDM women diagnosed during 1978 to 1985 at the Rigshospital, Copenhagen was performed. Glucose tolerance was evaluated in 241 women (81% of the GDM...... population) 2-11 years after pregnancy. Abnormal glucose tolerance was found in 34.4% of the women (3.7% IDDM, 13.7% NIDDM, 17% IGT) in contrast to a control group where none had diabetes and 5.3% had IGT. Logistic regression analysis identified the following independent risk factors for later development...

  2. Placental lipases in pregnancies complicated by gestational diabetes mellitus (GDM.

    Directory of Open Access Journals (Sweden)

    Helen L Barrett

    Full Text Available Infants of women with gestational diabetes mellitus (GDM are more likely to be born large for gestational age with a higher percentage body fat. Elevated maternal lipids may contribute to this. Placental lipases such as lipoprotein lipase (LPL, endothelial lipase (EL and hormone sensitive lipase (HSL are involved in transferring lipids from mother to fetus. Previous studies of expression of these lipases in placentae in women with diabetes in pregnancy have reported divergent results. Intracellular lipases such as adipose triglyceride lipase (ATGL, and HSL are central to lipid droplet metabolism. The activities of these lipases are both influenced by Perilipin 1, and ATGL is also activated by a co-factor comparative gene identification-58 (CGI-58 and inhibited by G0/G1 switch gene 2 (GS02. None of these modifying factors or ATGL have been examined previously in placenta. The purpose of this study was therefore to examine the expression of ATGL, HSL, LPL, EL, as well as Perilipin 1, GS02 and CGI-58 in term pregnancies complicated by GDM. mRNA and protein expression of the lipases were measured in placentae from 17 women with GDM and 17 normoglycaemic pregnancies, matched for maternal BMI and gestational age of delivery. ATGL mRNA expression was increased and HSL mRNA expression reduced in placentae from GDM although there was no differences in protein expression of any of the lipases. All lipases were localised to trophoblasts and endothelial cells. The expression of Perilipin 1 and CGI-58 mRNA was increased and GS02 not altered in GDM. These results suggest that there is no difference in expression in these four lipases between GDM and normoglycaemic placentae, and therefore altered lipid transfer via these lipases does not contribute to large for gestational age in infants of women with GDM.

  3. Placental Lipases in Pregnancies Complicated by Gestational Diabetes Mellitus (GDM)

    Science.gov (United States)

    Barrett, Helen L.; Kubala, Marta H.; Scholz Romero, Katherin; Denny, Kerina J.; Woodruff, Trent M.; McIntyre, H. David; Callaway, Leonie K.; Nitert, Marloes Dekker

    2014-01-01

    Infants of women with gestational diabetes mellitus (GDM) are more likely to be born large for gestational age with a higher percentage body fat. Elevated maternal lipids may contribute to this. Placental lipases such as lipoprotein lipase (LPL), endothelial lipase (EL) and hormone sensitive lipase (HSL) are involved in transferring lipids from mother to fetus. Previous studies of expression of these lipases in placentae in women with diabetes in pregnancy have reported divergent results. Intracellular lipases such as adipose triglyceride lipase (ATGL), and HSL are central to lipid droplet metabolism. The activities of these lipases are both influenced by Perilipin 1, and ATGL is also activated by a co-factor comparative gene identification-58 (CGI-58) and inhibited by G0/G1 switch gene 2 (GS02). None of these modifying factors or ATGL have been examined previously in placenta. The purpose of this study was therefore to examine the expression of ATGL, HSL, LPL, EL, as well as Perilipin 1, GS02 and CGI-58 in term pregnancies complicated by GDM. mRNA and protein expression of the lipases were measured in placentae from 17 women with GDM and 17 normoglycaemic pregnancies, matched for maternal BMI and gestational age of delivery. ATGL mRNA expression was increased and HSL mRNA expression reduced in placentae from GDM although there was no differences in protein expression of any of the lipases. All lipases were localised to trophoblasts and endothelial cells. The expression of Perilipin 1 and CGI-58 mRNA was increased and GS02 not altered in GDM. These results suggest that there is no difference in expression in these four lipases between GDM and normoglycaemic placentae, and therefore altered lipid transfer via these lipases does not contribute to large for gestational age in infants of women with GDM. PMID:25118138

  4. Gestational diabetes mellitus and macrosomia: a literature review.

    Science.gov (United States)

    Kc, Kamana; Shakya, Sumisti; Zhang, Hua

    2015-01-01

    Fetal macrosomia, defined as a birth weight ≥ 4,000 g, may affect 12% of newborns of normal women and 15-45% of newborns of women with gestational diabetes mellitus (GDM). The increased risk of macrosomia in GDM is mainly due to the increased insulin resistance of the mother. In GDM, a higher amount of blood glucose passes through the placenta into the fetal circulation. As a result, extra glucose in the fetus is stored as body fat causing macrosomia, which is also called 'large for gestational age'. This paper reviews studies that explored the impact of GDM and fetal macrosomia as well as macrosomia-related complications on birth outcomes and offers an evaluation of maternal and fetal health. Fetal macrosomia is a common adverse infant outcome of GDM if unrecognized and untreated in time. For the infant, macrosomia increases the risk of shoulder dystocia, clavicle fractures and brachial plexus injury and increases the rate of admissions to the neonatal intensive care unit. For the mother, the risks associated with macrosomia are cesarean delivery, postpartum hemorrhage and vaginal lacerations. Infants of women with GDM are at an increased risk of becoming overweight or obese at a young age (during adolescence) and are more likely to develop type II diabetes later in life. Besides, the findings of several studies that epigenetic alterations of different genes of the fetus of a GDM mother in utero could result in the transgenerational transmission of GDM and type II diabetes are of concern.

  5. [Incidence and clinical risk factors for the development of diabetes mellitus in women with previous gestational diabetes].

    Science.gov (United States)

    Domínguez-Vigo, P; Álvarez-Silvares, E; Alves-Pérez M T; Domínguez-Sánchez, J; González-González, A

    2016-04-01

    Gestational diabetes is considered a variant of diabetes mellitus as they share a common pathophysiological basis: insulin resistance in target and insufficient secretion of it by pancreatic p-cell bodies. Pregnancy is a unique physiological situation provides an opportunity to identify future risk of diabetes mellitus. To determine the long-term incidence of diabetes mellitus in women who have previously been diagnosed with gestational diabetes and identifying clinical risk factors for developing the same. nested case-control cohort study. 671 patients between 1996 and 2009 were diagnosed with gestational diabetes were selected. The incidence of diabetes mellitus was estimated and 2 subgroups were formed: Group A or cases: women who develop diabetes mellitus after diagnosis of gestational diabetes. Group B or control: random sample of 71 women with a history of gestational diabetes in the follow-up period remained normoglycemic. Both groups were studied up to 18 years postpartum. By studying Kaplan Meier survival of the influence of different gestational variables it was obtained in the later development of diabetes mellitus with time parameter and COX models for categorical variables were applied. Significant variables were studied by multivariate Cox analysis. In all analyzes the Hazard ratio was calculated with confidence intervals at 95%. The incidence of diabetes mellitus was 10.3% in patients with a history of gestational diabetes. They were identified as risk factors in the index pregnancy to later development of diabetes mellitus: greater than 35 and younger than 27 years maternal age, BMI greater than 30 kg/m2, hypertensive disorders of pregnancy, insulin therapy, poor metabolic control and more than a complicated pregnancy with gestational diabetes. Clinical factors have been identified in the pregnancy complicated by gestational diabetes that determine a higher probability of progression to diabetes mellitus in the medium and long term.

  6. CXC chemokine ligand 16 is increased in gestational diabetes mellitus and preeclampsia and associated with lipoproteins in gestational diabetes mellitus at 5 years follow-up.

    Science.gov (United States)

    Lekva, Tove; Michelsen, Annika E; Aukrust, Pål; Paasche Roland, Marie Cecilie; Henriksen, Tore; Bollerslev, Jens; Ueland, Thor

    2017-11-01

    Women with a history of gestational diabetes mellitus and preeclampsia are at increased risk of cardiovascular disease later in life, but the mechanism remains unclear. The aim of the study was to evaluate the association between CXC chemokine ligand 16 and indices of glucose metabolism, dyslipidemia and systemic inflammation in gestational diabetes mellitus and preeclampsia. This sub-study of the population-based prospective cohort included 310 women. Oral glucose tolerance test was performed during pregnancy and 5 years later along with lipid analysis. CXC chemokine ligand 16 was measured in plasma (protein) and peripheral blood mononuclear cells (messenger RNA) during pregnancy and at follow-up. Circulating CXC chemokine ligand 16 was higher in gestational diabetes mellitus women early in pregnancy and at follow-up, while higher in preeclampsia women late in pregnancy compared to control women. Messenger RNA of CXC chemokine ligand 16 in peripheral blood mononuclear cells were lower in gestational diabetes mellitus and preeclampsia women compared to control women. Increased circulating CXC chemokine ligand 16 level was associated with a higher apolipoprotein B and low-density lipoprotein cholesterol in gestational diabetes mellitus women but not in normal pregnancy at follow-up. Our study shows that women with gestational diabetes mellitus and preeclampsia had a dysregulated CXC chemokine ligand 16 during pregnancy, and in gestational diabetes mellitus, the increase in CXC chemokine ligand 16 early in pregnancy and after 5 years was strongly associated with their lipid profile.

  7. Gestational diabetes: An overview with attention for developing countries

    Directory of Open Access Journals (Sweden)

    Schiavone M.

    2016-04-01

    Full Text Available Gestational diabetes mellitus (GDM is defined as a glucose intolerance that occurs for the first time or it is first identified during pregnancy. The GDM etiology is multifactorial. It has not completely been established yet and several known risk factors may contribute to its onset. To date, there are no shared guidelines on the management and follow-up, especially regarding the low-income countries. In this paper, we describe the state of art about epidemiology, physiopathology, diagnosis, and management of GDM. Moreover, we focus on the current state in low income countries trying to outline basis for further research.

  8. Risk perception and unrecognized type 2 diabetes in women with previous gestational diabetes mellitus.

    Science.gov (United States)

    Malcolm, Janine; Lawson, Margaret L; Gaboury, Isabelle; Keely, Erin

    2009-09-01

    Women with a history of gestational diabetes mellitus (GDM) have a high chance of developing type 2 diabetes mellitus (T2DM) following the index pregnancy, however, little is known of women's perception of this risk. The objectives were to (1) determine women's perception of risk of future development of T2DM following a GDM pregnancy and (2) describe the prevalence of undetected dysglycaemia in a Canadian population. The study was designed as a 9-11 year follow-up study of women previously enrolled in a randomized controlled trial of tight versus minimal intervention for GDM. Women's perception of future risk of diabetes was determined by questionnaire. Fasting lipid profile, height and weight were performed on all participants. Oral glucose tolerance tests were performed on all women without prior history of diabetes mellitus type 2 (DM2). The study was conducted at Ottawa Hospital General Campus and Children's Hospital of Eastern Ontario, in Ottawa, Canada. Eighty-nine of 299 (30%) of the original cohort were recruited. Eighty-eight women completed the questionnaire and 77 women without known diabetes underwent two hour glucose tolerance testing. Twenty-three (30%) felt their risk was no different than other women or did not know, 27 (35%) felt risk was increased a little and 27 (35%) felt risk was increased a lot. Only 52% (40/77) had normal glucose tolerance. Of all, 25/88 (28%) patients had diabetes (11 previously diagnosed and 14 diagnosed within the study). Of those newly diagnosed with DM2, four (29%) were diagnosed by fasting glucose, six (42%) by two hour glucose tolerance test (GTT) alone and four (29%) by both. Twenty-four of the women (27%) had impaired glucose tolerance (IGT). Of those with IGT, 12 (57%) had a fasting food glucose DM2, and all had a waist circumference >88 cm. In conclusion the perception of being at high risk for T2DM did not prevent women from having undetected T2DM. Many factors are likely to contribute to this, including the

  9. Monitoring and managing mothers with gestational diabetes mellitus: a nursing perspective

    Directory of Open Access Journals (Sweden)

    Berry DC

    2015-10-01

    Full Text Available Diane C Berry,1 Quinetta B Johnson,2,3 Alison M Stuebe2,3 1The University of North Carolina School of Nursing, 2Women's Primary Health Care, The University of North Carolina School of Medicine, Division of Maternal Fetal Medicine, 3The University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA Abstract: Women diagnosed with gestational diabetes mellitus (GDM must work in partnership with their health care team to improve both maternal and fetal outcomes. This team may include physicians, midwives, nurse practitioners, physician assistants, registered nurses, certified diabetes educators, and registered dietitians. Management should include medical nutrition therapy, self-monitoring of blood glucose with tight control, and exercise to prevent postprandial hyperglycemia. Approximately 80% of women diagnosed with GDM are well controlled with medical nutrition therapy, self-monitoring of blood glucose, and exercise; however, approximately 20% require medication to bring their blood glucose levels under control during pregnancy. The risk of developing type 2 diabetes mellitus decreases dramatically for women who engage in interventions to lose weight postpartum, improve their nutrition and increase their physical activity. Therefore, postpartum women with GDM should be retested and reclassified at 6 weeks postpartum and strongly encouraged to lose weight through proper nutrition and exercise. Keywords: gestational diabetes mellitus, medical nutrition therapy, self-monitoring of blood glucose, exercise, medication, type 2 diabetes

  10. Integrated Intervention for Diabetes Risk After Gestational Diabetes ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    They will work with at-risk women from poor communities who use the public health system in the cities of Cape Town and Johannesburg. The proposed intervention involves offering women a special test to see whether they have diabetes six weeks after delivery, along with counselling about healthy lifestyles from a ...

  11. Can Diabetes Be Prevented (For Kids)

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Can Diabetes Be Prevented? KidsHealth / For Kids / Can Diabetes Be ... be prevented. How? Let's find out. What Is Diabetes? Diabetes is a disease that affects how the ...

  12. Beneficial Effects of Omega-3 Polyunsaturated Fatty Acids in Gestational Diabetes: Consequences in Macrosomia and Adulthood Obesity

    OpenAIRE

    Yessoufou, Akadiri; Nekoua, Magloire P.; Gbankoto, Adam; Mashalla, Yohana; Moutairou, Kabirou

    2015-01-01

    Omega-3 polyunsaturated fatty acids (PUFAs) are increasingly being used to prevent cardiovascular diseases, including diabetes and obesity. In this paper, we report data on the observed effects of omega-3 PUFA on major metabolic disorders and immune system disruption during gestational diabetes and their consequences on macrosomia. While controversies still exist about omega-3 PUFA effects on antioxidant status regarding the level of omega-3 PUFA in diet supplementation, their lipid-lowering ...

  13. [Association of abo blood groups with gestational diabetes mellitus].

    Science.gov (United States)

    Huidobro M, Andrea; Torres C, Demetrio; Paredes, Fabio

    2017-04-01

    ABO and Rhesus blood systems are associated with type 2 Diabetes Mellitus (DM2). Gestational Diabetes (GDM) is a model to study DM. To study the association between GDM and ABO and Rhesus groups. A retrospective cohort study was performed in 1,078 women who gave birth to a singleton in Talca Regional Hospital, Chile, during 2008. We analyzed personal, obstetric, medical data and ABO and Rh blood groups. GDM was diagnosed in 6.6% of women. Age and body mass index were significantly associated with GDM. There were no differences in Rh blood groups (p = 0.604), while ABO groups were different between GDM and controls. B antigen was present in 3% of GDM women and in 10.8% of controls (p = 0.037), with an odds ratio of 0.25 after adjusting for other associated risk factors (p = 0.06). ABO group is suggested as a possible protector marker for GDM.

  14. Increased infection with key periodontal pathogens during gestational diabetes mellitus

    Science.gov (United States)

    Gogeneni, Himabindu; Buduneli, Nurcan; Ceyhan-Öztürk, Banu; Gümüş, Pınar; Akcali, Aliye; Zeller, Iris; Renaud, Diane E.; Scott, David A.; Özçaka, Özgün

    2015-01-01

    Aim Gestational diabetes mellitus (GDM), gingivitis, infection with specific periodontal pathogens and systemic inflammation each increase the risk for poor pregnancy outcome. We set out to monitor the interactions of gingivitis and GDM with respect to oral infection and the systemic inflammatory burden. Materials and Methods Four case–control groups (n = 117) were recruited, (1) No gingivitis, No GDM (n = 27); (2) Gingivitis, No GDM (n = 31); (3) No gingivitis, GDM (n = 21); and (4) Gingivitis, GDM (n = 38). Oral infection with three key periodontal pathogens was determined by PCR. Systemic inflammation was determined by quantification of CRP by EIA. Results Gingivitis during pregnancy was associated with oral infection with Porphyromonas gingivalis, Filifactor alocis and Treponema denticola and combinations thereof (all p Diabetes and gingivitis act in concert to increase risk biomarkers for poor pregnancy outcome. PMID:25959628

  15. Clinical periodontal status and inflammatory cytokines in gestational diabetes mellitus.

    Science.gov (United States)

    Özçaka, Özgün; Ceyhan-Öztürk, Banu; Gümüş, Pınar; Akcalı, Aliye; Nalbantsoy, Ayşe; Buduneli, Nurcan

    2016-12-01

    The aim of the present cross-sectional study was to compare clinical periodontal findings as well as gingival crevicular fluid (GCF) and serum levels of tumour necrosis factor-alpha (TNF-α), interleukin-10 (IL-10), and IL-33 between women with and without gestational diabetes mellitus (GDM). Serum and GCF samples were collected, full-mouth recordings comprising plaque index, bleeding on probing and probing depth were performed in 96 females with GDM (cases) and 65 non-diabetic pregnant females (controls). Age, smoking status, pre-pregnancy body mass index, pregnancy outcomes were recorded. Serum and GCF IL-10, IL-33, TNF-α levels were determined. The GDM group was significantly older than the control group with an age difference of 3.27 years (mean ages were 32.05 and 28.78 years, respectively) (pperiodontal health during pregnancy. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Dietary iron intake, iron status, and gestational diabetes.

    Science.gov (United States)

    Zhang, Cuilin; Rawal, Shristi

    2017-12-01

    Pregnant women are particularly vulnerable to iron deficiency and related adverse pregnancy outcomes and, as such, are routinely recommended for iron supplementation. Emerging evidence from both animal and population-based studies, however, has raised potential concerns because significant associations have been observed between greater iron stores and disturbances in glucose metabolism, including increased risk of type 2 diabetes among nonpregnant individuals. Yet, the evidence is uncertain regarding the role of iron in the development of gestational diabetes mellitus (GDM), a common pregnancy complication which has short-term and long-term adverse health ramifications for both women and their children. In this review, we critically and systematically evaluate available data examining the risk of GDM associated with dietary iron, iron supplementation, and iron status as measured by blood concentrations of several indicators. We also discuss major methodologic concerns regarding the available epidemiologic studies on iron and GDM. © 2017 American Society for Nutrition.

  17. Diabetes Mellitus amp Its Prevention

    Directory of Open Access Journals (Sweden)

    KusumaNeela Bolla

    2015-08-01

    Full Text Available Abstract Diabetes Mellitus has been known for centuries as a disease related to sweetness. even though several million people all over the world are effected with diabetes not all are well informed about the nature of the disease. in diabetes there is excessive glucose in blood and urine due to inadequate production of insulin or insulin resistance. diabetics can lead a normal life provided they take prescribed durgs and make certain changes in their lifestyle particularly in their diet and physical activity. uncontrolled diabetes leads to some of the complication so some of the home remedies also play a major role to prevent the diabetes.

  18. Take Steps to Prevent Type 2 Diabetes

    Science.gov (United States)

    ... En español Take Steps to Prevent Type 2 Diabetes Browse Sections The Basics Overview Types of Diabetes ... 1 of 9 sections The Basics: Types of Diabetes What is diabetes? Diabetes means you have glucose ( ...

  19. Get Real about Diabetes Prevention

    Centers for Disease Control (CDC) Podcasts

    2007-11-01

    This podcast delivers a diabetes prevention message promoting small steps that can lead to big rewards.  Created: 11/1/2007 by National Diabetes Education Program (NDEP), a joint program of the Centers for Disease Control and Prevention and the National Institutes of Health.   Date Released: 11/15/2007.

  20. Contribution of maternal obesity and weight gain in pregnancy to the occurrence of gestational diabetes

    Directory of Open Access Journals (Sweden)

    Teodorescu Cristina

    2015-01-01

    Full Text Available An increase in prevalence of gestational diabetes mellitus (GDM was observed using new diagnostic criteria. We evaluated the prevalence of GDM in a population of pregnant women (109 women with gestational age of 24-28 weeks and risk factors for GDM, such as maternal obesity and weight gain. The evaluation of each patient included an oral glucose tolerance test (OGTT using the new diagnostic criteria of the International Association of Diabetes and Pregnancy Study Groups (IADPSG for GDM, 2D ultrasounds and the registration of risk factors. The prevalence of GDM in the age group ≥30 years was 11.9%, which is comparable to the results of other studies. The relative risk (RR for GDM was 1.738 (95% CI 0.630-4.795 in women over 30 years and 3.782 (95% CI 1.127-12.686 in women over 35. Weight gain in the group with GDM was significantly higher than in the group that included pregnant women without GDM (p <0.01. Considering the high risk of GDM with excessive gestational weight gain, educational nutrition programs should be established for the fertile-age population, not only to prevent obesity but also to prevent excessive weight gain during pregnancy.

  1. Common type 2 diabetes risk gene variants associate with gestational diabetes

    DEFF Research Database (Denmark)

    Lauenborg, Jeannet; Grarup, Niels; Damm, Peter

    2009-01-01

    Objective: We aimed to examine the association between gestational diabetes (GDM) and eleven recently identified type 2 diabetes susceptibility loci. Research Design and Methods: Type 2 diabetes risk variants in TCF7L2, CDKAL1, SLC30A8, HHEX/IDE, CDKN2A/2B, IGF2BP2, FTO, TCF2, PPARG, KCNJ11 and WFS......1 loci were genotyped in a cohort of women with a history of GDM (n=283) and in glucose tolerant women of the population-based Inter99 cohort (n=2,446). Results: All the risk alleles in the 11 examined type 2 diabetes risk variants showed an odds ratio greater than 1 for the GDM group compared...... previously proven type 2 diabetes risk alleles equals the findings from association studies on type 2 diabetes. This supports the hypothesis that GDM and type 2 diabetes are two of the same entity....

  2. A Combined Metabolomic and Proteomic Analysis of Gestational Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Joanna Hajduk

    2015-12-01

    Full Text Available The aim of this pilot study was to apply a novel combined metabolomic and proteomic approach in analysis of gestational diabetes mellitus. The investigation was performed with plasma samples derived from pregnant women with diagnosed gestational diabetes mellitus (n = 18 and a matched control group (n = 13. The mass spectrometry-based analyses allowed to determine 42 free amino acids and low molecular-weight peptide profiles. Different expressions of several peptides and altered amino acid profiles were observed in the analyzed groups. The combination of proteomic and metabolomic data allowed obtaining the model with a high discriminatory power, where amino acids ethanolamine, l-citrulline, l-asparagine, and peptide ions with m/z 1488.59; 4111.89 and 2913.15 had the highest contribution to the model. The sensitivity (94.44% and specificity (84.62%, as well as the total group membership classification value (90.32% calculated from the post hoc classification matrix of a joint model were the highest when compared with a single analysis of either amino acid levels or peptide ion intensities. The obtained results indicated a high potential of integration of proteomic and metabolomics analysis regardless the sample size. This promising approach together with clinical evaluation of the subjects can also be used in the study of other diseases.

  3. Gestational Diabetes Mellitus in Primigravidae: a Mild Disease

    Directory of Open Access Journals (Sweden)

    Nor Azlin Mohamed Ismail

    2011-01-01

    Full Text Available This prospective observational study was done to analyse the prevalence of gestational diabetes mellitus (GDM among primigravidae and its outcome. All healthy primigravidae with singleton pregnancies were offered universal glucose tolerance testing between 16 and 28 weeks gestation. GDM and non GDM groups were managed according to hospital protocol. The antenatal features and pregnancy outcomes were analysed. Out of 616 primigravidae, 113 (18.34 % were GDM with slightly older (27.9 ± 4.2 versus 26.32 ± 3.3, p < 0.001 age. The mean fasting and two hours postprandial blood glucose in both groups were 4.99 ± 1.08 mmol/l, 8.86 ± 1.41 mmol/l(GDM and 4.36 ± 0.43 mmol/l, 5.71 ± 1.11 mmol/l (Non GDM, respectively. Maternal family history of diabetes mellitus, weight exceeding 80 Kg, polyhydramnios (2.65 % versus 0.2 %, p=0.028 and neonatal hyperbilirubinaemia (9.73 % versus 2.98 %, p=0.01 occurred significantly more frequent in the GDM group compared to normal. There was no significant difference in other pregnancy outcomes and complications between the two groups. In conclusion GDM in primigravidae was detected at a relatively young age with more frequent maternal family history of DM, weight exceeding 80 Kg, polyhydromnions and neonatal hyperbilirubinaemia. The degree of disease was mild and treatment led to no significant complication.

  4. Two Cases of Allergy to Insulin in Gestational Diabetes

    Directory of Open Access Journals (Sweden)

    Gi Jun Kim

    2015-09-01

    Full Text Available Allergic reaction to insulin is uncommon since the introduction of human recombinant insulin preparations and is more rare in pregnant than non-pregnant females due to altered immune reaction during pregnancy. Herein, we report two cases of allergic reaction to insulin in gestational diabetes that were successfully managed. One case was a 33-year-old female using isophane-neutral protamine Hagedorn human insulin and insulin lispro. She experienced dyspnea, cough, urticaria and itching sensation at the sites of insulin injection immediately after insulin administration. We discontinued insulin therapy and started oral hypoglycemic agents with metformin and glibenclamide. The other case was a 32-year-old female using insulin lispro and insulin detemer. She experienced pruritus and burning sensation and multiple nodules at the sites of insulin injection. We changed the insulin from insulin lispro to insulin aspart. Assessments including immunoglobulin E (IgE, IgG, eosinophil, insulin antibody level and skin biopsy were performed. In the two cases, the symptoms were resolved after changing the insulin to oral agents or other insulin preparations. We report two cases of allergic reaction to human insulin in gestational diabetes due to its rarity.

  5. Association of Maternal Vitamin C Status with Gestational Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Hedyeh Masoodi

    2015-01-01

    Full Text Available Background: The role of antioxidants in the etiology of gestational diabetes mellitus (GDM has been given limited attention. Vitamin C is a nutrient with radical quenching property and has been claimed to influence glucose tolerance. Aim: To study the association between vitamin C status (dietary intake and plasma concentrations and GDM. Material and Methods: Using a case-control design with 1:3 ratio we examined 42 pregnant women with GDM and 158 normal glucose tolerant (NGT gestational age-matched healthy pregnant women at an average of 26 weeks of gestation. Maternal vitamin C intake was determined using detailed semi food frequency questionnaire (SFFQ and 24 hour diet recall. Plasma vitamin C was determined using a spectrophotometric method in non-fasting samples. GDM was diagnosed by 75 gm oral glucose tolerance test (OGTT using International Association for Diabetes in Pregnancy Study Group (IADPSG criteria (fasting ≥92mg%, 1hour ≥180mg%, 2 hour ≥153mg %. Results: GDM women had lower median intake of vitamin C (35.0 mg/day vs. 66.7; p<0.001 and lower median plasma vitamin C concentration (45.9 µmol/L vs. 95.2; p<0.001 compared to NGT women. Plasma vitamin C concentration was inversely related to fasting, 1 hour and 2 hour post glucose plasma glucose concentrations (p<0.001. The associations remained significant after adjustment for age, income, pre-pregnancy BMI, and stress. Conclusion: Our findings suggest that low vitamin C intake as well as low plasma vitamin C concentration is associated with GDM. This association needs to be tested in a large prospective study and subsequently in a clinical trial

  6. [Prevalence of postpartum impaired glucose tolerance after gestational diabetes].

    Science.gov (United States)

    Romero Gutiérrez, Gustavo; Macias Rocha, Ana Laura; Puente Alvarez, Erika Isela

    2012-10-01

    gestational diabetes mellitus (GDM) affects 2 to 10% of pregnancies and it has been postulated as a variant of type 2 diabetes mellitus (DM2) because they share a similar pathophysioiogy. Approximately in 90% the carbohydrate intolerance resolves after pregnancy, however after 5 to 16 years after delivery women will have a risk of 17 to 63% to the development of type 2 diabetes mellitus. to determine the frequency of postpartum impaired glucose tolerance in women with previous GDM. 125 patients with diagnosis of GMD were included, general data were captured, type of control during pregnancy and complications occurred. The women were instructed to undergo a postpartum oral glucose tolerance test of 75 g and 2 h, 6 weeks after their delivery date and they were classified into five groups: normal patients, type 2 diabetes mellitus, impaired glucose tolerance, impaired fasting glucose and combined both. after follow up 13 women (10.4%) were diagnosed as DM2; 14 patients (11.2%) were classified as glucose intolerance; 16 (12.8%) were catalogued with impaired fasting glucose; 6 (4.8%) had both disorders; and 76 (60.8%) were diagnosed as healthy women. the detection with a postpartum oral glucose tolerance test is necessary for the identification of the various types of disorders of the carbohydrate metabolism including DM2.

  7. Trends in the Diagnosis of Gestational Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Surabhi Mishra

    2016-01-01

    Full Text Available Introduction. Gestational diabetes mellitus (GDM is defined as carbohydrate intolerance of variable degree with onset or recognition during pregnancy. As prevalence of diabetes is linked to impaired glucose tolerance during antenatal period, routine antenatal screening of GDM is required. However, screening tests for GDM remain controversial. Objective. To review different diagnostic criteria for GDM. Materials and Methods. Freely accessible, full-text articles from 1964 to 2015, available in PubMed in English language, pertaining to screening of GDM were reviewed. Results. First diagnostic criteria for GDM in 1964 by O’Sullivan and Mahan, modified by the National Diabetes Data Group (NDDG in 1979 and Carpenter in 1982. The cut-off value as per WHO definition of GDM was 140 mg/dL, 2 hours after 75 g glucose intake. Diabetes in Pregnancy Study Group India (DIPSI, in 2006, endorsed WHO criteria but irrespective of the last meal timings. Being cost-effective, it formed the basis of national guidelines for Indians in 2014. Conclusions. As typical clinical scenarios are usually varied, practical guidelines that meet the constraints of low-resource settings like India are required.

  8. Gestational Diabetes Mellitus: a review of the diagnosis, clinical implications and management

    Directory of Open Access Journals (Sweden)

    Vincent Wing-Ming Wong

    2013-04-01

    Full Text Available Gestational diabetes mellitus (GDM is a condition that affects the wellbeing of mother and fetus. Women with GDM are at risk of type 2 diabetes mellitus in the future, while fetal exposure to hyperglycaemia in-utero may affect their glycometabolic profile later in life. Appropriate screening and management of this problem is important in ensuring good pregnancy outcomes. In this review, the clinical implications, the various ways to screen and diagnose GDM, and management strategies during pregnancy will be discussed. For years, insulin is the mainstay of treatment if medical nutrition therapy fails to maintain adequate glycaemic control, but use of other oral pharmacotherapy may gain greater acceptance in the future. Following delivery, ongoing follow-up of these women is worthwhile as early intervention through lifestyle or pharmacotherapy may prevent the development of diabetes.

  9. Physical Activity and Sedentary Behaviors Associated With Risk of Progression From Gestational Diabetes Mellitus to Type 2 Diabetes Mellitus

    DEFF Research Database (Denmark)

    Bao, Wei; Tobias, Deirdre K; Bowers, Katherine

    2014-01-01

    IMPORTANCE: Women with a history of gestational diabetes mellitus (GDM) are at substantially increased risk of type 2 diabetes mellitus (T2DM). The identification of important modifiable factors could help prevent T2DM in this high-risk population. OBJECTIVE: To examine the role of physical...... activity and television watching and other sedentary behaviors, and changes in these behaviors in the progression from GDM to T2DM. DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort study of 4554 women from the Nurses' Health Study II who had a history of GDM, as part of the ongoing Diabetes & Women......'s Health Study. These women were followed up from 1991 to 2007. EXPOSURES: Physical activity and television watching and other sedentary behaviors were assessed in 1991, 1997, 2001, and 2005. MAIN OUTCOMES AND MEASURE: Incident T2DM identified through self-report and confirmed by supplemental...

  10. Socio-economic status and risk of gestational diabetes mellitus among Chinese women.

    Science.gov (United States)

    Song, L; Shen, L; Li, H; Liu, B; Zheng, X; Zhang, L; Xu, S; Wang, Y

    2017-10-01

    The relationship between socio-economic status and gestational diabetes mellitus has received little attention. The purpose of this study was to investigate the association between socio-economic status and risk of gestational diabetes. Data were obtained from the ongoing Healthy Baby Cohort study in Hubei Province, China, in 2012-2014. Information on educational level and household income was collected using standard questionnaires during face-to-face interviews. Gestational diabetes was defined based on the International Association of Diabetes and Pregnancy Study Group's criteria. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for gestational diabetes in relation to socio-economic status. Among 6886 participants, 1005 (14.6%) pregnant women were diagnosed with gestational diabetes. Higher educational level was inversely associated with risk of gestational diabetes (OR, 0.74; 95% CI, 0.58, 0.95 for high school and OR, 0.62; 95% CI, 0.50, 0.76 for college or above). After adjustment for potential confounders, the ORs for gestational diabetes were 0.77 (95% CI, 0.59, 1.00) and 0.65 (95% CI, 0.51, 0.83) for women with high school and college or above education, respectively, compared with women with less than high school education. No significant association between household income and gestational diabetes was observed after adjustment for potential confounders. Subgroup analysis showed that the reduced risk of gestational diabetes with higher educational level was more evident among women with a pre-pregnancy BMI educational level was a more robust predictor of gestational diabetes than household income among Chinese women. © 2017 Diabetes UK.

  11. Geospatial analysis of food environment demonstrates associations with gestational diabetes.

    Science.gov (United States)

    Kahr, Maike K; Suter, Melissa A; Ballas, Jerasimos; Ramin, Susan M; Monga, Manju; Lee, Wesley; Hu, Min; Shope, Cindy D; Chesnokova, Arina; Krannich, Laura; Griffin, Emily N; Mastrobattista, Joan; Dildy, Gary A; Strehlow, Stacy L; Ramphul, Ryan; Hamilton, Winifred J; Aagaard, Kjersti M

    2016-01-01

    Gestational diabetes mellitus (GDM) is one of most common complications of pregnancy, with incidence rates varying by maternal age, race/ethnicity, obesity, parity, and family history. Given its increasing prevalence in recent decades, covariant environmental and sociodemographic factors may be additional determinants of GDM occurrence. We hypothesized that environmental risk factors, in particular measures of the food environment, may be a diabetes contributor. We employed geospatial modeling in a populous US county to characterize the association of the relative availability of fast food restaurants and supermarkets to GDM. Utilizing a perinatal database with >4900 encoded antenatal and outcome variables inclusive of ZIP code data, 8912 consecutive pregnancies were analyzed for correlations between GDM and food environment based on countywide food permit registration data. Linkage between pregnancies and food environment was achieved on the basis of validated 5-digit ZIP code data. The prevalence of supermarkets and fast food restaurants per 100,000 inhabitants for each ZIP code were gathered from publicly available food permit sources. To independently authenticate our findings with objective data, we measured hemoglobin A1c levels as a function of geospatial distribution of food environment in a matched subset (n = 80). Residence in neighborhoods with a high prevalence of fast food restaurants (fourth quartile) was significantly associated with an increased risk of developing GDM (relative to first quartile: adjusted odds ratio, 1.63; 95% confidence interval, 1.21-2.19). In multivariate analysis, this association held true after controlling for potential confounders (P = .002). Measurement of hemoglobin A1c levels in a matched subset were significantly increased in association with residence in a ZIP code with a higher fast food/supermarket ratio (n = 80, r = 0.251 P food environment and risk for gestational diabetes was identified. Copyright © 2016

  12. Gestational diabetes mellitus: risk factors development, occurrence, diagnostics and treatment (review

    Directory of Open Access Journals (Sweden)

    Kostenko I.V.

    2011-06-01

    Full Text Available Gestational diabetes is defined as a violation of carbohydrate metabolism resulting in hyperglycemia of varying severity, firstly revealed or developed during the pregnancy. The article presents current data on the occurrence, etiology and pathogenesis of gestational diabetes, as well as methods for screening and diagnostics of disorders of carbohydrate metabolism during pregnancy. It explains the basic principles of diet therapy

  13. Screening for gestational diabetes mellitus by a model based on risk indicators: a prospective study

    DEFF Research Database (Denmark)

    Jensen, Dorte; Mølsted-Pedersen, Lars; Beck-Nielsen, Henning

    2003-01-01

    This study was performed to prospectively evaluate a screening model for gestational diabetes mellitus on the basis of clinical risk indicators.......This study was performed to prospectively evaluate a screening model for gestational diabetes mellitus on the basis of clinical risk indicators....

  14. Healthy Pre-Pregnancy Diet and Exercise May Reduce Risk of Gestational Diabetes

    Science.gov (United States)

    ... the only pre-pregnancy factor related to gestational diabetes: exercise also lowered risk . Women who exercised more before ... became pregnant had a lower risk of gestational diabetes; the more intense the exercise, the lower the risk. For example, walking at ...

  15. Insulin Sensitivity and Plasma Glucose Response to Aerobic Exercise in Pregnant Women at Risk for Gestational Diabetes Mellitus.

    Science.gov (United States)

    Embaby, Heba; Elsayed, Enas; Fawzy, Mohamed

    2016-09-01

    Gestational diabetes mellitus (GDM) is one of the common complications that occur during pregnancy. Early intervention is essential to prevent the development of the disease in the non-pregnant state but also helpful in preventing the occurrence of GDM. The aim of the study was to assess the effect of aerobic exercises on insulin sensitivity and fasting plasma glucose level in pregnant women with risk for gestational diabetes mellitus. Forty multigravidae women between 20-24 weeks of gestation with risk for GDM were randomly selected (age range was 25-35 years), body mass index ranged from 30-35 kg/m 2 . Women were divided into two equal groups: intervention group (A), which followed an aerobic exercise program in the form of walking on treadmill, three times weekly until the end of 37 weeks of gestation in addition to diet control. Control group (B) which received diet control with usual care given by obstetricians and midwives. Evaluation of the women in both groups was carried out before and after treatment program through assessment of fasting blood glucose and insulin levels. There was a highly statistically significance decrease in fasting blood glucose level, fasting insulin level in both groups where the p value was 0.0001 favoring group (A). Moderate intensity of aerobic exercises were effective in reducing fasting blood glucose level and fasting insulin level in pregnant women with risk for gestational diabetes mellitus.

  16. THE RELATIONSHIP BETWEEN VITAMIN D AND GESTATIONAL DIABETES-A REVIEW ARTICLE

    OpenAIRE

    Fateme parooei, Zohreh Mahmoodi, Mohammad Reza Havasian, Mahmood Anbari, Elaham poorgholam ,Morteza Salarzaei , Alireza Abrishami

    2017-01-01

    Introduction: Gestational diabetes manifests itself as not having glucose tolerance, and is seen in around 2- 13% of all cases of pregnancy. One of the important factors in the development of gestational pregnancy is vitamin D deficiency.so, this study is designed to determine the relationship between low levels of vitamin D in pregnancy and gestational diabetes mellitus. Methods: In this review article, the databases Medline, Cochrane, Science Direct, and Google Scholar were thoroughly searc...

  17. Clinical profile, outcomes, and progression to type 2 diabetes among Indian women with gestational diabetes mellitus seen at a diabetes center in south India

    Directory of Open Access Journals (Sweden)

    Manni Mohanraj Mahalakshmi

    2014-01-01

    Full Text Available Aim: To describe the clinical profile, maternal and fetal outcomes, and the conversion rates to diabetes in women with gestational diabetes mellitus (GDM seen at a tertiary care diabetes center in urban south India. Materials and Methods: Clinical case records of 898 women with GDM seen between 1991 and 2011 were extracted from the Diabetes Electronic Medical Records (DEMR of a tertiary care diabetes center in Chennai, south India and their clinical profile was analyzed. Follow-up data of 174 GDM women was available. To determine the conversion rates to diabetes, oral glucose tolerance test (OGTT was done in these women. Glucose tolerance status postpartum was classified based on World Health Organization (WHO 2006 criteria. Results: The mean maternal age of the women was 29 ± 4 years and mean age of gestation at first visit were 24 ± 8.4 weeks. Seventy percent of the women had a family history of diabetes. Seventy-eight percent of the women delivered full-term babies and 65% underwent a cesarean section. The average weight gain during pregnancy was 10.0 ± 4.2 kg. Macrosomia was present in 17.9% of the babies, hypoglycemia in 10.4%, congenital anomalies in 4.3%, and the neonatal mortality rate was 1.9%. Mean follow-up duration of the 174 women of whom outcome data was available was 4.5 years. Out of the 174, 101 women who were followed-up developed diabetes, of whom half developed diabetes within 5 years and over 90%, within 10 years of the delivery. Conclusions: Progression to type 2 diabetes mellitus (T2DM in Indian women with GDM is rapid. There is an urgent need to develop standardized protocols for GDM care in India that can improve the maternal and fetal outcomes and help prevent future diabetes in women with GDM.

  18. Women with prior gestational diabetes mellitus and prediabetes are characterised by a decreased incretin effect

    DEFF Research Database (Denmark)

    Foghsgaard, Signe; Vedtofte, Louise; Andreasen, Camilla

    2017-01-01

    AIMS/HYPOTHESIS: We investigated whether a reduced incretin effect, as observed in patients with type 2 diabetes, can be detected in high-risk individuals, such as women with prior gestational diabetes mellitus (pGDM). METHODS: In this cross-sectional study, 102 women without diabetes with p...... participants, respectively (p diabetes. TRIAL REGISTRATION: clinicaltrialsregister.eu 2012-001371-37-DK....

  19. Relationship between hypothyroidism and the incidence of gestational diabetes: A meta-analysis.

    Science.gov (United States)

    Gong, Li-Li; Liu, He; Liu, Li-Hong

    2016-04-01

    Hypothyroidism disorders and gestational diabetes are among the most common endocrinopathies during pregnancy. We conducted a meta-analysis to investigate whether hypothyroidism in pregnancy is associated with gestational diabetes risk. Published literature from PubMed and EMBASE were searched for eligible publications. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a fixed- or random-effects model. Seven articles described the relationship between hypothyroidism and risk of gestational diabetes. This meta-analysis revealed that overt hypothyroidism was associated with an increased risk of gestational diabetes (OR 1.892, 95% CI 1.679-2.132, p hypothyroidism, with the OR of 1.558 (95% CI 1.292-1.877, p hypothyroidism was 1.749 (95% CI 1.586-1.928, p hypothyroidism may be a risk factor for gestational diabetes. Copyright © 2016. Published by Elsevier B.V.

  20. Periodontitis and gestational diabetes mellitus in non-smoking females.

    Science.gov (United States)

    Chokwiriyachit, Anyarat; Dasanayake, Ananda P; Suwannarong, Waraporn; Hormdee, Doosasee; Sumanonta, Gunniga; Prasertchareonsuk, Witoon; Wara-Aswapati, Nawarat; Combellick, Joan; Pitiphat, Waranuch

    2013-07-01

    Chronic inflammation has been implicated in the pathogenesis of gestational diabetes mellitus (GDM). Periodontal disease is associated with increased levels of inflammatory mediators and may be a risk factor for GDM. The authors aimed to examine the association between periodontitis and GDM among non-smoking pregnant females. This case-control study included 50 females who were diagnosed with GDM and 50 age- and hospital-matched females without diabetes in Khon Kaen, Thailand. Full-mouth periodontal examinations were performed during pregnancy by two calibrated dentists who were unaware of the case-control status. Periodontitis was defined as ≥1 site with probing depth (PD) ≥5 mm and clinical attachment level (CAL) ≥2 mm at the same site. Serum samples were collected to measure C-reactive protein (CRP), tumor necrosis factor-α, and interleukin-6 levels. Analyses were performed using conditional logistic regression. Fifty percent of the case females had periodontitis compared to 26% of the controls. Females with GDM had significantly higher mean PD and CAL, more sites with bleeding on probing, and increased levels of CRP compared to the controls. Periodontitis was significantly associated with GDM (odds ratio = 3.00, 95% confidence interval = 1.19 to 7.56). The association remained significant with additional adjustment for family history of diabetes, prepregnancy body mass index, and weight gain during pregnancy. The results suggest that periodontitis is associated with GDM. Therefore, clinicians should assess periodontal conditions of pregnant females.

  1. A review of current treatment strategies for gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Kristi W Kelley

    2015-07-01

    Full Text Available Approximately 90% of diabetes cases in pregnant women are considered gestational diabetes mellitus (GDM. It is well known that uncontrolled glucose results in poor pregnancy outcomes in both the mother and fetus. Worldwide there are many guidelines with recommendations for appropriate management strategies for GDM once lifestyle modifications have been instituted and failed to achieve control. The efficacy and particularly the safety of other treatment modalities for GDM has been the source of much debate in recent years. Studies that have demonstrated the safety and efficacy of both glyburide and metformin in the management of patients with GDM will be reviewed. There is a lack of evidence with other oral and injectable non-insulin agents to control blood glucose in GDM. The role of insulin will be discussed, with emphasis on insulin analogs. Ideal patient characteristics for each treatment modality will be reviewed. In addition, recommendations for postpartum screening of patients will be described as well as recommendations for use of agents to manage subsequent type 2 diabetes in patients who are breastfeeding.

  2. Prevalence, predictors and challenges of gestational diabetes mellitus screening among pregnant women in northern Tanzania.

    Science.gov (United States)

    Njete, H I; John, B; Mlay, P; Mahande, M J; Msuya, S E

    2018-02-01

    To determine the prevalence and predictors of gestational diabetes mellitus (GDM) as well as acceptability of returning for glucose tolerance testing among pregnant women in Moshi municipality, northern Tanzania. Cross-sectional study from October 2015 to April 2016 among women with gestation age of 24-28 weeks of pregnancy attending at Kilimanjaro Christian Medical Centre (KCMC) referral hospital, Majengo and Pasua Health Centres. Women were interviewed and requested to return the next day (window within a month, depending on gestational age) for fasting plasma glucose (FPG) testing, followed immediately by a 75 g oral glucose tolerance test (OGTT). GDM was diagnosed using the 2013 WHO criteria. Logistic regression was conducted to reveal independent predictors for GDM. Of 433 interviewed women, 100 (23%) did not return for FPG and OGTT testing. The prevalence of GDM among the 333 screened women was 19.5%, and 3% had diabetes in pregnancy (DIP). GDM was significantly associated with age ≥35 years (adjusted OR 6.75), pre-pregnancy obesity (AOR 2.22) and history of abortion (AOR 2.36). Prevalence of GDM is high in Moshi. We recommend introduction of routine screening for hyperglycaemia during pregnancy along with strategies for follow-up to prevent long-term effects of GDM and DIP in women and their children. © 2017 John Wiley & Sons Ltd.

  3. Lived experience of blood glucose self-monitoring among pregnant women with gestational diabetes mellitus: a phenomenological research.

    Science.gov (United States)

    Youngwanichsetha, Sununta; Phumdoung, Sasitorn

    2017-10-01

    To explore and describe lived experience of blood glucose self-monitoring among pregnant Thai women with gestational diabetes mellitus. Self-monitoring of blood glucose is an essential practice among pregnant women with diabetes to prevent complications in pregnancy and the newborn infant. Phenomenological research was employed to understand lived experiences in glycemic control. Thirty participants were approached and interviewed using a semistructured interview guides. Qualitative data were analysed following Colaizzi's method. The findings revealed three themes: being worried about diabetes and blood testing, trying to control it and being patient for the child. Their worry comprised three dimensions: (1) wondering about the impacts of diabetes on the child, (2) concern about maternal health and (3) being worried about doing blood test. Trying to control diabetes was composed of three dimensions: (1) learning to test blood glucose, (2) being afraid of elevated blood sugar and (3) being aware of what to eat. Being patient for the child was composed of three dimensions: (1) overcoming food desires, (2) tolerating the fingerprick pain and (3) satisfaction with the outcomes. Women with gestational diabetes experienced being worried and afraid regarding blood glucose self-monitoring; however, they could overcome and tolerate this with some difficulties. These findings can be used to guide nursing practice in assessment of perception and response towards blood glucose self-monitoring in order to improve achievement of a good glycaemic control among pregnant women with gestational diabetes mellitus. © 2016 John Wiley & Sons Ltd.

  4. Childhood cognitive ability: relationship to gestational diabetes mellitus in India.

    Science.gov (United States)

    Veena, S R; Krishnaveni, G V; Srinivasan, K; Kurpad, A V; Muthayya, S; Hill, J C; Kiran, K N; Fall, C H D

    2010-10-01

    Our aim was to test the hypothesis that gestational diabetes mellitus (GDM) in mothers is associated with poorer cognitive ability in their offspring in India. During 1997 to 1998 maternal GDM status was assessed by OGTT at 30 +/- 2 weeks of gestation. Between 2007 and 2008, at a mean age of 9.7 years, 515 children (32 offspring of GDM mothers [ODM]; 483 offspring of non-GDM mothers [controls]) from the Mysore Parthenon birth cohort underwent cognitive function assessment using tests from the Kaufman Assessment Battery for Children--Second Edition and additional tests measuring learning, long-term storage/retrieval, short-term memory, reasoning, attention and concentration, and visuo-spatial and verbal abilities. Compared with controls, ODM scored higher in tests for learning, long-term retrieval/storage (p = 0.008), reasoning (p = 0.02), verbal ability (p = 0.01), and attention and concentration (p = 0.003). In multiple regression, adjusted for the child's age, sex, gestation, neonatal weight and head circumference, maternal age, parity and BMI, and the parent's socioeconomic status, education and rural/urban residence, this difference remained significant only for learning, long-term retrieval/storage (beta = 0.4 SD (95% CI 0.01-0.75); p = 0.04) and verbal ability (beta = 0.5 SD (95% CI 0.09-0.83); p = 0.02), and not with other test scores. In this population of healthy Indian children, there was no evidence of lower cognitive ability in ODM. In fact some cognitive scores were higher in ODM.

  5. Obstructive sleep apnea and diet-controlled gestational diabetes.

    Science.gov (United States)

    Wanitcharoenkul, Ekasitt; Chirakalwasan, Naricha; Amnakkittikul, Somvang; Charoensri, Suranut; Saetung, Sunee; Chanprasertyothin, Suwannee; Chailurkit, La-Or; Panburana, Panyu; Bumrungphuet, Sommart; Ongphiphadhanakul, Boonsong; Reutrakul, Sirimon

    2017-11-01

    Obstructive sleep apnea (OSA) was shown to be associated with gestational diabetes mellitus (GDM). However, prevalence of OSA in GDM women, its relationship to metabolic control, and predictive factors have not been studied. Eighty-two obese pregnant women with diet-controlled GDM between 24 and 34 weeks of gestation participated. The Berlin questionnaire was used to assess OSA symptoms. OSA was diagnosed using an overnight monitor. Fasting glucose and hemoglobin A1c (HbA1c) were obtained. Those with OSA underwent meal tolerance test (MTT) to assess their metabolic parameters. Classification tree analysis was used to develop a screening tool for OSA. At a median gestational age of 29 weeks, OSA was diagnosed in 52.4% of the women, with a median apnea hypopnea index of 9.4 (interquartile range 6.4, 12.4). More severe OSA was significantly correlated with higher fasting glucose but not HbA1c. For those with OSA, sleep parameters related to oxygen desaturation significantly correlated with higher fasting insulin resistance and more severe β-cell dysfunction, as evaluated by MTT. A screening tool involving two variables, neck circumference and Berlin Questionnaire score, was developed. The sensitivity and specificity were 86% and 51%, respectively. The overall accuracy was 70%. OSA is prevalent in obese pregnant women with diet-controlled GDM in the late second to early third trimester. OSA severity, especially the degree of oxygen desaturation, correlated with fasting glucose, insulin resistance, and β-cell function. A simple screening tool involving the Berlin Questionnaire and neck circumference can aid in predicting OSA in this patient group. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Reduced incidence of gestational diabetes with bariatric surgery.

    Science.gov (United States)

    Burke, Anne E; Bennett, Wendy L; Jamshidi, Roxanne M; Gilson, Marta M; Clark, Jeanne M; Segal, Jodi B; Shore, Andrew D; Magnuson, Thomas H; Dominici, Francesca; Wu, Albert W; Makary, Martin A

    2010-08-01

    Obesity is a risk factor for gestational diabetes mellitus (GDM), and bariatric surgery is an effective treatment for obesity. Our objective was to determine the association of bariatric surgery with the incidence of GDM and related complications. We performed a retrospective study comparing rates of GDM and related outcomes (including cesarean section, large-for-gestational-age infant, shoulder dystocia, and infection) between a group of women with a delivery before bariatric surgery and a group with a delivery after bariatric surgery. We used a private insurance claims database with information on 23,594 women who had bariatric surgery between 2002 and 2006. The dataset was searched to identify women with codes for bariatric surgery and a pregnancy resulting in a delivery at greater than 22 weeks gestation. Incidences of GDM and selected delivery complications for delivery before versus after bariatric surgery were compared using Fisher exact test and logistic regression. There were 346 women who had a delivery before bariatric surgery, and 354 had a delivery after bariatric surgery. Women with delivery after bariatric surgery had lower incidences of GDM (8% vs 27%, odds ratio (OR) 0.23, (95% CI 0.15 to 0.36) and cesarean section (28% vs 43%, OR0.53, 95% CI 0.39 to 0.72) than those with delivery before bariatric surgery. Bariatric surgery is associated with a decreased incidence of GDM and cesarean section in subsequent pregnancies. This potential effect of bariatric surgery should be considered in the management of obese women of childbearing age. Prospective studies are needed to confirm these findings. Copyright 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Gestational Diabetes Mellitus: a review of current diagnostic strategies concepts

    Directory of Open Access Journals (Sweden)

    Juan Sebastián Frías-Ordoñez

    2016-10-01

    Full Text Available Gestational diabetes mellitus (GDM is a state of carbohydrate intolerance that is first recognized during pregnancy. The initial criteria for diagnosis were established more than 50 years ago by O’Sullivan & Mahan, and since then, some modifications have been made. Currently, diagnosis considers two methods: the onestep approach, consisting of an oral glucose tolerance test (OGTT for 2 hours with 75g of glucose, and the two-step approach, which involves an initial screening test with 50g of glucose and OGTT with 100g of glucose if screening is positive. Both diagnostic approaches have been justified by expert consensus; however, an absolute concept about the method to be applied has not been established yet. To select a method, the clinician must take into account various factors. This paper proposes a historical overview and the presentation of the current status of GDM diagnosis.

  8. Fetal Serum Metabolites Are Independently Associated with Gestational Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Yong-Ping Lu

    2018-01-01

    Full Text Available Background/Aims: Gestational diabetes (GDM might be associated with alterations in the metabolomic profile of affected mothers and their offspring. Until now, there is a paucity of studies that investigated both, the maternal and the fetal serum metabolome in the setting of GDM. Mounting evidence suggests that the fetus is not just passively affected by gestational disease but might play an active role in it. Metabolomic studies performed in maternal blood and fetal cord blood could help to better discern distinct fetal from maternal disease interactions. Methods: At the time of birth, serum samples from mothers and newborns (cord blood samples were collected and screened for 163 metabolites utilizing tandem mass spectrometry. The cohort consisted of 412 mother/child pairs, including 31 cases of maternal GDM. Results: An initial non-adjusted analysis showed that eight metabolites in the maternal blood and 54 metabolites in the cord blood were associated with GDM. After Benjamini-Hochberg (BH procedure and adjustment for confounding factors for GDM, fetal phosphatidylcholine acyl-alkyl C 32: 1 and proline still showed an independent association with GDM. Conclusions: This study found metabolites in cord blood which were associated with GDM, even after adjustment for established risk factors of GDM. To the best of our knowledge, this is the first study demonstrating an independent association between fetal serum metabolites and maternal GDM. Our findings might suggest a potential effect of the fetal metabolome on maternal GDM.

  9. Gestational diabetes and macrosomia by race/ethnicity in Hawaii.

    Science.gov (United States)

    Tsai, Pai-Jong Stacy; Roberson, Emily; Dye, Timothy

    2013-10-01

    Gestational diabetes (GDM) has been shown to have long-term sequelae for both the mother and infant. Women with GDM are at increased risk of macrosomia, which predisposes the infant to birth injuries. Previous studies noted increased rates of GDM in Asian and Pacific Islander (API) women; however, the rate of macrosomia in API women with GDM is unclear. The objective of this study was to examine the relationship between ethnicity, gestational diabetes (GDM), and macrosomia in Hawaii. A retrospective cohort study was performed using Hawaii Pregnancy Risk Assessment Monitoring System (PRAMS) data. Data from 2009-2011, linked with selected items from birth certificates, were used to examine GDM and macrosomia by ethnicity. SAS-callable SUDAAN 10.0 was used to generate odds ratios, point estimates and standard errors. Data from 4735 respondents were weighted to represent all pregnancies resulting in live births in Hawaii from 2009-2011. The overall prevalence of GDM in Hawaii was 10.9%. The highest prevalence of GDM was in Filipina (13.1%) and Hawaiian/Pacific Islander (12.1%) women. The lowest prevalence was in white women (7.4%). Hawaiian/Pacific Islander, Filipina, and other Asian women all had an increased risk of GDM compared to white women using bivariate analysis. Adjusting for obesity, age, maternal nativity, and smoking, Asian Pacific Islander (API) women, which includes Hawaiian/Pacific Islander, Filipina, and other Asian women, had a 50% increased odds of having GDM compared to white women when compared using multivariate analysis. Among women with GDM, the highest prevalence of macrosomia was in white women (14.5%) while the lowest was in Filipina (5.3%) women. API women in Hawaii have increased rates of GDM compared to white women. Paradoxically, this elevated GDM risk in API women is not associated with an increased rate of macrosomia. This suggests the relationship between GDM and macrosomia is more complex in this population.

  10. Preventing diabetic nephropathy

    DEFF Research Database (Denmark)

    Hansen, H P; Lund, S S; Rossing, P

    2001-01-01

    was to audit the effect of angiotensin converting enzyme (ACE) inhibition on the progression of microalbuminuria and development of diabetic nephropathy. We consecutively identified 227 type 1 diabetic patients with persistent microalbuminuria (urinary AER between 30 and 300mg/24h, ELISA). According...... to the level (> or = 100 or 6% or international guidelines, all patients at high-risk were....... Glycaemic control and blood pressure remained unchanged during the study. The implementation of modified international guidelines regarding the use of ACE inhibition in the treatment of microalbuminuric type 1 diabetic patients reduced progression to diabetic nephropathy comparable to what has previously...

  11. Associations between follow-up screening after gestational diabetes and early detection of diabetes

    DEFF Research Database (Denmark)

    Olesen, Christinna Rebecca; Hyldgaard Nielsen, Jane; Mortensen, Rikke Nørmark

    2016-01-01

    which attendance decreased with time after giving birth for both controls at general practitioners and biochemical departments. All differences in proportions were statistically significant. Women attending controls at general practitioners had a significantly higher risk of diabetes diagnosis....... Participation in follow-up screening and risk of diabetes was calculated. Time to obtaining diagnosis of diabetes or initiating treatment was analysed by Cox regression models. All models were adjusted for age, ethnicity and income. RESULTS: High attendance was found during the first control interval, after...... and treatment after gestational diabetes than women not attending. The results for women attending testing at biochemical departments also showed an increased risk of initiation of treatment. Women attending at least one general practitioners control had a significantly higher risk of early diabetes diagnosis...

  12. Gestational Diabetes Mellitus and Associated Risk Factors in Patients Attending Diabetic Association Medical College Hospital in Faridpur

    Directory of Open Access Journals (Sweden)

    Poly Begum

    2017-09-01

    Full Text Available Background: The prevalence of gestational diabetes mellitus (GDM is increasing all over the world and varies widely depending on the region of the country, dietary habits and socio-economic status. The prevalence of GDM with its associated risk factors has important health complications for both mother and child. Objectives: The aim of this study was to evaluate the prevalence of GDM and risk factors associated with it in women attending Diabetic Association Medical College Hospital in Faridpur for ante-natal care. Materials and Methods: In this cross-sectional study, screening for GDM was performed in 303 pregnant women. Women who consented to participate underwent a standardized 2-hour 75 gm oral glucose tolerance test (OGTT. A proforma containing general information on demographic characteristics, socio-economic status, education level, parity, family history of diabetes and past history of GDM etc. was filled in. American Diabetes Association (ADA criteria for 75 gm 2-hour OGTT was used for diagnosing GDM. Results: A total of 303 women participated in the study and GDM was diagnosed in 22 (7.3% women. A single abnormal value was observed in additional 33 (10.89% women. On bivariate analysis risk factors found to be significantly associated with GDM were age, household income, parity, educational level, socio-economic status, hypertension, BMI, weight gain, acanthosis nigricans, family history of diabetes and past history of GDM; but on multivariate analysis only upper middle class and presence of acanthosis nigricans were found to be significantly associated with GDM. Conclusion: This study demonstrates a high prevalence of GDM in Bangladesh. These estimates for GDM may help for new suggestions to prevent and manage gestational diabetes.

  13. Diagnosis of gestational diabetes mellitus: falling through the net.

    Science.gov (United States)

    Meek, Claire L; Lewis, Hannah B; Patient, Charlotte; Murphy, Helen R; Simmons, David

    2015-09-01

    Gestational diabetes mellitus (GDM) is associated with increased risks to mother and child, but globally agreed diagnostic criteria remain elusive. Identification of women with GDM is important, as treatment reduces adverse outcomes such as perinatal death, shoulder dystocia and neonatal hypoglycaemia. Recently, the UK's National Institute for Health and Care Excellence (NICE) recommended new diagnostic thresholds for GDM which are different from the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria endorsed by the WHO. The study aim was to assess neonatal and obstetric outcomes among women who would test positive for the IADPSG criteria but negative for the NICE 2015 criteria. Data from 25,543 consecutive singleton live births (2004-2008) were obtained retrospectively from hospital records. Women were screened with a random plasma glucose (RPG; 12-16 weeks) and a 50 g glucose challenge test (GCT; 26-28 weeks). If RPG >7.0 mmol/l, GCT >7.7 mmol/l or symptoms were present, a 75 g OGTT was offered (n = 3,848). In this study, GDM prevalence was 4.13% (NICE 2015) and 4.62% (IADPSG). Women who 'fell through the net', testing NICE-negative but IADPSG-positive (n = 387), had a higher risk of having a large-for-gestational-age (LGA) infant (birthweight >90th percentile for gestational age; adjusted OR [95% CI] 3.12 [2.44, 3.98]), Caesarean delivery (1.44 [1.15, 1.81]) and polyhydramnios (6.90 [3.94, 12.08]) compared with women with negative screening results and no OGTT (n = 21,695). LGA risk was highest among women with fasting plasma glucose 5.1-5.5 mmol/l (n = 167): the mean birthweight was 350 g above that of the reference population and 37.7% of infants were LGA. The IADPSG criteria identify women at substantial risk of complications who would not be identified by the NICE 2015 criteria.

  14. Nutrient intake of pregnant women at high risk of gestational diabetes

    Directory of Open Access Journals (Sweden)

    Jelena Meinilä

    2015-05-01

    Full Text Available Background: The prevalence of gestational diabetes (GDM has been increasing along with the obesity pandemic. It is associated with pregnancy complications and a risk of type 2 diabetes. Objective: To study nutrient intake among pregnant Finnish women at increased risk of GDM due to obesity or a history of GDM. Design: Food records from obese women or women with GDM history (n=394 were examined at baseline (≤20 weeks of pregnancy of the Finnish Gestational Diabetes Prevention Study. Results: The pregnant women had a mean fat intake of 33 en% (SD 7, saturated fatty acids (SFA 12 en% (SD 3, and carbohydrate 46 en% (SD 6. Sucrose intake among pregnant women with GDM history was 7 en% (SD 3, which was different from the intake of the other pregnant women, 10 en% (SD 4 (p<0.001. Median intakes of folate and vitamins A and D provided by food sources were below the Finnish national nutrition recommendation, but, excluding vitamin A, supplements raised the total intake to the recommended level. The frequency of use of dietary supplements among pregnant women was 77%. Conclusions: The observed excessive intake of SFA and low intake of carbohydrates among women at high risk of GDM may further increase their risk of GDM. A GDM history, however, seems to reduce sucrose intake in a future pregnancy. Pregnant women at high risk of GDM seem to have insufficient intakes of vitamin D and folate from food and thus need supplementation, which most of them already take.

  15. Is autoimmune thyroid dysfunction a risk factor for gestational diabetes?

    Science.gov (United States)

    Pascual Corrales, Eider; Andrada, Patricia; Aubá, María; Ruiz Zambrana, Alvaro; Guillén Grima, Francisco; Salvador, Javier; Escalada, Javier; Galofré, Juan C

    2014-01-01

    Some recent studies have related autoimmune thyroid dysfunction and gestational diabetes (GD). The common factor for both conditions could be the existence of pro-inflammatory homeostasis. The study objective was therefore to assess whether the presence of antithyroid antibodies is related to the occurrence of GD. Fifty-six pregnant women with serum TSH levels ≥ 2.5 mU/mL during the first trimester were retrospectively studied. Antithyroid antibodies were measured, and an O'Sullivan test was performed. GD was diagnosed based on the criteria of the Spanish Group on Diabetes and Pregnancy. Positive antithyroid antibodies were found in 21 (37.50%) women. GD was diagnosed in 15 patients, 6 of whom (10.71%) had positive antibodies, while 9 (16.07%) had negative antibodies. Data were analyzed using exact logistic regression by LogXact-8 Cytel; no statistically significant differences were found between GD patients with positive and negative autoimmunity (OR = 1.15 [95%CI = 0.28-4.51]; P=1.00). The presence of thyroid autoimmunity in women with TSH above the recommended values at the beginning of pregnancy is not associated to development of GD. However, GD prevalence was higher in these patients as compared to the Spanish general population, suggesting the need for closer monitoring in pregnant women with TSH levels ≥ 2.5 mU/mL. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

  16. The emerging role of metformin in gestational diabetes mellitus.

    Science.gov (United States)

    Gray, Susan G; McGuire, Treasure M; Cohen, Neale; Little, Peter J

    2017-06-01

    Metformin use during pregnancy is controversial and there is disparity in the acceptance of metformin treatment in women with gestational diabetes mellitus (GDM) in Australia. Despite short term maternal and neonatal safety measures, the placental transfer of metformin during GDM treatment and the absence of long-term safety data in offspring has regulators and prescribers cautious about its use. To determine the current role in GDM management, this literature review describes the physiological changes that occur in GDM and other forms of diabetes in pregnancy (DIP) and international changes in guidelines for GDM diagnosis. Management options are considered, with a focus on the evolving evidence for metformin, its mechanism of action, the maternal, foetal and neonatal outcomes associated with its use and benefit vs risk when compared with the current gold standard, insulin. Investigation reveals a favourable balance of evidence to support the safety and long-term benefits, to mother and child, of using metformin as an alternate to insulin for treatment of GDM. Recent findings of the gastrointestinal-directed action of metformin are at least as important as the hepatic effect and the availability of a novel delayed-release metformin dose form to exploit this new information provides a product and therapeutic strategy ideally suited to the use of metformin in GDM. © 2017 John Wiley & Sons Ltd.

  17. Serum homocysteine level in gestational diabetes: a prospective study

    Directory of Open Access Journals (Sweden)

    Davari Tanha F

    2009-08-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Increased total plasma homocysteine (Hcy is an accepted risk factor of cardiovascular disease (CVD, stroke, preclampsia, recurrent abortion and diabetes type I and II. The aim of the current study was to assess serum homocysteine and its relation with serum folat, vitamine B12 and lipid profile in gestational diabetes mellitus and to compare these with those of pregnant women."n"n Methods: In a prospective controlled survey 80 pregnant women (24-28 weeks with uncomplicated pregnancies were evaluated. They were assigned to one of two groups according to the results of 100g-OGTT. In the case group there were pregnant women with gestational diabetes mellitus according to the OGTT and in the control group women who had normal OGTT results were put. Levels of fasting glucose, homocysteine, vit B12, and folic acid, uric acid, total cholesterol, triglyceride, Low Density Lipoprotein cholesterol (LDL and High Density Lipoprotein cholesterol (HDL were measured in both groups."n"nResults: The mean level of homocysteine in GDM group was significantly higher than control group (p=0.000. The mean level of folic acid and vit B12 was significantly lower than the level in control group (p=0.001, p=0.004 respectively. Body

  18. Predictors of low diabetes risk perception in a multi-ethnic cohort of women with gestational diabetes mellitus.

    Science.gov (United States)

    Mukerji, G; Kainth, S; Pendrith, C; Lowe, J; Feig, D S; Banerjee, A T; Wu, W; Lipscombe, L L

    2016-10-01

    To determine what proportion of women with gestational diabetes underestimate their diabetes risk and identify factors associated with low diabetes risk perception. Participants included pregnant adult women with gestational diabetes between 2009 and 2012 across seven diabetes clinics in Ontario, Canada. Data were collected through chart review and a survey that included a diabetes risk perception question. Of the 614 of 902 women (68% response rate) with gestational diabetes, 89% correctly responded that gestational diabetes increases the risk for developing diabetes. However, 47.1% of women perceived themselves to be at low risk for developing diabetes within 10 years. On multivariable analysis, BMI ethnicity, high-risk ethnicity (Aboriginal, Latin American, West Indian, South Asian, Middle Eastern, Filipino, Black, Pacific Islander) [odds ratio (OR) 2.07; 95% CI 1.30-3.31] and East and South East Asian ethnicity (OR 2.01; 1.10-3.67) were associated with low diabetes risk perception. After further adjustment for immigration, only high-risk ethnicity remained a predictor of low diabetes risk perception (OR 1.86; 1.09-3.19), whereas East and South East Asian ethnicity did not (OR 1.67; 0.86-3.22). Although the majority of women recognized gestational diabetes as a risk factor for diabetes, almost half underestimated their personal high diabetes risk despite prenatal care. Furthermore, women from high-risk ethnic groups were more likely to underestimate their risk, even after adjusting for immigration. Interventions tailored to these groups are necessary to enhance perceived diabetes risk. © 2015 Diabetes UK.

  19. Impact of gestational weight gain on obstetric and neonatal outcomes in obese diabetic women.

    Science.gov (United States)

    Gante, Inês; Amaral, Njila; Dores, Jorge; Almeida, Maria C

    2015-10-08

    Both obesity and gestational diabetes mellitus are increasing in prevalence, being a major health problem in pregnancy with independent and additive impact on obstetrics outcomes. It is recognized that inadequate gestational weight gain is an independent risk factor for pregnancy-related morbidity. The aim of this study was to evaluate the effect of gestational weight gain on obstetric and neonatal outcomes in obese women with gestational diabetes. Retrospective multicenter study of obese women with gestational diabetes. The assessed group was divided into three categories: women who gained below (9 kg) the 2009 Institute of Medicine recommendations. Maternal and neonatal outcomes were compared and adjusted odds ratios calculated controlling for confounders. Only 35,1 % of obese women with gestational diabetes (n = 634) achieved the recommended gestational weight gain; 27,8 % (n = 502) gained below and 37,1 % (n = 670) above the recommendations. There was a positive correlation between gestational weight gain and neonatal birthweight (r = 0,225; p obstetric and neonatal outcomes than an excessive or even an adequate weight gain. Therefore, specific recommendations should be created since gestational weight gain could be a modifiable risk factor for adverse obstetric outcomes.

  20. Reasons for women's non-participation in follow-up screening after gestational diabetes

    DEFF Research Database (Denmark)

    Nielsen, Jane Hyldgaard; Olesen, Christinna Rebecca; Kristiansen, Tine Mechlenborg

    2015-01-01

    Background: Due to the increased risk of type 2 diabetes, follow-up screening after birth is recommended to women with previous gestational diabetes. Low participation in such screening has been shown to delay detection of diabetes with potentially serious consequences for the women's future heal...

  1. The Role of Metformin in Metabolic Disturbances during Pregnancy: Polycystic Ovary Syndrome and Gestational Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Joselyn Rojas

    2014-01-01

    Full Text Available Maintenance of gestation implicates complex function of multiple endocrine mechanisms, and disruptions of the global metabolic environment prompt profound consequences on fetomaternal well-being during pregnancy and postpartum. Polycystic Ovary Syndrome (PCOS and gestational diabetes mellitus (GDM are very frequent conditions which increase risk for pregnancy complications, including early pregnancy loss, pregnancy-induced hypertensive disorders, and preterm labor, among many others. Insulin resistance (IR plays a pivotal role in the pathogenesis of both PCOS and GDM, representing an important therapeutic target, with metformin being the most widely prescribed insulin-sensitizing antidiabetic drug. Although traditional views neglect use of oral antidiabetic agents during pregnancy, increasing evidence of safety during gestation has led to metformin now being recognized as a valuable tool in prevention of IR-related pregnancy complications and management of GDM. Metformin has been demonstrated to reduce rates of early pregnancy loss and onset of GDM in women with PCOS, and it appears to offer better metabolic control than insulin and other oral antidiabetic drugs during pregnancy. This review aims to summarize key aspects of current evidence concerning molecular and epidemiological knowledge on metformin use during pregnancy in the setting of PCOS and GDM.

  2. Diet quality and history of gestational diabetes mellitus among childbearing women, United States, 2007-2010.

    Science.gov (United States)

    Xiao, Rui S; Simas, Tiffany A Moore; Person, Sharina D; Goldberg, Robert J; Waring, Molly E

    2015-02-26

    Women with a history of gestational diabetes mellitus (GDM) have elevated risk of developing type 2 diabetes. Diet quality plays an important role in the prevention of type 2 diabetes. We compared diet quality among childbearing women with a history of GDM with the diet quality of childbearing women without a history of GDM. We used data from the National Health and Nutrition Examination Survey for 2007 through 2010. We included women without diabetes aged 20 to 44 years whose most recent live infant was born within the previous 10 years and who completed two 24-hour dietary recalls. The Healthy Eating Index (HEI)-2010 estimated overall and component diet quality. Multivariable linear regression models estimated the association between a history of GDM and current diet quality, adjusting for age, education, smoking status, and health risk for diabetes. A history of GDM was reported by 7.7% of women. Compared with women without a history of GDM, women with a history of GDM had, on average, 3.4 points lower overall diet quality (95% confidence interval [CI], -6.6 to -0.2) and 0.9 points lower score for consumption of green vegetables and beans (95% CI, -1.4 to -0.4). Other dietary component scores did not differ by history of GDM. In the United States, women with a history of GDM have lower diet quality compared with women who bore a child and do not have a history of GDM. Improving diet quality may be a strategy for preventing type 2 diabetes among childbearing women.

  3. Food choice decision-making by women with gestational diabetes.

    Science.gov (United States)

    Hui, Amy Leung; Sevenhuysen, Gustaaf; Harvey, Dexter; Salamon, Elizabeth

    2014-02-01

    To enhance the dietary education presented to women with gestational diabetes (GDM) by exploring the reasons and experiences that women with GDM reported in making their food-choice decisions after receipt of dietary education from a healthcare professional. Food Choice Map (FCM) semi-structured in-depth interviews were conducted with 30 women with GDM living in the Winnipeg area during their pregnancies. Verbatim transcripts were generated from the interviews. A constant comparative method was used to generate common themes to answer research inquiries. Personal food preferences, hunger and cravings were the main factors affecting food choice decision-making in women with GDM. Although the information from healthcare professionals was 1 factor that affected food choice decision-making for most of the participants, more than half of the women, including all the women who were on insulin, reported difficulties in quick adaptation to dietary management in a limited time period. Information from other sources such as family members, friends, and internet were used to cope with the adaptation. These difficulties led to a sense of decreased control of GDM and were accompanied by frustration, especially for women taking insulin. Food choice decision-making varied for this group of women with GDM. Knowledge and information aided in making healthy food choices and in portion control. However, balancing individual needs and blood glucose control in a short time period was felt to be difficult and created frustration. The findings suggested that dietary consultation needs to be personalized and to be time sensitive to promote confidence in self-control. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  4. Mild gestational diabetes mellitus and long-term child health.

    Science.gov (United States)

    Landon, Mark B; Rice, Madeline Murguia; Varner, Michael W; Casey, Brian M; Reddy, Uma M; Wapner, Ronald J; Rouse, Dwight J; Biggio, Joseph R; Thorp, John M; Chien, Edward K; Saade, George; Peaceman, Alan M; Blackwell, Sean C; VanDorsten, J Peter

    2015-03-01

    To evaluate whether treatment of mild gestational diabetes mellitus (GDM) confers sustained offspring health benefits, including a lower frequency of obesity. Follow-up study of children (ages 5-10) of women enrolled in a multicenter trial of treatment versus no treatment of mild GDM. Height, weight, blood pressure, waist circumference, fasting glucose, fasting insulin, triglycerides, and HDL cholesterol were measured. Five hundred of 905 eligible offspring (55%) were enrolled. Maternal baseline characteristics were similar between the follow-up treated and untreated groups. The frequencies of BMI ≥95th (20.8% and 22.9%) and 85th (32.6% and 38.6%) percentiles were not significantly different in treated versus untreated offspring (P = 0.69 and P = 0.26). No associations were observed for BMI z score, log waist circumference, log triglycerides, HDL cholesterol, blood pressure, or log HOMA-estimated insulin resistance (HOMA-IR). The effect of treatment was different by sex for fasting glucose and log HOMA-IR (P for interaction = 0.002 and 0.02, respectively) but not by age-group (5-6 and 7-10 years) for any outcomes. Female offspring of treated women had significantly lower fasting glucose levels. Although treatment for mild GDM has been associated with neonatal benefits, no reduction in childhood obesity or metabolic dysfunction in the offspring of treated women was found. However, only female offspring of women treated for mild GDM had lower fasting glucose. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  5. Serial fetal abdominal circumference measurements in predicting normal birth weight in gestational diabetes mellitus.

    LENUS (Irish Health Repository)

    Neff, Karl J

    2013-06-24

    To construct a clinical management matrix using serial fetal abdominal circumference measurements (ACMs) that will predict normal birth weight in pregnancies complicated by gestational diabetes (GDM) and reduce unnecessary ultrasound examination in women with GDM.

  6. Gestational diabetes mellitus in Europe: prevalence, current screening practice and barriers to screening. A review

    NARCIS (Netherlands)

    Buckley, B.; Harreiter, J.; Damm, P.; Corcoy, R.; Chico, A.; Simmons, D.; Snoek, F.J.; van Poppel, M.N.M.; Vellinga, A.; Dunne, F.

    2012-01-01

    Background Gestational diabetes mellitus is a potentially serious condition that affects many pregnancies and its prevalence is increasing. Evidence suggests early detection and treatment improves outcomes, but this is hampered by continued disagreement and inconsistency regarding many aspects of

  7. Gestational diabetes mellitus in Europe: prevalence, current screening practice and barriers to screening

    DEFF Research Database (Denmark)

    Buckley, B S; Harreiter, J; Damm, P

    2012-01-01

    Background: Gestational diabetes mellitus is a potentially serious condition that affects many pregnancies and its prevalence is increasing. Evidence suggests early detection and treatment improves outcomes, but this is hampered by continued disagreement and inconsistency regarding many aspects...... an overview of the context within which the programme will be conducted and its findings interpreted, systematic searching and narrative synthesis have been used to identify and review the best available European evidence relating to the prevalence of gestational diabetes, current screening practices...... standards for gestational diabetes could lead to better detection and treatment, improved outcomes for women and children and a strengthened evidence base. There is an urgent need for well-designed research that can inform decisions on best practice in gestational diabetes mellitus screening and diagnosis...

  8. Is there a role for exosomes in foetoplacental endothelial dysfunction in gestational diabetes mellitus?

    NARCIS (Netherlands)

    Saez, Tamara; de Vos, Paul; Sobrevia, Luis; Faas, Marijke M.

    Gestational diabetes mellitus (GDM) is a disease of pregnancy associated with endothelial dysfunction in the foetoplacental vasculature. Foetoplacental endothelial dysfunction is characterized by changes in the L-arginine-adenosine signalling pathway and inflammation. The mechanisms involved in

  9. Cord blood chemerin: differential effects of gestational diabetes mellitus and maternal obesity

    NARCIS (Netherlands)

    van Poppel, M.N.M.; Zeck, W.; Ulrich, D.; Schest, E.C.; Hirschmugl, B.; Lang, U.; Wadsack, C.; Desoye, G.

    2014-01-01

    Objective Chemerin is a novel adipokine implicated in inflammation and obesity. We hypothesized that foetal chemerin would be elevated in gestational diabetes mellitus (GDM) and correlate with foetal and maternal adiposity. Design Observational, longitudinal study. Subjects and measurements Foetal

  10. Fetal growth in relation to gestational weight gain in women with Type 2 diabetes

    DEFF Research Database (Denmark)

    Parellada, C B; Asbjörnsdóttir, Björg; Ringholm, Lene

    2014-01-01

    AIMS: To evaluate fetal growth in relation to gestational weight gain in women with Type 2 diabetes. METHODS: A retrospective cohort study of 142 consecutive pregnancies in 28 women of normal weight, 39 overweight women and 75 obese women with Type 2 diabetes (pre-pregnancy BMI ... was almost 0.5 kg higher in women with Type 2 diabetes and excessive gestational weight gain than in women with Type 2 diabetes and non-excessive weight gain....... kg/m2, respectively). Gestational weight gain was categorized as excessive (exceeding the US Institute of Medicine recommendations) or as non-excessive (within or below the Institute of Medicine recommendations). RESULTS: Excessive and non-excessive gestational weight gain were seen in 61 (43...

  11. The Role of Metformin in Metabolic Disturbances during Pregnancy: Polycystic Ovary Syndrome and Gestational Diabetes Mellitus

    OpenAIRE

    Joselyn Rojas; Mervin Chávez-Castillo; Valmore Bermúdez

    2014-01-01

    Maintenance of gestation implicates complex function of multiple endocrine mechanisms, and disruptions of the global metabolic environment prompt profound consequences on fetomaternal well-being during pregnancy and postpartum. Polycystic Ovary Syndrome (PCOS) and gestational diabetes mellitus (GDM) are very frequent conditions which increase risk for pregnancy complications, including early pregnancy loss, pregnancy-induced hypertensive disorders, and preterm labor, among many others. Insuli...

  12. Use of metformin earlier in pregnancy predicts supplemental insulin therapy in women with gestational diabetes.

    Science.gov (United States)

    McGrath, Rachel T; Glastras, Sarah J; Hocking, Samantha; Fulcher, Gregory R

    2016-06-01

    The use of metformin in gestational diabetes is safe and effective, yet some women require additional insulin therapy to achieve glycaemic targets. We found a significant association between earlier gestational age at initiation of metformin therapy and the necessity for supplemental insulin in women treated with metformin during pregnancy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Effect of hyperemesis gravidarum on gestational diabetes mellitus screening.

    Science.gov (United States)

    Ohara, Rena; Obata-Yasuoka, Mana; Abe, Kanako; Yagi, Hiroya; Hamada, Hiromi; Yoshikawa, Hiroyuki

    2016-02-01

    To clarify the effect of starvation due to hyperemesis gravidarum on the screening of gestational diabetes mellitus (GDM). A retrospective study was undertaken of pregnant women who delivered at Tsukuba University Hospital, Japan, between October 1, 2010, and September 30, 2013. GDM screening was performed in the first trimester using the random blood glucose test with a cutoff value of 5.2mmol/L and in the second trimester using a 50-g glucose challenge test with a cutoff value of 7.8mmol/L. If the screening was positive, a 75-g oral glucose tolerance test was performed for a definite diagnosis. Among 2112 eligible women, 33 (1.6%) required hospitalization for hyperemesis; the remaining 2079 women formed the control group. In the first trimester, the positive GDM screening rate was significantly higher in the hyperemesis group than in the control group (13 [39.4%] vs 115 [5.5%]; Phyperemesis group (23.1% vs 73.9%; PHyperemesis gravidarum affects the positive GDM screening rate in the first trimester. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  14. Obstetric and Neonatal Outcome in PCOS with Gestational Diabetes Mellitus.

    Directory of Open Access Journals (Sweden)

    Fatemeh Foroozanfard

    2014-03-01

    Full Text Available There are some metabolic similarities between women with gestational diabetes mellitus (GDM and polycystic ovary syndrome (PCOS; it is still uncertain, however, to what extent coexistence GDM and PCOS affects pregnancy outcome. The present study was designed to determine the obstetric and neonatal outcome in PCOS with GDM.A case-control study was conducted involving 261 GDM women. Thirty hundred-one cases had PCOS based on Rotterdam criteria and the other thirty hundred cases (control group were women without PCOS. The subjects in each group were evaluated regarding obstetric and those women whose documentation's were complete entered the study.In present study, women with PCOS and GDM had more than twofold increased odds of preeclampsia (p = 0.003, CI = 1.56-5.01, and OR = 2.8 and PIH (p= 0.04, CI = 1.28-4.5, and OR= 2.4. Maternal PCOS and GDM were also associated with threefold increased odds of neonatal hypoglycemia (p= 0.004, CI= 1.49-6.58, and OR= 3.13.Our finding emphasized that pregnant PCOS patients should be followed carefully for the occurrence of various pregnancy and neonatal complications including hypertension and hypoglycemia. We suggested that these neonates should be given more care regarding hypoglycemia symptoms.

  15. Gestational diabetes mellitus: advocating for policy change in India.

    Science.gov (United States)

    Madhab, Anand; Prasad, Vishwa Mohan; Kapur, Anil

    2011-11-01

    A multimedia awareness and advocacy campaign for mainstreaming gestational diabetes mellitus (GDM) in the public health domain is described. The multimedia campaign has created awareness about the relevance of GDM to women's health and the health of future generations through direct contact, reaching out to over half a million people in 7 districts of 4 states in northern India. Using mass media, over 3.7 million people have received information on GDM. Through multistakeholder forums, more than 1000 key stakeholders have been encouraged to mainstream GDM into the existing health delivery system. The Indian Ministry of Health has introduced free screening for GDM among the 5 services offered to pregnant women below the poverty line in the National Rural Health Mission (NRHM) program. In addition, several state governments, such as in Bihar, Delhi, Jharkhand, and Punjab, have pledged similar initiatives addressing GDM; the Government of Tamil Nadu is already implementing such a policy. Policy development is a complex process that requires action on many fronts. By showcasing evidence, raising awareness, creating public opinion through dialogue and discussion, media can help build a positive environment and momentum for effective policy creation as well as service utilization. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd.. All rights reserved.

  16. Metformin in gestational diabetes mellitus: predictors of poor response.

    Science.gov (United States)

    Gante, Inês; Melo, Luís; Dores, Jorge; Ruas, Luísa; Almeida, Maria do Céu

    2018-01-01

    Metformin can be regarded as a first-line treatment in gestational diabetes mellitus (GDM) due to its safety and effectiveness. However, a proportion of women do not achieve adequate glycemic control with metformin alone. We aim to identify predictors of this poor response to metformin. Retrospective multicentre cohort study of women with GDM who started metformin as first-line treatment. The assessed cohort was divided into a metformin group and metformin plus insulin group. Biometric and demographic characteristics, glycemic control data, obstetric, neonatal and postpartum outcomes were compared between groups and analysed in order to identify predictors of poor response to metformin. Data were analysed using STATA, version 13.1. Of the 388 women enrolled in the study, 135 (34.8%) required additional insulin therapy to achieve the glycemic targets. Higher age (aOR: 1.08 (1.03-1.13), P  = 0.003), higher pre-pregnancy body mass index (BMI) (1.06 (1.02-1.10), P  = 0.003) and earlier introduction of metformin (0.89 (0.85-0.94), P  metformin, insulin supplementation was not associated with poor neonatal outcomes. Higher age, higher pre-pregnancy BMI and earlier introduction of metformin could be used as predictors of poor response to metformin. © 2018 European Society of Endocrinology.

  17. Metformin for the management of gestational diabetes mellitus.

    Science.gov (United States)

    Singh, Kamal P; Rahimpanah, Farhad; Barclay, Margot

    2015-08-01

    Glycaemic control in women with gestational diabetes mellitus (GDM) has typically been achieved with diet, exercise and insulin therapy. Controversy exists in the literature about a potential role for metformin. A literature review was completed aiming to compare the glycaemic control, maternal and fetal out comes of metformin therapy with insulin. Searches were completed on databases, including Medline, PubMed and ScienceDirect. Seven randomised control trials (RCTs) fit the inclusion criteria, with a total sample size of 1514 women. The majority of studies found no difference in glycaemic control between metformin and insulin groups. When comparing maternal outcomes, those receiving metformin therapy recorded less maternal weight gain in four studies. A number of studies reported lower rates of neonatal hypoglycaemia, and one reported higher rates of preterm birth in the metformin group. There were no other differences in the recorded maternal and fetal outcomes. The Jadad score for assessing risk of bias for most included studies was either 3 or 4. The criteria for diagnosis of GDM, maternal and neonatal complications varied between studies. Only one study has published follow-up data, and most are single-centre trials with relatively small sample sizes. Though there is a growing body of evidence to suggest a role for metformin in GDM management, further large-scale, multicentre RCTs are needed before guidelines can be altered. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  18. Maternal and perinatal outcomes in 143 Danish women with gestational diabetes mellitus and 143 controls with a similar risk profile

    DEFF Research Database (Denmark)

    Jensen, Dorte Møller; Sørensen, B; Feilberg-Jørgensen, N

    2000-01-01

    To assess maternal and fetal outcomes in pregnancies complicated by gestational diabetes mellitus (GDM) compared to non-diabetic pregnancies with an otherwise similar risk profile and to study the association between different anti-diabetic treatments and fetal outcomes....

  19. Metabolic specifics of women with a positive history of gestational diabetes

    OpenAIRE

    Jarošová, Adéla

    2017-01-01

    Gestational diabetes (GDM) is a disorder of glucose metabolism arising for the first time in pregnancy and spontaneously receding after birth. The issue of GDM is very topical since, according to the latest update of diagnostic criteria, up to 17% of pregnant women is threatened by this disorder. The incidence of GDM correlates with the increasing prevalence of overweight/obesity and metabolic syndrome. It is proved that women who have had gestational diabetes have an enormously increased ris...

  20. Antioxidant status and circulating lipids are altered in human gestational diabetes and macrosomia.

    Science.gov (United States)

    Grissa, Oussama; Atègbo, Jean-Marc; Yessoufou, Akadiri; Tabka, Zouhair; Miled, Abdelhedi; Jerbi, Mehdi; Dramane, Karim L; Moutairou, Kabirou; Prost, Josiane; Hichami, Aziz; Khan, Naim Akhtar

    2007-09-01

    Fetuses from mothers with gestational diabetes are at increased risk of developing neonatal macrosomia and oxidative stress. We investigated the modulation of antioxidant status and circulating lipids in gestational diabetic mothers and their macrosomic babies and in healthy age-matched pregnant women and their newborns. The serum antioxidant status was assessed by employing anti-radical resistance kit (KRL; Kirial International SA, Couternon, France) and determining levels of vitamin A, C, and E and the activity of superoxide dismutase (SOD). Circulating serum lipids were quantified, and lipid peroxidation was measured as the concentrations of serum thiobarbituric acid-reactive substances (TBARS). As compared with non-diabetic mothers, gestational diabetic women exhibited decreased levels of vitamin E and enhanced concentrations of vitamin C without any changes in vitamin A. Vitamin A and C levels did not change in macrosomic babies except vitamin E whose levels were lower in these infants than in the newborns of non-diabetic mothers. Gestational diabetes mellitus (GDM) and macrosomia were also associated with impaired SOD activities and enhanced TBARS levels. Globally, total serum antioxidant defense status in diabetic mothers and their macrosomic babies was diminished as compared with control subjects. Triglyceride and cholesterol concentrations did not differ significantly between gestational diabetic and control mothers; however, macrosomia was associated with enhanced plasma cholesterol and triglyceride levels. These results suggest that human GDM and macrosomia are associated with downregulation of antioxidant status, and macrosomic infants also exhibit altered lipid metabolism.

  1. Maternal and perinatal outcomes in 143 Danish women with gestational diabetes mellitus and 143 controls with a similar risk profile

    DEFF Research Database (Denmark)

    Jensen, Dorte Møller; Sørensen, B; Feilberg-Jørgensen, N

    2000-01-01

    To assess maternal and fetal outcomes in pregnancies complicated by gestational diabetes mellitus (GDM) compared to non-diabetic pregnancies with an otherwise similar risk profile and to study the association between different anti-diabetic treatments and fetal outcomes.......To assess maternal and fetal outcomes in pregnancies complicated by gestational diabetes mellitus (GDM) compared to non-diabetic pregnancies with an otherwise similar risk profile and to study the association between different anti-diabetic treatments and fetal outcomes....

  2. Self-management of gestational diabetes among Chinese migrants: A qualitative study.

    Science.gov (United States)

    Wah, Yat Yin Eric; McGill, Margaret; Wong, Jencia; Ross, Glynis P; Harding, Anna-Jane; Krass, Ines

    2018-04-21

    Gestational diabetes mellitus is one of the most common complications of pregnancy. Women with Gestational diabetes are at increased risk of serious health outcomes, such as pre-eclampsia, obstructed labor, and the development of Type 2 diabetes later in life. Chinese migrants, the third largest cultural group in Australia, are more likely to develop Gestational diabetes than Australian-born women. However, to date, Gestational diabetes self-management has not been investigated in this population. To explore the understanding and self-management experiences of Gestational diabetes among Chinese migrants. Data were collected through individual semi-structured face-to-face interviews. Participants were recruited from the antenatal clinic at the Royal Prince Alfred Hospital. Interviews were audio-recorded, transcribed verbatim and thematically analyzed. Although the majority of participants demonstrated a good understanding of Gestational diabetes, some did not understand the principles behind healthcare advice and faced challenges in self-management. Confusion about self-monitoring of blood glucose and fear of insulin were also evident. Participants relied on both formal and informal sources of information. Some had difficulty obtaining adequate support. Cultural influences on self-management included meeting family needs, Chinese diet and use of Chinese medicines. To assist Chinese women with Gestational diabetes to better self-manage their condition, there is a need for clinicians to: (1) provide more effective diabetes education to ensure clear understanding of self-management principles; (2) actively elicit and respond to women's confusion and concerns; (3) provide women with adequate practical support; and (4) develop greater cultural awareness. Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  3. Effects of gestational diabetes on human placental glucose uptake, transfer, and utilisation.

    Science.gov (United States)

    Osmond, D T; Nolan, C J; King, R G; Brennecke, S P; Gude, N M

    2000-05-01

    Gestational diabetes is associated with complications for the offspring before, during and after delivery. Poor maternal glucose control, however, is a weak predictor of these complications. Given its position at the interface of the maternal and fetal circulations, the placenta possibly plays a crucial part in protecting the fetus from adverse effects from the maternal diabetic milieu. We hypothesised that gestational diabetes may result in changes in placental function, particularly with respect to the uptake, transfer, and/or utilisation of glucose. We aimed to examine glucose transport and utilisation in intact human placental lobules from women with gestational diabetes and those from normal pregnancies. Dual perfusion of an isolated placental lobule was done on placentae from diet treated gestational diabetic (n = 7) and normal pregnant patients (n = 9) using maternal glucose concentrations of 4, 8, 16 and 24 mmol/l in random order over a 4-h experiment. Results were expressed in micromol x min(-1) x g(-1). D-glucose uptake from the maternal circulation (control 0.492 vs gestational diabetes mellitus 0.248, at 8 mmol/l maternal glucose), D-glucose utilisation by the placenta (0.255 vs 0.129), D-glucose transfer to the fetal circulation (direct 0.979 vs 0.402; net transfer 0.269 vs 0.118) and L-lactate maternal release into both the fetal (0.052 vs 0.042) and maternal (0.255 vs 0.129) circulation were significantly reduced during in vitro perfusion of placentae from patients with gestational diabetic pregnancies. Transfer of 3H-L-glucose also significantly reduced in the diabetic group (8.1% vs 2.6%). These results suggest that placental transport and metabolism of D-glucose is altered during gestational diabetes.

  4. Effects of pregnancy on hemoglobin AIc in normal, gestational diabetic, and diabetic women.

    Science.gov (United States)

    Schwartz, H C; King, K C; Schwartz, A L; Edmunds, D; Schwartz, R

    1976-12-01

    Hemoglobin AIc, a normal minor hemoglobin, has glucose linked by a Schiff base to the N-terminal end of the beta chain. The glucose interferes with the binding of 2,3 diphosphoglycerate, probably resulting in an increased affinity of that hemoglobin for oxygen. Hb AIc is increased to twice normal levels in juvenile-onset (insulin-dependent) diabetes. In the present studies, the Hb AIc, when expressed as per cent of total hemoglobin, was found to be elevated slightly in pregnany normal (m = 6.97 per cent), pregnant nondiabetic obese (m = 6.89 per cent), and gestationally diabetic subjects (m = 8.77 per cent) above that of normal females (m = 5.68 per cent). A remarkable difference was observed between the nonpregnant diabetics (m = 12.77 per cent) and the pregnant diabetics (m = 8.46 per cent). This decrease in the level of Hb AIc in diabetics who are pregnant more than 30 weeks may reflect either a better state of diabetic control and/or a compensatory mechanism to protect the fetus by facilitating oxygen exchange from mother to fetus.

  5. Leisure Time Physical Activity and Gestational Diabetes Mellitus in the Omega Study

    Science.gov (United States)

    Badon, Sylvia E; Wartko, Paige D; Qiu, Chunfang; Sorensen, Tanya K; Williams, Michelle A; Enquobahrie, Daniel A

    2016-01-01

    Purpose Findings of studies investigating associations of leisure time physical activity (LTPA) with gestational diabetes mellitus (GDM) risk have been inconsistent. We investigated associations of LTPA with GDM and whether these associations differ by pre-pregnancy overweight/obese status or gestational weight gain category. Methods Participants (N=3209) of the Omega study, a pregnancy cohort study in Washington State (1996–2008), reported LTPA duration (hours/week) and energy expenditure (MET-hours/week) in the year before pregnancy and in early pregnancy. Diagnoses of GDM were abstracted from medical records. Poisson regression models were used to determine relative risks of GDM across tertiles of pre-pregnancy or early pregnancy LTPA duration and energy expenditure. Stratified analyses and interaction terms were used to assess effect modification by pre-pregnancy overweight/obese status (BMI ≥ 25 kg/m2) or gestational weight gain category (adequate or excessive). Results Each tertile increase in pre-pregnancy LTPA duration or energy expenditure was associated with 15% (95% CI: 0.72–1.00) and 19% (95% CI: 0.69–0.96) lower risk of GDM, respectively. Each tertile increase in early pregnancy LTPA duration or energy expenditure was associated with 16% (95% CI: 0.72–0.97) and 17% (95% CI: 0.72–0.95) lower risk of GDM, respectively. LTPA during both pre- and early pregnancy was associated with 46% reduced risk of GDM (95% CI: 0.32, 0.89) compared to inactivity during both time periods. LTPA-GDM associations were similar by pre-pregnancy BMI and gestational weight gain. Conclusion Our results support a role for promotion of physical activity before and during pregnancy in prevention of GDM. PMID:26741121

  6. Atlantic DIP: Diabetes in Pregnancy: a comparative study of stress and wellbeing in women with established diabetes, gestational diabetes, and those without diabetes

    LENUS (Irish Health Repository)

    Lydon, K

    2011-09-15

    Background and aims: Diabetes in pregnancy increases the risk of maternal and perinatal morbidity and mortality. The experience of diabetes during pregnancy may be a significant source of stress, both because of the impact of the illness and associated treatments on the expectant mother and because of concern about the impact on the unborn child. In order to examine stress associated with diabetes during pregnancy, we carried out a prospective study in women with pre-existing (Type 1 or Type 2) Diabetes (PDM), Gestational Diabetes Mellitus (GDM), and non-diabetic pregnant controls (NDM).\\r\

  7. Sleep duration and quality, and risk of gestational diabetes mellitus in pregnant Chinese women.

    Science.gov (United States)

    Wang, H; Leng, J; Li, W; Wang, L; Zhang, C; Li, W; Liu, H; Zhang, S; Chan, J; Hu, G; Yu, Z; Yang, X

    2017-01-01

    To examine the association between sleep disturbances during pregnancy and risk of gestational diabetes mellitus. From 2010 to 2012, 12 506 women in Tianjin, China, were screened using a 50-g 1-h glucose challenge test at 24-28 weeks' gestation. Those with glucose challenge test values of ≥ 7.8 mmol/l were invited to further undergo a 75-g 2-h oral glucose tolerance test. Gestational diabetes was determined according to the International Association of Diabetes and Pregnancy Study Group's definition. Self-reported sleep duration and sleep quality during pregnancy was documented using a modified questionnaire. Logistic regression was used to obtain odds ratios and 95% CIs. A total of 919 women (7.3%) had gestational diabetes. Sleep duration was found to have an approximate J-shaped association with gestational diabetes risk after adjusting for covariates. Compared with a sleep duration of 7-9 h/day (43% of 12 506 women), the adjusted odds ratios for sleep duration of ≥ 9 h/day (55%) and good sleep quality (37.9% of 12 506 women), the adjusted odds ratios of moderate (59.9%) and poor sleep quality (2.2%) for gestational diabetes were 1.19 (95% CI 1.01-1.41) and 1.61 (95% CI 1.04-2.50), respectively. In pregnant Chinese women, poor sleep quality, and shorter and longer duration of sleep during pregnancy were independently associated with an increased risk of gestational diabetes. © 2016 Diabetes UK.

  8. Pilot Study of an Individualised Early Postpartum Intervention to Increase Physical Activity in Women with Previous Gestational Diabetes

    Directory of Open Access Journals (Sweden)

    Harold David McIntyre

    2012-01-01

    Full Text Available Optimal strategies to prevent progression towards overt diabetes in women with recent gestational diabetes remain ill defined. We report a pilot study of a convenient, home based exercise program with telephone support, suited to the early post-partum period. Twenty eight women with recent gestational diabetes were enrolled at six weeks post-partum into a 12 week randomised controlled trial of Usual Care (n=13 versus Supported Care (individualised exercise program with regular telephone support; n=15. Baseline characteristics (Mean ± SD were: Age  33±4  years; Weight 80 ± 20 kg and Body Mass Index (BMI 30.0±9.7 kg/m2. The primary outcome, planned physical activity {Median (Range}, increased by 60 (0–540 mins/week in the SC group versus 0 (0–580 mins/week in the UC group (P=0.234. Walking was the predominant physical activity. Body weight, BMI, waist circumference, % body fat, fasting glucose and insulin did not change significantly over time in either group. This intervention designed to increase physical activity in post-partum women with previous gestational diabetes proved feasible. However, no measurable improvement in metabolic or biometric parameters was observed over a three month period.

  9. Can Diabetes Be Prevented? (For Teens)

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Can Diabetes Be Prevented? KidsHealth / For Teens / Can Diabetes Be ... español ¿Es posible prevenir la diabetes? What Is Diabetes? Diabetes is a disease that affects how the ...

  10. Diabetes Prevention: 5 Tips for Taking Control

    Science.gov (United States)

    ... items in the ingredient list. If you're overweight, diabetes prevention may hinge on weight loss. Every pound ... Diabetes Association. Diabetes Care. 2008;31(suppl):S61. Overweight. American Diabetes Association. http://www.diabetes.org/are-you-at- ...

  11. Screening gestational diabetes mellitus: The role of maternal age.

    Directory of Open Access Journals (Sweden)

    Chun-Heng Kuo

    Full Text Available Using a specific cutoff of fasting plasma glucose (FPG to screen gestational diabetes mellitus (GDM can reduce the use of oral glucose tolerance tests (OGTT. Since the prevalence of GDM increases with age, this screening method may not be appropriate in healthcare systems where women become pregnant at older ages. Therefore, we aimed to develop a screening algorithm for GDM that takes maternal age into consideration.We included 945 pregnant women without history of GDM who received 75g OGTT to diagnose GDM in 2011. Screening algorithms using FPG with or without age were developed. Another 362 pregnant women were recruited in 2013-2015 as the validation cohort.Using FPG criteria alone, more GDM diagnoses were missed in women ≥35 years than in women <35 years (13.2% vs. 5.8%, p <0.001. Among GDM women ≥35 years, 63.6% had FPG <92 mg/dL (5.1 mmol/L. Use of the algorithm with an "age plus FPG" cutoff could reduce the use of OGTT (OGTT% from 77.6% to 62.9%, while maintaining good sensitivity (from 91.9% to 90.2% and specificity (from 100% to 100%. Similar reduction in OGTT% was found in the validation cohort (from 86.4% to 76.8%. In the simulation, if the percentage of women ≥35 years were 40% or more, the screening algorithm with an "age plus FPG" cutoff could further reduce OGTT% by 11.0%-18.8%.A screening algorithm for GDM that takes maternal age into consideration can reduce the use of OGTT when women become pregnant at older ages.

  12. UNIVERSAL VERSUS SELECTIVE SCREENING FOR DETECTION OF GESTATIONAL DIABETES MELLITUS IN A MALAYSIAN POPULATION

    Directory of Open Access Journals (Sweden)

    RUSHDAN MN

    2009-01-01

    Full Text Available Objectives: To compare the efficacy of two screenings methods for gestational diabetes mellitus, namely the universal screening using 50g Glucose Challenge Test to that of selective screening based on risk factors. Methodology: A cross-sectional study involving 366 women between 24 weeks to 28 weeks gestation who attended a community health clinic for their antenatal care between January to May 2003. All women had their risk factors for gestational diabetes identified at the beginning of the study, after which they underwent a 50g Glucose Challenge Test and subsequently the 75g Oral Glucose Tolerance Test. Results: The prevalence of gestational diabetes mellitus in this population was 18.3%. The universal screening had a sensitivity of 83.5% and specificity of 82.6% compared to that of selective screening, 76.1% and 60.9% respectively. Of all patients diagnosed to have gestational diabetes mellitus, 23.8% were without risk factors. Conclusion: Universal screening strategy using 50g glucose challenge test is a better predictor of gestational diabetes mellitus compared to risk-based selective screening.

  13. Lifestyle interventions for the treatment of women with gestational diabetes.

    Science.gov (United States)

    Brown, Julie; Alwan, Nisreen A; West, Jane; Brown, Stephen; McKinlay, Christopher Jd; Farrar, Diane; Crowther, Caroline A

    2017-05-04

    Gestational diabetes (GDM) is glucose intolerance, first recognised in pregnancy and usually resolving after birth. GDM is associated with both short- and long-term adverse effects for the mother and her infant. Lifestyle interventions are the primary therapeutic strategy for many women with GDM. To evaluate the effects of combined lifestyle interventions with or without pharmacotherapy in treating women with gestational diabetes. We searched the Pregnancy and Childbirth Group's Trials Register (14 May 2016), ClinicalTrials.gov, WHO International Clinical Trials Registry Platform (ICTRP) (14th May 2016) and reference lists of retrieved studies. We included only randomised controlled trials comparing a lifestyle intervention with usual care or another intervention for the treatment of pregnant women with GDM. Quasi-randomised trials were excluded. Cross-over trials were not eligible for inclusion. Women with pre-existing type 1 or type 2 diabetes were excluded. We used standard methodological procedures expected by the Cochrane Collaboration. All selection of studies, data extraction was conducted independently by two review authors. Fifteen trials (in 45 reports) are included in this review (4501 women, 3768 infants). None of the trials were funded by a conditional grant from a pharmaceutical company. The lifestyle interventions included a wide variety of components such as education, diet, exercise and self-monitoring of blood glucose. The control group included usual antenatal care or diet alone. Using GRADE methodology, the quality of the evidence ranged from high to very low quality. The main reasons for downgrading evidence were inconsistency and risk of bias. We summarised the following data from the important outcomes of this review. Lifestyle intervention versus control groupFor the mother:There was no clear evidence of a difference between lifestyle intervention and control groups for the risk of hypertensive disorders of pregnancy (pre-eclampsia) (average

  14. Gestational Diabetes Mellitus in Korean Women: Similarities and Differences from Other Racial/Ethnic Groups

    Directory of Open Access Journals (Sweden)

    Catherine Kim

    2014-02-01

    Full Text Available Gestational diabetes mellitus (GDM reflects defects in insulin secretion in response to the metabolic demands of pregnancy. While GDM is increasingly common worldwide due in large part to the obesity epidemic, its frequency is relatively low in Korean women. In this report, the prevalence and risk factors for GDM, perinatal outcomes, and postpartum course are compared in non-Korean and Korean women. While Koreans and non-Koreans with GDM share pathophysiology and complications, there may be differences in the role of obesity and thus the effectiveness of interventions targeting obesity in GDM women. Further investigations of the effectiveness of weight loss interventions and pharmacotherapy specifically among Korean women are needed. Dietary and other lifestyle data from Korean populations could inform prevention and treatment strategies in other countries which suffer from significantly higher prevalences of GDM.

  15. GAD65 autoantibodies in women with gestational or insulin dependent diabetes mellitus diagnosed during pregnancy

    DEFF Research Database (Denmark)

    Petersen, J S; Dyrberg, Torben Bech; Damm, P

    1996-01-01

    We have studied the presence of GAD65 autoantibodies in women with insulin-dependent diabetes mellitus (IDDM) (n = 28) or gestational diabetes (GDM) (n = 139) diagnosed during pregnancy and investigated the temporal relationship between these autoantibodies and the subsequent recurrence...

  16. Gestational diabetes as a risk factor for pancreatic cancer: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Calderon R

    2007-08-01

    Full Text Available Abstract Background Diabetes is known to be associated with cancer of the pancreas, though there is some debate as to whether it is a cause or a consequence of the disease. We investigated the incidence of pancreatic cancer in a cohort of 37926 Israeli women followed for 28–40 years for whom information on diabetes had been collected at the time they gave birth, in 1964–1976, in Jerusalem. There were 54 cases of pancreatic cancer ascertained from the Israel Cancer Registry during follow-up. Methods We used Cox proportional hazards models to adjust for age at baseline and explore effects of other risk factors, including ethnic groups, preeclampsia, birth order and birth weight of offspring. Results We observed no cases of pancreatic cancer in the women with insulin dependent diabetes; however, there were five cases in the women with gestational diabetes. The interval between the record of diabetes in pregnancy and the diagnosis of pancreatic cancer ranged from 14–35 years. Women with a history of gestational diabetes showed a relative risk of pancreatic cancer of 7.1 (95% confidence interval, 2.8–18.0. Conclusion We conclude that gestational diabetes is strongly related to the risk of cancer of the pancreas in women in this population, and that gestational diabetes can precede cancer diagnosis by many years.

  17. Comparison of accuracy measures of two screening tests for gestational diabetes mellitus

    NARCIS (Netherlands)

    van Leeuwen, Marsha; Zweers, Egbert J. K.; Opmeer, Brent C.; van Ballegooie, Evert; ter Brugge, Henk G.; de Valk, Harold W.; Mol, Ben W. J.; Visser, Gerard H. A.

    2007-01-01

    OBJECTIVE: To compare the accuracy measures of the random glucose test and the 50-g glucose challenge test as screening tests for gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS: In this prospective cohort study, pregnant women without preexisting diabetes in two perinatal centers

  18. ATLANTIC DIP: simplifying the follow-up of women with previous gestational diabetes.

    LENUS (Irish Health Repository)

    Noctor, E

    2013-11-01

    Previous gestational diabetes (GDM) is associated with a significant lifetime risk of type 2 diabetes. In this study, we assessed the performance of HbA1c and fasting plasma glucose (FPG) measurements against that of 75 g oral glucose tolerance testing (OGTT) for the follow-up screening of women with previous GDM.

  19. Gestational diabetes mellitus and exposure to ambient air pollution and road traffic noise

    DEFF Research Database (Denmark)

    Pedersen, Marie; Olsen, Sjurdur F; Halldorsson, Thorhallur I

    2017-01-01

    Background: Road traffic is a main source of air pollution and noise. Both exposures have been associated with type 2 diabetes, but associations with gestational diabetes mellitus (GDM) have been studied less. Objectives: We aimed to examine single and joint associations of exposure to air pollut...

  20. Maternal Vitamin D Status and Risk of Gestational Diabetes: a Meta-Analysis.

    Science.gov (United States)

    Hu, Lingmin; Zhang, Yue; Wang, Xing; You, Lianghui; Xu, Pengfei; Cui, Xianwei; Zhu, Lijun; Ji, Chenbo; Guo, Xirong; Wen, Juan

    2018-01-01

    Whether maternal vitamin D deficiency is associated with gestational diabetes remains controversial. This meta-analysis aimed to systematically evaluate published evidence on the association between maternal vitamin D status and the risk of gestational diabetes. We retrieved relevant articles from the PubMed, Medline and Embase databases up to May 2017 for observational studies investigating the association between vitamin D status and the risk of gestational diabetes. Odds ratios (OR) or risk ratios (RR) from individual studies were pooled using the fixed and random effect models. The meta-analysis of 29 observational studies included 28,982 participants, of which 4,634 were diagnosed with gestational diabetes, and showed that maternal vitamin D insufficiency was associated with a significantly increased risk of gestational diabetes by 39% (pooled OR = 1.39, 95%CI = 1.20-1.60) with moderate heterogeneity (I2 = 50.2%; P = 0.001). Moreover, the 25(OH)D level was significantly lower in gestational diabetes cases than in controls with a pooled effect of -4.79 nmol/L (95% CI = -6.43, -3.15). Significant heterogeneity was also detected (I2 = 65.0%, P analysis indicated that this association was also evident in most subpopulations. This meta-analysis indicated a significant association between vitamin D insufficiency and increased risk of gestational diabetes. Further well-designed large-scale clinical trials are essential to verify this association. © 2018 The Author(s). Published by S. Karger AG, Basel.

  1. Prenatal exposure to gestational diabetes mellitus as an independent risk factor for long-term neuropsychiatric morbidity of the offspring.

    Science.gov (United States)

    Nahum Sacks, Kira; Friger, Michael; Shoham-Vardi, Ilana; Abokaf, Hanaa; Spiegel, Efrat; Sergienko, Ruslan; Landau, Daniella; Sheiner, Eyal

    2016-09-01

    The reported rates of gestational diabetes mellitus are constantly escalating and little is known about long-term complications in the offspring. Evidence from the field of epigenetics strongly advocates the need for research on the neuropsychiatric complications in offspring prenatally exposed to gestational diabetes mellitus. We sought to assess whether in utero exposure to gestational diabetes mellitus increases the risk of long-term neuropsychiatric morbidity in the offspring. A population-based cohort study compared the incidence of hospitalizations due to neuropsychiatric disease between singletons exposed and unexposed to gestational diabetes mellitus. Deliveries occurred in the years 1991 through 2014 in a regional tertiary medical center. Perinatal deaths, multiple gestations, mothers with pregestational diabetes or lack of prenatal care, and children with congenital malformations were excluded from the study. A multivariate generalized estimating equation logistic regression model analysis was used to control for confounders and for maternal clusters. During the study period 231,271 deliveries met the inclusion criteria; 5.4% of the births were to mothers diagnosed with gestational diabetes mellitus (n = 12,642), of these 4.3% had gestational diabetes type A1 (n = 10,076) and 1.1% had gestational diabetes type A2 (n = 2566). During the follow-up period, a significant linear association was noted between the severity of the gestational diabetes (no gestational diabetes, gestational diabetes mellitus A1, gestational diabetes mellitus A2) and neuropsychiatric disease of the offspring (1.02% vs 1.36% vs 1.68%, respectively, P long-term neuropsychiatric disease of the offspring (gestational diabetes mellitus A1 [adjusted odds ratio, 1.83; 95% confidence interval, 1.53-2.19] and gestational diabetes mellitus A2 [adjusted odds ratio, 1.64; 95% confidence interval, 1.18-2.27]). Within the limits of our database, our findings also point to a possible

  2. Comparing a telephone- and a group-delivered diabetes prevention program

    DEFF Research Database (Denmark)

    S, Lim; Dunbar, James; Versace, Vin

    2017-01-01

    Aims To explore the acceptability of a telephone- or a group-delivered diabetes prevention program for women with previous gestational diabetes and to compare the characteristics associated with program engagement. Methods Postpartum women participated in a lifestyle modification program delivere...

  3. Advancements and challenges in generating accurate animal models of gestational diabetes mellitus

    Science.gov (United States)

    Pasek, Raymond C.

    2013-01-01

    The maintenance of glucose homeostasis during pregnancy is critical to the health and well-being of both the mother and the developing fetus. Strikingly, approximately 7% of human pregnancies are characterized by insufficient insulin production or signaling, resulting in gestational diabetes mellitus (GDM). In addition to the acute health concerns of hyperglycemia, women diagnosed with GDM during pregnancy have an increased incidence of complications during pregnancy as well as an increased risk of developing type 2 diabetes (T2D) later in life. Furthermore, children born to mothers diagnosed with GDM have increased incidence of perinatal complications, including hypoglycemia, respiratory distress syndrome, and macrosomia, as well as an increased risk of being obese or developing T2D as adults. No single environmental or genetic factor is solely responsible for the disease; instead, a variety of risk factors, including weight, ethnicity, genetics, and family history, contribute to the likelihood of developing GDM, making the generation of animal models that fully recapitulate the disease difficult. Here, we discuss and critique the various animal models that have been generated to better understand the etiology of diabetes during pregnancy and its physiological impacts on both the mother and the fetus. Strategies utilized are diverse in nature and include the use of surgical manipulation, pharmacological treatment, nutritional manipulation, and genetic approaches in a variety of animal models. Continued development of animal models of GDM is essential for understanding the consequences of this disease as well as providing insights into potential treatments and preventative measures. PMID:24085033

  4. Effects of gestational and overt diabetes on placental cytochromes P450 and glutathione S-transferase.

    Science.gov (United States)

    Glover; McRobie; Tracy

    1998-07-01

    Objective: Animal and in vivo human studies have observed that diabetes alters the expression of hepatic metabolizing cytochrome P450 (CYP) and glutathione S-transferase (GST) enzymes. The placenta has the ability to metabolize a number of xenobiotic and endogenous compounds by processes similar to those seen in the liver. Our objective was to compare placental xenobiotic metabolizing activity in diabetics to matched non-diabetic controls to determine if the presence of diabetes alters placental xenobiotic metabolizing activity.Methods: The catalytic activities of 7-ethoxyresorufin-O-deethylation [EROD] (CYP1A1), chlorzoxazone 6-hydroxylation (CYP2E1), dextromethorphan N-demethylation (CYP3A4), dextromethorphan O-demethylation (CYP2D6), and 1-chloro-2,4-dinitrobenzene (CDNB) conjugation with glutathione (GST) from placentas of diet controlled (class A1) and insulin-dependent (class A2) gestational diabetics and overt diabetics were compared to matched controls.Results: No differences in EROD activity were observed among overt or gestational diabetics and their respectively matched controls. CYP2E1, 2D6, and 3A4 enzyme activity were not detected in human placentas. In contrast, GST activity was significantly reduced by 30% (P diabetics as compared to their matched controls and gestational diabetics.Conclusion: Pregnant women with overt diabetes have reduced GST activity in the placenta, which could potentially result in exposure of the fetus to harmful reactive electrophilic metabolites.

  5. Relationship between blood pressure and insulin resistance in patients with gestational diabetes

    International Nuclear Information System (INIS)

    Kan Shujuan; Zhang Sujuan

    2008-01-01

    Objective: To study the relationship existe between blood pressure level and degree of insulin resistance in patients with gestational diabetes. Methods: Ninety-five cases of gestational diabetes were diagnosed among 350 pregnant women. Of them, 55 were found to be hypertensive and 40 were normotensive. Fasting, 1,2, 3h post-prandial (75g glucose) blood sugar (with peroxidase method) levels and fasting insulin (with RIA) levels were measured in these patients and 85 normal pregnant women (as control). Results: Fasting, 1, 2, 3h post 75g glucose blood sugar and fasting insulin levels in the 55 hypertensive diabetics were significantly higher than those in the normotensives and controls (P<0.05). The calculated insulin sensitivity indices were significantly lower (P also < 0.05). Conclusion: A higher insulin resistance existed in hypertensive gestational diabetics which might be a risk factor of developing hypertension. (authors)

  6. The effect of gestational diabetes, pre-gravid maternal obesity, and their combination ('diabesity') on outcomes of singleton gestations.

    Science.gov (United States)

    Blickstein, Isaac; Doyev, Reut; Trojner Bregar, Andreja; Bržan Šimenc, Gabrijela; Verdenik, Ivan; Tul, Natasa

    2018-03-01

    To assess the effect of the combination of gestational diabetes mellitus (GDM) and pre-gravid obesity ('diabesity') in singleton gestations. We compared perinatal outcomes of singleton gestations in mothers with GDM and pre-gravid obesity, with GDM but with normal pre-gravid BMI, and obese mothers without GDM. We compared diabesity mothers (n = 1525, 24.4% of mothers with GDM, 9.9% of all obese women) to mothers with GDM but with normal BMI (n = 4704, 75.6% of mothers with GDM) and to obese mothers without GDM (n = 13,937, 90.1% of all obese mothers). Obesity, with and without GDM, increased the odds of having chronic hypertension whereas preeclampsia appears to be influenced by obesity only, as were the risk of births at 4000 g, low 5-min Apgar scores and NICU admissions. Obesity (without diabetes) is more frequently associated with adverse perinatal outcomes than diabesity or GDM in non-obese mothers. A campaign to decrease pre-gravid obesity should have at least the same priority as any campaign to control GDM.

  7. Fast Food Consumption and Gestational Diabetes Incidence in the SUN Project

    Science.gov (United States)

    Dominguez, Ligia J.; Martínez-González, Miguel A.; Basterra-Gortari, Francisco Javier; Gea, Alfredo; Barbagallo, Mario; Bes-Rastrollo, Maira

    2014-01-01

    Background Gestational diabetes prevalence is increasing, mostly because obesity among women of reproductive age is continuously escalating. We aimed to investigate the incidence of gestational diabetes according to the consumption of fast food in a cohort of university graduates. Methods The prospective dynamic “Seguimiento Universidad de Navarra” (SUN) cohort included data of 3,048 women initially free of diabetes or previous gestational diabetes who reported at least one pregnancy between December 1999 and March 2011. Fast food consumption was assessed through a validated 136-item semi-quantitative food frequency questionnaire. Fast food was defined as the consumption of hamburgers, sausages, and pizza. Three categories of fast food were established: low (0–3 servings/month), intermediate (>3 servings/month and ≤2 servings/week) and high (>2 servings/week). Non-conditional logistic regression models were used to adjust for potential confounders. Results We identified 159 incident cases of gestational diabetes during follow-up. After adjusting for age, baseline body mass index, total energy intake, smoking, physical activity, family history of diabetes, cardiovascular disease/hypertension at baseline, parity, adherence to Mediterranean dietary pattern, alcohol intake, fiber intake, and sugar-sweetened soft drinks consumption, fast food consumption was significantly associated with a higher risk of incident gestational diabetes, with multivariate adjusted OR of 1.31 (95% conficence interval [CI]:0.81–2.13) and 1.86 (95% CI: 1.13–3.06) for the intermediate and high categories, respectively, versus the lowest category of baseline fast food consumption (p for linear trend: 0.007). Conclusion Our results suggest that pre-pregnancy higher consumption of fast food is an independent risk factor for gestational diabetes. PMID:25215961

  8. Fast food consumption and gestational diabetes incidence in the SUN project.

    Directory of Open Access Journals (Sweden)

    Ligia J Dominguez

    Full Text Available BACKGROUND: Gestational diabetes prevalence is increasing, mostly because obesity among women of reproductive age is continuously escalating. We aimed to investigate the incidence of gestational diabetes according to the consumption of fast food in a cohort of university graduates. METHODS: The prospective dynamic "Seguimiento Universidad de Navarra" (SUN cohort included data of 3,048 women initially free of diabetes or previous gestational diabetes who reported at least one pregnancy between December 1999 and March 2011. Fast food consumption was assessed through a validated 136-item semi-quantitative food frequency questionnaire. Fast food was defined as the consumption of hamburgers, sausages, and pizza. Three categories of fast food were established: low (0-3 servings/month, intermediate (>3 servings/month and ≤2 servings/week and high (>2 servings/week. Non-conditional logistic regression models were used to adjust for potential confounders. RESULTS: We identified 159 incident cases of gestational diabetes during follow-up. After adjusting for age, baseline body mass index, total energy intake, smoking, physical activity, family history of diabetes, cardiovascular disease/hypertension at baseline, parity, adherence to Mediterranean dietary pattern, alcohol intake, fiber intake, and sugar-sweetened soft drinks consumption, fast food consumption was significantly associated with a higher risk of incident gestational diabetes, with multivariate adjusted OR of 1.31 (95% conficence interval [CI]:0.81-2.13 and 1.86 (95% CI: 1.13-3.06 for the intermediate and high categories, respectively, versus the lowest category of baseline fast food consumption (p for linear trend: 0.007. CONCLUSION: Our results suggest that pre-pregnancy higher consumption of fast food is an independent risk factor for gestational diabetes.

  9. Fast food consumption and gestational diabetes incidence in the SUN project.

    Science.gov (United States)

    Dominguez, Ligia J; Martínez-González, Miguel A; Basterra-Gortari, Francisco Javier; Gea, Alfredo; Barbagallo, Mario; Bes-Rastrollo, Maira

    2014-01-01

    Gestational diabetes prevalence is increasing, mostly because obesity among women of reproductive age is continuously escalating. We aimed to investigate the incidence of gestational diabetes according to the consumption of fast food in a cohort of university graduates. The prospective dynamic "Seguimiento Universidad de Navarra" (SUN) cohort included data of 3,048 women initially free of diabetes or previous gestational diabetes who reported at least one pregnancy between December 1999 and March 2011. Fast food consumption was assessed through a validated 136-item semi-quantitative food frequency questionnaire. Fast food was defined as the consumption of hamburgers, sausages, and pizza. Three categories of fast food were established: low (0-3 servings/month), intermediate (>3 servings/month and ≤2 servings/week) and high (>2 servings/week). Non-conditional logistic regression models were used to adjust for potential confounders. We identified 159 incident cases of gestational diabetes during follow-up. After adjusting for age, baseline body mass index, total energy intake, smoking, physical activity, family history of diabetes, cardiovascular disease/hypertension at baseline, parity, adherence to Mediterranean dietary pattern, alcohol intake, fiber intake, and sugar-sweetened soft drinks consumption, fast food consumption was significantly associated with a higher risk of incident gestational diabetes, with multivariate adjusted OR of 1.31 (95% conficence interval [CI]:0.81-2.13) and 1.86 (95% CI: 1.13-3.06) for the intermediate and high categories, respectively, versus the lowest category of baseline fast food consumption (p for linear trend: 0.007). Our results suggest that pre-pregnancy higher consumption of fast food is an independent risk factor for gestational diabetes.

  10. Risk of Type 2 Diabetes Mellitus following Gestational Diabetes Pregnancy in Women with Polycystic Ovary Syndrome

    Directory of Open Access Journals (Sweden)

    Joan C. Lo

    2017-01-01

    Full Text Available Background. This study examines gestational diabetes mellitus (GDM in women with polycystic ovary syndrome (PCOS and the risk of type 2 diabetes mellitus (DM following GDM pregnancy. Methods. A cohort of 988 pregnant women with PCOS who delivered during 2002–2005 was examined to determine the prevalence and predictors of GDM, with follow-up through 2010 among those with GDM to estimate the risk of DM. Results. Of the 988 pregnant women with PCOS, 192 (19% developed GDM. Multivariable predictors of GDM included older age, Asian race, prepregnancy obesity, family history of DM, preconception metformin use, and multiple gestation. Among women with PCOS and GDM pregnancy, the incidence of DM was 2.8 (95% confidence interval (CI 1.9–4.2 per 100 person-years and substantially higher for those who received pharmacologic treatment for GDM (6.6 versus 1.5 per 100 person-years, p<0.01. The multivariable adjusted risk of DM was fourfold higher in women who received pharmacologic treatment for GDM (adjusted hazard ratio 4.1, 95% CI 1.8–9.6. The five-year incidence of DM was 13.1% overall and also higher in the pharmacologic treatment subgroup (27.0% versus 7.1%, p<0.01. Conclusions. The strongest predictors of GDM among women with PCOS included Asian race and prepregnancy obesity. Pharmacologic treatment of GDM is associated with fourfold higher risk of subsequent DM.

  11. Prevention of preterm delivery in twin gestations (PREDICT)

    DEFF Research Database (Denmark)

    Rode, L; Klein, K; Nicolaides, K H

    2011-01-01

    -blind, placebo-controlled randomized trial performed in 17 centers in Denmark and Austria. Women with twin gestations were randomized to daily treatment with progesterone pessaries or apparently identical placebo pessaries, starting from 20-24 weeks until 34 weeks' gestation. Primary outcome was incidence...

  12. The risk of postpartum maternal hyperglycaemia in women with gestational diabetes is reduced by breastfeeding

    LENUS (Irish Health Repository)

    O'Reilly, MW

    2011-09-01

    Background and aims: Gestational diabetes (GDM) is associated with adverse fetal and maternal outcomes. It identifies women at risk of pre-diabetes, type 2 diabetes (T2DM) and cardiovascular risk in later life. Recent studies have suggested that breastfeeding may confer a beneficial effect on postpartum maternal glucose tolerance in both women with GDM and normal glucose tolerance (NGT) in pregnancy.\\r\

  13. The role of gestational diabetes, pre-pregnancy body mass index and gestational weight gain on the risk of newborn macrosomia: results from a prospective multicentre study.

    Science.gov (United States)

    Alberico, Salvatore; Montico, Marcella; Barresi, Valentina; Monasta, Lorenzo; Businelli, Caterina; Soini, Valentina; Erenbourg, Anna; Ronfani, Luca; Maso, Gianpaolo

    2014-01-15

    It is crucial to identify in large population samples the most important determinants of excessive fetal growth. The aim of the study was to evaluate the independent role of pre-pregnancy body mass index (BMI), gestational weight gain and gestational diabetes on the risk of macrosomia. A prospective study collected data on mode of delivery and maternal/neonatal outcomes in eleven Hospitals in Italy. Multiple pregnancies and preterm deliveries were excluded. The sample included 14109 women with complete records. Associations between exposure variables and newborn macrosomia were analyzed using Pearson's chi squared test. Multiple logistic regression models were built to assess the independent association between potential predictors and macrosomia. Maternal obesity (adjusted OR 1.7, 95% CI 1.4-2.2), excessive gestational weight gain (adjusted OR 1.9, 95% CI 1.6-2.2) and diabetes (adjusted OR 2.1, 95% CI 1.5-3.0 for gestational; adjusted OR 3.0, 95% CI 1.2-7.6 for pre-gestational) resulted to be independent predictors of macrosomia, when adjusted for other recognized risk factors. Since no significant interaction was found between pre-gestational BMI and gestational weight gain, excessive weight gain should be considered an independent risk factor for macrosomia. In the sub-group of women affected by gestational or pre-gestational diabetes, pre-gestational BMI was not significantly associated to macrosomia, while excessive pregnancy weight gain, maternal height and gestational age at delivery were significantly associated. In this sub-population, pregnancy weight gain less than recommended was not significantly associated to a reduction in macrosomia. Our findings indicate that maternal obesity, gestational weight gain excess and diabetes should be considered as independent risk factors for newborn macrosomia. To adequately evaluate the clinical evolution of pregnancy all three variables need to be carefully assessed and monitored.

  14. Beneficial effects of omega-3 polyunsaturated Fatty acids in gestational diabetes: consequences in macrosomia and adulthood obesity.

    Science.gov (United States)

    Yessoufou, Akadiri; Nekoua, Magloire P; Gbankoto, Adam; Mashalla, Yohana; Moutairou, Kabirou

    2015-01-01

    Omega-3 polyunsaturated fatty acids (PUFAs) are increasingly being used to prevent cardiovascular diseases, including diabetes and obesity. In this paper, we report data on the observed effects of omega-3 PUFA on major metabolic disorders and immune system disruption during gestational diabetes and their consequences on macrosomia. While controversies still exist about omega-3 PUFA effects on antioxidant status regarding the level of omega-3 PUFA in diet supplementation, their lipid-lowering effects are unanimously recognized by researchers. Animal studies have shown that omega-3 PUFA contributes to the maintenance of the immune defense system by promoting the differentiation of T helper (Th) cell to a Th2 phenotype in diabetic pregnancy and by shifting the Th1/Th2 ratio from a deleterious proinflammatory Th1 phenotype to a protective anti-inflammatory Th2 phenotype in macrosomia and in adulthood obesity that results from macrosomia at birth. Based on the available evidence, international nutritional and food agencies recommend administration of omega-3 PUFA as triglyceride-lowering agents, for the prevention of cardiovascular disease risk and during human pregnancy and lactation. Furthermore, studies targeting humans are still required to explore application of the fatty acids as supplement in the management of gestational diabetes and inflammatory and immune diseases.

  15. Beneficial Effects of Omega-3 Polyunsaturated Fatty Acids in Gestational Diabetes: Consequences in Macrosomia and Adulthood Obesity

    Directory of Open Access Journals (Sweden)

    Akadiri Yessoufou

    2015-01-01

    Full Text Available Omega-3 polyunsaturated fatty acids (PUFAs are increasingly being used to prevent cardiovascular diseases, including diabetes and obesity. In this paper, we report data on the observed effects of omega-3 PUFA on major metabolic disorders and immune system disruption during gestational diabetes and their consequences on macrosomia. While controversies still exist about omega-3 PUFA effects on antioxidant status regarding the level of omega-3 PUFA in diet supplementation, their lipid-lowering effects are unanimously recognized by researchers. Animal studies have shown that omega-3 PUFA contributes to the maintenance of the immune defense system by promoting the differentiation of T helper (Th cell to a Th2 phenotype in diabetic pregnancy and by shifting the Th1/Th2 ratio from a deleterious proinflammatory Th1 phenotype to a protective anti-inflammatory Th2 phenotype in macrosomia and in adulthood obesity that results from macrosomia at birth. Based on the available evidence, international nutritional and food agencies recommend administration of omega-3 PUFA as triglyceride-lowering agents, for the prevention of cardiovascular disease risk and during human pregnancy and lactation. Furthermore, studies targeting humans are still required to explore application of the fatty acids as supplement in the management of gestational diabetes and inflammatory and immune diseases.

  16. Results From a European Multicenter Randomized Trial of Physical Activity and/or Healthy Eating to Reduce the Risk of Gestational Diabetes Mellitus: The DALI Lifestyle Pilot

    NARCIS (Netherlands)

    Simmons, D.; Jelsma, J.G.M.; Galjaard, S.; Devlieger, R.; van Assche, A.; Jans, G.; Corcoy, R.; Adelantado, J.M.; Dunne, F.; Desoye, G.; Harreiter, J.; Kautzky-Willer, A.; Damm, P.; Mathiesen, E.R.; Jensen, D.M.; Andersen, L.L.; Lapolla, A.; Dalfra, M.; Bertolotto, A.; Wender-Ozegowska, E.; Zawiejska, A.; Hill, D.; Rebollo, P.; Snoek, F.J.; van Poppel, M.N.M.

    2015-01-01

    OBJECTIVE Ways to prevent gestational diabetes mellitus (GDM) remain unproven. We compared the impact of three lifestyle interventions (healthy eating [HE], physical activity [PA], and both HE and PA [HE+PA]) on GDM risk in a pilot multicenter randomized trial. RESEARCH DESIGN AND METHODS Pregnant

  17. Second trimester amniotic fluid myo-inositol concentrations in women later developing gestational diabetes mellitus or pregnancy-induced hypertension.

    Science.gov (United States)

    Santamaria, Angelo; Corrado, Francesco; Baviera, Giovanni; Carlomagno, Gianfranco; Unfer, Vittorio; D'anna, Rosario

    2016-01-01

    To evaluate myo-inositol concentrations in amniotic fluid in women later developing gestational diabetes and hypertension. A retrospective study was carried out with three groups of amniotic fluid samples (15-18 gestational weeks): 30 gestational hypertension pregnancies, 30 gestational diabetes pregnancies, and 30 normal pregnancy. A significant difference was observed in myo-inositol concentrations between the median gestational diabetes values (124.0 µmol/L, IQR 90.0-162.5) and the control group values (79.0 µmol/L, IQR 62.0-107.5), but also with gestational hypertension median values (79.0 µmol/L, IQR 67.75-92.0) (p inositol concentrations in amniotic fluid increased significantly in women later developing gestational diabetes compared to the control group.

  18. High Fasting Plasma Glucose during Early Pregnancy: A Review about Early Gestational Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    E. Cosson

    2017-01-01

    Full Text Available Fasting plasma glucose (FPG is nowadays routinely measured during early pregnancy to detect preexisting diabetes (FPG ≥ 7 mmol/L. This screening has concomitantly led to identify early intermediate hyperglycemia, defined as FPG in the 5.1 to 6.9 mmol/L range, also early gestational diabetes mellitus (eGDM. Early FPG has been associated with poor pregnancy outcomes, but the recommendation by the IADPSG to refer women with eGDM for immediate management is more pragmatic than evidence based. Although eGDM is characterized by insulin resistance and associated with classical risk factors for type 2 diabetes and incident diabetes after delivery, it is not necessarily associated with preexisting prediabetes. FPG ≥ 5.1 mmol/L in early pregnancy is actually poorly predictive of gestational diabetes mellitus diagnosed after 24 weeks of gestation. An alternative threshold should be determined but may vary according to ethnicity, gestational age, and body mass index. Finally, observational data suggest that early management of intermediate hyperglycemia may improve prognosis, through reduced gestational weight gain and potential early introduction of hypoglycemic agents. Considering all these issues, we suggest an algorithm for the management of eGDM based on early FPG levels that would be measured in case of risk factors. Nevertheless, interventional randomized trials are still missing.

  19. Comparison of Serum Homocystein and Folic Acid Levels in Gestational Diabetes with Normal Pregnancy

    Directory of Open Access Journals (Sweden)

    F. Movahed

    2015-07-01

    Full Text Available Introduction & Objective: High levels of homocystein are a risk factor for insulin resistance, diabetes mellitus and cardio-vascular complications. This study was done to assess serum homocystein and folic acid levels and their relationship in women with gestational diabetes and compare them with normal pregnant women. Materials & Methods: This analytic epidemiologic case-control study was performed in Qazvin Kosar hospital in 2013-2015. 120 singleton pregnant women with 24-28 weeks of gestation according to 2-hour 75g oral glucose tolerance test were assigned to two groups; gestational diabetes (n=60, and normal pregnancy (n=60. Serum homocystein and folic acid levels were measured in two groups. Data were analyzed with statistical t-test and correlation method. Results: In gestational diabetes serum homocystein level was significantly higher (P<0.001 and folic acid was significantly lower (P<0.001 than normal pregnancy group .No relation-ship was observed between serum homocystein and serum folate. In both groups, serum folic acid was significantly related to fasting blood sugar. This relationship was inverse in gesta-tional diabetes group (P<0.001, r = - 0.512 and direct in normal pregnancy group (P=0.001 r =0.417. Conclusion: It seems folic acid has a role in regulation of serum homocystein level and blood sugar.(Sci J Hamadan Univ Med Sci 2015; 22 (2: 93-98

  20. High prevalence of type 2 diabetes and pre-diabetes in adult offspring of women with gestational diabetes mellitus or type 1 diabetes: the role of intrauterine hyperglycemia

    DEFF Research Database (Denmark)

    Clausen, Tine D; Mathiesen, Elisabeth R; Hansen, Torben

    2008-01-01

    OBJECTIVE: The role of intrauterine hyperglycemia and future risk of type 2 diabetes in human offspring is debated. We studied glucose tolerance in adult offspring of women with either gestational diabetes mellitus (GDM) or type 1 diabetes, taking the impact of both intrauterine hyperglycemia...... glucose metabolism during pregnancy and genetic predisposition to type 2 diabetes: 1) offspring of women with diet-treated GDM (O-GDM), 2) offspring of genetically predisposed women with a normal OGTT (O-NoGDM), 3) offspring of women with type 1 diabetes (O-type 1), and 4) offspring of women from...... intrauterine environment appears to be involved in the pathogenesis of type 2 diabetes/pre-diabetes in adult offspring of primarily Caucasian women with either diet-treated GDM or type 1 diabetes during pregnancy...

  1. Maternal Lipids May Predict Fetal Growth in Type 2 Diabetes Mellitus and Gestational Diabetes Mellitus Pregnancies.

    Science.gov (United States)

    Krstevska, Brankica; Jovanovska, Sasha Misevska; Krstevska, Slagjana Simeonova; Nakova, Valentina Velkoska; Serafimoski, Vladimir

    2016-11-01

    During diabetic pregnancy, complex metabolic changes occur in the lipid profile. The aim of the study was to determine the predictive values of maternal serum lipid levels on large-for-gestational age newborns during the third trimester in pregnancies of women with type 2 diabetes mellitus (DM2) and gestational diabetes mellitus (GDM). Data of forty three pregnancies of women with DM2 and two hundred women with GDM were analyzed. The analysis encompassed the following parameters: age, body mass index (BMI), lipid parameters, HbA1c in first, second and third trimester of pregnancy, preeclampsia and baby birth weight. DM2 and GDM groups showed statistically significant differences in the following variables: total lipids, triglycerides, total cholesterol, BMI, age, baby birth weight, incidence of SGA and preterm delivery (9.4 ± 2.3 vs. 11.0 ± 2.3 mmol/L, 2.4 ± 1.4 vs. 3.4 ± 1.6 mmol/L, 5.5 ± 1.2 vs. 6.4 ± 1.4 mmol/L, 30.6 ± 5.4 vs. 26.9 ± 5.2 kg/m2, 34 ± 7.8 vs. 31.5 ± 5.6 years, 3183 ± 972 vs. 3533 ± 699 g., 20% vs. 7.5%, 27.9 vs. 14%, respectively, p DM2 and GDM pregnancies. Thus, the maternal serum triglycerides and LDL-C levels determined in the maternal blood taken in the third trimester of pregnancy may indentify women who will give birth to LGA newborns.

  2. Pre-Pregnancy Fast Food Consumption Is Associated with Gestational Diabetes Mellitus among Tehranian Women

    OpenAIRE

    Lamyian, Minoor; Hosseinpour-Niazi, Somayeh; Mirmiran, Parvin; Moghaddam Banaem, Lida; Goshtasebi, Azita; Azizi, Fereidoun

    2017-01-01

    The aim of this study was to evaluate the association between fast food consumption and gestational diabetes mellitus (GDM) among Tehranian women. This study was conducted over a 17-month period, on a random sample of pregnant women (n = 1026), aged 18–45 years, attending prenatal clinics in five hospitals affiliated with universities of medical sciences, located in different districts of Tehran, Iran. Dietary data were collected during gestational age ≤6 weeks, using a 168-item valid and rel...

  3. Gestational diabetes: should it be added to the syndrome of insulin resistance?

    Science.gov (United States)

    Clark, C M; Qiu, C; Amerman, B; Porter, B; Fineberg, N; Aldasouqi, S; Golichowski, A

    1997-05-01

    The significance of gestational diabetes mellitus (GDM) results from its short-term detrimental effects on the fetus and its long-term prediction of NIDDM in the mother. We compared several variables associated with insulin resistance between GDM and non-GDM pregnant women to show the similarities between GDM and NIDDM (and thus insulin resistance). On the basis of a 3-h oral glucose tolerance test (OGTT), 52 GDM patients and 127 non-GDM patients were recruited from pregnant, non-diabetic women who had a nonfasting 1-h-50-g glucose screening test > or = 7.2 mmol/l (130 mg/dl) performed between 16 and 33 weeks of gestation (a total of 518 of 3,041 women drawn from six community health care prenatal clinics were screened positive). During the OGTT, several potential markers of insulin resistance were measured at fasting and 2-h time points, in addition to the standard glucose measurements. The relationship of these variables with the diagnosis of GDM was studied. GDM patients, compared with non-GDM patients, had 1) higher prepregnancy weight (P = 0.011), prepregnancy BMI (P = 0.006), C-peptide at fasting (P = 0.002) and at 2 h (P women with GDM did not differ significantly from those without GDM. Our results show that many of the known metabolic components of the syndrome of insulin resistance (syndrome X) are predictive of GDM. These results are in keeping with the argument that GDM is one phase of the syndrome of insulin resistance. We suggest that GDM be looked upon as a component of the syndrome of insulin resistance that provides an excellent model for the study and prevention of NIDDM in a relatively young age-group.

  4. Preventing Vision Loss in Diabetes - Summary

    Centers for Disease Control (CDC) Podcasts

    2008-04-24

    This podcast is for a professional audience and briefly discusses how to prevent vision loss in people with diabetes.  Created: 4/24/2008 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Diabetes Translation (DDT), National Diabetes Education Program (NDEP).   Date Released: 6/4/2008.

  5. Incidence and Contributing Factors of Persistent Hyperglycemia at 6?12 Weeks Postpartum in Iranian Women with Gestational Diabetes: Results from LAGA Cohort Study

    OpenAIRE

    Nouhjah, Sedigheh; Shahbazian, Hajieh; Shahbazian, Nahid; Jahanshahi, Alireza; Jahanfar, Shayesteh; Cheraghian, Bahman

    2017-01-01

    Background. A history of gestational diabetes is an important predictor of many metabolic disturbances later in life. Method. Life after gestational diabetes Ahvaz Study (LAGAs) is an ongoing population-based cohort study. Up to February 2016, 176 women with gestational diabetes underwent a 75 g oral glucose tolerance test (OGTT) at 6–12 weeks postpartum in Ahvaz (southwestern of Iran). Gestational diabetes was diagnosed according to the International Association of Diabetes and Pregnancy Stu...

  6. Proposed diagnostic thresholds for gestational diabetes mellitus according to a 75-g oral glucose tolerance test

    DEFF Research Database (Denmark)

    Jensen, Dorte Møller; Damm, P; Sørensen, B

    2003-01-01

    AIMS: To study if established diagnostic threshold values for gestational diabetes based on a 75-g, 2-h oral glucose tolerance test can be supported by maternal and perinatal outcomes. METHODS: Historical cohort study of 3260 pregnant women examined for gestational diabetes on the basis of risk....../l than in women with 2-h glucose of 9.0-11.0 mmol/l. CONCLUSIONS: The risk for several maternal and perinatal complications increased with the diagnostic threshold for 2-h glucose. Large-scale blinded studies are needed to clarify the question of a clinically meaningful diagnosis of gestational diabetes...... mellitus. Until these results are available, a 2-h threshold level of 9.0 mmol/l after a 75-g oral glucose tolerance test seems acceptable....

  7. A Predictive Metabolic Signature for the Transition From Gestational Diabetes Mellitus to Type 2 Diabetes

    DEFF Research Database (Denmark)

    Allalou, Amina; Nalla, Amarnadh; Prentice, Kacey J

    2016-01-01

    Gestational diabetes mellitus (GDM) affects 3-14% of pregnancies, with 20-50% of these women progressing to type 2 diabetes (T2D) within 5 years. This study sought to develop a metabolomics signature to predict the transition from GDM to T2D. A prospective cohort of 1,035 women with GDM pregnancy...... with a discriminative power of 83.0% in the training set and 76.9% in an independent testing set, which is far superior to measuring fasting plasma glucose levels alone. The American Diabetes Association recommends T2D screening in the early postpartum period via oral glucose tolerance testing after GDM, which...... were enrolled at 6-9 weeks postpartum (baseline) and were screened for T2D annually for 2 years. Of 1,010 women without T2D at baseline, 113 progressed to T2D within 2 years. T2D developed in another 17 women between 2 and 4 years. A nested case-control design used 122 incident case patients matched...

  8. The Association Between Physical Activity During Pregnancy and Gestational Diabetes Mellitus: A Case-Control Study.

    Science.gov (United States)

    Nasiri-Amiri, Fatemeh; Bakhtiari, Afsaneh; Faramarzi, Mahbobeh; Adib Rad, Hajar; Pasha, Hajar

    2016-07-01

    Gestational diabetes mellitus is one of the most common complications of pregnancy. Physical activity is associated with a lower risk of type 2 diabetes mellitus. A recent meta-analysis study suggested that more research is needed to investigate the type, duration and intensity of physical activity that can help to reduce the risk of gestational diabetes mellitus. The present study aimed to understand the association between physical activity and gestational diabetes mellitus through comparing the type and intensity of physical activity performed by pregnant females with gestational diabetes and healthy pregnant females in the first 20 weeks of their pregnancy. In the current case-control study, 100 pregnant females with gestational diabetes mellitus as the case group and 100 pregnant females as the non-diabetic control group were recruited. The age range of the participants was 18 - 40 years with the gestation of 20 - 28 weeks. To diagnose gestational diabetes mellitus using the criteria introduced by carpenter and coustan females with abnormal glucose challenge test (> 140 mg/dL) were asked to perform the three-hour 100 g oral glucose tolerance test. The details of physical activity were collected by a modified version of the pregnancy physical activity questionnaire. Anthropometric and relevant data were recorded for all of the participants. Data were analyzed by SPSS version 21. Risk estimates were obtained by logistic regression and adjusted for confounders. Females who had low total physical activity according to the pregnancy physical activity questionnaire during early pregnancy were at a significantly higher risk of developing gestational diabetes mellitus (OR = 4.12, 95% CI (2.28 - 7.43), P = 0.001) compared to the ones who reported higher levels of physical activity. Moreover, after adjusting for age, body mass index (BMI), gravidity and a family history of diabetes, females with low physical activity in the domain of transportation activity during 20

  9. Macrosomia Predictors in Infants Born to Cuban Mothers with Gestational Diabetes.

    Science.gov (United States)

    Cruz, Jeddú; Grandía, Raiden; Padilla, Liset; Rodríguez, Suilbert; Hernández García, Pilar; Lang Prieto, Jacinto; Márquez-Guillén, Antonio

    2015-07-01

    INTRODUCTION Fetal macrosomia is the most important complication in infants of women with diabetes, whether preconceptional or gestational. Its occurrence is related to certain maternal and fetal conditions and negatively affects maternal and perinatal outcomes. The definitive diagnosis is made at birth if a newborn weighs >4000 g. OBJECTIVE Identify which maternal and fetal conditions could be macrosomia predictors in infants born to Cuban mothers with gestational diabetes. METHODS A case-control study comprising 236 women with gestational diabetes who bore live infants (118 with macrosomia and 118 without) was conducted in the América Arias University Maternity Hospital, Havana, Cuba, during 2002-2012. The dependent variable was macrosomia (birth weight >4000 g). Independent maternal variables included body mass index at pregnancy onset, overweight or obesity at pregnancy onset, gestational age at diabetes diagnosis, pregnancy weight gain, glycemic control, triglycerides and cholesterol. Fetal variables examined included third-semester fetal abdominal circumference, estimated fetal weight at ≥28 weeks (absolute and percentilized by Campbell and Wilkin, and Usher and McLean curves). Chi square was used to compare continuous variables (proportions) and the student t test (X ± SD) for categorical variables, with significance threshold set at p macrosomia were for maternal hypertriglyceridemia (OR 4.80, CI 2.34-9.84), third-trimester fetal abdominal circumference >75th percentile (OR 7.54, CI 4.04-14.06), and estimated fetal weight >90th percentile by Campbell and Wilkin curves (OR 4.75, CI 1.42-15.84) and by Usher and McLean curves (OR 8.81, CI 4.25-18.26). CONCLUSIONS Most variables assessed were predictors of macrosomia in infants of mothers with gestational diabetes. They should therefore be taken into account for future studies and for patient management. Wide confidence intervals indicate uncertainty about the magnitude of predictive power. KEYWORDS Fetal

  10. [Risk factors for fetal macrosomia in patients without gestational diabetes mellitus].

    Science.gov (United States)

    García-De la Torre, J I; Rodríguez-Valdez, A; Delgado-Rosas, A

    2016-03-01

    Fetal macrosomia is birth weight of 4,000 grams or more, regardless of gestational age, in Mexico representing about 5.4%. Associated with multiple demographic, physiological, metabolic and genetic factors of each population. Determine the risk factors associated with the development of fetal macrosomia in patients without gestational diabetes mellitus. Retrospective, descriptive and comparative study of patients who came to delivery from January 2012 to June 2014, 88 patients, 23 patients with diagnosis of macrosomia, and 65 patients without macrosomia without gestational diabetes mellitus were included. An incidence of fetal macrosomia of 18.6%. Risk factors such as parity, history of fetal macrosomia, maternal age, maternal height more to 1.70 meters showed no difference, the percentage of overweight 105% showed 69% vs 52% on the control group and gestational diabetes screening altered that present 30.4 vs 20%. Increased incidence of macrosomia was demonstrated in patients with metabolic factors such as the percentage of overweight and screening altered gestational diabetes mellitus, as they showed higher prevalence in the study group, all modifiable with preconception nutritional management and during pregnancy, to reduce initial weight and weight gain, improved fasting and postprandial blood glucose in patients with positive screening and negative tolerance curve carbohydrates to maintain fetal growth curve with in the percentiles.

  11. Screening for gestational diabetes mellitus by a model based on risk indicators

    DEFF Research Database (Denmark)

    Jensen, Dorte Møller; Mølsted-Pedersen, Lars; Beck-Nielsen, Henning

    2003-01-01

    OBJECTIVE: This study was performed to prospectively evaluate a screening model for gestational diabetes mellitus on the basis of clinical risk indicators. STUDY DESIGN: In a prospective multicenter study with 5235 consecutive pregnant women, diagnostic testing with a 2-hour 75-g oral glucose...... of the results from tested women to the whole group in question, a 2.4% prevalence of gestational diabetes mellitus was calculated. Sensitivity and specificity of the model was 80.6 (73.7-87.6) and 64.8 (63.5-66.1), respectively (95% CIs). CONCLUSION: Under ideal conditions, sensitivity of the model...

  12. Prediction of Gestational Diabetes by Measuring First Trimester ...

    African Journals Online (AJOL)

    Between 24 and 28 weeks' gestation random blood sugar and glucose challenge test were done. Positive cases were confirmed by 3 h glucose tolerance curve. Results: The results demonstrated an association between first trimester maternal serum uric acid concentration obesity and GDM. Approximately, 41.4% (60/145) ...

  13. Dietary self-efficacy predicts AHEI diet quality in women with previous gestational diabetes.

    Science.gov (United States)

    Ferranti, Erin Poe; Narayan, K M Venkat; Reilly, Carolyn M; Foster, Jennifer; McCullough, Marjorie; Ziegler, Thomas R; Guo, Ying; Dunbar, Sandra B

    2014-01-01

    The purpose of this study was to examine the association of intrapersonal influences of diet quality as defined by the Health Belief Model constructs in women with recent histories of gestational diabetes. A descriptive, correlational, cross-sectional design was used to analyze relationships between diet quality and intrapersonal variables, including perceptions of threat of type 2 diabetes mellitus development, benefits and barriers of healthy eating, and dietary self-efficacy, in a convenience sample of 75 community-dwelling women (55% minority; mean age, 35.5 years; SD, 5.5 years) with previous gestational diabetes mellitus. Diet quality was defined by the Alternative Healthy Eating Index (AHEI). Multiple regression was used to identify predictors of AHEI diet quality. Women had moderate AHEI diet quality (mean score, 47.6; SD, 14.3). Only higher levels of education and self-efficacy significantly predicted better AHEI diet quality, controlling for other contributing variables. There is a significant opportunity to improve diet quality in women with previous gestational diabetes mellitus. Improving self-efficacy may be an important component to include in nutrition interventions. In addition to identifying other important individual components, future studies of diet quality in women with previous gestational diabetes mellitus are needed to investigate the scope of influence beyond the individual to potential family, social, and environmental factors. © 2014 The Author(s).

  14. Metformin vs insulin in the management of gestational diabetes: a systematic review and meta-analysis.

    Science.gov (United States)

    Su, D F; Wang, X Y

    2014-06-01

    To evaluate the effectiveness of metformin compared with insulin in achieving glycemic control and investigate the maternal and neonatal outcomes in gestational diabetes mellitus. We searched four electronic databases from inception through December 2012. Terms for Gestational diabetes/gestational diabetes mellitus/diabetes pregnancy AND/OR Metformin/hypoglycemic drugs/Hypoglycemic Agents/Antidiabetic Medications were used in the search. Two investigators independently reviewed titles and abstracts, performed data abstraction on full articles, and assessed study quality. Meanwhile, manual search of other resources and the search on Google Scholar were also carried out to identify more related articles .Rev Man 5.0 was used to analyze the data. Six randomized clinical trials involving 1420 subjects were included. The current limited data suggested that using metformin in gestational diabetes subjects did not significantly increase adverse maternal outcomes and neonatal outcomes, also with less weight gain and neonatal hypoglycemia, but a higher incidence of premature birth. Metformin will not increase the incidence of adverse maternal outcomes and neonatal outcomes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  15. Intergenerational transmission of macrosomia in women with gestational diabetes and normal glucose tolerance.

    Science.gov (United States)

    Ogonowski, J; Miazgowski, T

    2015-12-01

    It has been suggested that neonatal macrosomia may contribute to increased risk of obesity and type 2 diabetes in later life. Much less is known about the association between maternal birth weight (MBW) and offspring birth weight (OBW). This retrospective study evaluated the prevalence of macrosomia in women with treated gestational diabetes mellitus (GDM) and normal glucose tolerance during pregnancy. The study also investigated associations between MBW and OBW. Medical records of 519 pregnant women with treated GDM and 766 women with normal glucose tolerance, referred to the Gestational Diabetes Outpatient Clinic in Szczecin, Poland, were analyzed. The following data were assessed: maternal age, pregravid body weight, height, gestational weight gain, prior GDM, prior macrosomia, MBW and OBW. Birth weight was classified as small for gestational age (SGA), appropriate for gestational age (AGA), large for gestational age (LGA) and macrosomia (≥4000g). OBW was obtained from birth certificates, and MBW was obtained from birth certificates or self-report. The overall prevalence of macrosomia was 8.1%, and was comparable in subgroups of women with and without GDM (7.7% and 8.4%, respectively; p=0.905). The frequencies of SGA, AGA and LGA did not differ between study groups. A positive correlation was found between MBW and OBW in women with treated GDM (r=0.211, pmacrosomia in offspring [odds ratio (OR) 1.64, 95% confidence interval (CI) 1.15-2.36 in women with treated GDM; OR 1.35, 95% CI 1.07-1.76 in women with normal glucose tolerance). Other independent predictors of fetal macrosomia were gestational weight gain, prior macrosomia and pregravid body mass index (BMI). MBW, prior macrosomia, pregravid BMI and gestational weight gain were predictors of macrosomia in offspring, but GDM was not. High MBW seems to contribute to intergenerational transmission of macrosomia. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. Insulin aspart in patients with gestational diabetes mellitus and pregestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    M C Deepaklal

    2015-01-01

    Full Text Available Aims: This study was undertaken to assess the effectiveness and safety of insulin aspart in patients with gestational and pregestational diabetes. Settings and Design: An open-label, prospective, nonrandomized, comparative, and observational study conducted at single center in India. Subjects and Methods: A total of 276 patients were in gestational diabetes mellitus (GDM group, 79 were in the pre-GDM group. Patients were started on insulin therapy (insulin aspart ± neutral protamine hagedorn once medical nutrition therapy for 2 weeks failed to achieve control, that is., fasting plasma glucose ≥90 mg/dL and/or 1.0 h postprandial plasma glucose ≥130 mg/dL. Insulin dose was titrated to keep the blood glucose values between 90 and 130 mg/dL. Patients were followed once every 4 weeks until the 28 th week, then once every 2 weeks until 32 nd week, then once every week until delivery, and the final visit was on 60 ± 7 days. The final outcome was assessed in terms of incidence of macrosomia (>3.5 kg body weight between the two groups and episodes of confirmed (blood glucose <56 mg/dL minor or major maternal hypoglycemia. Results: There was no statistically significant difference among the two groups in terms of incidence of macrosomia that is., it was 5.1%, 8.9% in GDM, pre-GDM group, respectively. Conclusions: Insulin aspart was found safe in pregnancy, however, more studies with double-blind, standard controlled studies are required to confirm the findings of this study.

  17. Random plasma glucose in early pregnancy is a better predictor of gestational diabetes diagnosis than maternal obesity

    OpenAIRE

    Meek, Claire L.; Murphy, Helen R.; Simmons, David

    2015-01-01

    AIMS: Asymptomatic pregnant women are screened for Gestational Diabetes (GDM) between 24-28 weeks gestation. Recent guidelines also recommend screening early in gestation to identify undiagnosed pre-existing overt diabetes. We assessed the performance of random plasma glucose (RPG) at antenatal booking to predict GDM diagnosis later in pregnancy. METHODS: Data from 25543 consecutive singleton pregnancies at the Rosie hospital in Cambridge (UK) were obtained from hospital electron...

  18. The prevalence and risk factors for gestational diabetes and ...

    African Journals Online (AJOL)

    Objectives: To determine the common diabetes risk factors (or OGTT; the prevalence of GDM; and the maternal and perinatal outcomes of GDM pregnancies in a Nigerian urban antenatal population. Patients and Methods: A retrospective study of pregnant women, who attended antenatal clinic, screened for diabetes ...

  19. Gestational Diabetes Mellitus: a review of the diagnosis, clinical implications and management

    OpenAIRE

    Wong, Vincent Wing-Ming

    2013-01-01

    Gestational diabetes mellitus (GDM) is a condition that affects the wellbeing of mother and fetus. Women with GDM are at risk of type 2 diabetes mellitus in the future, while fetal exposure to hyperglycaemia in-utero may affect their glycometabolic profile later in life. Appropriate screening and management of this problem is important in ensuring good pregnancy outcomes. In this review, the clinical implications, the various ways to screen and diagnose GDM, and management strategies d...

  20. Gestational diabetes mellitus: the effects of diagnosis time and implementation of diabetic care on management of glycemia

    OpenAIRE

    Andrzej Gruszka; Olga Adamczyk-Gruszka; Izabela Lewandowska-Andruszuk; Marzena Siennicka; Jakub Gruszka

    2014-01-01

    Introduction : Pregnancy is considered diabetogenic condition related to increased requirements for insulin, its increased secretion and ongoing insulin resistance. In pregnancy increased insulin secretion cannot compensate increased requirements which leads to gestational diabetes mellitus (GDM). If diagnosed too late or ill-treated diabetes can cause serious complications in the course of pregnancy and delivery as well as late complications in neonate. Aim of the research: To assess i...

  1. [Gestational diabetes mellitus: data from outpatient department for women for years 1994-1998].

    Science.gov (United States)

    Kanadys, W M; Oleszczuk, J

    1999-10-01

    This study was undertaken to determine the incidence of gestational diabetes mellitus. This study involved analysis of data collected prospectively from a cohort of women who received prenatal care from Outpatient Department for Women, from 1994 to 1998. The population consisted of 1017 pregnant women. It is a group of patients living mainly in geographical area, including Czechów district in Lublin. Therefore, it represents quantitative relations characteristics in natural conditions of the place of residence of a larger group of municipality population. Glucose challenge test (GCT) according to indications of Experts Team of Polish Diabetologic Society in early diagnostics of gestational diabetes melitus--a 50-g loading dose of glucose and 1-h test was considered abnormal if value was 140 mg/dl (7.8 mmol/L). Patients with abnormal GCT underwent an oral glucose tolerance test (GTT) according to criteria the World Health Organization, e.g., venous plasma glucose 2 h after 75 g oral glucose load > 140 mg/dl (7.8 mmol/L). From patients screened for GDM between 24 and 28 wk gestation, 59 (5.8%) showed an abnormal GCT and from these 18 (1.8%) had an abnormal GTT. The testing sequence was repeated in 32 wk gestation among patients with normal GTT after an abnormal GCT and 1 had abnormal GTT. Incidence of gestational diabetes mellitus is shown to be 1.9%.

  2. Influence of food intake on the predictive value of the gestational diabetes mellitus screening test.

    Science.gov (United States)

    Wang, Panchalli; Lu, Mei-Chun; Yu, Cheng-Wei; Wang, Li-Chu; Yan, Yuan-Horng

    2013-04-01

    To investigate the influence of prior food ingestion on the predictive value of a screening test for gestational diabetes mellitus. This prospective, nonrandomized study enrolled 1,387 pregnant women who underwent the 50-g glucose challenge test. Gestational diabetes mellitus was diagnosed according to the National Diabetes Data Group criteria. A nutritional survey of dietary information before the glucose challenge test was conducted. The patients were stratified into three groups based on the time of last food ingestion (fasting interval): 1 hour or less, 1-2 hours, and more than 2 hours. The more than 2-hours fasting interval group was defined as the "fasting" group, and the combined 1 hour or less and 1-2 hours fasting interval groups were defined as the "fed" group. We calculated the positivity rate and the positive predictive value to detect the predictive value. Among women who fasted 1 hour or less, 1-2 hours, and more than 2 hours before a glucose challenge test, 2.5%, 3.1%, and 6.9% were diagnosed with gestational diabetes mellitus, respectively. The positive predictive value of the glucose challenge test was greater in the fasting group than in the fed group (27.1% compared with 13.7%, P=.003). A multinomial logistic analysis showed that gestational diabetes mellitus was more prevalent in the fasting group than in the fed group (adjusted odds ratio 2.86, 95% confidence interval 1.65-4.95). Our findings suggest that food intake influences the predictive value of the gestational diabetes screening test. II.

  3. Metformin versus Insulin in the Management of Pre-Gestational Diabetes Mellitus in Pregnancy and Gestational Diabetes Mellitus at the Korle Bu Teaching Hospital: A Randomized Clinical Trial.

    Science.gov (United States)

    Beyuo, Titus; Obed, Samuel Amenyi; Adjepong-Yamoah, Kenneth Kweku; Bugyei, Kwasi Agyei; Oppong, Samuel Antwi; Marfoh, Kissinger

    2015-01-01

    To determine if metformin monotherapy or metformin in combination with insulin is equally effective as insulin monotherapy at glycemic control in diabetes mellitus in pregnancy among Ghanaians. This was a study involving 104 pregnant women with type 2 diabetes mellitus (T2DM) or gestational diabetes mellitus (GDM) at 20-30 weeks gestation. Participants were randomized into metformin and insulin treatment groups. Starting dose of metformin was 500 mg once a day and increased gradually over two (2) weeks, to meet glycemic targets. Insulin was added if targets could not be reached on metformin alone at maximum doses. Total daily dose of premixed insulin at initiation was calculated as 0.3 IU/kg body weight and titrated upwards to achieve glycemic control. Glycemic profile monitoring was done every two weeks. The two hour post prandial blood glucose (2HPG) levels were significantly lower in the metformin group than the insulin group (p= 0.004). The findings of this study suggest that metformin monotherapy is effective in achieving glycemic targets in the management of diabetes in pregnancy. It is more effective than insulin in lowering the 2HPG level. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12614000942651.

  4. Metformin versus Insulin in the Management of Pre-Gestational Diabetes Mellitus in Pregnancy and Gestational Diabetes Mellitus at the Korle Bu Teaching Hospital: A Randomized Clinical Trial.

    Directory of Open Access Journals (Sweden)

    Titus Beyuo

    Full Text Available To determine if metformin monotherapy or metformin in combination with insulin is equally effective as insulin monotherapy at glycemic control in diabetes mellitus in pregnancy among Ghanaians.This was a study involving 104 pregnant women with type 2 diabetes mellitus (T2DM or gestational diabetes mellitus (GDM at 20-30 weeks gestation. Participants were randomized into metformin and insulin treatment groups. Starting dose of metformin was 500 mg once a day and increased gradually over two (2 weeks, to meet glycemic targets. Insulin was added if targets could not be reached on metformin alone at maximum doses. Total daily dose of premixed insulin at initiation was calculated as 0.3 IU/kg body weight and titrated upwards to achieve glycemic control. Glycemic profile monitoring was done every two weeks.The two hour post prandial blood glucose (2HPG levels were significantly lower in the metformin group than the insulin group (p= 0.004.The findings of this study suggest that metformin monotherapy is effective in achieving glycemic targets in the management of diabetes in pregnancy. It is more effective than insulin in lowering the 2HPG level.Australian New Zealand Clinical Trials Registry (ANZCTR ACTRN12614000942651.

  5. The benefit of early treatment without rescreening in women with a history of gestational diabetes.

    LENUS (Irish Health Repository)

    Maher, Nicola

    2013-02-01

    In this center, women with a history of gestational diabetes (GDM) are treated without rescreening from early pregnancy in any subsequent pregnancies, commencing with a low glycemic diet and insulin if and when indicated. The objective of this study was to see if this practice reduced the incidence of macrosomia compared with the index pregnancy.

  6. Risk stratification for healthcare planning in women with gestational diabetes mellitus

    NARCIS (Netherlands)

    Koning, S. H.; Scheuneman, K. A.; Lutgers, H. L.; Korteweg, F. J.; van den Berg, G.; Sollie, K. M.; Roos, A.; van Loon, A. J.; Links, T. P.; van Tol, K. M.; Hoogenberg, K.; Berg, van den Paul; Wolffenbuttel, B. H. R.

    Background: To identify relevant factors predicting the need for insulin therapy in women with gestational diabetes mellitus (GDM) and secondly to determine a potential 'low-risk' diet-treated group who are likely to have good pregnancy outcomes. Methods: A retrospective analysis between 2011-2014.

  7. Reduced postprandial GLP-1 responses in women with gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Bonde, L; Vilsbøll, T; Nielsen, T

    2013-01-01

    AIM: We investigated postprandial glucagon-like peptide-1 (GLP-1) responses in pregnant women with and without gestational diabetes mellitus (GDM) and again following delivery when normal glucose tolerance (NGT) was re-established. METHODS: Eleven women with GDM [plasma glucose (PG) concentration...

  8. Parental smoking during pregnancy and the risk of gestational diabetes in the daughter

    DEFF Research Database (Denmark)

    Bao, Wei; Michels, Karin B; Tobias, Deirdre K

    2016-01-01

    BACKGROUND: Fetal exposure to parental smoking may have long-term impact on the development of disease in adulthood. We examined the association of parental smoking during pregnancy with risk of gestational diabetes mellitus (GDM) in the daughter. METHODS: We included 15,665 singleton pregnancies...

  9. Glucose challenge test for detecting gestational diabetes mellitus: a systematic review

    NARCIS (Netherlands)

    van Leeuwen, M.; Louwerse, M. D.; Opmeer, B. C.; Limpens, J.; Serlie, M. J.; Reitsma, J. B.; Mol, B. W. J.

    2012-01-01

    Background The best strategy to identify women with gestational diabetes mellitus (GDM) is unclear. Objectives To perform a systematic review to calculate summary estimates of the sensitivity and specificity of the 50-g glucose challenge test for GDM. Search strategy Systematic search of MEDLINE,

  10. Clinical significance of DVM and its prevalence in pre-gestational diabetes cases versus normal pregnancies

    Directory of Open Access Journals (Sweden)

    Farideh Akhlaghi

    2015-06-01

    Full Text Available Pre-gestational diabetes mellitus affects less than 1% of all pregnancies and is a significant cause of fetal morbidity and mortality. It is hypothesized that impaired placental function, in the form of abnormal placental weight and/or abnormal placental histology, may be responsible for this event in such pregnancies. Delayed villous maturation of placental villi, which is one of the findings associated with pre-gestational diabetes increases the rate of perinatal mortality. There is limited literature regarding the delayed maturation of placental villous. This review included trials (randomized and non-randomized, cohort and case-control studies registered in Medline/PubMed database, from January 2001 to September 2012 that evaluated the clinical significance of delayed villous maturation and its prevalence in pre-gestational diabetic cases compared to normal pregnancies.It emphasizes that further studies with focus on possible clinical or ultrasound markers of placental delayed villous maturation, especially in a high risk-group such as women with pre-gestational diabetes mellitus are highly recommended.

  11. External validation of a clinical scoring system for the risk of gestational diabetes mellitus

    NARCIS (Netherlands)

    van Leeuwen, M.; Opmeer, B. C.; Zweers, E. J. K.; van Ballegooie, E.; ter Brugge, H. G.; de Valk, H. W.; Visser, G. H. A.; Mol, B. W. J.

    Aim: A prediction rule for gestational diabetes mellitus (GDM) could be helpful in early detection and increased efficiency of screening. A prediction rule by means of a clinical scoring system is available, but has never been validated externally. The aim of this study was to validate the scoring

  12. Food Perceptions and Concerns of Aboriginal Women Coping with Gestational Diabetes in Winnipeg, Manitoba

    Science.gov (United States)

    Neufeld, Hannah Tait

    2011-01-01

    Objective: To describe how Aboriginal women in an urban setting perceive dietary treatment recommendations associated with gestational diabetes mellitus (GDM). Design: Semi-structured explanatory model interviews explored Aboriginal women's illness experiences with GDM. Setting and Participants: Twenty-nine self-declared Aboriginal women who had…

  13. Maternal insulin therapy does not restore foetoplacental endothelial dysfunction in gestational diabetes mellitus

    NARCIS (Netherlands)

    Subiabre, Mario; Silva, Luis; Villalobos-Labra, Roberto; Toledo, Fernando; Paublo, Mario; López, Marcia A.; Salsoso, Rocío; Pardo, Fabián; Leiva, Andrea; Sobrevia, Luis

    2017-01-01

    Pregnant women diagnosed with gestational diabetes mellitus subjected to diet (GDMd) that do not reach normal glycaemia are passed to insulin therapy (GDMi). GDMd associates with increased human cationic amino acid transporter 1 (hCAT-1)-mediated transport of L-arginine and nitric oxide synthase

  14. Vitamin D and gestational diabetes: A systematic review and meta-analysis

    NARCIS (Netherlands)

    Poel, Y.H.M.; Hummel, P.; Lips, P.T.A.M.; Stam, F.; van der Ploeg, T.; Simsek, S.

    2012-01-01

    Background: Conflicting results currently exists on the association between vitamin D and glucose metabolism. The role of maternal vitamin D status in gestational diabetes mellitus (GDM) is not clear. This meta-analysis aimed to examine this role in women with GDM compared with normal glucose

  15. Is there a tendency for thrombosis in gestational diabetes mellitus?

    Directory of Open Access Journals (Sweden)

    Suheyla Gorar

    2016-01-01

    Conclusions: Our findings indicate tendency to develop thrombosis in GDM similar to diabetes mellitus; but more comprehensive studies with larger sample size are needed to determine the relationship between GDM and hemostasis.

  16. Prevalence of gestational diabetes mellitus in Europe: A meta-analysis.

    Science.gov (United States)

    Eades, Claire E; Cameron, Dawn M; Evans, Josie M M

    2017-07-01

    Estimates of the prevalence of gestational diabetes vary widely. It is important to have a clear understanding of the prevalence of this condition to be able to plan interventions and health care provision. This paper describes a meta-analysis of primary research data reporting the prevalence of gestational diabetes mellitus in the general pregnant population of developed countries in Europe. Four electronic databases were systematically searched in May 2016. English language articles reporting gestational diabetes mellitus prevalence using universal screening in general pregnant population samples from developed countries in Europe were included. All papers identified by the search were screened by one author, and then half screened independently by a second author and half by a third author. Data were extracted by one author. Values for the measures of interest were combined using a random effects model and analysis of the effects of moderator variables was carried out. A total of 3258 abstracts were screened, with 40 studies included in the review. Overall prevalence of gestational diabetes mellitus was 5.4% (3.8-7.8). Maternal age, year of data collection, country, area of Europe, week of gestation at testing, and diagnostic criteria were found to have a significant univariate effect on GDM prevalence, and area, week of gestation at testing and year of data collection remained statistically significant in multivariate analysis. Quality category was significant in multivariate but not univariate analysis. This meta-analysis shows prevalence of GDM that is at the upper end of previous estimates in Europe. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Urinary incontinence and vaginal squeeze pressure two years post-cesarean delivery in primiparous women with previous gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Angélica Mércia Pascon Barbosa

    2011-01-01

    Full Text Available OBJECTIVE: To assess the prevalence of urinary incontinence and associated vaginal squeeze pressure in primiparous women with and without previous gestational diabetes mellitus two years post-cesarean delivery. METHODS: Primiparous women who delivered by cesarean two years previously were interviewed about the delivery and the occurrence of incontinence. Incontinence was reported by the women and vaginal pressure evaluated by a Perina perineometer. Sixty-three women with gestational diabetes and 98 women without the disease were screened for incontinence and vaginal pressure. Multiple logistic regression models were used to evaluate the independent effects of gestational diabetes. RESULTS: The prevalence of gestational incontinence was higher among women with gestational diabetes during their pregnancies (50.8% vs. 31.6% and two years after a cesarean (44.8% vs. 18.4%. Decreased vaginal pressure was also significantly higher among women with gestational diabetes (53.9% vs. 37.8%. Maternal weight gain and newborn weight were risk factors for decreased vaginal pressure. Maternal age, gestational incontinence and decreased vaginal pressure were risk factors for incontinence two years after a cesarean. In a multivariate logistic model, gestational diabetes was an independent risk factor for gestational incontinence. CONCLUSIONS: The prevalence of incontinence and decreased vaginal pressure two years post-cesarean were elevated among women with gestational diabetes compared to women who were normoglycemic during pregnancy. We confirmed an association between gestational diabetes mellitus and a subsequent decrease of vaginal pressure two years post-cesarean. These results may warrant more comprehensive prospective and translational studies.

  18. Results From a European Multicenter Randomized Trial of Physical Activity and/or Healthy Eating to Reduce the Risk of Gestational Diabetes Mellitus: The DALI Lifestyle Pilot.

    Science.gov (United States)

    Simmons, David; Jelsma, Judith G M; Galjaard, Sander; Devlieger, Roland; van Assche, Andre; Jans, Goele; Corcoy, Rosa; Adelantado, Juan M; Dunne, Fidelma; Desoye, Gernot; Harreiter, Jürgen; Kautzky-Willer, Alexandra; Damm, Peter; Mathiesen, Elisabeth R; Jensen, Dorte M; Andersen, Lise Lotte; Lapolla, Annunziata; Dalfra, Maria; Bertolotto, Alessandra; Wender-Ozegowska, Ewa; Zawiejska, Agnieszka; Hill, David; Rebollo, Pablo; Snoek, Frank J; van Poppel, Mireille N M

    2015-09-01

    Ways to prevent gestational diabetes mellitus (GDM) remain unproven. We compared the impact of three lifestyle interventions (healthy eating [HE], physical activity [PA], and both HE and PA [HE+PA]) on GDM risk in a pilot multicenter randomized trial. Pregnant women at risk for GDM (BMI ≥29 kg/m2) from nine European countries were invited to undertake a 75-g oral glucose tolerance test before 20 weeks' gestation. Those without GDM were randomized to HE, PA, or HE+PA. Women received five face-to-face and four optional telephone coaching sessions, based on the principles of motivational interviewing. A gestational weight gain (GWG) Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  19. Prevalence and predictive value of islet cell antibodies and insulin autoantibodies in women with gestational diabetes

    DEFF Research Database (Denmark)

    Damm, P; Kühl, C; Buschard, K

    1994-01-01

    The objective of the present study was to investigate the predictive value of islet cell antibodies (ICA) and insulin autoantibodies (IAA) for development of diabetes in women with previous gestational diabetes (GDM). Two hundred and forty-one previous diet-treated GDM patients and 57 women without...... previous GDM were examined 2-11 years after the index pregnancy. In subgroups, plasma from the diagnostic OGTT during index pregnancy was analysed for ICA and IAA. Among the previous GDM patients, 3.7% had developed Type 1 diabetes and 13.7% Type 2 diabetes. Four (2.9%) of the 139 GDM patients tested...... for ICA were ICA-positive and three of these had Type 1 diabetes at follow-up, as well as three ICA-negative patients. The sensitivity, specificity, and predictive value of ICA-positivity for later development of diabetes were 50%, 99%, and 75%, respectively. None of the women was IAA-positive during...

  20. A longitudinal study of plasma insulin and glucagon in women with previous gestational diabetes

    DEFF Research Database (Denmark)

    Damm, P; Kühl, C; Hornnes, P

    1995-01-01

    OBJECTIVE: To investigate whether plasma insulin or glucagon predicts later development of diabetes in women with gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS: The subjects studied were 91 women with diet-treated GDM and 33 healthy women. Plasma insulin and glucagon during a 50...... at follow-up (2 had insulin-dependent diabetes mellitus, 13 had non-insulin-dependent diabetes mellitus, and 12 had impaired glucose tolerance). Compared with the control subjects, women with previous GDM had relatively impaired insulin secretion (decreased insulinogenic index and delayed peak insulin...... for subsequent development of overt diabetes (logistic regression analysis). CONCLUSIONS: Women who develop GDM have a relative insulin secretion deficiency, the severity of which is predictive for later development of diabetes. Furthermore, our data indicate that their relatively reduced beta-cell function may...

  1. A cohort study of gestational diabetes mellitus and complimentary qualitative research: background, aims and design.

    Science.gov (United States)

    Balaji, Vijayam; Balaji, Madhuri S; Datta, Manjula; Rajendran, Rekha; Nielsen, Karoline Kragelund; Radhakrishnan, Rohini; Kapur, Anil; Seshiah, Veerasamy

    2014-11-25

    Women with gestational diabetes mellitus (GDM) and their offsprings are at increased risk of future type 2 diabetes and metabolic abnormalities. Early diagnosis and proper management of GDM, as well as, postpartum follow-up and preventive care is expected to reduce this risk. However, no large scale prospective studies have been done particularly from the developing world on this aspect. The objective of this study is to identify and follow a cohort of pregnant women with and without GDM and their offspring to identify determinants and risk factors for GDM, for various pregnancy outcomes, as well as, for the development of future diabetes and metabolic abnormalities. This is a prospective cohort study involving pregnant women attending prenatal clinics from urban, semi-urban and rural areas in the greater Chennai region in South India. Around 9850 pregnant women will be screened for GDM. Socio-economic status, demographic data, obstetric history, delivery and birth outcomes, perinatal and postnatal complications, neonatal morbidity, maternal postpartum and offsprings follow-up data will be collected. Those diagnosed with GDM will initially be advised routine care. Those unable to reach glycaemic control with diet alone will be advised to take insulin. Postpartum screening for glucose abnormalities will be performed at months 3 and 6 and then every year for 10 years. The offsprings will be followed up every year for anthropometric measurements and growth velocity, as well as, plasma glucose, insulin and lipid profile. In addition, qualitative research will be carried out to identify barriers and facilitators for early GDM screening, treatment compliance and postpartum follow-up and testing, as well as, for continued adherence to lifestyle modifications. The study will demonstrate whether measures to improve diagnosis and care of GDM mothers followed by preventive postpartum care are possible in the routine care setting. It will also map out the barriers and

  2. Hypertensive disorders of pregnancy in women with gestational diabetes mellitus from Rio de Janeiro, Brazil.

    Science.gov (United States)

    Dos Santos da Silva, Luciana Lourenço Gomes; Saunders, Cláudia; Campos, Aline Bull Ferreira; Belfort, Gabriella Pinto; de Carvalho Padilha, Patricia; Pereira, Rosangela Alves; Bornia, Rita Guérios

    2017-10-01

    Pregnant women with Gestational Diabetes Mellitus (GDM) have a greater chance of developing Hypertensive Disorders of Pregnancy (HDP) by the effect of insulin resistance in nitric oxide action.This study aims to describe factors associated with the development of HDP in pregnant women with GDM, assisted in a public maternity hospital in Rio de Janeiro, Brazil. This is a cross-sectional study including 292 pregnant adult women with GDM assisted at Maternidade Escola of the Universidade Federal do Rio de Janeiro. The women were examined during pregnancy and postpartum. Data were collected between 2011 and 2014 from medical records and through in-person interviews. The Student t-test and the chi-square test were applied; additionally, the magnitude of the association between independents variables and HDP was estimated by logistic regression models. The occurrence of HDP was observed in 19.5% (n=57) of the evaluated women: 9.2% had pregnancy hypertension and 10.3% had preeclampsia. The chance of HDP was higher among women with GDM in a previous pregnancy (Odds Ratio-OR=3.8; Confidence Interval of 95%-95% CI: 1.1; 12.8) and among those who were 35 years old or older (OR 3.3; 95% CI: 1.2; 8.7) after controlling the effects of pre-gestational weight and dietary ingestion of calcium, riboflavin, thiamine, vitamin A and protein. Women that had any alteration in blood pressure in a previous pregnancy and those over 35 years old were under higher risk of HDP. The findings may help in the design of interventions aiming to prevent HDP in adult women. Copyright © 2017 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.

  3. Comportamiento de la diabetes gestacional en el embarazo en la adolescencia Behaviour of gestational diabetes during pregnancy in adolescence

    Directory of Open Access Journals (Sweden)

    Gertrudis Rimbao Torres

    2007-09-01

    Full Text Available Se realizó un estudio observacional analítico de tipo caso-control de las 113 adolescentes que parieron en el período comprendido desde el 1ro. de enero de 2006 hasta el 1ro. de junio del propio año, en el Hospital Ginecoobstétrico Universitario “América Arias”, con el objetivo de determinar la frecuencia de la diabetes gestacional y su relación con algunas variables maternas y neonatales en el embarazo en la adolescencia. Se analizaron las variables siguientes: presencia de diabetes gestacional, índice de masa corporal, presencia de hipertensión arterial inducida por el embarazo, tipo de parto, y peso y apgar del recién nacido. Se demostró que la frecuencia de la diabetes gestacional en las adolescentes fue baja (2,7 %. El principal factor de riesgo para el desarrollo de la diabetes gestacional a estas edades fue el exceso de peso al inicio del embarazo (15,7 %. La hipertensión inducida por el embarazo no se asoció con la diabetes gestacional. El mayor número de pacientes tuvo un parto transpelviano (74,3 %. La macrosomía fetal no fue un hallazgo frecuente en ninguno de los 2 grupos, mientras que el bajo peso al nacer lo fue algo más. El apgar bajo al nacer al minuto y a los 5 minutos fue, en general, un hallazgo muy infrecuente.An analytical observation study was conducted of case-control type of 113 adolescent gave birth from January 1 2006 to June 1 2006 in “America Arias” Gynecoly-Obstetrics Hospital to determine frequency of gestational diabetes and its relationship with some maternal and neonatal variables during pregnancy in adolescence. Following variables were analyzed: gestational diabetes, body mass index, presence of pregnancy-induced high blood pressure, type of labor, and weight and Apgar score of newborn. It was possible to demonstrate a low frequency of gestational diabetes in adolescents (2.7 %. Main risk factor for development of gestational diabetes at these ages was an overweight at onset of pregnancy

  4. Glucose intolerance in early postpartum in women with gestational diabetes: Who is at increased risk?

    Science.gov (United States)

    Leuridan, Liesbeth; Wens, Johan; Devlieger, Roland; Verhaeghe, Johan; Mathieu, Chantal; Benhalima, Katrien

    2015-08-01

    Women with a history of gestational diabetes (GDM) have an increased risk for developing type 2 diabetes in the years after the index pregnancy. Some women with GDM already develop glucose intolerance in early postpartum. The best screening strategy for glucose intolerance in early postpartum among women with a history of GDM is still debated. We review the most important risk factors of women with GDM to develop glucose intolerance within one year postpartum. We also discuss the current recommendations for screening in early postpartum and the many challenges to organize postpartum follow up in primary care. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  5. Changing psychosocial determinants of physical activity and diet in women with a history of gestational diabetes mellitus.

    Science.gov (United States)

    Jelsma, Judith G M; van Poppel, Mireille N M; Smith, Ben J; Cinnadaio, Nancy; Bauman, Adrian; Tapsell, Linda; Cheung, N Wah; van der Ploeg, Hidde P

    2018-01-01

    To investigate how a behavioural lifestyle intervention influences psychosocial determinants of physical activity and dietary behaviours in a population at risk of type 2 diabetes (T2DM). Fifty-nine women with a body mass index of ≥25 kg/m 2 and a history of gestational diabetes mellitus (GDM) participated in a randomized controlled study. The intervention group (n = 29) received 2 face-to-face and 5 telephone lifestyle-counselling sessions with a health professional. The control group (n = 30) received care as usual. At baseline and 6 months, psychosocial determinants related to physical activity and diet were measured with a self-administrated questionnaire. Linear regression analyses were applied to test for intervention effects. The intervention was effective in improving social support (β = 3.5, P diet from baseline to 6-month follow-up in the intervention group compared with the control group. The intervention reduced the following barriers to a physically active lifestyle: lack of energy and lack of motivation. Physical activity barriers like lack of time and lack of childcare were unchanged. The intervention reduced the following barriers to a healthy diet: lack of time, costs, having unhealthy snacks at home, and having cravings for sweets. This lifestyle intervention influenced psychosocial determinants relevant for overweight women with a history of gestational diabetes mellitus (GDM) in prevention of T2DM. Copyright © 2017 John Wiley & Sons, Ltd.

  6. The Diabetes Prevention Program (DPP)

    Science.gov (United States)

    2005-01-01

    The purpose of the present article is to provide a detailed description of the highly successful lifestyle intervention administered to 1,079 participants, which included 45% racial and ethnic minorities and resulted in a 58% reduction in the incidence rate of diabetes (2). The two major goals of the Diabetes Prevention Program (DPP) lifestyle intervention were a minimum of 7% weight loss/weight maintenance and a minimum of 150 min of physical activity similar in intensity to brisk walking. Both goals were hypothesized to be feasible, safe, and effective based on previous clinical trials in other countries (3–7). The methods used to achieve these lifestyle goals include the following key features: 1) individual case managers or “lifestyle coaches;” 2) frequent contact with participants; 3) a structured, state-of-the-art, 16-session core-curriculum that taught behavioral self-management strategies for weight loss and physical activity; 4) supervised physical activity sessions; 5) a more flexible maintenance intervention, combining group and individual approaches, motivational campaigns, and “restarts;” 6) individualization through a “toolbox” of adherence strategies; 7) tailoring of materials and strategies to address ethnic diversity; and finally 8) an extensive network of training, feedback, and clinical support. PMID:12453955

  7. A proposal for the use of uniform diagnostic criteria for gestational diabetes in Europe

    DEFF Research Database (Denmark)

    Benhalima, Katrien; Mathieu, Chantal; Damm, Peter

    2015-01-01

    Group (DPSG) associated with the EASD, to develop a proposal for the use of uniform diagnostic criteria for GDM in Europe. A proposal has been developed and has now been approved by the Council of the EBCOG. The current proposal is to screen for overt diabetes at the first prenatal contact using cut......-off values for diabetes outside pregnancy, with particular efforts made to screen high-risk groups. When screening for GDM is performed at 24 weeks' gestation or later, the proposal is now to use the 75 g OGTT with the new WHO diagnostic criteria for GDM. However, more research is necessary to evaluate......Screening and diagnostic criteria for gestational diabetes (GDM) are inconsistent across Europe, and the development of a uniform GDM screening strategy is necessary. Such a strategy would create opportunities for more women to receive timely treatment for GDM. Developing a consensus on screening...

  8. It's Never Too Late To Prevent Diabetes

    Centers for Disease Control (CDC) Podcasts

    2007-11-01

    This podcast delivers a diabetes prevention message tailored for older adults.  Created: 11/1/2007 by National Diabetes Education Program (NDEP), a joint program of the Centers for Disease Control and Prevention and the National Institutes of Health.   Date Released: 11/20/2007.

  9. 50 Ways to Prevent Type 2 Diabetes

    Centers for Disease Control (CDC) Podcasts

    2007-11-01

    This podcast delivers a diabetes prevention message tailored for African Americans.  Created: 11/1/2007 by National Diabetes Education Program (NDEP), a joint program of the Centers for Disease Control and Prevention and the National Institutes of Health.   Date Released: 11/18/2007.

  10. Tropical diabetic hand syndrome: prevention through education ...

    African Journals Online (AJOL)

    Tropical diabetic hand syndrome describes an acute symptom complex found in patients with diabetes in the tropics, usually following minor trauma to the hand. Two different ... Education remains the most important preventive tool in underdeveloped countries, and should remain an integral part of prevention. Keywords: ...

  11. Ketosis-prone diabetes and SLE co-presenting in an African lady with previous gestational diabetes

    Directory of Open Access Journals (Sweden)

    S Hussain

    2017-10-01

    Full Text Available We describe the case of an African woman who was diagnosed with ketosis-prone diabetes with diabetes-associated autoantibodies, after being admitted for diabetic ketoacidosis (DKA precipitated by her first presentation of systemic lupus erythematosus (SLE. She had a seven-year history of recurrent gestational diabetes (GDM not requiring insulin therapy, with return to normoglycaemia after each pregnancy. This might have suggested that she had now developed type 2 diabetes (T2D. However, the diagnosis of SLE prompted testing for an autoimmune aetiology for the diabetes, and she was found to have a very high titre of GAD antibodies. Typical type 1 diabetes (T1D was thought unlikely due to the long preceding history of GDM. Latent autoimmune diabetes of adults (LADA was considered, but ruled out as she required insulin therapy from diagnosis. The challenge of identifying the type of diabetes when clinical features overlap the various diabetes categories is discussed. This is the first report of autoimmune ketosis-prone diabetes (KPD presenting with new onset of SLE.

  12. Effect of treatment of gestational diabetes mellitus: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Nalinee Poolsup

    Full Text Available OBJECTIVE: To assess the efficacy and safety of treating pregnant women with gestational diabetes mellitus in comparison to usual antenatal care. METHODS: A systematic review and meta-analysis was conducted by including randomized controlled trials comparing any form of therapeutic intervention in comparison to usual antenatal care. A literature search was conducted using electronic databases together with a hand search of relevant journals and conference proceedings. RESULTS: Ten studies involving 3,881 patients contributed to meta-analysis. Our results indicated that gestational diabetes mellitus treatment significantly reduced the risk for macrosomia (RR, 0.47; 95% CI, 0.38-0.57, large for gestational age births (RR, 0.55; 95% CI, 0.45-0.67, shoulder dystocia (RR, 0.42; 95% CI, 0.23-0.77 and gestational hypertension (RR, 0.68; 95% CI, 0.53-0.87 without causing any significant increase in the risk for small for gestational age babies. However, no significant difference was observed between the two groups regarding perinatal/neonatal mortality, neonatal hypoglycemia, birth trauma, preterm births, pre-eclampsia, caesarean section and labor induction. CONCLUSION: Treating GDM reduces risk for many important adverse pregnancy outcomes and its association with any harm seems unlikely.

  13. Prevention and treatment of diabetic foot ulcers.

    Science.gov (United States)

    Lim, Jonathan Zhang Ming; Ng, Natasha Su Lynn; Thomas, Cecil

    2017-03-01

    The rising prevalence of diabetes estimated at 3.6 million people in the UK represents a major public health and socioeconomic burden to our National Health Service. Diabetes and its associated complications are of a growing concern. Diabetes-related foot complications have been identified as the single most common cause of morbidity among diabetic patients. The complicating factor of underlying peripheral vascular disease renders the majority of diabetic foot ulcers asymptomatic until latter evidence of non-healing ulcers become evident. Therefore, preventative strategies including annual diabetic foot screening and diabetic foot care interventions facilitated through a multidisciplinary team have been implemented to enable early identification of diabetic patients at high risk of diabetic foot complications. The National Diabetes Foot Care Audit reported significant variability and deficiencies of care throughout England and Wales, with emphasis on change in the structure of healthcare provision and commissioning, improvement of patient education and availability of healthcare access, and emphasis on preventative strategies to reduce morbidities and mortality of this debilitating disease. This review article aims to summarise major risk factors contributing to the development of diabetic foot ulcers. It also considers the key evidence-based strategies towards preventing diabetic foot ulcer. We discuss tools used in risk stratification and classifications of foot ulcer.

  14. Paternal and maternal obesity but not gestational weight gain is associated with type 1 diabetes.

    Science.gov (United States)

    Magnus, Maria C; Olsen, Sjurdur F; Granstrom, Charlotta; Lund-Blix, Nicolai A; Svensson, Jannet; Johannesen, Jesper; Fraser, Abigail; Skrivarhaug, Torild; Joner, Geir; Njølstad, Pål R; Størdal, Ketil; Stene, Lars C

    2018-02-05

    Our objective was to examine the associations of parental body mass index (BMI) and maternal gestational weight gain with childhood-onset type 1 diabetes. Comparing the associations of maternal and paternal BMI with type 1 diabetes in the offspring will provide further insight into the role of unmeasured confounding by characteristics linked to BMI in both parents. We studied 132 331 children participating in the Norwegian Mother and Child Cohort Study (MoBa) and the Danish National Birth Cohort (DNBC) who were born between February 1998 and July 2009. Exposures of interest included parental BMI and maternal gestational weight gain obtained by maternal report. We used Cox-proportional hazards regression to examine the risk of type 1 diabetes (n=499 cases), which was ascertained by national childhood diabetes registers. The incidence of type 1 diabetes was 32.7 per 100 000 person-years in MoBa and 28.5 per 100 000 person-years in DNBC. Both maternal pre-pregnancy obesity, adjusted hazard ratio (HR) 1.41 [95% confidence interval (CI): 1.06, 1.89] and paternal obesity, adjusted HR 1.51 (95% CI: 1.11, 2.04), were associated with childhood-onset type 1 diabetes. The associations were similar after mutual adjustment. In contrast, maternal total gestational weight gain was not associated with childhood-onset type 1 diabetes, adjusted HR 1.00 (95% CI: 0.99, 1.02) per kilogram increase. Our study suggests that the association between maternal obesity and childhood-onset type 1 diabetes is not likely explained by intrauterine mechanisms, but possibly rather by unknown environmental factors influencing BMI in the family. © The Author(s) 2018. Published by Oxford University Press on behalf of the International Epidemiological Association.

  15. Frequency of Gestational diabetes mellitus and impaired glucose ...

    African Journals Online (AJOL)

    3.9 ± 2.1 respectively , p<0.001]. Conclusion: The frequency of GDM and IGT in Sudanese pregnant women is within the universal estimates and parity is an important risk factor that affects impaired glucose tolerance incidence in pregnancy. Keywords: microvascular, chemical diabetes, carbohydrate intolerance.

  16. Zinc and selenium levels in women with gestational diabetes mellitus at Medani Hospital, Sudan.

    Science.gov (United States)

    Hamdan, H Z; Elbashir, L M; Hamdan, S Z; Elhassan, E M; Adam, I

    2014-10-01

    Gestational diabetes is a common medical disorder in pregnancy. There is a growing body of evidence of the association between zinc, selenium status and diabetes mellitus during pregnancy. A case-control study was conducted at Medani Hospital, Sudan, to compare zinc and selenium levels in pregnant women with gestational diabetes and normal pregnant women (controls). The two groups (31 in each arm) were well-matched in age, parity, gestational age, haemoglobin and body mass index. Zinc and selenium levels were measured using atomic absorption spectrophotometry. There were no significant differences in the median (interquartile) zinc (498.9 [395-703] vs 486.4 [404-667] μg/l, p = 0.905) and selenium (164.4 [61-415] vs 204 [68-541] μg/l, p = 0.838) values between the two groups. There were no significant correlations between zinc and selenium, or between these trace elements and body mass index, gestational age and blood glucose levels.

  17. Serum triglycerides and cholesterol status in patients with and without gestational diabetes mellitus

    International Nuclear Information System (INIS)

    Khan, S.H.; Tabassum, H.; Shahzad, S.

    2017-01-01

    To measure the differences of lipids including total cholesterol and triglycerides among subjects with or without GDM. Study Design: Cross sectional comparative study. Place and duration of study: This study was carried out between Dec 2010 to Jun 2012 at the department of gynecology and obstetrics Pakistan Naval Ship (PNS) Shifa and department of pathology, PNS Rahat. Material and Methods: Pregnant women who presented in outpatient department of gynaecology between 24-34 weeks of gestation were randomly selected, and were requested to undergo 100 Gm oral glucose tolerance test for diagnosis of gestational diabetes mellitus (GDM). A total of 93 pregnant women were included in the study. Afterwards they were divided in 2 groups on basis of presence and absence of GDM. Later all the patients were analyzed for total cholesterol and triglycerides. Results of triglycerides and total cholesterol were compared among subjects with or without GDM. Results: The differences for serum triglycerides and total cholesterol were not found to be significant among subject with or without gestational diabetes mellitus, where 0.05 was considered significant. Conclusion: There was no difference between serum triglyceride and total cholesterol levels among subjects with or without gestational diabetes mellitus. (author)

  18. Impact of pre-gestational and gestational diabetes mellitus on the expression of glucose transporters GLUT-1, GLUT-4 and GLUT-9 in human term placenta.

    Science.gov (United States)

    Stanirowski, Paweł Jan; Szukiewicz, Dariusz; Pyzlak, Michał; Abdalla, Nabil; Sawicki, Włodzimierz; Cendrowski, Krzysztof

    2017-03-01

    Various studies in placental tissue suggest that diabetes mellitus alters the expression of glucose transporter (GLUT) proteins, with insulin therapy being a possible modulatory factor. The aim of the present study was quantitative evaluation of the expression of glucose transporters (GLUT-1, GLUT-4, GLUT-9) in the placenta of women in both, uncomplicated and diabetic pregnancy. Additionally, the effect of insulin therapy on the expression of selected glucose transporter isoforms was analyzed. Term placental samples were obtained from healthy control (n = 25) and diabetic pregnancies, including diet-controlled gestational diabetes mellitus (GDMG1) (n = 16), insulin-controlled gestational diabetes mellitus (GDMG2) (n = 6), and pre-gestational diabetes mellitus (PGDM) (n = 6). Computer-assisted quantitative morphometry of stained placental sections was performed to determine the expression of selected glucose transporter proteins. Morphometric analysis revealed a significant increase in the expression of GLUT-4 and GLUT-9 in insulin-dependent diabetic women (GDMG2 + PGDM) as compared to both, control and GDMG1 groups (p diabetic pregnancies. In addition, insulin therapy may increase placental expression of GLUT-4 and GLUT-9, and partially GLUT-1, in women with GDMG2/PGDM.

  19. Adiponectin and leptin as first trimester markers for gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Thagaard, Ida Näslund; Krebs, Lone; Holm, Jens Christian

    2017-01-01

    Background: Gestational diabetes mellitus (GDM) is increasing partly due to the obesity epidemic. Adipocytokines have thus been suggested as first trimester screening markers for GDM. In this study we explore the associations between body mass index (BMI) and serum concentrations of adiponectin......, leptin, and the adiponectin/leptin ratio. Furthermore, we investigate whether these markers can improve the ability to screen for GDM in the first trimester. Methods: A cohort study in which serum adiponectin and leptin were measured between gestational weeks 6+0 and 14+0 in 2590 pregnant women...

  20. The relationship between insulin resistance and the change of cytosol free calcium concentration in gestational diabetes mellitus

    International Nuclear Information System (INIS)

    Li Pu; Zheng Lei; Cen Rongguang; Song Yangxiu

    2004-01-01

    To investigate the relationship between the insulin resistance (IR) and abnormalities of cellular calcium metabolism in gestational diabetes mellitus, the changes in the [Ca 2+ ]i and the insulin receptor tyrosine kinase activity in circulating erythrocytes of 32 cases gestational diabetes were compared with those of 47 normal pregnant and 43 non pregnant women. The level of [Ca 2+ ]i in circulating erythrocyte in gestational diabetes mellitus women was significantly higher than that in the pregnant and non pregnant women (P 2+ ]i in circulating erythrocytes in gestational diabetes mellitus was positively correlated with fasting blood glucose and fasting insulin, negatively with the insulin receptor tyrosine kisase activity (P 2+ ]i level during the gastational period might be one of the possible factor in the insulin resistance of gestaional diabetes mellitus. (authors)

  1. Risk Factors for the Requirement of Antenatal Insulin Treatment in Gestational Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Mayu Watanabe

    2016-01-01

    Full Text Available Poor maternal glycemic control increases maternal and fetal risk for adverse outcomes, and strict management of gestational diabetes mellitus (GDM is recommended to prevent neonatal and maternal complications. However, risk factors for the requirement of antenatal insulin treatment (AIT are not well-investigated in the pregnant women with GDM. We enrolled 37 pregnant women with GDM and investigated the risk for AIT by comparing the patients with AIT (AIT group; n=10 and without insulin therapy (Diet group; n=27. The 1-h and 2-h plasma glucose levels and the number of abnormal values in 75 g OGTT were significantly higher in AIT group compared with Diet group. By logistic regression analysis, plasma glucose level at 1-h was significant predictor for AIT and the odds ratios were 1.115 (1.004–1.239 using forward selection method and 1.192 (1.006–1.413 using backward elimination method. There were no significant differences in obstetrical outcomes and neonatal complications. 1-h plasma glucose levels in 75 g OGTT are useful parameters in predicting the requirement for AIT in GDM. Both maternal and neonatal complications are comparable in GDM patients with and without insulin therapy.

  2. Healthy Food Intake Index (HFII – Validity and reproducibility in a gestational-diabetes-risk population

    Directory of Open Access Journals (Sweden)

    Jelena Meinilä

    2016-07-01

    Full Text Available Abstract Background The aim was to develop and validate a food-based diet quality index for measuring adherence to the Nordic Nutrition Recommendations (NNR in a pregnant population with high risk of gestational diabetes (GDM. Methods This study is a part of the Finnish Gestational Diabetes Prevention Study (RADIEL, a lifestyle intervention conducted between 2008 and 2014. The 443 pregnant participants (61 % of those invited, were either obese or had a history of GDM. Food frequency questionnaires collected at 1st trimester served for composing the HFII; a sum of 11 food groups (available score range 0–17 with higher scores reflecting higher adherence to the NNR. Results The average HFII of the participants was 10.2 (SD 2.8, range 2–17. Factor analysis for the HFII component matrix revealed three factors that explained most of the distribution (59 % of the HFII. As an evidence of the component relevance 9 out of 11 of the HFII components independently contributed to the total score (item-rest correlation coefficients <0.31. Saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, sucrose, and fiber intakes (among other nutrients showed linearity across the HFII categories (P ≤ 0.030 for all nutrients tested; the higher the HFII, the closer the nutrient intake to the recommended intake level. Educational attainment (P = 0.0045, BMI (P = 0.0098, smoking (P = 0.007, and leisure time physical exercise (P = 0.038 showed linearity across the HFII categories. Intra-class correlation coefficient for the HFII was 0.85 (CI 0.79, 0.90. Conclusions The HFII components reflect the food guidelines of the NNR, intakes of relevant nutrients, and characteristics known to vary with diet quality. It largely ignores energy intake, its components have independent contribution to the HFII, and it exhibits reproducibility. The main shortcomings are absence of red and processed meat component, and the validation in a

  3. Preventing Excessive Gestational Weight Gain and Postpartum Weight Retention.

    LENUS (Irish Health Repository)

    O’Dwyer, V

    2017-10-01

    regnancy and the postpartum period are unique opportunities to promote healthy lifestyle choices including a healthy diet and regular exercise. This is especially important for those who are overweight or obese. Women are weighed at their first antenatal visit and body mass index (BMI) calculated, but not all hospitals routinely weigh women throughout pregnancy. A qualitative Dublin study examined experiences of routine weighing during antenatal care. This study found that women expected to be weighed during pregnancy and postpartum. The benefits of this included providing reassurance and minimising postpartum weight retention. Furthermore, women were eager to receive more information about healthy lifestyle interventions and gestational weight gain (GWG) from healthcare professionals

  4. Reasons for women’s non-participation in follow-up screening after gestational diabetes

    DEFF Research Database (Denmark)

    Hyldgaard Nielsen, Jane; Olesen, Christinna Rebecca; Kristiansen, Tine Mechlenborg

    2016-01-01

    which attendance decreased with time after giving birth for both controls at general practitioners and biochemical departments. All differences in proportions were statistically significant. Women attending controls at general practitioners had a significantly higher risk of diabetes diagnosis....... Participation in follow-up screening and risk of diabetes was calculated. Time to obtaining diagnosis of diabetes or initiating treatment was analysed by Cox regression models. All models were adjusted for age, ethnicity and income. RESULTS: High attendance was found during the first control interval, after...... and treatment after gestational diabetes than women not attending. The results for women attending testing at biochemical departments also showed an increased risk of initiation of treatment. Women attending at least one general practitioners control had a significantly higher risk of early diabetes diagnosis...

  5. Long-term BMI and growth profiles in offspring of women with gestational diabetes.

    Science.gov (United States)

    Hammoud, Nurah M; Visser, Gerard H A; van Rossem, Lenie; Biesma, Douwe H; Wit, Jan M; de Valk, Harold W

    2018-05-01

    , with the LGA counterparts of all three offspring groups in the highest BMI SDS ranges. Until early adolescence, OGDM have a BMI that is 0.5 SDS higher than that of the Dutch background population. LGA OGDM appear to be at particularly higher risk of being overweight in adolescence compared with non-LGA OGDM, putting them also at a higher lifetime risk of being overweight and developing obesity. ODM2 showed the highest BMI SDS values and had an average BMI SDS of +1.6 until the age of 14, when it became +2 SD. These results emphasize the importance of adequate recognition and timely treatment of maternal gestational diabetes to prevent fetal macrosomia in obstetrics.

  6. Mild gestational diabetes as a risk factor for congenital cryptorchidism

    DEFF Research Database (Denmark)

    Virtanen, Helena E; Tapanainen, Anna E; Kaleva, Marko M

    2006-01-01

    CONTEXT: Cryptorchidism is the most common malformation in newborn boys. Maternal diabetes has previously been suggested to be a risk factor for this disorder in one epidemiological study. OBJECTIVE: Evaluation of the prevalence of maternal glucose metabolism disorders during pregnancy in newborn...... boys having normal testicular descent or congenital cryptorchidism. DESIGN: Postnatal analysis of maternal history concerning glucose metabolism abnormalities during pregnancy among cryptorchid and healthy Finnish boys. SETTING AND PARTICIPANTS: The material of this case-control study comprises 1163...... diabetes diagnosis and abnormality of the result of a 2-h 75-g oral glucose tolerance test during pregnancy were obtained from the hospital records after delivery. RESULTS: After adjustment for possible confounding factors, i.e. maternal smoking during pregnancy, maternal age at delivery, and risk factors...

  7. The prevention of type 2 diabetes: what is the evidence?

    Science.gov (United States)

    Chiasson, J L; Brindisi, M C; Rabasa-Lhoret, R

    2005-09-01

    The prevalence of diabetes is increasing in epidemic proportion worldwide. Because of the morbidity and mortality associated with the disease, it is becoming a major burden for the health care system. With a better understanding of the pathogenesis of type 2 diabetes, the concept of primary prevention has emerged. A number of studies demonstrated that both lifestyle modification program and pharmacological interventions in subjects with impaired glucose tolerance (IGT) can prevent or delay the progression to diabetes. The Diabetes Prevention Study (DPS) and the Diabetes Prevention Program (DPP) convincingly showed that an intensive lifestyle modification program is highly effective in decreasing the risk of diabetes in a high risk population (risk reduction of 58%). Four other smaller studies have made similar observations. The DPP study showed that metformin can reduced the risk of diabetes by 31% in subjects with IGT. The STOP-NIDDM trial confirmed the efficacy of acarbose in decreasing the risk of diabetes by 36% in similar high risk population. The TRIPOD study showed that troglitazone can reduce the incidence of diabetes by 55% in Hispanic women with a history of gestational diabetes. And more recently, the XENDOS study showed that in very obese population on intensive lifestyle modification program, xenical treatment was associated with a 37% reduced incidence of diabetes compared to placebo. Three studies suggested that bariatric surgery in morbidly obese subjects with or without IGT can reduce the incidence of diabetes to near zero. Eight of 10 studies showed that treatment with inhibitors of the renin-angiotensin aldosterone system in high risk population for cardiovascular disease (CVD) were associated with a significant reduction in the subsequent development of diabetes as a secondary outcome. The WOSCOPS study and the HERS study examined the effect of pravastatin and estrogen/progestin respectively on cardiovascular events and observed that these

  8. ENDOCRINOLOGY OF PREGNANCY: Gestational diabetes mellitus: definition, aetiological and clinical aspects.

    Science.gov (United States)

    Baz, Baz; Riveline, Jean-Pierre; Gautier, Jean-François

    2016-02-01

    Gestational diabetes (GDM) is defined as a glucose intolerance resulting in hyperglycaemia of variable severity with onset during pregnancy. This review aims to revisit the pathogenesis and aetiology of GDM in order to better understand its clinical presentation and outcomes. During normal pregnancy, insulin sensitivity declines with advancing gestation. These modifications are due to placental factors, progesterone and estrogen. In a physiological situation, a compensatory increase in insulin secretion maintains a normal glucose homeostasis. GDM occurs if pancreatic β-cells are unable to face the increased insulin demand during pregnancy. GDM is most commonly a forerunner of type 2 diabetes (T2D) - the most prevalent form of diabetes. These women share similar characteristics with predisposed subjects to T2D: insulin resistance before and after pregnancy, and carry more T2D risk alleles. Auto-immune and monogenic diabetes are more rare aetiologies of GDM. Adverse pregnancy outcomes of GDM are mainly related to macrosomia caused by fetal hyperinsulinism in response to high glucose levels coming from maternal hyperglycaemia. Screening recommendations and diagnosis criteria of GDM have been recently updated. High risk patients should be screened as early as possible using fasting plasma glucose, and if normal, at 24-28 weeks of gestation using 75 g oral glucose tolerance test. The treatment of GDM is based on education with trained nurses and dieticians, and if necessary insulin therapy. © 2016 European Society of Endocrinology.

  9. Periodontitis and type 2 diabetes among women with previous gestational diabetes: epidemiological and immunological aspects in a follow-up of three years

    Directory of Open Access Journals (Sweden)

    Rafael Paschoal ESTEVES LIMA

    Full Text Available Abstract Periodontitis can contribute to the development of insulin resistance. Gestational diabetes is a risk factor for type 2 diabetes. Therefore, periodontitis, when associated with gestational diabetes, could increase the risk for the development of type 2 diabetes after pregnancy. Objective The aim of this study was to verify the incidence on the development of type 2 diabetes in women with previous gestational diabetes with and without periodontitis after a three-year time interval. Material and Methods Initial sample of this follow-up study consisted of 90 women diagnosed with gestational diabetes who underwent periodontal examination. After three years, 49 women were subjected to new periodontal examination and biological, behavioral, and social data of interest were collected. Additionally, the quantification of the C-reactive protein in blood samples was performed. Fasting glucose and glycated hemoglobin levels were requested. Saliva samples were collected for quantification of interleukin 6 and 10, tumor necrosis factor α, matrix metalloproteinase 2 and 9. Results The incidence of type 2 diabetes mellitus was 18.4% and of periodontitis was 10.2%. There was no significant difference in the incidence of type 2 diabetes mellitus among women with and without periodontitis. It was observed impact of C-reactive protein in the development of type 2 diabetes mellitus. However, it was not observed impact of periodontitis on the development of type 2 diabetes mellitus among women with previous gestational diabetes. Conclusions It was not observed impact of periodontitis on the development of type 2 diabetes among women with previous gestational diabetes. The impact of C-reactive protein in the development of type 2 diabetes mellitus highlights the importance of an inflammatory process in the diabetes pathogenesis.

  10. The role of blood groups in the development of diabetes mellitus after gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Karagoz H

    2015-10-01

    Full Text Available Hatice Karagoz,1 Abdulsamet Erden,2 Ozerhan Ozer,2 Kubra Esmeray,2 Ali Cetinkaya,2 Deniz Avci,2 Samet Karahan,2 Mustafa Basak,2 Kadir Bulut,2 Hasan Mutlu,3 Yasin Simsek4 1Internal Medicine Department, Acibadem Kayseri Hospital, 2Internal Medicine Department, 3Medical Oncology Department, 4Endocrinology Department, Kayseri Training and Research Hospital, Kayseri, Turkey Introduction: Gestational diabetes mellitus (GDM is a common condition that is defined as glucose intolerance of varying degree with onset or first recognition during pregnancy and it affects approximately 5% of all pregnancies all over the world. GDM is not only associated with adverse pregnancy outcomes such as macrosomia, dystocia, birth trauma, and metabolic complications in newborns, but it is also a strong predictor of transitioning to overt DM postpartum. The association of ABO blood groups with DM has been observed before in several epidemiological and genetic studies and resulted with inconsistent findings, but still there are not enough studies in the literature about the association of ABO blood groups with GDM. In this study, we aimed at investigating any possible relationship between the ABO blood group system and GDM and also the transitioning of GDM to overt DM postpartum, in Turkey.Patients and methods: A total of 233 patients with GDM from Kayseri Training and Research Hospital between 2002 and 2012 were included in the study. The cases that have serologically determined blood groups and Rh factor in the hospital records were included in the study, and the patients with unknown blood groups were excluded. Patients were classified according to blood groups (A, B, AB, and O and Rh status (+/-. GDM was diagnosed based on the glucose cut-points of the International Association of the Diabetes and Pregnancy Society Groups. The distributions of blood groups of the patients with GDM were compared with the distribution of blood groups of 17,314 healthy donors who were

  11. SOS1 gene polymorphisms are associated with gestational diabetes mellitus in a Chinese population: Results from a nested case-control study in Taiyuan, China.

    Science.gov (United States)

    Chen, Qiong; Yang, Hailan; Feng, Yongliang; Zhang, Ping; Wu, Weiwei; Li, Shuzhen; Thompson, Brian; Wang, Xin; Peng, Tingting; Wang, Fang; Xie, Bingjie; Guo, Pengge; Li, Mei; Wang, Ying; Zhao, Nan; Wang, Suping; Zhang, Yawei

    2018-03-01

    Gestational diabetes mellitus is a growing public health concern due to its large disease burden; however, the underlying pathophysiology remains unclear. Therefore, we examined the relationship between 107 single-nucleotide polymorphisms in insulin signalling pathway genes and gestational diabetes mellitus risk using a nested case-control study. The SOS1 rs7598922 GA and AA genotype were statistically significantly associated with reduced gestational diabetes mellitus risk ( p trend  = 0.0006) compared with GG genotype. At the gene level, SOS1 was statistically significantly associated with gestational diabetes mellitus risk after adjusting for multiple comparisons. Moreover, AGGA and GGGG haplotypes in SOS1 gene were associated with reduced risk of gestational diabetes mellitus. Our study provides evidence for an association between the SOS1 gene and risk of gestational diabetes mellitus; however, its role in the pathogenesis of gestational diabetes mellitus will need to be verified by further studies.

  12. Oral anti-diabetic agents for women with pre-existing diabetes mellitus/impaired glucose tolerance or previous gestational diabetes mellitus.

    Science.gov (United States)

    Tieu, Joanna; Coat, Suzette; Hague, William; Middleton, Philippa

    2010-10-06

    While most guidelines recommend the use of insulin in women whose pregnancies are affected by pre-existing diabetes, oral agents have obvious benefits for patient acceptability and adherence. It is necessary, however, to assess the effects of these anti-diabetic agents on maternal and infant health outcomes. Additionally, women with previous gestational diabetes mellitus are increasingly found to be predisposed to impaired glucose tolerance and, despite the potential need for intervention for these women, there has been little evidence about the use of oral anti-diabetic agents by these women pre-conceptionally or during a subsequent pregnancy. To investigate the effect of oral anti-diabetic agents in women with pre-existing diabetes mellitus, impaired glucose tolerance or previous gestational diabetes planning a pregnancy or pregnant women with diabetes mellitus on maternal and infant health.The use of oral antidiabetic agents for management of gestational diabetes in a current pregnancy is evaluated in a separate Cochrane review. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (March 2010). We included randomised and quasi-randomised trials. Two review authors independently assessed trial eligibility for inclusion. We identified 13 trials published as 25 papers using the Cochrane Pregnancy and Childbirth group literature search, and an additional ongoing trial. We have not included any trials in the review. One trial is awaiting assessment and we have excluded twelve trials because they evaluated treatment of women with gestational diabetes or women with polycystic ovary syndrome, were not randomised controlled trials or data were not available. Little randomised evidence is available evaluating the use of oral anti-diabetic agents in women with diabetes mellitus, impaired glucose tolerance, previous gestational diabetes mellitus planning a pregnancy or pregnant women with pre-existing diabetes mellitus. Large trials comparing any

  13. Impact of gestational diabetes mellitus nutrition practice guidelines implemented by registered dietitians on pregnancy outcomes.

    Science.gov (United States)

    Reader, Diane; Splett, Patricia; Gunderson, Erica P

    2006-09-01

    Nutrition practice guidelines were developed for gestational diabetes mellitus by registered dietitians from the Diabetes Care and Education and the Women's Health and Reproductive Nutrition dietetic practice groups. To validate the guidelines, a clinical trial was designed with clinic sites randomly assigned to either nutrition practice guidelines care (12 sites) or usual nutrition care (13 sites), with diabetes, obstetric, and other clinic types represented in both groups. Volunteer dietitians served as study coordinators and recruited women diagnosed with gestational diabetes mellitus. The nutrition practice guidelines define medical nutrition therapy (MNT) for gestational diabetes and emphasize three areas-definition of MNT clinical goals with indexes to modify or advance MNT and criteria to start insulin; use of self-monitoring tools; and provision of three nutrition visits. Usual care sites provided prenatal nutrition care according to usual practice. The effect of nutrition care (sites following the nutrition care guidelines) and type of clinic site on changes in glycated hemoglobin and infant birth weight, adjusted for other covariates, were evaluated using linear regression. Differences in insulin use and other infant outcomes between treatment groups were evaluated using logistic regression. Generalized estimating equations were used to accommodate nonindependence within randomized clusters of patients within clinic sites. Data from 215 women indicated less insulin use at diabetes clinic sites in the nutrition practice guidelines groups and improved glycated hemoglobin control during the treatment period in diabetes clinics compared with obstetric or other clinics. A higher proportion of women in the usual care group had glycated hemoglobin levels that exceeded 6% at follow-up compared with women in the nutrition practice guidelines group (13.6% vs 8.1%), although not statistically significant (P=0.26). A significant clinic type and treatment group effect

  14. Costs and consequences of treatment for mild gestational diabetes mellitus – evaluation from the ACHOIS randomised trial

    Directory of Open Access Journals (Sweden)

    Willson Kristyn J

    2007-10-01

    Full Text Available Abstract Background Recommended best practice is that economic evaluation of health care interventions should be integral with randomised clinical trials. We performed a cost-consequence analysis of treating women with mild gestational diabetes mellitus by dietary advice, blood glucose monitoring and insulin therapy as needed compared with routine pregnancy care, using patient-level data from a multi-centre randomised clinical trial. Methods Women with a singleton pregnancy who had mild gestational diabetes diagnosed by an oral glucose-tolerance test between 24 and 34 weeks' gestation and their infants were included. Clinical outcomes and outpatient costs derived from all women and infants in the trial. Inpatient costs derived from women and infants attending the hospital contributing the largest number of enrolments (26.1%, and charges to women and their families derived from a subsample of participants from that hospital (in 2002 Australian dollars. Occasions of service and health outcomes were adjusted for maternal age, ethnicity and parity. Analysis of variance was used with bootstrapping to confirm results. Primary clinical outcomes were serious perinatal complications; admission to neonatal nursery; jaundice requiring phototherapy; induction of labour and caesarean delivery. Economic outcome measures were outpatient and inpatient costs, and charges to women and their families. Results For every 100 women with a singleton pregnancy and positive oral glucose tolerance test who were offered treatment for mild gestational diabetes mellitus in addition to routine obstetric care, $53,985 additional direct costs were incurred at the obstetric hospital, $6,521 additional charges were incurred by women and their families, 9.7 additional women experienced induction of labour, and 8.6 more babies were admitted to a neonatal nursery. However, 2.2 fewer babies experienced serious perinatal complication and 1.0 fewer babies experienced perinatal death

  15. Screening in high-risk group of gestational diabetes mellitus with its maternal and fetal outcomes

    Directory of Open Access Journals (Sweden)

    Angadi Rajasab Nilofer

    2012-01-01

    Full Text Available Background: Gestational diabetes mellitus (GDM is a metabolic disorder defined as glucose intolerance with the onset or first recognition during pregnancy. Women with GDM are at increased risk for adverse obstetric and perinatal outcome. The complications associated with GDM can be prevented by early recognition, intense monitoring and proper treatment. Aims: The present study was done to screen the high-risk pregnancy group for GDM, to find the incidence of abnormal results on screening and to correlate the abnormal results with the maternal and fetal outcomes. The study was done in a tertiary care hospital and teaching institute. It was a prospective cohort study. Materials and Methods: Selective screening for GDM was done in 150 pregnant women with high-risk factors. Screening was done with 50 g glucose challenge test (GCT after 18 weeks, and if GCT was negative then the test was repeated after 28 weeks of pregnancy. The patients who were having an abnormal GCT were subjected to 100 g oral glucose tolerance test (OGTT. All GDM patients were followed up and treated with diet and/or insulin therapy till delivery to know maternal and fetal outcomes. The period of study was from April 2008 to March 2009. Results: 7.3% of study population was OGCT positive. 6% of the study population was OGTT positive. Age >25 years, obesity, family history of DM, and past history of GDM were the risk factors significantly associated with GDM. One newborn had hypoglycemia and one had hyperbilirubinemia. The fetal and maternal outcome in GDM patients was good in our study due to early diagnosis and intervention. Conclusion: Women with GDM are at an increased risk for adverse obstetric and perinatal outcome. The increased morbidity in GDM is preventable by meticulous antenatal care.

  16. The impact of gestational weight gain in different trimesters of pregnancy on glucose challenge test and gestational diabetes.

    Science.gov (United States)

    Hantoushzadeh, Sedigheh; Sheikh, Mahdi; Bosaghzadeh, Zeynab; Ghotbizadeh, Fahimeh; Tarafdari, Azam; Panahi, Zahra; Shariat, Mamak

    2016-09-01

    Assessing the effects of excessive weight gain before pregnancy, in the first and second trimesters and in the month preceding glucose challenge test (GCT) on GCT results and gestational diabetes mellitus (GDM). This prospective cohort study evaluated 1279 pregnant women who were referred for their first prenatal visit in 2012-2015. Mother's body mass index (BMI) was recorded before pregnancy, during the first visit and every 4 weeks until 28 gestational weeks. All mothers underwent GCT at 28 weeks and when 1 h glucose ≥140 mg/dL (≥7.8 mmol/L), they were referred for a 100 g fasting glucose 3 h glucose tolerance test. Obesity and being overweight prior to pregnancy were associated with 2.8-fold and 1.5-fold higher rates of developing GDM (ppregnancy (all ppregnancy BMI (p=0.03). When these women adhered to the recommended weight gain during the subsequent period, the risk of developing GDM was not increased, however the risk of having false-positive GCT remained high (ppregnancy BMI independently increases the risk of GDM and false-positive GCT. First trimester weight gain is the most important predictor of GCT and GDM regardless of pre-pregnancy BMI. The weight gain during the subsequent period affects the risk of developing GDM only in women with excessive first-trimester weight gain. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. Insulin receptor binding and tyrosine kinase activity in skeletal muscle from normal pregnant women and women with gestational diabetes

    DEFF Research Database (Denmark)

    Damm, P.; Handberg, A.; Kühl, C.

    1993-01-01

    values within the groups. CONCLUSION: The insulin resistance found in normal and gestational diabetic pregnancy is not likely to be caused by a defective insulin receptor tyrosine kinase, whereas decreased insulin receptor binding might have some pathogenic importance in gestational diabetes.......OBJECTIVE: To ascertain whether the decreased glucose tolerance and insulin resistance found in normal and gestational diabetic pregnancy might be associated with changes in insulin receptor function. METHODS: Eight nonpregnant healthy women (nonpregnant controls), eight healthy pregnant women...... (pregnant controls), and eight women with gestational diabetes were investigated. All were non-obese. Muscle biopsies were obtained from the vastus lateralis muscle, and insulin binding and tyrosine kinase activities in partially purified skeletal muscle insulin receptors were studied. The pregnant controls...

  18. Self-Care Behaviors of Mothers with Gestational Diabetes Treated with Insulin Based on the Theory of Planned Behavior

    Directory of Open Access Journals (Sweden)

    Talaat Khadivzadeh

    2016-07-01

    Conclusion: TPB emphasizes on behavioral intention and perceived behavioral control, which could be used as a framework to design educational interventions for promotion of gestational diabetes self-care behaviors in mothers.

  19. Health economic modeling to assess short-term costs of maternal overweight, gestational diabetes, and related macrosomia - a pilot evaluation

    NARCIS (Netherlands)

    Lenoir-Wijnkoop, Irene; van der Beek, Eline M; Garssen, Johan; Nuijten, Mark J C; Uauy, Ricardo D

    2015-01-01

    BACKGROUND: Despite the interest in the impact of overweight and obesity on public health, little is known about the social and economic impact of being born large for gestational age or macrosomic. Both conditions are related to maternal obesity and/or gestational diabetes mellitus (GDM) and

  20. Monitoring and managing mothers with gestational diabetes mellitus: a nursing perspective

    OpenAIRE

    Berry, Diane; Johnson,Quinetta; Stuebe,Allison

    2015-01-01

    Diane C Berry,1 Quinetta B Johnson,2,3 Alison M Stuebe2,3 1The University of North Carolina School of Nursing, 2Women's Primary Health Care, The University of North Carolina School of Medicine, Division of Maternal Fetal Medicine, 3The University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA Abstract: Women diagnosed with gestational diabetes mellitus (GDM) must work in partnership with their health care team to improve both maternal and fetal outcom...

  1. Gestational diabetes mellitus and pregnancy outcomes among Chinese and South Asian women in Canada.

    Science.gov (United States)

    Mukerji, Geetha; Chiu, Maria; Shah, Baiju R

    2013-02-01

    To determine the association between Chinese or South Asian ethnicity and adverse neonatal and maternal outcomes for women with gestational diabetes compared to the general population. A cohort study was conducted using population-based health care databases in Ontario, Canada. All 35,577 women aged 15-49 with gestational diabetes who had live births between April 2002 and March 2011 were identified. Their delivery hospitalization records and the birth records of their neonates were examined to identify adverse neonatal outcomes and adverse maternal outcomes. Compared to infants of mothers from the general population (55.5%), infants of Chinese mothers had a lower risk of an adverse outcome at delivery (42.9%, adjusted odds ratio 0.63, 95% confidence interval 0.58-0.68), whereas infants of South Asian mothers had a higher risk (58.9%, adjusted odds ratio 1.15, 95% confidence interval 1.07-1.23). Chinese women also had a lower risk of adverse maternal outcomes (32.4%, adjusted odds ratio 0.58, 95% confidence interval 0.54-0.63) compared to general population women (41.2%), whereas the risk for South Asian women was not different (39.4%, adjusted odds ratio 0.94, 95% confidence interval 0.88-1.02) from that of general population women. The risk of complications of gestational diabetes differs significantly between Chinese and South Asian patients and the general population in Ontario. Tailored interventions for gestational diabetes management may be required to improve pregnancy outcomes in high-risk ethnic groups.

  2. The Possible Role of Epigenetics in Gestational Diabetes: Cause, Consequence, or Both

    Directory of Open Access Journals (Sweden)

    J. L. Fernández-Morera

    2010-01-01

    Full Text Available Gestational diabetes mellitus (GDM is defined as the glucose intolerance that is not present or recognized prior to pregnancy. Several risk factors of GDM depend on environmental factors that are thought to regulate the genome through epigenetic mechanisms. Thus, epigenetic regulation could be involved in the development of GDM. In addition, the adverse intrauterine environment in patients with GDM could also have a negative impact on the establishment of the epigenomes of the offspring.

  3. Low-Carbohydrate Diet for the Treatment of Gestational Diabetes Mellitus

    OpenAIRE

    Moreno-Castilla, Cristina; Hernandez, Marta; Bergua, Merce; Alvarez, Maria C.; Arce, Maria A.; Rodriguez, Karen; Martinez-Alonso, Montserrat; Iglesias, Montserrat; Mateu, Magdalena; Santos, Maria D.; Pacheco, Linda R.; Blasco, Yolanda; Martin, Eva; Balsells, Nuria; Aranda, Nuria

    2013-01-01

    OBJECTIVE Medical nutrition therapy based on the control of the amount and distribution of carbohydrates (CHO) is the initial treatment for gestational diabetes mellitus (GDM), but there is a need for randomized controlled trials comparing different dietary strategies. The purpose of this study was to test the hypothesis that a low-CHO diet for the treatment of GDM would lead to a lower rate of insulin treatment with similar pregnancy outcomes compared with a control diet. RESEARCH DESIGN AND...

  4. Impaired insulin-stimulated nonoxidative glucose metabolism in glucose-tolerant women with previous gestational diabetes

    DEFF Research Database (Denmark)

    Damm, P; Vestergaard, H; Kühl, C

    1996-01-01

    euglycemic clamp including indirect calorimetry. All women were lean and had normal oral glucose tolerance test results. Activities of glycogen synthase, phosphofructokinase, and hexokinase were measured in vastus lateralis muscle biopsy specimens obtained in the basal state and after insulin stimulation....... RESULTS: Women with previous gestational diabetes had a decreased glucose disposal rate (pmetabolism (6.63 +/- 0.47 vs 9.04 +/- 0.57 mg/kg fat-free mass per minute, p

  5. Evaluation of serum zonulin for use as an early predictor for gestational diabetes

    OpenAIRE

    Mokkala, K; Tertti, K; R?nnemaa, T; Vahlberg, T; Laitinen, K

    2017-01-01

    Diet has an important role in regulating intestinal permeability and subsequently the risk for metabolic disorders. In this observational study, we examined whether serum intestinal permeability marker zonulin, could be used as a predictor for gestational diabetes mellitus (GDM). Serum zonulin concentration was measured in early pregnancy in overweight or obese pregnant women (n=88) at risk for developing GDM. Serum zonulin was associated with higher odds of GDM (adjusted OR for 1?ng?ml?1 inc...

  6. Exercise improves glycaemic control in women diagnosed with gestational diabetes mellitus: a systematic review.

    Science.gov (United States)

    Harrison, Anne L; Shields, Nora; Taylor, Nicholas F; Frawley, Helena C

    2016-10-01

    Does exercise improve postprandial glycaemic control in women diagnosed with gestational diabetes mellitus? A systematic review of randomised trials. Pregnant women diagnosed with gestational diabetes mellitus. Exercise, performed more than once a week, sufficient to achieve an aerobic effect or changes in muscle metabolism. Postprandial blood glucose, fasting blood glucose, glycated haemoglobin, requirement for insulin, adverse events and adherence. This systematic review identified eight randomised, controlled trials involving 588 participants; seven trials (544 participants) had data that were suitable for meta-analysis. Five trials scored ≥ 6 on the PEDro scale, indicating a relatively low risk of bias. Meta-analysis showed that exercise, as an adjunct to standard care, significantly improved postprandial glycaemic control (MD -0.33mmol/L, 95% CI -0.49 to -0.17) and lowered fasting blood glucose (MD -0.31 mmol/L, 95% CI -0.56 to -0.05) when compared with standard care alone, with no increase in adverse events. Effects of similar magnitude were found for aerobic and resistance exercise programs, if performed at a moderate intensity or greater, for 20 to 30minutes, three to four times per week. Meta-analysis did not show that exercise significantly reduced the requirement for insulin. All studies reported that complications or other adverse events were either similar or reduced with exercise. Aerobic or resistance exercise, performed at a moderate intensity at least three times per week, safely helps to control postprandial blood glucose levels and other measures of glycaemic control in women diagnosed with gestational diabetes mellitus. PROSPERO CRD42015019106. [Harrison AL, Shields N, Taylor NF, Frawley HC (2016) Exercise improves glycaemic control in women diagnosed with gestational diabetes mellitus: a systematic review.Journal of Physiotherapy62: 188-196]. Copyright © 2016 Australian Physiotherapy Association. Published by Elsevier B.V. All rights

  7. The influence of ethnicity on the development of type 2 diabetes mellitus in women with gestational diabetes: a prospective study and review of the literature.

    Science.gov (United States)

    Girgis, Christian M; Gunton, Jenny E; Cheung, N Wah

    2012-01-01

    As the worldwide prevalence of type 2 diabetes continues to rise at an alarming rate, the search for susceptible populations likely to benefit from preventative measures becomes more important. One such population is women with a previous history of gestational diabetes mellitus (GDM). In this prospective study of 101 women who had GDM in Australia, ethnicity was a major risk factor for the development of diabetes following a diagnosis of GDM. With a mean followup of 5.5 years after GDM, South Asian women had a significantly higher risk of developing abnormal glucose tolerance (AGT) (69%) than women of all other ethnicities (P Asian (11/27, 41%), Middle-Eastern (8/18, 44%), South European backgrounds (5/12, 42%), and Australian-born women 39% (11/28). A review of the literature supports the role of ethnicity in the development of diabetes amongst these women. These findings have implications for South Asian countries and countries such as Australia where there is a population from diverse ethnic backgrounds and where the implementation of targeted measures to stem the growing tide of diabetes is needed.

  8. Metformin - a potentially effective drug for gestational diabetes mellitus: a systematic review and meta-analysis.

    Science.gov (United States)

    Feng, Ye; Yang, Huixia

    2017-08-01

    Metformin has been gradually used in the management of gestational diabetes mellitus (GDM). In order to prove the safety and efficacy of metformin used in pregnancy, we searched several databases for the reports of randomized trials comparing insulin and metformin used in GDM and conducted a meta-analysis. Data showed the rates of neonatal large for gestational age, cesarean section, neonatal respiratory distress and preterm birth were similar in both groups. Maternal glycated hemoglobin-% at gestational week 36-37 was significantly lower in metformin group, indicating good glycemic control of metformin. Maternal weight gain since enrollment to gestational week 36-37 was also lower in metformin group, making metformin worth using even when metformin is insufficient and supplementary insulin is needed. Data also showed that metformin significantly reduced the gestational hypertension complications in GDM patients, probably by reducing the endothelial activation and maternal inflammatory response of insulin resistance. Although metformin can cross the placenta, it is less likely to cause severe neonatal hypoglycemia compared with insulin since it neither stimulates pancreatic insulin release nor increases circulating insulin levels. According to most maternal and neonatal outcomes, metformin is an effective and safe alternative to insulin for GDM patients.

  9. Peptidome profiling of umbilical cord plasma associated with gestational diabetes-induced fetal macrosomia.

    Science.gov (United States)

    Liu, Fei; Zhao, Chun; Liu, Lan; Ding, Hongjuan; Huo, Ran; Shi, Zhonghua

    2016-04-29

    Fetal macrosomia, defined as a birth weight ≥4000g, may affect 15-45% of newborns of women with gestational diabetes mellitus (GDM). The associations between endogenous peptides and gestational diabetes-induced macrosomia have not been investigated extensively by peptidome analysis. Here, we analyzed the umbilical cord plasma by combining ultrafiltration using molecular weight cut-off filters and liquid chromatography-tandem mass spectrometry (LC-MS/MS) to investigate potential associations of GDM with macrosomia. As macrosomic babies have increased susceptibility to obesity, diabetes and cardiovascular diseases in later life, we also aimed to identify specific biomarkers to detect these future diseases. Thirty pairs of GDM mothers and controls were randomly divided into three subgroups. We identified 235 peptides of around 1000-3000Da, originating from 115 proteins. Analyzing the cleavage sites revealed that these peptides were cleaved in regulation, which may reflect the protease activity and distribution in umbilical cord plasma. Four identified peptides, of 2471.7, 1077.2, 1446.5 and 2372.7Da, were significantly differentially expressed in the GDM macrosomia groups compared with controls, whose precursors may play a critical role in developing GDM macrosomia. We provide for the first time a validated GDM macrosomia peptidome profile and identify potential biomarkers linking the effects of macrosomia to later-life diseases. Fetal macrosomia is the predominant adverse outcome of gestational diabetes mellitus (GDM), which is a frequent medical condition during pregnancy. Till now, the detailed molecular mechanisms underlying gestational diabetes-induced macrosomia are still not elucidated. With high detection sensitivity and high throughput of peptidome technology, it is now possible to systemically identify peptides possibly involved in the umbilical cord plasma of GDM induced macrosomia cases. With LC-MS/MS based quantification, totally, we identified 235

  10. Potential protective effect of lactation against incidence of type 2 diabetes mellitus in women with previous gestational diabetes mellitus: A systematic review and meta-analysis.

    Science.gov (United States)

    Tanase-Nakao, Kanako; Arata, Naoko; Kawasaki, Maki; Yasuhi, Ichiro; Sone, Hirohito; Mori, Rintaro; Ota, Erika

    2017-05-01

    Lactation may protect women with previous gestational diabetes mellitus (GDM) from developing type 2 diabetes mellitus, but the results of existing studies are inconsistent, ranging from null to beneficial. We aimed to conduct a systematic review to gather available evidence. Databases MEDLINE, CINAHL, PubMed, and EMBASE were searched on December 15, 2015, without restriction of language or publication year. A manual search was also conducted. We included observational studies (cross-sectional, case-control, and cohort study) with information on lactation and type 2 diabetes mellitus incidence among women with previous GDM. We excluded case studies without control data. Data synthesis was conducted by random-effect meta-analysis. Fourteen reports of 9 studies were included. Overall risk of bias using RoBANS ranged from low to unclear. Longer lactation for more than 4 to 12 weeks postpartum had risk reduction of type 2 diabetes mellitus compared with shorter lactation (OR 0.77, 95% CI 0.01-55.86; OR 0.56, 95% CI 0.35-0.89; OR 0.22, 95% CI 0.13-0.36; type 2 diabetes mellitus evaluation time 2 y, 2-5 y, and >5 y, respectively). Exclusive lactation for more than 6 to 9 weeks postpartum also had lower risk of type 2 diabetes mellitus compared with exclusive formula (OR 0.42, 95% CI 0.22-0.81). The findings support the evidence that longer and exclusive lactation may be beneficial for type 2 diabetes mellitus prevention in women with previous GDM. However, the evidence relies only on observational studies. Therefore, further studies are required to address the true causal effect. © 2017 The Authors. Diabetes/Metabolism Research and Reviews Published by John Wiley & Sons Ltd.

  11. Efficacy of insulin lispro in improving glycemic control in gestational diabetes

    Directory of Open Access Journals (Sweden)

    M C Deepaklal

    2014-01-01

    Full Text Available Aim: To assess the safety and efficacy of insulin lispro in improving glycemic control in patients with gestational diabetes. Materials and Methods: A retrospective observational study was conducted at a single center on 201 gestational women with diabetes. Subjects who received insulin lispro performed blood glucose self-monitoring and recorded the readings in the fasting state and 1 h after each meal. At each contact (in person or telephonic contact, the insulin dose was adjusted based on the readings measured. A total of 53 subjects also recorded glucose levels post-partum. Pregnancy and post-delivery glucose level and insulin requirements of these 53 patients were compared. Results: Analysis of glucose levels both fasting and post-prandial glucose levels revealed that after using insulin lispro, the number of episodes of post-prandial hyperglycemia (1 h plasma glucose >120 mg/dL was minimal and so was the incidence of hypoglycemia. Hypoglycemia was defined as a blood sugar value of. There was neither any congenital abnormality except for a poorly formed pinna in the right ear of one baby nor any post-partum complications of note. Conclusion: Insulin lispro is an effective and safe treatment option in gestational diabetes.

  12. Maternal Dietary Patterns and Gestational Diabetes Risk: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    Fatemeh Sedaghat

    2017-01-01

    Full Text Available Background. Maternal dietary patterns play an important role in the progress of gestational diabetes mellitus (GDM. The aim of the present study was to explore this association. Method. A total of 388 pregnant women (122 case and 266 control were included. Dietary intake were collected using a food frequency questionnaire (FFQ. GDM was diagnosed using a 100-gram, 3-hour oral glucose tolerance test. Dietary pattern was identified by factor analysis. To investigate the relation between each of the independent variables with gestational diabetes, the odds ratio (OR was calculated. Results. Western dietary pattern was high in sweets, jams, mayonnaise, soft drinks, salty snacks, solid fat, high-fat dairy products, potatoes, organ meat, eggs, red meat, processed foods, tea, and coffee. The prudent dietary pattern was characterized by higher intake of liquid oils, legumes, nuts and seeds, fruits and dried fruits, fish and poultry whole, and refined grains. Western dietary pattern was associated with increased risk of gestational diabetes mellitus before and after adjustment for confounders (OR = 1.97, 95% CI: 1.27–3.04, OR = 1.68, 95% CI: 1.04–2.27. However, no significant association was found for a prudent pattern. Conclusion. These findings suggest that the Western dietary pattern was associated with an increased risk of GDM.

  13. Neurodevelopment of Two-Year-Old Children Exposed to Metformin and Insulin in Gestational Diabetes Mellitus.

    Science.gov (United States)

    Tertti, Kristiina; Eskola, Eeva; Rönnemaa, Tapani; Haataja, Leena

    2015-01-01

    To compare cognitive, language, and motor skills and results of neurological examination in 2-year-old children born to mothers with gestational diabetes mellitus treated with metformin with those treated with insulin. The children of mothers with gestational diabetes mellitus randomized to metformin (n = 75) or insulin (n = 71) treatment during pregnancy were examined by standardized developmental and neurological measures; the Bayley Scales of Infant and Toddler Development (Bayley-III) and the Hammersmith Infant Neurological Examination. There were no significant differences between the metformin and insulin groups in the Bayley Scales of Infant and Toddler Development (Bayley-III) test of cognitive scale (p = .12), receptive communication (p = .14) or expressive communication (p = .75), fine motor scale (p = .10) or gross motor scale (p = .13), or the global scores of Hammersmith Infant Neurological Examination (p = .14). None of the children had a clinically significant developmental problem. However, compared with age-adjusted norms, a trend for weaker language performance was observed in both study groups. No differences in neurodevelopmental outcome were seen in 2-year-old children born to mothers with gestational diabetes mellitus (GDM) treated with insulin or metformin during pregnancy. The results suggest that children born to mothers with GDM and exposed to metformin in utero do not systematically need extensive formal neurodevelopmental assessment in early childhood.

  14. The prevalence of the metabolic syndrome in a danish population of women with previous gestational diabetes mellitus is three-fold higher than in the general population

    DEFF Research Database (Denmark)

    Lauenborg, Jeannet; Mathiesen, Elisabeth; Hansen, Torben

    2005-01-01

    Diabetes and obesity, components of the metabolic syndrome, are common characteristics of women with prior gestational diabetes mellitus (GDM). Due to increasing incidence of diabetes and obesity, the metabolic syndrome might comprise a major health problem among these women....

  15. Association of recently identified type 2 diabetes gene variants with Gestational Diabetes in Asian Indian population.

    Science.gov (United States)

    Kanthimathi, Sekar; Chidambaram, Manickam; Bodhini, Dhanasekaran; Liju, Samuel; Bhavatharini, Aruyerchelvan; Uma, Ram; Anjana, Ranjit Mohan; Mohan, Viswanathan; Radha, Venkatesan

    2017-06-01

    Earlier studies have provided evidence that the gestational diabetes mellitus (GDM) and Type 2 diabetes mellitus (T2DM) share common genetic background. A recent genome wide association study (GWAS) showed a strong association of six novel gene variants with T2DM among south Asians but not with Europeans. The aim of this study was to investigate whether these variants that confer susceptibility to T2DM in Asian Indian population also correlate with GDM in Asian Indian population. In addition to these novel variants, three T2DM associated SNPs that were previously identified by GWAS in Caucasian populations, which also showed association with T2DM in south Indian population in our previous study were also evaluated for their susceptibility to GDM in our population. The study groups comprised unrelated pregnant women with GDM (n = 518) and pregnant women with normal glucose tolerance (NGT) (n = 1220). A total of nine SNPs in or near nine loci, namely AP3S2 (rs2028299), BAZ1B (rs12056034), CDKN2A/B (rs7020996), GRB14 (rs3923113), HHEX (rs7923837), HMG20A (rs7178572), HNF4A (rs4812829), ST6GAL1 (rs16861329) and VPS26A (rs1802295) were genotyped using the MassARRAY system. Among these nine SNPs that previously showed an association with T2DM in Asian Indians, HMG20A (rs7178572) and HNF4A (rs4812829) gene variants showed a significant association with GDM. The risk alleles of rs7178572 in HMG20A and rs4812829 in HNF4A gene conferred 1.24 and 1.28 times higher risk independently and about 1.44 and 1.97 times increased susceptibility to GDM for one and two risk genotypes, respectively. We report that the HMG20A (rs7178572) and HNF4A (rs4812829) variants that have previously shown a strong association with T2DM in Asian Indians also contributes significant risk to GDM in this population. This is the first report of the association of HMG20A (rs7178572) and HNF4A (rs4812829) variants with GDM.

  16. Periodontitis and type 2 diabetes among women with previous gestational diabetes: epidemiological and immunological aspects in a follow-up of three years.

    Science.gov (United States)

    Esteves Lima, Rafael Paschoal; Cota, Luis Otávio Miranda; Silva, Tarcília Aparecida; Cortelli, Sheila Cavalca; Cortelli, José Roberto; Costa, Fernando Oliveira

    2017-01-01

    The aim of this study was to verify the incidence on the development of type 2 diabetes in women with previous gestational diabetes with and without periodontitis after a three-year time interval. Initial sample of this follow-up study consisted of 90 women diagnosed with gestational diabetes who underwent periodontal examination. After three years, 49 women were subjected to new periodontal examination and biological, behavioral, and social data of interest were collected. Additionally, the quantification of the C-reactive protein in blood samples was performed. Fasting glucose and glycated hemoglobin levels were requested. Saliva samples were collected for quantification of interleukin 6 and 10, tumor necrosis factor α, matrix metalloproteinase 2 and 9. The incidence of type 2 diabetes mellitus was 18.4% and of periodontitis was 10.2%. There was no significant difference in the incidence of type 2 diabetes mellitus among women with and without periodontitis. It was observed impact of C-reactive protein in the development of type 2 diabetes mellitus. However, it was not observed impact of periodontitis on the development of type 2 diabetes mellitus among women with previous gestational diabetes. It was not observed impact of periodontitis on the development of type 2 diabetes among women with previous gestational diabetes. The impact of C-reactive protein in the development of type 2 diabetes mellitus highlights the importance of an inflammatory process in the diabetes pathogenesis.

  17. Urinary incontinence and vaginal squeeze pressure two years post-cesarean delivery in primiparous women with previous gestational diabetes mellitus

    OpenAIRE

    Barbosa, Angélica Mércia Pascon; Dias, Adriano; Marini, Gabriela; Calderon, Iracema Mattos Paranhos; Witkin, Steven; Rudge, Marilza Vieira Cunha

    2011-01-01

    OBJECTIVE: To assess the prevalence of urinary incontinence and associated vaginal squeeze pressure in primiparous women with and without previous gestational diabetes mellitus two years post-cesarean delivery. METHODS: Primiparous women who delivered by cesarean two years previously were interviewed about the delivery and the occurrence of incontinence. Incontinence was reported by the women and vaginal pressure evaluated by a Perina perineometer. Sixty-three women with gestational diabetes ...

  18. Effect of dietary approaches to stop hypertension diet plan on pregnancy outcome patients with gestational diabetes mellitus

    OpenAIRE

    Jie Yao; Lin Cong; Benli Zhu; Ting Wang

    2015-01-01

    The purpose of this study is to test the effects of Dietary Approaches to Stop Hypertension (DASH) diet plan on pregnancy outcomes patients with gestational diabetes mellitus. This randomized controlled clinical trial was performed among 33 women diagnosed with gestational diabetes. These patients were randomly distributed to the control group (n = 16) or DASH diet group (n = 17) for 4 weeks. Whereas 47.1% of women in the DASH diet needed to have a cesarean section, this percentage of mean ge...

  19. Aboriginal Women's Experiences With Gestational Diabetes Mellitus: A Participatory Study With Mi'kmaq Women in Canada.

    Science.gov (United States)

    Whitty-Rogers, Joanne; Caine, Vera; Cameron, Brenda

    2016-01-01

    In Canada, diabetes is 3 to 5 times more common among Aboriginal people than in the general population. Women with a diagnosis of gestational diabetes mellitus have an increased risk of developing glucose intolerance later in life, with almost half developing type II diabetes within 15 years. A participatory action research study using a Two-Eyed Seeing approach was conducted. Conversational interviews with 9 Mi'kmaq women who experienced gestational diabetes mellitus and talking circles were held. Hermeneutic phenomenology was used for data analysis. Themes included life-altering experience; barriers limiting access to health care; social support during pregnancy; and feeling compelled to take action.

  20. Women born preterm or with inappropriate weight for gestational age are at risk of subsequent gestational diabetes and pre-eclampsia

    DEFF Research Database (Denmark)

    á Rogvi, Rasmus; Forman, Julie Lyng; Damm, Peter

    2012-01-01

    Low birthweight, which can be caused by inappropriate intrauterine growth or prematurity, is associated with development of gestational diabetes mellitus (GDM) as well as pre-eclampsia later in life, but the relative effects of prematurity and inappropriate intrauterine growth remain uncertain....

  1. Patient education for preventing diabetic foot ulceration

    NARCIS (Netherlands)

    Dorresteijn, J.A.; Kriegsman, D.M.; Assendelft, W.J.J.; Valk, G.D.

    2012-01-01

    BACKGROUND: Ulceration of the feet, which can result in loss of limbs and even death, is one of the major health problems for people with diabetes mellitus. OBJECTIVES: To assess the effects of patient education on the prevention of foot ulcers in patients with diabetes mellitus. SEARCH METHODS:

  2. Patient education for preventing diabetic foot ulceration

    NARCIS (Netherlands)

    Dorresteijn, J.A.; Kriegsman, D.M.; Assendelft, W.J.; Valk, G.D.

    2014-01-01

    BACKGROUND: Ulceration of the feet, which can result in loss of limbs and even death, is one of the major health problems for people with diabetes mellitus. OBJECTIVES: To assess the effects of patient education on the prevention of foot ulcers in patients with diabetes mellitus. SEARCH METHODS: We

  3. Can Diabetes Be Prevented? (For Parents)

    Science.gov (United States)

    ... activities — like watching TV, being online, or playing video or computer games — can help reduce the risk of weight gain and help prevent the onset of type 2 diabetes. Being active can be as simple ...

  4. Gestational Diabetes Alters Offspring DNA Methylation Profiles in Human and Rat: Identification of Key Pathways Involved in Endocrine System Disorders, Insulin Signaling, Diabetes Signaling, and ILK Signaling.

    Science.gov (United States)

    Petropoulos, Sophie; Guillemin, Claire; Ergaz, Zivanit; Dimov, Sergiy; Suderman, Matthew; Weinstein-Fudim, Liza; Ornoy, Asher; Szyf, Moshe

    2015-06-01

    Gestational diabetes is associated with risk for metabolic disease later in life. Using a cross-species approach in rat and humans, we examined the hypothesis that gestational diabetes during pregnancy triggers changes in the methylome of the offspring that might be mediating these risks. We show in a gestation diabetes rat model, the Cohen diabetic rat, that gestational diabetes triggers wide alterations in DNA methylation in the placenta in both candidate diabetes genes and genome-wide promoters, thus providing evidence for a causal relationship between diabetes during pregnancy and DNA methylation alterations. There is a significant overlap between differentially methylated genes in the placenta and the liver of the rat offspring. Several genes differentially methylated in rat placenta exposed to maternal diabetes are also differentially methylated in the human placenta of offspring exposed to gestational diabetes in utero. DNA methylation changes inversely correlate with changes in expression. The changes in DNA methylation affect known functional gene pathways involved in endocrine function, metabolism, and insulin responses. These data provide support to the hypothesis that early-life exposures and their effects on metabolic disease are mediated by DNA methylation changes. This has important diagnostic and therapeutic implications.

  5. Treatment With Diet and Exercise for Women With Gestational Diabetes Mellitus Diagnosed Using IADPSG Criteria.

    Science.gov (United States)

    Kgosidialwa, Oratile; Egan, Aoife M; Carmody, Louise; Kirwan, Breda; Gunning, Patricia; Dunne, Fidelma P

    2015-12-01

    Prevalence of gestational diabetes mellitus (GDM) and obesity continue to increase. This study aimed to ascertain whether diet and exercise is a successful intervention for women with GDM and whether a subset of these women have comparable outcomes to those with normal glucose tolerance (NGT). This was a retrospective cohort study of five antenatal centers along the Irish Atlantic seaboard of 567 women diagnosed with GDM and 2499 women with NGT during pregnancy. Diet and exercise therapy on diagnosis of GDM were prescribed and multiple maternal and neonatal outcomes were examined. Infants of women with GDM were more likely to be hypoglycemic (adjusted odds ratio [aOR], 7.25; 95% confidence interval [CI], 2.94-17.9) at birth. They were more likely to be admitted to the neonatal intensive care unit (aOR, 2.16; 95% CI, 1.60-2.91). Macrosomia and large-for-gestational-age rates were lower in the GDM group (aOR, 0.48; 95% CI, 0.37-0.64 and aOR, 0.61; 95% CI, 0.46-0.82, respectively). There was no increase in small for gestational age among offspring of women with GDM (aOR, 0.81; 95% CI, 0.49-1.34). Women with diet-treated GDM and body mass index (BMI) diabetes status. Medical nutritional therapy and exercise for women with GDM may be successful in lowering rates of large for gestational age and macrosomia without increasing small-for-gestational-age rates. Women with GDM and a BMI less than 25 kg/m(2) had outcomes similar to those with NGT suggesting that these women could potentially be treated in a less resource intensive setting.

  6. Evaluation of the International Association of the Diabetes In Pregnancy Study Group new criteria: gestational diabetes project.

    Science.gov (United States)

    Kong, Jason M; Lim, Ken; Thompson, David M

    2015-04-01

    To examine the diagnostic rates of gestational diabetes (GDM) and maternal/fetal outcomes before and after replacement of the Carpenter and Coustan (C&C) criteria with the International Association Diabetes Pregnancy Study Group (IADPSG) criteria. A retrospective analysis of all pregnancies in 2 separate 6-month cohorts in the province of British Columbia. The first C&C cohort was defined as a 6-month period prior to the introduction of the IADPSG 75 g glucose tolerance test on October 1, 2010. The IADPSG cohort was studied during a 6-month period after the change. There was a significant increase in rates of GDM when using the IADPSG 75 g criteria, from 7.9% (1838 of 23 211) to 9.4% (2104 of 22 397). There were no significant changes in maternal outcomes when using the IADPSG criteria (caesarean section, induction of labour, perineal laceration, pregnancy-induced hypertension, antepartum hemorrhage >20 weeks or postpartum hospital length of stay). The caesarean section rate was not increased according to multivariate analysis (30.9% vs. 29.7%; p=0.073). There were no significant changes in most fetal outcomes when using the IADPSG criteria (mean gestational age at birth, premature birth, meconium, birth trauma, mean birth weight, large for gestational age, small for gestational age, intrauterine growth restriction), but neonatal hypoglycemia was significantly higher (1.6 % vs. 1.3 %; p=0.007). The rates of GDM were higher when using the new IADPSG criteria. Overall, all of the maternal and most of the fetal outcomes were similar. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  7. Barriers to postpartum screening for type 2 diabetes: a qualitative study of women with previous gestational diabetes.

    Science.gov (United States)

    Rafii, Forough; Rahimparvar, Seyedeh Fatemeh Vasegh; Mehrdad, Neda; Keramat, Afsaneh

    2017-01-01

    Risk of developing type 2 diabetes is increased in women with previous gestational diabetes mellitus (GDM). Postpartum glycemic screening is recommended in women with recent GDM. But this screening rate is low and the reasons are unclear. The aim of this study was to explore the experiences of Iranian women with recent GDM on barriers of postpartum screening for diabetes. This qualitative study was conducted in Tehran, Iran in 2016. Semi-structured interview was used for data collection. 22 women with recent GDM were interviewed. These women gave birth in Tehran hospitals at a minimum of 6 months before interview. The missed screening defined as not attending to laboratory for Fasting Blood Sugar and/or Oral Glucose Tolerance Test, 6 week to 6 month after their child birthing. The data was analyzed by content analysis method. Themes and sub-themes that illustrated the barriers to postpartum diabetes screening were: inadequate education (about developing diabetes in the future, implementation of the screening, and glucometer validity in diagnosis of diabetes), perceiving the screening as difficult (feeling comfortable with the glucometer, poor laboratory conditions, issues related to the baby/babies, and financial problems), improper attitudes toward the screening (unwilling to get diagnosed, not giving priority to oneself, having false beliefs) and procrastination (gap to intention and action, self-deception and self-regulation failure). Women with recent GDM reported several barriers for postpartum diabetes screening. This study help to develop the evidence-based interventions for improving this screening rate.

  8. Epidemiological studies of exercise in diabetes prevention

    DEFF Research Database (Denmark)

    Hu, Gang; Lakka, Timo A; Oskari Kilpeläinen, Tuomas

    2007-01-01

    for more than 70% of total mortality among patients with type 2 diabetes. The associations of physical activity, physical fitness, and changes in the lifestyle with the risk of type 2 diabetes have been assessed by a number of prospective studies and clinical trials in the past decade. Several studies have...... also evaluated the joint associations of physical activity, body mass index, and glucose levels with the risk of type 2 diabetes. Prospective studies and clinical trials have shown that moderate or high levels of physical activity or physical fitness and changes in the lifestyle (dietary modification...... and increase in physical activity) can prevent type 2 diabetes. Our review of the scientific evidence confirms that 30 min/d of moderate- or high-level physical activity is an effective and safe way to prevent type 2 diabetes in all populations....

  9. Macrosomia Rates in Women with Diet-Controlled Gestational Diabetes: A Retrospective Study.

    Science.gov (United States)

    Vally, Fatima; Presneill, Jeffrey; Cade, Thomas

    2017-01-01

    Current data on the rates of macrosomia in women with gestational diabetes mellitus (GDM) are heterogenous. No study has specifically examined macrosomia rates in women with diet-controlled gestational diabetes. To compare the rates of macrosomia between mothers with diet-controlled GDM to mothers without diabetes mellitus. A retrospective study in which all patients with diet-controlled GDM and singleton pregnancies in 2014 were considered for inclusion in the study. These cases were individually matched to mothers without GDM and without type 1 or 2 diabetes. Cases were matched to parity, age, and BMI. Controls were selected from the same year and as close as possible to the date of delivery of the case. Primary outcomes were macrosomia, defined by estimated fetal weight >90th centile and >95th centile (separately). The estimated adjusted odds ratio for the presence of maternal GDM in the presence of EFW > 90th percentile (adjusted for maternal age, BMI, gravidity, parity, baby gender, and EGA) was 0.63 (95% CI 0.30-1.3; P = 0.21). The estimated adjusted odds ratio for the association of maternal GDM and EFW > 95th percentile was 0.66 (95% CI 0.26-1.7; P = 0.38). Our findings suggest that macrosomia is not increased in women with diet-controlled GDM. The study registration number is AQA 16/01.

  10. Glycemic Excursions in Type 1 Diabetes in Pregnancy: A Semiparametric Statistical Approach to Identify Sensitive Time Points during Gestation

    Directory of Open Access Journals (Sweden)

    Resmi Gupta

    2017-01-01

    Full Text Available Aim. To examine the gestational glycemic profile and identify specific times during pregnancy that variability in glucose levels, measured by change in velocity and acceleration/deceleration of blood glucose fluctuations, is associated with delivery of a large-for-gestational-age (LGA baby, in women with type 1 diabetes. Methods. Retrospective analysis of capillary blood glucose levels measured multiple times daily throughout gestation in women with type 1 diabetes was performed using semiparametric mixed models. Results. Velocity and acceleration/deceleration in glucose levels varied across gestation regardless of delivery outcome. Compared to women delivering LGA babies, those delivering babies appropriate for gestational age exhibited significantly smaller rates of change and less variation in glucose levels between 180 days of gestation and birth. Conclusions. Use of innovative statistical methods enabled detection of gestational intervals in which blood glucose fluctuation parameters might influence the likelihood of delivering LGA baby in mothers with type 1 diabetes. Understanding dynamics and being able to visualize gestational changes in blood glucose are a potentially useful tool to assist care providers in determining the optimal timing to initiate continuous glucose monitoring.

  11. Glycemic Excursions in Type 1 Diabetes in Pregnancy: A Semiparametric Statistical Approach to Identify Sensitive Time Points during Gestation

    Science.gov (United States)

    Gupta, Resmi; Khoury, Jane; Altaye, Mekibib; Dolan, Lawrence

    2017-01-01

    Aim. To examine the gestational glycemic profile and identify specific times during pregnancy that variability in glucose levels, measured by change in velocity and acceleration/deceleration of blood glucose fluctuations, is associated with delivery of a large-for-gestational-age (LGA) baby, in women with type 1 diabetes. Methods. Retrospective analysis of capillary blood glucose levels measured multiple times daily throughout gestation in women with type 1 diabetes was performed using semiparametric mixed models. Results. Velocity and acceleration/deceleration in glucose levels varied across gestation regardless of delivery outcome. Compared to women delivering LGA babies, those delivering babies appropriate for gestational age exhibited significantly smaller rates of change and less variation in glucose levels between 180 days of gestation and birth. Conclusions. Use of innovative statistical methods enabled detection of gestational intervals in which blood glucose fluctuation parameters might influence the likelihood of delivering LGA baby in mothers with type 1 diabetes. Understanding dynamics and being able to visualize gestational changes in blood glucose are a potentially useful tool to assist care providers in determining the optimal timing to initiate continuous glucose monitoring. PMID:28280744

  12. Prevalence and Determinants of Gestational Diabetes Mellitus: A Cross-Sectional Study in China

    Directory of Open Access Journals (Sweden)

    Xianglong Xu

    2017-12-01

    Full Text Available Objectives: This study aimed to identify the prevalence of gestational diabetes mellitus (GDM and to examine its associations with social and behavioral factors, maternal body mass index (BMI, anemia, and hypertension. Methods: A cross-sectional analysis was performed on data collected from 2345 pregnant women from 16 hospitals in five selected provinces in mainland China. Results: Prevalence of GDM was as follows: overall: 3.7%; pregnant women in the first pregnancy: 3.4%; pregnant women in the second pregnancy: 4.6%. Compared with early pregnancy women, late-stage pregnant women were more likely to have GDM (OR = 4.32, 95% CI (1.82, 10.27. Compared with 18–25 years old pregnant women, women aged 36–45 years were more likely to have GDM (OR = 3.98, 95% CI (1.41, 11.28. Compared with non-hypertensive patients, hypertensive patients were more likely to have GDM (OR = 6.93, 95% CI (1.28, 37.64. However, second pregnancy, high maternal BMI, prolonged screen time (TV-viewing time, computer-using time, and mobile-phone using time, insufficient and excessive sleep duration, poor sleep quality, smoking, and secondhand smoke exposure were not significantly associated with an increased risk of GDM. Conclusions: Women in the second pregnancy do not appear to predict an increased risk for developing GDM than women in the first pregnancy. High-risk groups of GDM included women in their late pregnancy, aged 36–45 years old, and with hypertension. The findings will contribute to an improved understanding of social and behavioral determinants of GDM in Chinese population and contribute to the development of health-prevention promotion interventions to address GDM.

  13. Healthy Lifestyle During Early Pregnancy and Risk of Gestational Diabetes Mellitus.

    Science.gov (United States)

    Badon, Sylvia E; Enquobahrie, Daniel A; Wartko, Paige D; Miller, Raymond S; Qiu, Chunfang; Gelaye, Bizu; Sorensen, Tanya K; Williams, Michelle A

    2017-08-01

    Previous studies have found associations between individual healthy behaviors and reduced risk of gestational diabetes mellitus (GDM); however, the association of composite healthy lifestyle during pregnancy with GDM has not been examined. Participants in the Omega Study (n = 3,005), a pregnancy cohort study conducted in Washington State (1996-2008), reported information on diet, physical activity, smoking, and stress during early pregnancy. Lifestyle components were dichotomized into healthy/unhealthy and then combined into a total lifestyle score (range, 0-4). Regression models were used to determine relative risk of GDM (n = 140 cases) in relation to healthy lifestyle. Twenty percent of participants had a healthy diet, 66% were physically active, 95% were nonsmokers, and 55% had low stress. Each 1-point increase in lifestyle score was associated with a 21% lower risk of GDM (95% confidence interval: 0.65, 0.96) after adjustment for age, race, and nulliparity. Adjustment for prepregnancy body mass index, prepregnancy physical activity, and prepregnancy smoking attenuated the associations slightly. Associations were similar in normal-weight and overweight/obese women. In this study, a composite measure of healthy lifestyle during early pregnancy was associated with substantially lower GDM risk. Public health messaging and interventions promoting multiple aspects of a healthy lifestyle during early pregnancy should be considered for GDM prevention. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Is there a value for probiotic supplements in gestational diabetes mellitus? A randomized clinical trial.

    Science.gov (United States)

    Dolatkhah, Neda; Hajifaraji, Majid; Abbasalizadeh, Fatemeh; Aghamohammadzadeh, Naser; Mehrabi, Yadollah; Abbasi, Mehran Mesgari

    2015-11-25

    Although several studies have found probiotics encouraging in prevention of gestational diabetes mellitus (GDM), the evidence for the use of probiotics in diagnosed GDM is largely limited. The aim of this study was to assess the effect of a probiotic supplement capsule containing four bacterial strains on glucose metabolism indices and weight changes in women with newly diagnosed GDM. Sixty-four pregnant women with GDM were enrolled into a double-blind placebo-controlled randomized clinical trial. They were randomly assigned to receive either a probiotic or placebo capsule along with dietary advice for eight consecutive weeks. The trend of weight gain along with glucose metabolism indices was assayed. During the first 6 weeks of the study, the weight gain trend was similar between the groups. However, in the last 2 weeks of the study, the weight gain in the probiotic group was significantly lower than in the placebo group (p Fasting blood sugar (FBS) decreased in both intervention (from 103.7 to 88.4 mg/dl) and control (from 100.9 to 93.6 mg/dl) groups significantly, and the decrease in the probiotic group was significantly higher than in the placebo group (p probiotic group had 6.74% reduction over the study period (p probiotic group was not significantly different from placebo when adjusted for the baseline levels. The probiotic supplement appeared to affect glucose metabolism and weight gain among pregnant women with GDM. This needs to be confirmed in other settings before a therapeutic value could be approved.

  15. Prevention of Preeclampsia with Aspirin in Multiple Gestations: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Bergeron, Tessa S; Roberge, Stéphanie; Carpentier, Caroline; Sibai, Baha; McCaw-Binns, Affette; Bujold, Emmanuel

    2016-05-01

    Objective The objective of this study was to estimate the effect of low-dose aspirin in multiple gestations to prevent preeclampsia and small for gestational age (SGA) neonates. Methods A systematic review and meta-analysis were performed through electronic database searches. Randomized controlled trials (RCTs) of women with multiple gestations assigned to receive aspirin or placebo or no treatment were included. Outcomes included preeclampsia (mild and severe) and SGA neonates. Relative risks (RR) with their 95% confidence intervals (CI) were calculated. Result Out of 6,853 citations, 6 RCTS, including 898 pregnancies, were included. We observed a significant reduction in the risk of preeclampsia (RR, 0.67; 95% CI, 0.48-0.94) and mild preeclampsia (RR, 0.44; 95% CI, 0.24-0.82) but not severe preeclampsia (RR, 1.02; 95% CI, 0.61-1.72) with low-dose aspirin. The risk of SGA was not changed (RR, 1.09; 95% CI, 0.80-1.47). The reduction of preeclampsia was not different between women randomized before (RR, 0.86; 95% CI, 0.41-1.81) or after 16 weeks' gestation (RR, 0.64; 95% CI, 0.43-0.96) (p = 0.50). Conclusion There is low level of evidence supporting the use of low-dose aspirin for the prevention of preeclampsia and SGA neonates in multiple gestations. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  16. Maternal hyperinsulinism and glycaemic status in the first trimester of pregnancy are associated with the development of pregnancy-induced hypertension and gestational diabetes.

    LENUS (Irish Health Repository)

    Kayemba-Kay's, Simon

    2013-03-01

    To evaluate the relationships across a range of glucose and insulin measures at 12 weeks of gestation with the development of pregnancy-induced hypertension (PIH), gestational diabetes mellitus (GDM) and birth size.

  17. Low-Dose Aspirin in Early Gestation for Prevention of Preeclampsia and Small-for-Gestational-Age Neonates: Meta-analysis of Large Randomized Trials.

    Science.gov (United States)

    Roberge, Stéphanie; Sibai, Baha; McCaw-Binns, Affette; Bujold, Emmanuel

    2016-07-01

    Objectives Meta-analyses of small to moderate size randomized controlled trials (RCTs) suggested that aspirin started before 17 weeks' gestation reduces the risk of preeclampsia and small-for-gestational-age (SGA) neonates. We evaluated data from large randomized trials originally excluded from meta-analyses. Methods We performed meta-analyses of RCTs including more than 350 participants that compared aspirin to placebo during pregnancy. Corresponding authors were contacted to obtain data according to gestational age. Outcomes included preeclampsia, severe preeclampsia, and SGA. Relative risks (RRs) with their 95% confidence intervals (CIs) were calculated. Results Data for women recruited before 17 weeks' gestation were obtained for three (50%) of the six eligible trials for a total of 11,949 participants including 3,293 recruited before 17 weeks' gestation with available data. We observed no impact of low-dose aspirin (60 mg) started before 17 weeks' gestation on the risk of preeclampsia (RR: 0.93; 95% CI: 0.75-1.15), severe preeclampsia (RR: 0.96; 95% CI: 0.71-1.28), or SGA (RR: 0.84; 95% CI: 0.56-1.26) and it was not statistically different than when started at or after 17 weeks' gestation. Conclusion Data from large randomized trials do not support greater benefits of low-dose aspirin (at 60 mg daily) when started before 17 weeks' gestation for the prevention of preeclampsia or SGA. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  18. Effect of dietary approaches to stop hypertension diet plan on pregnancy outcome patients with gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Jie Yao

    2015-12-01

    Full Text Available The purpose of this study is to test the effects of Dietary Approaches to Stop Hypertension (DASH diet plan on pregnancy outcomes patients with gestational diabetes mellitus. This randomized controlled clinical trial was performed among 33 women diagnosed with gestational diabetes. These patients were randomly distributed to the control group (n = 16 or DASH diet group (n = 17 for 4 weeks. Whereas 47.1% of women in the DASH diet needed to have a cesarean section, this percentage of mean gestational age in control diet was 81.3% (p<0.01. Approximately 23.5% of women in the DASH diet and 75% of women in control diet needed to commence insulin therapy after intervention (p<0.01. In conclusion, the effect of DASH diet improved pregnancy outcomes patients with gestational diabetes.

  19. Circulating galanin levels are increased in patients with gestational diabetes mellitus.

    Science.gov (United States)

    Fang, Penghua; Bo, Ping; Shi, Mingyi; Yu, Mei; Zhang, Zhenwen

    2013-06-01

    Galanin is a 29/30-amino acid peptide that stimulates food intake and regulates energy metabolism. A significantly higher level of plasma galanin was found in diabetes in non-pregnant women, but there are no data regarding galanin levels in diabetes in pregnant women. In this study we compared plasma galanin concentrations in pregnant women with gestational diabetes mellitus (GDM) and normal glucose tolerance (NGT). The study registered twenty pregnant women with GDM and twenty pregnant women with NGT. Fasting venous blood samples were collected from all cases. Galanin was analyzed by an enzyme-linked immunosorbent assay. A statistically significant higher level of galanin was found in pregnant women with GDM compared with NGT (Prelated to the changes of blood glucose in GDM. The higher level of galanin observed in GDM may represent a physiological adaptation to the rise of glucose associated with GDM. Copyright © 2012 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  20. Prenatal Clinical Assessment of NT-proBNP as a Diagnostic Tool for Preeclampsia, Gestational Hypertension and Gestational Diabetes Mellitus.

    Directory of Open Access Journals (Sweden)

    Pawel Sadlecki

    Full Text Available Common complications of pregnancy include preeclampsia (PE, gestational hypertension (GH and gestational diabetes mellitus (GDM. Hypertensive disorders (PE/GH and GDM may result in greater maternal, fetal and neonatal morbidity and mortality. Women with PE/GH, one of the most common causes of heart burden in an obstetrical setting, present with elevated serum levels of BNP and NT-proBNP. The aim of this study was to shed more light on the role of NT-proBNP in pathophysiology of PE, GH and GDM. The study included 156 pregnant women with singleton pregnancies. A total of 26 women developed arterial hypertension during pregnancy, 14 were diagnosed with PE, and GDM was detected in 81 patients. The control group included 35 women with uncomplicated pregnancies, normal arterial blood pressure and normal glucose concentrations. Patients with GH presented with significantly higher serum concentrations of NT-proBNPthan normotensive women (65.5 vs. 37.4 pg/ml; p = 0.0136. Serum levels of NT-proBNP in patients with PE were the highest of all the analyzed subsets, being significantly higher than in women without this condition (89.00 vs. 37.4pg/ml,p = 0,0136. However, women with and without GDM did not differ significantly in terms of their serum NT-proBNPconcentrations. Serum NT-proBNP (pg/ml (p = 0.0001 and BMI (p<0.0001 turned out to be independent predictors of GH on multivariate logistic regression analysis.Moreover, serum NT-proBNP (pg/ml was identified as an independent indicator of PE (p = 0.0016. A significant inverse correlation was found between birth weight and maternal serum NT-proBNP concentrations. In our opinion, NT-proBNP can be a useful clinical marker of GH and PE. Determination of NT-proBNP levels may be helpful in identification of patients with PE and GH and in their qualification for intensive treatment; this in turn, may be reflected by better neonatal outcomes.

  1. Gestational diabetes exhibits lack of carnitine deficiency despite relatively low carnitine levels and alterations in ketogenesis.

    Science.gov (United States)

    Pappa, Kalliopi I; Anagnou, Nicholas P; Salamalekis, Emmanuel; Bikouvarakis, Stylianos; Maropoulos, George; Anogianaki, Nektaria; Evangeliou, Athanasios; Koumantakis, Eugene

    2005-01-01

    Previous studies have underlined the importance of the carnitine shuttle system and its dysfunction both in normal pregnancy and in type 1 and 2 diabetes. The objective of this paper was to delineate more systematically the role of the carnitine shuttle system in normal pregnancy and in gestational diabetes. A total of 119 women matched for age comprised three groups: 40 normal adult non-pregnant women (NNP), 46 normal pregnant women with uncomplicated pregnancy (NP) and 33 women with gestational diabetes (GDM). The latter group was further subdivided into those being managed either by diet alone (25 women, GDM-D) or by insulin (8 women,GDM-I). The following biochemical parameters were assayed: fasting plasma total, free and acyl-carnitine, FFA and beta-OH-butyrate, together with several essential anthropometric parameters. Women with GDM, in contrast to the control groups, displayed the biochemical features characteristic of insulin resistance: higher body weight, higher BMI, higher skinfold and higher HbAlc levels. No differences on any parameters were found between the two GDM subgroups. Both NP and GDM groups had low levels of total carnitine compared to NNP control group, but surprisingly, the GDM group did not exhibit any further decrease of carnitine levels, as would have been expected by the combination of pregnancy and diabetes. Both groups, despite these low carnitine levels, had no clinical symptoms of carnitine deficiency. Furthermore, the GDM group displayed higher levels of FFA and beta-hydroxybutyrate, which were statistically significant compared to the other two control groups. The data corroborate the negative effect of normal gestation on the carnitine shuttle system, while they document for the first time that GDM does not further affect the efficiency of the carnitine system. The mild effect of GDMon carnitine status could be explained by the concurrent increased gluconeogenesis, a process which does not affect directly carnitine metabolism.

  2. The acidity of early pregnancy diet and risk of gestational diabetes mellitus.

    Science.gov (United States)

    Saraf-Bank, Sahar; Tehrani, Hotav; Haghighatdoost, Fahimeh; Moosavian, Seyedeh Parisa; Azadbakht, Leila

    2017-10-03

    Recently, an increasing interest has been addressed to the acid-base imbalance in the pathogenesis of diabetes while we are not aware of any study among patients affected by gestational diabetes mellitus (GDM). Therefore, the purpose of present study was to reveal the potential relation between dietary acid load (DAL) and glycemic indices, lipid profiles and GDM odds ratio among Iranian pregnant women with GDM. This case-control study (hospital-based setting) was performed in singleton fetus pregnant women; healthy (n = 263) and GDM (n = 200), aged 22-44 years, and between weeks 5-28 of pregnancy. Three-day 24-h dietary records were applied to determine usual intakes of women. The tertiles of protein to potassium ratio (Pr/K) and potential renal acid load (PRAL) were calculated and used for statistical analyses. Across tertiles of both DAL scores, fasting blood sugar, HbA1C, total cholesterol and LDL-C increased significantly. Diastolic blood pressure of participants significantly increased only across the tertiles of Pr/K ratio. Participants in the highest tertile of Pr/K and PRAL had more than 7 (OR = 7.60; 95% CI: 3.43-16.84) and 9 times (OR = 9.27; 95% CI: 4.00-21.46) increased odds of gestational diabetes mellitus, respectively. Women with higher scores of DAL were more likely to have gestational diabetes mellitus during pregnancy. Copyright © 2017. Published by Elsevier Ltd.

  3. Association between periodontal disease and gestational diabetes mellitus (GDM) - a prospective cohort study.

    Science.gov (United States)

    Kumar, Ashok; Sharma, Deepika S; Verma, Mahesh; Lamba, Arundeep Kaur; Gupta, Madhavi M; Sharma, Shashi; Perumal, Vanamail

    2018-04-03

    The present study aims to determine the association between periodontal disease and gestational diabetes mellitus (GDM) and the effect of this association on pregnancy outcome in North Indian population. A total of 584 primigravidae were recruited at 12-14 weeks of gestation. Their periodontal examination was done along with 75g oral glucose load test at the time of recruitment. GDM was diagnosed as per the DIPSI (The Diabetes in Pregnancy Study group India) guidelines (≥140mg/dL). Women with normal plasma glucose values underwent a repeat 75g oral glucose load test at 24-28 weeks of gestation. All patients were followed up for pregnancy outcomes. Out of 584 primigravida, 184 (31.5%) had gingivitis and 148 (25.3%) had periodontitis. Overall, 332 (56.8%) pregnant women had periodontal disease. It was associated with GDM with adjusted hazard ratio (aHR) of 2.85 (95%CI=1.47-5.53). The occurrence of preeclampsia was associated with periodontal disease with aHR of 2.20 (95%CI=0.86-5.60). If primigravidae had periodontal disease along with GDM, the risk of preeclampsia had shown increased aHR of 18.79 (95% CI= 7.45 - 47.40). The study shows a significant association of periodontal disease with GDM and an increased risk of developing preeclampsia due to this association. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  4. Pre-Pregnancy Fast Food Consumption Is Associated with Gestational Diabetes Mellitus among Tehranian Women

    Directory of Open Access Journals (Sweden)

    Minoor Lamyian

    2017-03-01

    Full Text Available The aim of this study was to evaluate the association between fast food consumption and gestational diabetes mellitus (GDM among Tehranian women. This study was conducted over a 17-month period, on a random sample of pregnant women (n = 1026, aged 18–45 years, attending prenatal clinics in five hospitals affiliated with universities of medical sciences, located in different districts of Tehran, Iran. Dietary data were collected during gestational age ≤6 weeks, using a 168-item valid and reliable food frequency questionnaire. Consumption of total fast foods including hamburgers, sausages, bologna (beef, pizza and French fries was calculated. Between 24 and 28 weeks of gestation, all pregnant women underwent a scheduled 100 g 3 h oral glucose tolerance test. GDM was defined according to the American Diabetes Association definition. The mean age and pre-pregnancy body mass index BMI of participants were 26.7 ± 4.3 years and 25.4 ± 4.5 Kg/m2, respectively. A total of 71 women developed GDM. After adjustment for confounders, the OR (95% CI for GDM for total fast food consumption was 2.12 (1.12–5.43 and for French fries it was 2.18 (1.05–4.70. No significant association was found between hamburgers, sausages, bologna (beef, pizza and GDM. Fast food consumption in women of reproductive age was found to have undesirable effects in the prevalence of GDM.

  5. Evaluation of fetal liver volume by tridimensional ultrasound in women with gestational diabetes mellitus.

    Science.gov (United States)

    Dubé, Marie-Christine; Girard, Mario; Morisset, Anne-Sophie; Tchernof, André; Weisnagel, S John; Bujold, Emmanuel

    2011-11-01

    To evaluate the effect of gestational diabetes mellitus (GDM) on fetal liver growth during the third trimester. We performed a longitudinal study of pregnant women recruited at the time of GDM screening (24 to 28 weeks of gestation), with follow-up visits at 32 weeks, 36 weeks, and delivery. Women with GDM were followed with nutritional recommendations and insulin when necessary according to the Canadian Diabetes Association guidelines. Fetal liver volume was evaluated using 3-D ultrasound at each antenatal visit, and fetal liver growth was compared between women with and without GDM. Twenty-seven women were recruited, 10 with normal glucose tolerance (NGT) and 17 with confirmed GDM, five who required insulin and 12 who were treated by diet only. We found no difference in fetal liver volume between groups at any of the three visits, and median birth weight was also similar between groups. On the other hand, we found a strong correlation between fetal liver volume at 36 weeks' gestation and birth weight (ρ = 0.61, P < 0.001). In our preliminary study, we found that fetal liver volume could be a strong predictor of infant birth weight independent of GDM status. This suggests that fetal liver volume of offspring of women with NGT is similar to that of offspring of women with GDM treated following recommended targets. Larger studies are required.

  6. Magnetic resonance imaging in pregnancies complicated by gestational diabetes predicts infant birthweight ratio and neonatal morbidity.

    Science.gov (United States)

    Jovanovic-Peterson, L; Crues, J; Durak, E; Peterson, C M

    1993-11-01

    The use of magnetic resonance imaging (MRI) has been shown to be safe during pregnancy and can accurately assess fetal fat and rate of growth. The purpose of this study was to investigate with MRI the relationship between maternal weight, fat distribution, and glucose levels and neonatal birthweight ratio, percent fat, and infant outcome in pregnancies complicated by gestational diabetes. Twenty gestational diabetic women were studied at 36 to 38 weeks' gestation with hemoglobin A1c, a glucose tolerance test and maternal body fat by electrical impedance. MRI scans of the maternal upper arm and from her zyphoid process to her pubic symphysis, including all fetal components, were analyzed for percent fat of the mother's arm and trunk and her fetus' trunk. All variables were then related to infant outcome (birthweight, birthweight ratio, and neonatal morbidity). Maternal body composition was related to maternal weight (p = 0.012, r = 0.54), as was maternal arm fat (p weight (p = NS). Although maternal Hb A1c correlated with maternal weight (p = 0.05, r = 0.43), it did not correlate with infant birthweight. In contrast, maternal mean glucose levels correlated with both maternal and infant weight and infant birthweight ratio (p = 0.05, r = 0.60; p = 0.05, r = 0.42; and p = 0.01, r = 0.64, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Pre-Pregnancy Fast Food Consumption Is Associated with Gestational Diabetes Mellitus among Tehranian Women.

    Science.gov (United States)

    Lamyian, Minoor; Hosseinpour-Niazi, Somayeh; Mirmiran, Parvin; Moghaddam Banaem, Lida; Goshtasebi, Azita; Azizi, Fereidoun

    2017-03-01

    The aim of this study was to evaluate the association between fast food consumption and gestational diabetes mellitus (GDM) among Tehranian women. This study was conducted over a 17-month period, on a random sample of pregnant women ( n = 1026), aged 18-45 years, attending prenatal clinics in five hospitals affiliated with universities of medical sciences, located in different districts of Tehran, Iran. Dietary data were collected during gestational age ≤6 weeks, using a 168-item valid and reliable food frequency questionnaire. Consumption of total fast foods including hamburgers, sausages, bologna (beef), pizza and French fries was calculated. Between 24 and 28 weeks of gestation, all pregnant women underwent a scheduled 100 g 3 h oral glucose tolerance test. GDM was defined according to the American Diabetes Association definition. The mean age and pre-pregnancy body mass index BMI of participants were 26.7 ± 4.3 years and 25.4 ± 4.5 Kg/m², respectively. A total of 71 women developed GDM. After adjustment for confounders, the OR (95% CI) for GDM for total fast food consumption was 2.12 (1.12-5.43) and for French fries it was 2.18 (1.05-4.70). No significant association was found between hamburgers, sausages, bologna (beef), pizza and GDM. Fast food consumption in women of reproductive age was found to have undesirable effects in the prevalence of GDM.

  8. Which Factors Influence the Type of Delivery and Cesarean Section Rate in Women with Gestational Diabetes?

    Science.gov (United States)

    Inocêncio, Gonçalo; Braga, António; Lima, Tânia; Vieira, Bruna; Zulmira, Rosa; Carinhas, Maria; Gonçalves, Joaquim; Silva, Clara

    2015-01-01

    To discover the differences between women with gestational diabetes mellitus (GDM) who delivered vaginally and those who delivered by cesarean section, and to assess the cesarean rate in this group of women. We divided all pregnant women with GDM into 2 groups: those who had vaginal delivery and those who gave birth by cesarean section (retrospective study of 6 years). We evaluated 460 births at term (≥ 37 weeks' gestation), for a total of 240 vaginal births and 220 cesarean births. All occurred in our institution. Of all the variables that were compared between the 2 groups, we found statistically significant differences (p history of macrosomia and gestational age at the time of beginning insulin treatment. Pregnant women with GDM and previous history of macrosomia are more likely to be submitted to cesarean section. Also, the initiation of insulin treatment at an early gestational age is associated with a higher chance of a woman delivering by cesarean section. The cesarean section rate in women with GDM was 47.8%.

  9. The role of blood groups in the development of diabetes mellitus after gestational diabetes mellitus.

    Science.gov (United States)

    Karagoz, Hatice; Erden, Abdulsamet; Ozer, Ozerhan; Esmeray, Kubra; Cetinkaya, Ali; Avci, Deniz; Karahan, Samet; Basak, Mustafa; Bulut, Kadir; Mutlu, Hasan; Simsek, Yasin

    2015-01-01

    Gestational diabetes mellitus (GDM) is a common condition that is defined as glucose intolerance of varying degree with onset or first recognition during pregnancy and it affects approximately 5% of all pregnancies all over the world. GDM is not only associated with adverse pregnancy outcomes such as macrosomia, dystocia, birth trauma, and metabolic complications in newborns, but it is also a strong predictor of transitioning to overt DM postpartum. The association of ABO blood groups with DM has been observed before in several epidemiological and genetic studies and resulted with inconsistent findings, but still there are not enough studies in the literature about the association of ABO blood groups with GDM. In this study, we aimed at investigating any possible relationship between the ABO blood group system and GDM and also the transitioning of GDM to overt DM postpartum, in Turkey. A total of 233 patients with GDM from Kayseri Training and Research Hospital between 2002 and 2012 were included in the study. The cases that have serologically determined blood groups and Rh factor in the hospital records were included in the study, and the patients with unknown blood groups were excluded. Patients were classified according to blood groups (A, B, AB, and O) and Rh status (+/-). GDM was diagnosed based on the glucose cut-points of the International Association of the Diabetes and Pregnancy Society Groups. The distributions of blood groups of the patients with GDM were compared with the distribution of blood groups of 17,314 healthy donors who were admitted to the Turkish Red Crescent Blood Service in our city in 2012. There was a significant difference between the patients with GDM and control group in terms of distribution of ABO blood groups. Blood group AB was found to be higher in the patients with GDM compared to the control group (P=0.029). When the patients were compared according to the development of DM, the ratio of group O was higher than others, while the

  10. Periodontal disease in gestational and type 1 diabetes mellitus pregnant women.

    Science.gov (United States)

    Ruiz, D R; Romito, G A; Dib, S A

    2011-07-01

    The present study evaluated the relationship between periodontal disease and its clinical variables in Brazilian non-diabetic pregnant women (C), gestational diabetes mellitus (GDM), or type 1 diabetes mellitus (T1DM). A periodontal exam was performed in one hundred and sixty-one pregnant women (GDM:80; T1DM:31; C:50) by a single-blinded calibrated examiner who recorded plaque index (PI), gingival index (GI), bleeding index (BI), gingival margin location (GM), probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and tooth mobility index (MI). The medical variables were age, pregestational body mass index (pre-BMI), fasting plasma glucose (FPG), and glycated hemoglobin (HbA(1c) ). The GI, GM, PD, CAL, BOP, and MI were significantly higher (P periodontal parameters confirmed these results. The presence of periodontal disease was significantly higher in Brazilian diabetic pregnancies (GDM and T1DM) when compared to non-diabetic pregnant women (C). The degree of periodontal disease was similar between the GDM and T1DM groups. Age, pregestational BMI, and HbA(1c) were factors related to CAL development in these two types of diabetes mellitus. © 2011 John Wiley & Sons A/S.

  11. First Trimester Aneuploidy Screening Markers in Women with Pre-Gestational Diabetes Mellitus

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    Padmalatha Gurram

    2014-05-01

    Full Text Available Objective: To investigate whether maternal serum pregnancy associated plasma protein-A (PAPP-A, total β human chorionic gonadotropin (hCG levels and nuchal translucency (NT measurements differ in women with pre-gestational diabetes mellitus (PGDM compared to non-diabetic controls and to assess whether correction factors are needed for diabetic women in calculation of aneuploidy risks. Study Design: We performed a retrospective study of all women who underwent first trimester aneuploidy screening (11 + 0 to 13 + 6 weeks from 2005 to 2011. The primary study outcome was the difference in PAPP-A, β-hCG and NT multiples of median between women with PGDM and non-diabetic women. Results: Of 6741 eligible patients, 103 patients with PGDM were using insulin and 4 patients were using oral hypoglycemic agents; the latter were excluded due to small number. There was 12% reduction of median PAPP-A (p = 0.001 and 18% reduction of median hCG (p = 0.006 in women with PGDM receiving insulin. There was no difference in NT. Conclusions: In women with PGDM receiving insulin, PAPP-A and β-hCG levels are significantly lower compared to non-diabetic women. This suggests that when calculating risks for aneuploidy, correction factors should be considered to adjust PAPP-A and β-hCG concentrations to those seen in non-diabetic women.

  12. Impact of gestational diabetes on the risk of diabetes following pregnancy among Chinese and South Asian women.

    Science.gov (United States)

    Mukerji, G; Chiu, M; Shah, B R

    2012-08-01

    Ethnicity and gestational diabetes mellitus (GDM) are both risk factors for the development of type 2 diabetes. However, it is uncertain whether ethnicity modifies the effect of GDM on diabetes risk. We aimed to determine the risk of diabetes following pregnancy with and without GDM for Chinese and South Asian women compared with white women. Using healthcare databases, all 1,050,108 women aged 20-49 with live births between January 1995 and June 2008 in Ontario were identified. They were followed for up to 15 years for the diagnosis of diabetes. The age-standardised prevalences of GDM were 4.1%, 7.1% and 2.9% for Chinese, South Asian and white women, respectively. The cumulative incidence of diagnosed diabetes at the median follow-up time of 7.6 years was 16.5% and 1.8% for Chinese women with and without GDM, 31.8% and 3.6% for South Asian women with and without GDM, and 25.7% and 1.8% for white women with and without GDM. The presence of GDM conferred an increase in the risk for diabetes after pregnancy of more than 13-fold in white women, but only a nine- to tenfold increase among Chinese and South Asian women. Although one-third of South Asian women with GDM were diagnosed with diabetes within 8 years postpartum, the incremental impact of GDM on diabetes risk was not as strong among Chinese and South Asian women as it was among white women.

  13. Clinical significance of neuregulin 4 (NRG4) in gestational diabetes mellitus.

    Science.gov (United States)

    Kurek Eken, Meryem; Yayla Abide, Cigdem; Sahin Ersoy, Gulcin; Altun Ensari, Tugba; Pekin, Oya; Cevik, Ozge

    2017-12-28

    Gestational diabetes mellitus (GDM) is defined as glucose intolerance detected during pregnancy. GDM is increasing worldwide and is associated with adverse maternal and fetal outcomes. Neuregulin 4 (NGR4) is epidermal growth factor like signaling molecule. It plays an important role in cell to cell communication furthermore recent studies indicate that NRG4 may work as a novel adipokine with a possible role in maintaining energy and metabolic homeostasis. The aim of the present study was to assess serum NRG4 levels along with several metabolic parameters in patients diagnosed with gestational diabetic mellitus. In this prospective cross-sectional study, the study group was composed of 63 women with GDM and 64 healthy pregnant women matched for age, body mass index (BMI) and gestational age. Blood samples were collected at the 24-28th gestational weeks. Serum NRG4, total cholesterol, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides, glucose levels during 75-gr OGTT, fasting insulin, glycosylated hemoglobin A1c (HbA1c), alanine aminotransferase (ALT) and creatinine levels were measured. Homeostasis model assessment of insulin resistance (HOMA-IR) values were calculated. Serum NRG4 values were significantly elevated in the GDM group compared to the control group (p HOMA-IR (β = 0.222, p < .001) independently and positively predicted NRG4 levels. Serum NRG4 levels were associated with metabolic parameters of GDM. The present study can be considered to be a guide for future studies to clarify the pathophysiology of NGR4 in GDM patients.

  14. The Usage of Oral Anti Hyperglycemic Agent in Gestational Diabetes: Pros and Cons

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    Bram Pradipta

    2014-06-01

    Full Text Available The prevalence of gestational diabetes mellitus (GDM  is increasing as the pregnant population becomes older and more obese. Fifteen percent of GDM patients require medical intervention. Insulin is still the drug of choice because it has not been implicated as a teratogen in human pregnancies.Insulin has its disadvantages such as the need for injections, the risk of hypoglycaemia, excessive weight gain and the costs. The use of oral anti hyperglicemic agent (OAHA, traditionally contraindicated, now can be considered as an alternative for insulin which can be beneficial in developing countries. From four groups of OAHA, sulfonylurea and biguanides can be used during pregnancy. Studies and randomized controlled trial (RCT have been done and most summarized that it does not increase any maternal and perinatal morbidity. Most data also show that thereare also no differences in glycemic control or pregnancy outcomes compared with insulin. There are conflicting data shows metformin increase prevalence of preeclampsia patient and perinatal morbidity. OAHA usage, although not yet recommended internationally, can be considered in GDMpatients with uncontrolled blood sugar levels that require medical intervention but can not use insulin. Wellconducted, prospective, controlled studies regarding itsfeasibility in pregnant women with diabetes are still needed.Keywords:oral antihyperglycemic agent, gestational, diabetes

  15. Frequency of impaired oral glucose tolerance test in high risk pregnancies for gestational diabetes mellitus

    International Nuclear Information System (INIS)

    Naheed, F.; Narijo, S.; Kammeruddin, K.

    2008-01-01

    To determine the frequency of impaired oral glucose tolerance test in high risk pregnancies for Gestational Diabetes Mellitus (GDM). A total of 50 high risk pregnancies for gestational diabetes mellitus were selected through outpatient department of obstetrics. Data was collected according to certain obstetric and non-obstetric risk factors for GDM as inclusion criteria through a designed proforma i.e. family history of diabetes, macrosomia (i.e, wt > 3.5 kg), abortions, grand multiparity, a sudden increase in weight (>1 kg/wk) during pregnancy, age > 35 years, early neonatal deaths/sudden IUDS, polyhydramnios, urogenital infections (vulvo-vaginal candidiasis and UTI), previous history of GDM, congenital abnormalities (with or without polyhydramnios) and multiple pregnancy. Oral glucose tolerance test was performed and analyzed according to American Diabetic Association criteria, 2004. The most frequent risk factors were family history of diabetes mellitus in 1st degree relative and large for dates babies in 18 patients. Similarly, high risk factors such as history of abortions and grand multiparity were present in 16 and 14 pregnant women respectively. Least common factors, which contributed for GDM, were polyhydramnios in 4 cases and perinatal mortality (due to congenital anomalies of foetus, intrauterine deaths or neonatal deaths) seen only in 5 cases. Overall impaired oral glucose tolerance test was found in 24%. Most patients had one (17%) or two risk factors commonly (23%). Only 2% had shown five or more risk factors. Oral glucose tolerance test is a useful diagnostic tool to detect GDM in high risk pregnancies, depending upon the high frequency of number of risk factors in each individual. (author)

  16. Serum Phthalate and Triclosan Levels Have Opposing Associations With Risk Factors for Gestational Diabetes Mellitus

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    Benjamin G. Fisher

    2018-03-01

    Full Text Available Certain phthalates and bisphenol A (BPA have been associated with insulin resistance and type 2 diabetes in non-pregnant adults, but studies of gestational diabetes mellitus (GDM have reported conflicting results for phthalates and no associations with BPA. Our aim was to investigate the relationship between maternal serum levels of phthalate metabolites and phenols at 10–17 weeks of gestation and glucose homeostasis at 28 weeks of gestation. 232 women aged ≥16 years without type 1 or 2 diabetes with singleton male pregnancies were recruited from a single UK maternity centre between 2001 and 2009 as part of a prospective observational study (Cambridge Baby Growth Study. Serum levels of 16 phthalate metabolites and 9 phenols (including BPA were measured using liquid chromatography/tandem mass spectrometry. Oral glucose tolerance tests were performed at 28 weeks. 47/232 (20.3% women had GDM. First-trimester triclosan (TCS was inversely associated with incident GDM (adjusted odds ratio per log increase in concentration 0.54, 95% confidence interval 0.34–0.86, p = 0.010. Amongst women without GDM, first-trimester mono-(2-ethylhexyl phthalate and mono(carboxyisooctyl phthalate levels were positively associated with 120-min plasma glucose (adjusted β 0.268 and 0.183, p = 0.0002 and 0.010, respectively in mid-pregnancy. No other monotonic associations were detected between phthalate or phenol levels and fasting or stimulated plasma glucose, β-cell function, insulin resistance, or 60-min disposition index. Our results support a glycaemia-raising effect of phthalates during pregnancy, consistent with findings in non-pregnant populations and suggest a possible protective effect of exposure to TCS against GDM.

  17. Cigarette smoking and risk of gestational diabetes: a systematic review of observational studies

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    Belizán José M

    2008-12-01

    Full Text Available Abstract Background Gestational diabetes is a prevalent disease associated with adverse outcomes of pregnancy. Smoking as been associated with glucose intolerance during pregnancy in some but not all studies. Therefore, we aimed to systematically review all epidemiological evidence to examine the association between cigarette smoking during pregnancy and risk of developing gestational diabetes mellitus. Methods We conducted a systematic review of articles published up to 2007, using PubMed, Embase, LILACS e CINAHL to identify the articles. Because this review focuses on studies of smoking during pregnancy, we excluded studies evaluating smoking outside pregnancy. Two investigators independently abstracted information on participant's characteristics, assessment of exposure and outcome, and estimates for the association under study. We evaluated the studies for publication bias and performed heterogeneity analyses. We also assessed the effect of each study individually through sensitivity analysis. Results We found and critically reviewed 32 studies, of which 12 met the criteria for inclusion in the review. Most of the studies provided only unadjusted measurements. Combining the results of the individual studies, we obtained a crude odds ratio of 1.03 (99% CI 0.85–1.25. Only 4 studies presented adjusted measurements of association, and no association was found when these alone were analyzed (OR 0.95; 99% CI 0.85–1.07. Subgroup analysis could not be done due to small sample size. Conclusion The number of studies is small, with major heterogeneity in research design and findings. Taken together, current data do not support an association between cigarette smoking during pregnancy and the risk of gestational diabetes.

  18. CTX (crosslaps rather than osteopontin is associated with disturbed glucose metabolism in gestational diabetes.

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    Yvonne Winhofer

    Full Text Available OBJECTIVE: Reciprocal interaction between bone and glucose metabolism might play a pivotal role in the development of type 2 diabetes. We recently demonstrated that osteocalcin is increased in women with gestational diabetes (GDM compared to healthy pregnant women and related to enhanced insulin secretion. Here, we aimed to investigate the role of the bone resorption marker CTX and osteopontin (OPN, a key molecule in subclinical inflammation underlying insulin resistance, in gestational diabetes. METHODS: Insulin sensitivity and secretion (derived from OGTT as well as CTX and osteopontin were investigated in 26 GDM and 52 women with normal glucose tolerance during pregnancy [CON] between 24th and 28th gestational weeks; 24 women also underwent postpartum examination. RESULTS: CTX was significantly higher in GDM compared to CON (0.44±0.20 vs.0.28±0.12 ng/ml, p<.0001 and positively correlated with osteocalcin (R = 0.64, p<.0001 and parameters of insulin secretion. Osteopontin plasma concentrations were decreased in GDM compared to CON (28.81±22.12 vs.37.68±19.63 ng/ml, p = 0.04, and did not show any relation to insulin secretion or sensitivity, but were significantly correlated with CRP (R = 0.3, p<0.007 and liver enzymes. Twelve weeks after delivery CTX and OPN were increased compared to pregnancy (both p<.0001 and did not differ between GDM and CON. CONCLUSION: Our findings support the idea of a tight regulation between bone and glucose metabolism, and suggest, that less curbed CTX during pregnancy might be involved in osteocalcin-mediated amelioration of insulin secretion in GDM. On the other hand, osteopontin was unrelated to insulin resistance in GDM, but associated with inflammatory markers and liver enzymes in all women.

  19. CTX (Crosslaps) Rather than Osteopontin Is Associated with Disturbed Glucose Metabolism in Gestational Diabetes

    Science.gov (United States)

    Winhofer, Yvonne; Kiefer, Florian W.; Handisurya, Ammon; Tura, Andrea; Klein, Katharina; Schneider, Barbara; Marculescu, Rodrig; Wagner, Oswald F.; Pacini, Giovanni; Luger, Anton; Stulnig, Thomas M.; Kautzky-Willer, Alexandra

    2012-01-01

    Objective Reciprocal interaction between bone and glucose metabolism might play a pivotal role in the development of type 2 diabetes. We recently demonstrated that osteocalcin is increased in women with gestational diabetes (GDM) compared to healthy pregnant women and related to enhanced insulin secretion. Here, we aimed to investigate the role of the bone resorption marker CTX and osteopontin (OPN), a key molecule in subclinical inflammation underlying insulin resistance, in gestational diabetes. Methods Insulin sensitivity and secretion (derived from OGTT) as well as CTX and osteopontin were investigated in 26 GDM and 52 women with normal glucose tolerance during pregnancy [CON] between 24th and 28th gestational weeks; 24 women also underwent postpartum examination. Results CTX was significantly higher in GDM compared to CON (0.44±0.20 vs.0.28±0.12 ng/ml, p<.0001) and positively correlated with osteocalcin (R = 0.64, p<.0001) and parameters of insulin secretion. Osteopontin plasma concentrations were decreased in GDM compared to CON (28.81±22.12 vs.37.68±19.63 ng/ml, p = 0.04), and did not show any relation to insulin secretion or sensitivity, but were significantly correlated with CRP (R = 0.3, p<0.007) and liver enzymes. Twelve weeks after delivery CTX and OPN were increased compared to pregnancy (both p<.0001) and did not differ between GDM and CON. Conclusion Our findings support the idea of a tight regulation between bone and glucose metabolism, and suggest, that less curbed CTX during pregnancy might be involved in osteocalcin-mediated amelioration of insulin secretion in GDM. On the other hand, osteopontin was unrelated to insulin resistance in GDM, but associated with inflammatory markers and liver enzymes in all women. PMID:22844418

  20. Atlantic Diabetes in Pregnancy (DIP): the prevalence and outcomes of gestational diabetes mellitus using new diagnostic criteria.

    LENUS (Irish Health Repository)

    O'Sullivan, E P

    2012-01-31

    AIMS\\/HYPOTHESIS: New diagnostic criteria for gestational diabetes mellitus (GDM) have recently been published. We wished to evaluate what impact these new criteria would have on GDM prevalence and outcomes in a predominantly European population. METHODS: The Atlantic Diabetes In Pregnancy (DIP) programme performed screening for GDM in 5,500 women with an oral glucose tolerance test at 24-28 weeks. GDM was defined according to the new International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria and compared with previous WHO criteria; maternal and neonatal adverse outcomes were prospectively recorded. RESULTS: Of the participants, 12.4% and 9.4% were diagnosed with GDM using IADPSG and WHO criteria, respectively. IADPSG GDM pregnancies were associated with a statistically significant increased incidence of adverse maternal outcomes (gestational hypertension, polyhydramnios and Caesarean section) and neonatal outcomes (prematurity, large for gestational age, neonatal unit admission, neonatal hypoglycaemia and respiratory distress). The odds ratio for the development of these adverse outcomes remained significant after adjustment for maternal age, body mass index and non-European ethnicity. Those women who were classified as having normal glucose tolerance by WHO criteria but as having GDM by IADPSG criteria also had significant adverse pregnancy outcomes. CONCLUSIONS\\/INTERPRETATION: GDM prevalence is higher when using newer IADPSG, compared with WHO, criteria, and these women and their offspring experience significant adverse pregnancy outcomes. Higher rates of GDM pose a challenge to healthcare systems, but improved screening provides an opportunity to attempt to reduce the associated morbidity for mother and child.

  1. Risk of Vaginal Infections at Early Gestation in Patients with Diabetic Conditions during Pregnancy: A Retrospective Cohort Study.

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    Julian Marschalek

    Full Text Available Pregnant women with gestational diabetes mellitus (GDM are reported to be at increased risk for infections of the genital tract. This study aimed to compare the prevalence of asymptomatic bacterial vaginosis (BV and Candida colonization at early gestation between pregnant women with and without diabetic conditions during pregnancy. We included data from 8, 486 singleton pregnancies that underwent an antenatal infection screen-and-treat programme at our department. All women with GDM or pre-existing diabetes were retrospectively assigned to the diabetic group (DIAB, whereas non-diabetic women served as controls (CON. Prevalence for BV and Candida colonization was 9% and 14% in the DIAB group, and 9% and 13% in the CON group, respectively (n.s.. No significant difference regarding stillbirth and preterm delivery (PTD, defined as a delivery earlier than 37 + 0 (37 weeks plus 0 days weeks of gestation was found. We could not find an increased risk of colonization with vaginal pathogens at early gestation in pregnant women with diabetes, compared to non-diabetic women. Large prospective studies are needed to evaluate the long-term risk of colonization with vaginal pathogens during the course of pregnancy in these women.

  2. The relative contribution of prepregnancy overweight and obesity, gestational weight gain, and IADPSG-defined gestational diabetes mellitus to fetal overgrowth.

    Science.gov (United States)

    Black, Mary Helen; Sacks, David A; Xiang, Anny H; Lawrence, Jean M

    2013-01-01

    The International Association of Diabetes in Pregnancy Study Groups (IADPSG) criteria for diagnosis of gestational diabetes mellitus (GDM) identifies women and infants at risk for adverse outcomes, which are also strongly associated with maternal overweight, obesity, and excess gestational weight gain. We conducted a retrospective study of 9,835 women who delivered at ≥20 weeks' gestation; had a prenatal, 2-h, 75-g oral glucose tolerance test; and were not treated with diet, exercise, or antidiabetic medications during pregnancy. Women were classified as having GDM based on IADPSG criteria and were categorized into six mutually exclusive prepregnancy BMI/GDM groups: normal weight ± GDM, overweight ± GDM, and obese ± GDM. Overall, 5,851 (59.5%) women were overweight or obese and 1,892 (19.2%) had GDM. Of those with GDM, 1,443 (76.3%) were overweight or obese. The prevalence of large-for-gestational-age (LGA) infants was significantly higher for overweight and obese women without GDM compared with their normal-weight counterparts. Among women without GDM, 21.6% of LGA infants were attributable to maternal overweight and obesity, and the combination of being overweight or obese and having GDM accounted for 23.3% of LGA infants. Increasing gestational weight gain was associated with a higher prevalence of LGA in all groups. Prepregnancy overweight and obesity account for a high proportion of LGA, even in the absence of GDM. Interventions that focus on maternal overweight/obesity and gestational weight gain, regardless of GDM status, have the potential to reach far more women at risk for having an LGA infant.

  3. A longitudinal study of sleep duration in pregnancy and subsequent risk of gestational diabetes: findings from a prospective, multiracial cohort.

    Science.gov (United States)

    Rawal, Shristi; Hinkle, Stefanie N; Zhu, Yeyi; Albert, Paul S; Zhang, Cuilin

    2017-04-01

    Both short and prolonged sleep duration have been linked to impaired glucose metabolism. Sleep patterns change during pregnancy, but prospective data are limited on their relation to gestational diabetes. We sought to prospectively examine the trimester-specific (first and second trimester) association between typical sleep duration in pregnancy and subsequent risk of gestational diabetes, as well as the influence of compensatory daytime napping on this association. In the prospective, multiracial Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies-Singleton Cohort, 2581 pregnant women reported their typical sleep duration and napping frequency in the first and second trimesters. Diagnosis of gestational diabetes (n = 107; 4.1%) was based on medical records review. Adjusted relative risks with 95% confidence intervals for gestational diabetes were estimated with Poisson regression, adjusting for demographics, prepregnancy body mass index, and other risk factors. From the first and second trimester, sleep duration and napping frequency declined. Sleeping duration in the second but not first trimester was significantly related to risk of gestational diabetes. The association between second-trimester sleep and gestational diabetes differed by prepregnancy obesity status (P for interaction = .04). Among nonobese but not obese women, both sleeping >8-9 hours or <8-9 hours were significantly related to risk of gestational diabetes: 5-6 hours (adjusted relative risk, 2.52; 95% confidence interval, 1.27-4.99); 7 hours (adjusted relative risk, 2.01; 95% confidence interval, 1.09-3.68); or ≥10 hours (adjusted relative risk, 2.17; 95% confidence interval, 1.01-4.67). Significant effect modification by napping frequency was also observed in the second trimester (P for interaction = .03). Significant and positive association between reduced sleep (5-7 hours) and gestational diabetes was observed among women napping rarely

  4. Periodontitis may be Associated with Gestational Diabetes Mellitus but not Affirmatively.

    Science.gov (United States)

    Jiang, Hong; Xiong, Xu

    2016-06-01

    Association Between Periodontitis and Gestational Diabetes Mellitus: Systematic Review and Meta-Analysis. Esteves Lima RP, es Cyrino RM, Dutra BC, da Silveira JO, Martins CC, Cota LOM, Costa FO. J Periodontol 2016;87(1):48-57. The research was supported by the Coordination for the Improvement of Higher Education Personnel (CAPES, Brazil), the Minas Gerais State Research Foundation (FAPEMIG, Brazil), the National Council of Scientific and Technological Development (CNPq, Brazil), and the Dean of Research from the Federal University of Minas Gerais (PRPq/UFMG, Brazil) Systematic review with meta-analysis. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. The Influence of Gestational Diabetes on Neurodevelopment of Children in the First Two Years of Life: A Prospective Study.

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    Shirong Cai

    Full Text Available Analyze the relation of gestational diabetes and maternal blood glucose levels to early cognitive functions in the first two years of life.In a prospective Singaporean birth cohort study, pregnant women were screened for gestational diabetes at 26-28 weeks gestation using a 75-g oral glucose tolerance test. Four hundred and seventy three children (n = 74 and n = 399 born to mothers with and without gestational diabetes respectively underwent neurocognitive assessments at 6, 18, and/or 24 month, including electrophysiology during an attentional task and behavioral measures of attention, memory and cognition.Gestational diabetes is related to left hemisphere EPmax amplitude differences (oddball versus standard at both six (P = 0.039 and eighteen months (P = 0.039, with mean amplitudes suggesting offspring of mothers with gestational diabetes exhibit greater neuronal activity to standard stimuli and less to oddball stimuli. Associations between 2-hour maternal glucose levels and the difference in EPmax amplitude were marginal at 6 months [adjusted β = -0.19 (95% CI: -0.42 to +0.04 μV, P = 0.100] and significant at 18 months [adjusted β = -0.27 (95% CI: -0.49 to -0.06 μV, P = 0.014], and the EPmax amplitude difference (oddball-standard associated with the Bayley Scales of Infant and toddler Development-III cognitive score at 24 months [β = 0.598 (95% CI: 0.158 to 1.038, P = 0.008].Gestational diabetes and maternal blood glucose levels are associated with offspring neuronal activity during an attentional task at both six and eighteen months. Such electrophysiological differences are likely functionally important, having been previously linked to attention problems later in life.

  6. Prevalence of gestational diabetes and its risk factors in Kermanshah 2009

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    Mehrali Rahimi

    2010-09-01

    Full Text Available Background: Prevalence of gestational diabetes (GD varied between 1-14% around the world. Such variation in the prevalence of GD as well as no available information in Kermanshah encouraged us to design this study aimed to investigate about prevalence of GD and factors associated with this condition in Kermanshah.Methods: A cross-sectional descriptive analytic study was designed. The study population was 1720 pregnant women referred to Kermanshah's primary health and treatment centers. All recorded information within their profiles including demographic data, last pregnancies, familial history, result of GCT and OGTT (if data were available was collected. Data were analyzed using univariate and multivariate statistical methods (logistic regression.Results: Prevalence of GD cases was 3.43%. Diabetic mothers were more obese and older than non-diabetic mothers and greater proportion of such women had previous history of GD, still birth, familial history of diabetes, history of abortion, macrosomia and PCO. In multivariate analysis showed that age, obesity, familial history of diabetes, previous history of GD and abortion increased the risk of GD.Conclusion: The prevalence of GD in Kermanshah is comparable with other studies in Iran. Controlling related risk factors may reduce risk of GD.

  7. What is the postpartum experience of Danish women following gestational diabetes?

    DEFF Research Database (Denmark)

    Svensson, Line; Kragelund Nielsen, Karoline; Terkildsen Maindal, Helle

    2017-01-01

    BACKGROUND: Women with gestational diabetes mellitus (GDM) receive acute but short-term care during pregnancy. There is less direct support during the postpartum period; women are offered general advice on how to follow a healthy lifestyle to avoid developing future type 2 diabetes. Observational...... lifestyle. The women's experience of the health system varied. However, in the postpartum period all the women experienced limited interaction and initiative from their healthcare providers in supporting them to engage in a healthy lifestyle. CONCLUSIONS: This study identified barriers and facilitators...... to sustaining a healthy lifestyle postpartum. Efforts at multiple levels - including the individual, family and health system - are needed to facilitate and support a healthy lifestyle among women with prior GDM....

  8. Paternal and maternal obesity but not gestational weight gain is associated with type 1 diabetes

    DEFF Research Database (Denmark)

    Magnus, Maria C; Olsen, Sjurdur F; Granstrom, Charlotta

    2018-01-01

    100 000 person-years in MoBa and 28.5 per 100 000 person-years in DNBC. Both maternal pre-pregnancy obesity, adjusted hazard ratio (HR) 1.41 [95% confidence interval (CI): 1.06, 1.89] and paternal obesity, adjusted HR 1.51 (95% CI: 1.11, 2.04), were associated with childhood-onset type 1 diabetes....... The associations were similar after mutual adjustment. In contrast, maternal total gestational weight gain was not associated with childhood-onset type 1 diabetes, adjusted HR 1.00 (95% CI: 0.99, 1.02) per kilogram increase. Conclusions: Our study suggests that the association between maternal obesity...

  9. Prevention of preterm delivery in twin gestations (PREDICT): a multicenter, randomized, placebo-controlled trial on the effect of vaginal micronized progesterone

    DEFF Research Database (Denmark)

    Rode, L; Klein, K; Nicolaides, K H

    2011-01-01

    Studies on high-risk singleton gestations have shown a preventive effect of progesterone treatment on preterm delivery. This study was conducted to investigate the preventive effect of vaginal micronized progesterone in a large population of twin gestations....

  10. Noise exposure during the first trimester and the risk of gestational diabetes mellitus

    Science.gov (United States)

    Min, Kyoung-Bok; Min, Jin-Young

    2017-07-01

    Gestational diabetes mellitus (GDM) is a form of diabetes that affects pregnant women. GDM tends to resolve after delivery, but has an impact on the health of the mother and her offspring. Considering the potential association between noise and diabetes and the susceptibility of the pregnant state to diabetogenesis, noise pollution may be associated with the risk of GDM; however, there is no evidence of the effect of noise pollution on GDM. In this study, we investigated the association between residential exposure to noise during the first trimester and incidence of GDM using the National Health Insurance Service-National Sample Cohort (NHIS-NSC), a representative sample of South Koreans. We analyzed the National Health Insurance Service-National Sample Cohort (2002-2013), a population-wide health insurance claim data. Study population was a total of 18 165 pregnant women. GDM was defined as ICD-10 code O244, and noise exposure levels were categorized as daytime (07:00-19:00) and nighttime (23:00-7:00). Other known risk factors for GDM were age, income, residential area, physical activity, smoking, drinking, blood sugar levels, and body mass index before getting pregnant. The study population included 18 165 pregnant women, of which 8.8% developed gestational diabetes. After adjustment, the adjusted OR (95% CI) for GDM associated with 1 dB increase in nighttime noise was 1.07 (95% CI: 1.05-1.10). Compared with the reference group (Quartile 1), the adjusted ORs for GDM in those exposed to the highest quartile of noise exposure (Quartile 4) was 1.61 (95% CI: 1.38-1.87) at nighttime noise. However, no significant association was observed between daytime noise exposure (07:00-19:00) and the incidence of GDM. We observed that the odds of gestational diabetes during the first trimester was 1.6 times higher for pregnant women exposed to elevated nighttime noise compared to similar women exposed to normal baseline noise levels in South Korea. Although this finding

  11. Are There Benefits for Gestational Diabetes Mellitus in Treating Lower Levels of Hyperglycemia Than Standard Recommendations?

    Science.gov (United States)

    Nguyen, Thi Hoang Lan; Yang, Ji Wei; Mahone, Michèle; Godbout, Ariane

    2016-12-01

    The new International Association of Diabetes and Pregnancy Study Groups (IADPSG) recommendations for diagnosis of gestational diabetes mellitus (GDM) are generating discussion regarding their universal adoption. Our centre is currently using stricter GDM diagnostic criteria than those proposed by the IADPSG. Evaluation of complication rates and their predictors in our cohort may provide insight for the care of this high-risk population. Therefore, we determined complication rates and identified antepartum maternal predictors of adverse outcomes in our cohort with mild GDM. A retrospective cohort study was performed between 2005 and 2011. It included women with and without GDM, which was diagnosed if fasting plasma glucose levels were 5.0 or above or 2-hour post 75 gram oral glucose tolerance test (OGTT) were 7.8 mmol/L or higher. A total of 3712 women, with and without diabetes, were included. Rates of macrosomia and pre-eclampsia were significantly higher in the group with GDM but were lower than the rates usually reported. Macrosomia, the need for insulin therapy or caesarean section and postpartum glucose intolerance predictors included prepregnancy body mass index, excessive gestational weight gain and OGTT screening results, although no specific threshold was found. This study provides insight into GDM-related complications rates and the benefits of intervention in a large cohort of women with levels of hyperglycemia lower than those currently recommended for diagnosis of GDM. These findings suggest a continuous association between adverse outcomes and maternal hyperglycemia and highlight the important role of maternal risk factors other than glycemic results in the development of pregnancy-related complications. Milder forms of hyperglycemia that would not be identified by IADPSG guidelines may benefit from treatment. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  12. Implications of Lipids in Neonatal Body Weight and Fat Mass in Gestational Diabetic Mothers and Non-Diabetic Controls.

    Science.gov (United States)

    Herrera, Emilio; Ortega-Senovilla, Henar

    2018-02-05

    Maternal lipid metabolism greatly changes during pregnancy and we review in this article how they influence fetal adiposity and growth under non-diabetic and gestational diabetic conditions. In pregnant women without diabetes (control), maternal glycemia correlates with neonatal glycemia, neonatal body weight and fat mass. In pregnant women with gestational diabetes mellitus (GDM), maternal glucose correlates with neither neonatal glycemia, neonatal birth weight nor fat mass, but maternal triacylglycerols (TAG), non-esterified fatty acids (NEFA) and glycerol do correlate with birth weight and neonatal adiposity. The proportions of maternal plasma arachidonic (AA) and docosahexaenoic (DHA) acids decrease from the first to the third trimester of pregnancy, and at term these long-chain polyunsaturated fatty acids are higher in cord blood plasma than in mothers, indicating efficient placental transfer. In control or pregnant women with GDM at term, the maternal concentration of individual fatty acids does not correlate with neonatal body weight or fat mass, but cord blood fatty acid levels correlate with birth weight and neonatal adiposity-positively in controls, but negatively in GDM. The proportion of AA and DHA in umbilical artery plasma in GDM is lower than in controls but not in umbilical vein plasma. Therefore, an increased utilization of those two fatty acids by fetal tissues, rather than impaired placental transfer, is responsible for their smaller proportion in plasma of GDM newborns. In control pregnant women, maternal glycemia controls neonatal body weight and fat mass, whereas in mothers with GDM-even with good glycemic control-maternal lipids and their greater utilization by the fetus play a critical role in neonatal body weight and fat mass. We propose that altered lipid metabolism rather than hyperglycemia constitutes a risk for macrosomia in GDM.

  13. Gestational diabetes mellitus: the effects of diagnosis time and implementation of diabetic care on management of glycemia

    Directory of Open Access Journals (Sweden)

    Andrzej Gruszka

    2014-06-01

    Full Text Available Introduction : Pregnancy is considered diabetogenic condition related to increased requirements for insulin, its increased secretion and ongoing insulin resistance. In pregnancy increased insulin secretion cannot compensate increased requirements which leads to gestational diabetes mellitus (GDM. If diagnosed too late or ill-treated diabetes can cause serious complications in the course of pregnancy and delivery as well as late complications in neonate. Aim of the research: To assess if time of diagnosis of gestational diabetes mellitus and implementation of diabetic care influence glycemia management and clinical condition of neonate after birth. Material and methods: The survey was carried out in the group of 300 pregnant women with GDM. The patients were divided into 3 groups: group A – patients with GDM diagnosed between 10–12 week hbd, group B – patients who had GDM diagnosed between 24–28 week hbd and group C – GDM diagnosed between 29 week hbd and delivery. Results: The analysis revealed correlation between the frequency of GDM and patient’s age and body mass index. Time of GDM diagnosis and following recommendations for GDM management depend on patient’s place of living and socio-economic status. Neonate’s condition is affected by proper glycemia management. Conclusions: There is a correlation between place of living, poor socio-economic status and managing glycemia, which should contribute to developing effective methods of care for women living in those areas. Patients’ body mass index significantly correlated with fetus macrosomy, which significantly affected the way pregnancy was terminated and neonate’s condition after birth. Time of GDM diagnosis has a big influence on glycemia management which is essential for mother’s and neonate’s health.

  14. WISP1 is a novel adipokine linked to metabolic parameters in gestational diabetes mellitus.

    Science.gov (United States)

    Sahin Ersoy, Gulcin; Altun Ensari, Tugba; Subas, Seda; Giray, Burak; Simsek, Engin Ersin; Cevik, Ozge

    2017-04-01

    To investigate Wnt1-inducible signaling pathway protein-1 (WISP1) levels and their correlation with metabolic parameters in pregnant women with gestational diabetes mellitus (GDM) and non-GDM healthy pregnant women. In this prospective cross-sectional study, the study group was composed of 62 women with GDM and 73 healthy pregnant women matched for age, body mass index (BMI) and gestational age. Blood samples were collected at 25-29th gestational week. Serum WISP1, betatrophin, glucose, fasting insulin, glycosylated hemoglobin A1c, total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, C reactive protein, alanine aminotransferase and creatinine levels were measured. Homeostasis model assessment of insulin resistance (HOMA-IR) values was calculated. The level of significance was accepted as p HOMA-IR values and fasting glucose, fasting insulin, triglyceride, betatrophin levels. BMI, HOMA-IR and betatrophin independently and positively predicted WISP1 levels. These results demonstrate a relationship between WISP1 and the metabolic parameters of GDM. And, WISP1 might be involved in the pathophysiology of GDM. As a part of this pathophysiological mechanism, the activation of WISP1 and betatrophin might take place through several ways; WISP1 and betatrophin might either use same signaling pathways and potentiate each other or they might also constitute the sequential steps of a common pathway.

  15. Efficacy of metformin in maintaining euglycemia in patients with gestational diabetes mellitus

    International Nuclear Information System (INIS)

    Amir, Z.E.; Saifuddin, Z.; Tanveer, S.; Khan, S.A.

    2017-01-01

    To determine efficacy of metformin in maintaining euglycemia in patients with GDM among women presenting in our institution. Methodology: It was a prospective study conducted at the department of Obstetrics and Gynecology Railway teaching Hospital IIMCT, Rawalpindi from October 2014 to April 2015 and included 60 patients of 18-45 years of age at 10-32 weeks gestation in singleton pregnancy with fasting blood glucose levels > 6.1 mmol /L and 2 hours Post Prandial levels > 7.8 mml/L Metformin is started at a dose of 500 mg daily and increased up to 2500 mg daily. Aim was to keep fasting sugar level between 3.5 - 5.9 mmol/L and 2 hours post prandial < 7.8 mmol/L. Results: The median daily dose of metformin was 1500 mg. The mean gestational age at delivery was 38.1 weeks. Neonatal hypoglycemia (glucose level < 1.6mmol/L ) was less common. The only adverse effects of metformin was GI upset (13.1 %) The results of postpartum questionnaire assessing acceptability of treatment among women treated with metformin alone, 65.6 % said they would chose metformin in subsequent pregnancy. The efficacy of metformin alone was 85.7%. Conclusion: In women with gestational diabetes mellitus, metformin (alone or with supplemental insulin) is not associated with increased prenatal complications. The women preferred metformin to insulin treatment. (author)

  16. Gut microbiome in gestational diabetes: a cross-sectional study of mothers and offspring 5 years postpartum.

    Science.gov (United States)

    Hasan, Sayyid; Aho, Velma; Pereira, Pedro; Paulin, Lars; Koivusalo, Saila B; Auvinen, Petri; Eriksson, Johan G

    2018-01-01

    An altered gut microbiome composition is shown to be associated with various diseases and health outcomes. We compare the gut microbiota of women who developed gestational diabetes mellitus (GDM) with that of those who did not, and the gut microbiota of their offspring, to determine any differences in the composition and diversity of their gut microbiota, which may be correlated with their GDM state. All women were at high risk for GDM and participated in the Finnish Gestational Diabetes Prevention Study (RADIEL). Stool samples were obtained, 5 years postpartum, from 60 GDM-positive women, 68 non-GDM control women, and their children (n = 109), 237 individuals in total. 16S ribosomal RNA gene sequencing was employed to determine the composition of bacterial communities present. Statistical correlations were inferred between clinical variables and microbiota, while taking into account potential confounders. In mothers, no significant differences were observed in microbiota composition between the two groups. Genus Anaerotruncus was increased in children of women with GDM (p microbiome composition when compared with unrelated children, other mothers, or the children compared with each other (p microbiome basis to GDM susceptibility in high-risk women, whereas microbiome differences between the offspring could be of greater biological significance. The heterogeneous nature of the disease could be obscuring potential differences between women. A longer time-series study, with carefully defined subject subgroups, may be an appropriate course of future investigation into GDM and the microbiome. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  17. Hepatic rather than cardiac steatosis relates to glucose intolerance in women with prior gestational diabetes.

    Directory of Open Access Journals (Sweden)

    Yvonne Winhofer

    Full Text Available BACKGROUND: Increased myocardial lipid accumulation has been described in patients with pre- and overt type 2 diabetes and could underlie the development of left-ventricular dysfunction in metabolic diseases (diabetic cardiomyopathy. Since women with prior gestational diabetes (pGDM display a generally young population at high risk of developing diabetes and associated cardiovascular complications, we aimed to assess whether myocardial lipid accumulation can be detected at early stages of glucose intolerance and relates to markers of hepatic steatosis (Fatty Liver Index, cardiac function, insulin sensitivity and secretion. METHODS: Myocardial lipid content (MYCL, left-ventricular function (1H-magnetic-resonance-spectroscopy and -imaging, insulin sensitivity/secretion (oral glucose tolerance test and the fatty liver index (FLI were assessed in 35 pGDM (45.6±7.0 years, 28.3±4.8 kg/m2 and 14 healthy control females (CON; 44.7±9.8 years, 26.1±2.5 kg/m2, matching for age and body-mass-index (each p>0.1. RESULTS: Of 35 pGDM, 9 displayed normal glucose tolerance (NGT, 6 impaired glucose regulation (IGR and 20 had been already diagnosed with type 2 diabetes (T2DM. MYCL and cardiac function were comparable between pGDM and CON; in addition, no evidence of left-ventricular dysfunction was observed. MYCL was inversely correlated with the ejection fraction in T2DM (R = -0.45, p<0.05, while the FLI was tightly correlated with metabolic parameters (such as HbA1C, fasting plasma glucose and HDL-cholesterol and rose along GT-groups. CONCLUSIONS: There is no evidence of cardiac steatosis in middle-aged women with prior gestational diabetes, suggesting that cardiac complications might develop later in the time-course of diabetes and may be accelerated by the co-existence of further risk factors, whereas hepatic steatosis remains a valid biomarker for metabolic diseases even in this rather young female cohort.

  18. "GINEXMAL RCT: Induction of labour versus expectant management in gestational diabetes pregnancies"

    Directory of Open Access Journals (Sweden)

    Hadar Eran

    2011-04-01

    Full Text Available Abstract Background Gestational Diabetes (GDM is one of the most common complications of pregnancies affecting around 7% of women. This clinical condition is associated with an increased risk of developing fetal macrosomia and is related to a higher incidence of caesarean section in comparison to the general population. Strong evidence indicating the best management between induction of labour at term and expectant monitoring are missing. Methods/Design Pregnant women with singleton pregnancy in vertex presentation previously diagnosed with gestational diabetes will be asked to participate in a multicenter open-label randomized controlled trial between 38+0 and 39+0 gestational weeks. Women will be recruited in the third trimester in the Outpatient clinic or in the Day Assessment Unit according to local protocols. Women who opt to take part will be randomized according to induction of labour or expectant management for spontaneous delivery. Patients allocated to the induction group will be admitted to the obstetric ward and offered induction of labour via use of prostaglandins, Foley catheter or oxytocin (depending on clinical conditions. Women assigned to the expectant arm will be sent to their domicile where they will be followed up until delivery, through maternal and fetal wellbeing monitoring twice weekly. The primary study outcome is the Caesarean section (C-section rate, whilst secondary measurement4s are maternal and neonatal outcomes. A total sample of 1760 women (880 each arm will be recruited to identify a relative difference between the two arms equal to 20% in favour of induction, with concerns to C-section rate. Data will be collected until mothers and newborns discharge from the hospital. Analysis of the outcome measures will be carried out by intention to treat. Discussion The present trial will provide evidence as to whether or not, in women affected by gestational diabetes, induction of labour between 38+0 and 39+0 weeks is an

  19. Metformin versus insulin in gestational diabetes mellitus: a meta-analysis of randomized clinical trials.

    Science.gov (United States)

    Zhu, B; Zhang, L; Fan, Y Y; Wang, L; Li, X G; Liu, T; Cao, Y S; Zhao, Z G

    2016-05-01

    Metformin is widely used in treatment of type 2 diabetes. However, whether it is safe for use in pregnancy is controversial. A search for relevant studies were performed using PubMed (1948-2014), Embase (1974-2014), the Web of knowledge (1950-2014), and the Cochrane database, included all randomized control trials published in English. Eight RCTs (1712 patients with gestational diabetes mellitus) were retrieved; of those 853 patients were given metformin, and 859 patients were given insulin. Our results showed that metformin does not increase risk of prematurity (RR = 1.26; 95 % CI [0.89, 1.79], P = 0.19). In addition, metformin can either decrease the total weight gain [MD = -1.49, 95 % CI (-2.66, -0.31), P = 0.01] or weight gain after randomization [MD = -1.23, 95 % CI (-1.75, -0.71), P metformin also significantly decreased the risk of neonatal hypoglycemia [RR = 0.58, 95 % CI (0.43, 0.78), P = 0.0003] and admission rates to neonatal intensive care units [RR = 0.74, 95 % CI (0.61, 0.89), P = 0.002]. No other adverse effects were observed, such as hyperbilirubinaemia [RR = 0.83, 95 % CI (0.64, 1.08), P = 0.16], large for gestational age [RR = 0.85, 95 % CI (0.68, 1.05), P = 0.14], small for gestational age [RR = 0.92, 95 % CI (0.61, 1.39), P = 0.69], macrosomia [RR = 0.75, 95 % CI (0.54, 1.03), P = 0.07] or respiratory distress syndrome [RR = 0.88, 95 % CI (0.55, 1.41), P = 0.6]. Metformin may be beneficial in treating gestational diabetes. However, even more studies are needed to provide more evidence for the future use of metformin.

  20. Tei index in determination of fetal cardiac function in pregnant women with gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Guo-Dong Li

    2016-09-01

    Full Text Available Objective: To explore the application value of Tei index in determination of fetal cardiac function in pregnant women with gestational diabetes mellitus (GDM. Methods: A total of 60 gestational diabetes mellitus pregnant women with single birth were included in the study and served as GDM group, while 60 healthy pregnant women with single birth were served as the control group. The fetal echocardiography was performed. The cardiac structure, function, and other related indicators were detected and compared. Results: IVSs, LVWT, RVWT, LVEF, LVFS, and RVFS in GDM group were significantly greater than those in the control group (P<0.05. E/A MV and E/A TV in GDM group were significantly lower than those in the control group (P<0.05. The left and right ventricular Tei index in GDM group was significantly higher than that in the control group (P<0.05. Conclusions: The fetal cardiac structure and function in GDM pregnant women can cause damage to a different degree. Tei index is an important indicator to evaluate the fetal cardiac function in GDM pregnant women, and can be applied in the early diagnosis and treatment; therefore, it deserved to be widely recommended in the clinic.

  1. A distinctive fatty acid profile in circulating lipids of Korean gestational diabetics: a pilot study.

    Science.gov (United States)

    Min, Yoeju; Nam, Joo-Hyun; Ghebremeskel, Kebreab; Kim, Ahm; Crawford, Michael

    2006-08-01

    Gestational diabetes mellitus (GDM) is a transient metabolic disorder that is a strong predictor of type 2 diabetes and cardiovascular disease. Previously, GDM was associated with reduced red cell long-chain omega-6 and omega-3 fatty acids in population (British) with high intake of total and saturated fat. The aim of the study was to examine blood fatty acids status of GDM patients (n=12) and normoglycaemic women (control, n=12) from South Korea where typical diet retains high omega-3 fat with low total fat intake. Subjects were matched for BMI and gestation week. Blood obtained at delivery were analyzed for plasma triacylglycerols (TG), phosphatidylcholine (PC), sphingomyelin (SM), and red cell PC, phosphatidylethanolamine (PE) and SM fatty acids. GDM patients had lower total saturated fatty acids (SFA) in the plasma TG (p0.05) acids compared with the controls. Interestingly, red cell PC arachidonic acid level was comparable between Korean and British women whereas docosahexaenoic acid level decreased in the order of Korean control (5.5+/-0.9)>Korean GDM (3.5+/-2.1)=British control (3.9+/-2.9)>British GDM (2.8+/-2.3) (pKorean and British cohort suggests that the reduced membrane arachidonic and docosahexaenoic acids in GDM might be attributed to the effect of the disease itself regardless of ethnicity, obesity, or diet.

  2. Glucagon-like peptide-1 secretion in women with gestational diabetes mellitus during and after pregnancy.

    Science.gov (United States)

    Lencioni, C; Resi, V; Romero, F; Lupi, R; Volpe, L; Bertolotto, A; Ghio, A; Del Prato, S; Marchetti, P; Di Cianni, G

    2011-10-01

    Gestational diabetes mellitus (GDM) predisposes women to future development of Type 2 diabetes mellitus (DM2) and the two conditions share similar metabolic alterations. Recent observations suggest that a defective glucose stimulated insulin secretion by glucagon-like peptide-1 (GLP- 1) plays a role in the pathogenesis of DM2. Whether such a defect is impaired in GDM remains to be ascertained. We have determined GLP-1 secretion in response to oral glucose tolerance test (OGTT) in GDM and normal glucose tolerance (NGT) during and after pregnancy. 100-g-3h OGTT was performed in 12 GDM and 16 NGT women at 27.3 ± 4.1 weeks of gestation, for determination of plasma GLP-1, glucose, insulin, and C-peptide. Insulin sensitivity (ISI) and insulin secretion (first and second phase); as well as ISI-secretion index (ISSI) were also derived. NGT and GDM women were comparable for age pre-pregnancy body mass index (BMI) and weight gain. GDM had higher glucose area under the curve (AUC): 27,575.5 ± 3448 vs 20,685.88 ± 2715 mg/dl min (pwomen (2542 ± 273 vs 10,092 ± 7367 pmol·l-1·min-1, pwomen is inadequate for the prevailing glycemic levels both in pregnancy and post partum. Moreover, we cannot exclude that other important aspects of the incretin effect may be involved in GDM development.

  3. Protein turnover and 3-methylhistidine excretion in non-pregnant, pregnant and gestational diabetic women

    International Nuclear Information System (INIS)

    Fitch, W.L.; King, J.C.

    1986-01-01

    Protein turnover was studied in nine non-pregnant (NP) women, eight pregnant (P) and two gestational diabetic (GDM) women. Whole body protein turnover, synthesis and catabolism rates were measured using a single oral dose of 15 N-glycine followed by measurement of enrichment of urinary ammonia. Urinary 3-methylhistidine (3MH) excretion was measured for three consecutive days, including the day of the protein turnover study. Whole body protein turnover and synthesis rates did not differ between the P and NP women, although the synthesis rates tended to be higher in the P group. Gestational diabetic women appeared to have considerably higher rates of both turnover and synthesis. Pregnant women excreted significantly more urinary 3MH than did non-pregnant women. GDM women appeared to have lower 3MH excretion than the P women. Correlation between 3MH excretion and protein turnover rates was nearly significant (p = .06) in the NP women, but was poorly correlated (p = .43) in the P women, suggesting that muscles may be a less important site of whole body protein turnover in pregnancy than in the non-pregnant state

  4. Maternal and fetal lipid metabolism under normal and gestational diabetic conditions.

    Science.gov (United States)

    Herrera, Emilio; Desoye, Gernot

    2016-05-01

    Maternal lipids are strong determinants of fetal fat mass. Here we review the overall lipid metabolism in normal and gestational diabetes mellitus (GDM) pregnancies. During early pregnancy, the increase in maternal fat depots is facilitated by insulin, followed by increased adipose tissue breakdown and subsequent hypertriglyceridemia, mainly as a result of insulin resistance (IR) and estrogen effects. The response to diabetes is variable as a result of greater IR but decreased estrogen levels. The vast majority of fatty acids (FAs) in the maternal circulation are esterified and associated with lipoproteins. These are taken up by the placenta and hydrolyzed by lipases. The released FAs enter various metabolic routes and are released into fetal circulation. Although these determinants are modified in maternal GDM, the fetus does not seem to receive more FAs than in non-GDM pregnancies. Long-chain polyunsaturated FAs are essential for fetal development and are obtained from the mother. Mitochondrial FA oxidation occurs in fetal tissue and in placenta and contributes to energy production. Fetal fat accretion during the last weeks of gestation occurs very rapidly and is sustained not only by FAs crossing the placenta, but also by fetal lipogenesis. Fetal hyperinsulinemia in GDM mothers promotes excess accretion of adipose tissue, which gives rise to altered adipocytokine profiles. Fetal lipoproteins are low at birth, but the GDM effects are unclear. The increase in body fat in neonates of GDM women is a risk factor for obesity in early childhood and later life.

  5. Continuous Positive Airway Pressure Therapy in Gestational Diabetes With Obstructive Sleep Apnea: A Randomized Controlled Trial.

    Science.gov (United States)

    Chirakalwasan, Naricha; Amnakkittikul, Somvang; Wanitcharoenkul, Ekasitt; Charoensri, Suranut; Saetung, Sunee; Chanprasertyothin, Suwannee; Chailurkit, La-Or; Panburana, Panyu; Bumrungphuet, Sommart; Thakkinstian, Ammarin; Reutrakul, Sirimon

    2018-03-15

    Obstructive sleep apnea (OSA) is associated with gestational diabetes mellitus (GDM). This study assessed the effects of continuous positive airway pressure (CPAP) in obese pregnant females with GDM and OSA. A randomized controlled trial was conducted (April 2014 - June 2016). Obese females at 24 to 34 weeks gestation and with diet-controlled GDM were screened for OSA. Those with OSA were randomly assigned to receive 2 weeks nightly CPAP or be part of a waitlist control group. After 2 weeks, all patients were offered CPAP. The primary outcome was glucose metabolism, obtained from an oral meal tolerance test (MTT) at baseline and 2 weeks. Pregnancy outcomes were collected. Eighteen patients were randomized to CPAP and 18 to control groups. There were no significant changes between groups in fasting glucose, glucose response to MTT, and insulin sensitivity or secretion after 2 weeks. Those adherent to CPAP had significantly improved insulin secretion ( P = .016) compared to the control group. When a counterfactual instrumental variable approach was applied to deal with nonadherence, the CPAP group had significantly improved insulin secretion ( P = .002) and insulin sensitivity ( P = .015). Lower rates of preterm delivery ( P = .002), unplanned cesarean section ( P = .005), and neonatal intensive care unit admissions ( P < .001) were observed among those who used CPAP longer than 2 weeks. Two weeks of CPAP in females with GDM and OSA did not result in improved glucose levels, but insulin secretion improved in those adherent to CPAP. Continued CPAP use was possibly associated with improved pregnancy outcomes. Registry: ClinicalTrials.gov; Title: Obstructive Sleep Apnea and Gestational Diabetes: Incidence and Effects of Continuous Positive Airway Pressure Treatment on Glucose Metabolism; Identifier: NCT02108197; URL: https://clinicaltrials.gov/ct2/show/NCT02108197. © 2018 American Academy of Sleep Medicine.

  6. Fetal sex and maternal risk of gestational diabetes mellitus: the impact of having a boy.

    Science.gov (United States)

    Retnakaran, Ravi; Kramer, Caroline K; Ye, Chang; Kew, Simone; Hanley, Anthony J; Connelly, Philip W; Sermer, Mathew; Zinman, Bernard

    2015-05-01

    Retrospective analyses of perinatal databases have raised the intriguing possibility of an increased risk of gestational diabetes mellitus (GDM) in women carrying a male fetus, but it has been unclear if this was a spurious association. We thus sought to evaluate the relationship between fetal sex and maternal glucose metabolism in a well-characterized cohort of women reflecting the full spectrum of gestational glucose tolerance from normal to mildly abnormal to GDM. A total of 1,074 pregnant women underwent metabolic characterization, including oral glucose tolerance test (OGTT), at mean 29.5 weeks' gestation. The prevalence of GDM, its pathophysiologic determinants (β-cell function and insulin sensitivity/resistance), and its clinical risk factors were compared between women carrying a female fetus (n = 534) and those carrying a male fetus (n = 540). Women carrying a male fetus had lower mean adjusted β-cell function (insulinogenic index divided by HOMA of insulin resistance: 9.4 vs. 10.5, P = 0.007) and higher mean adjusted blood glucose at 30 min (P = 0.025), 1 h (P = 0.004), and 2 h (P = 0.02) during the OGTT, as compared with those carrying a female fetus. Furthermore, women carrying a male fetus had higher odds of developing GDM (odds ratio 1.39 [95% CI 1.01-1.90]). Indeed, male fetus further increased the relative risk of GDM conferred by the classic risk factors of maternal age >35 years and nonwhite ethnicity by 47 and 51%, respectively. Male fetus is associated with poorer β-cell function, higher postprandial glycemia, and an increased risk of GDM in the mother. Thus, fetal sex potentially may influence maternal glucose metabolism in pregnancy. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  7. Circulating early- and mid-pregnancy microRNAs and risk of gestational diabetes.

    Science.gov (United States)

    Wander, Pandora L; Boyko, Edward J; Hevner, Karin; Parikh, Viraj J; Tadesse, Mahlet G; Sorensen, Tanya K; Williams, Michelle A; Enquobahrie, Daniel A

    2017-10-01

    Epigenetic regulators, including microRNAs (miRNAs), are implicated in type 2 diabetes, but evidence linking circulating miRNAs in pregnancy and risk of gestational diabetes (GDM) is sparse. Potential modifiers, including pre-pregnancy overweight/obesity and offspring sex, are unexamined. We hypothesized that circulating levels of early-mid-pregnancy (range 7-23weeks of gestation) candidate miRNAs are related to subsequent development of GDM. We also hypothesized that miRNA-GDM associations might vary by pre-pregnancy body-mass index (ppBMI) or offspring sex. In a case-control analysis (36GDM cases/80 controls) from the Omega study, a prospective cohort study of pregnancy complications, we measured early-mid-pregnancy plasma levels of 10miRNAs chosen for potential roles in pregnancy course and complications (miR-126-3p, -155-5p, -21-3p, -146b-5p, -210-3p, -222-3p, -223-3p, -517-5p, -518a-3p, and 29a-3p) using qRT-PCR. Logistic regression models adjusted for gestational age at blood draw (GA) were fit to compare circulating miRNAs between cases and controls. We repeated analyses among overweight/obese (ppBMI≥25kg/m 2 ) or lean (ppBMIpregnancy miRNAs are associated with GDM, particularly among women who are overweight/obese pre-pregnancy or pregnant with male offspring. This area has potential to clarify mechanisms underlying GDM pathogenesis and identify at-risk mothers earlier in pregnancy. Published by Elsevier B.V.

  8. Early second-trimester serum miRNA profiling predicts gestational diabetes mellitus.

    Directory of Open Access Journals (Sweden)

    Chun Zhao

    Full Text Available BACKGROUND: Gestational diabetes mellitus (GDM is one type of diabetes that presents during pregnancy and significantly increases the risk of a number of adverse consequences for the fetus and mother. The microRNAs (miRNA have recently been demonstrated to abundantly and stably exist in serum and to be potentially disease-specific. However, no reported study investigates the associations between serum miRNA and GDM. METHODOLOGY/PRINCIPAL FINDINGS: We systematically used the TaqMan Low Density Array followed by individual quantitative reverse transcription polymerase chain reaction assays to screen miRNAs in serum collected at 16-19 gestational weeks. The expression levels of three miRNAs (miR-132, miR-29a and miR-222 were significantly decreased in GDM women with respect to the controls in similar gestational weeks in our discovery evaluation and internal validation, and two miRNAs (miR-29a and miR-222 were also consistently validated in two-centric external validation sample sets. In addition, the knockdown of miR-29a could increase Insulin-induced gene 1 (Insig1 expression level and subsequently the level of Phosphoenolpyruvate Carboxy Kinase2 (PCK2 in HepG2 cell lines. CONCLUSIONS/SIGNIFICANCE: Serum miRNAs are differentially expressed between GDM women and controls and could be candidate biomarkers for predicting GDM. The utility of miR-29a, miR-222 and miR-132 as serum-based non-invasive biomarkers warrants further evaluation and optimization.

  9. Comparison between metformin and insulin in treatment of gestational diabetes mellitus and effect on neonatal hypoglycaemia

    International Nuclear Information System (INIS)

    Ayub, S.; Jaffar, S.R.

    2015-01-01

    To compare the efficacy of metformin in the treatment of gestational diabetes mellitus (GDM) with insulin and to compare the frequency of hypoglycaemia in neonates of the mothers treated with metformin and insulin. Study Design: Randomized control trial to compare the efficacy of metformin with insulin in the treatment of GDM. Place and Duration of Study: Outpatient department and labour ward of Obstetric and Gynaecology department of Benazir Bhutto Hospital Rawalpindi from August 2012 to January 2013. Patients and Method: A total of 110 pregnant ladies with GDM diagnosed after 20 weeks of gestation were included and divided into group A and group B with 55 patients in each group. Group A patients were treated with insulin and group B with metformin. Plasma fasting glucose and two hours postprandial glucose levels were determined on weekly basis for four weeks after starting the treatment to determine the efficacy of insulin and metformin. At birth plasma glucose levels of all the neonates were carried out two hourly, and more frequently depending upon the requirement, during first 24 hours in both the groups to determine neonatal hypoglycaemia. Results: Fasting plasma glucose in group A and B were calculated as 5.96 ± 0.58 and 5.76 ± 0.46 mmol/L respectively (p=0.280), while two hours post-prandial plasma glucose levels were 7.34 ± 0.48 and 7.28 ± 0.58 mmol/L respectively (p=0.650). Efficacy in group A was 78.18% and in group B was 70.91% (p=0.381) while frequency of neonatal hypoglycaemia was calculated as 61.54% in group A and 41% in group B (p=0.113). Conclusion: The efficacy of metformin in treatment of gestational diabetes mellitus is similar as with insulin and the frequency of hypoglycemia in neonates of the mother treated with metformin and insulin is also similar. (author)

  10. Birth weight predicts the risk of gestational diabetes mellitus and pregravid obesity.

    Science.gov (United States)

    Ogonowski, Jarosław; Miazgowski, Tomasz; Engel, Karina; Celewicz, Zbigniew

    2014-01-01

    It has been suggested that birth weight may determine metabolic abnormalities later in life. The aim of the current study was to assess the association between birth weight and future risk of gestational diabetes mellitus (GDM) and pregravid obesity in a homogenous sample of Caucasian Polish women. In this retrospective study, we collected the medical reports of 787 women with GDM and 801 healthy pregnant women. We analyzed the following data: birth weight, age, pregravid weight, prior GDM, prior macrosomia, parity, and family history of diabetes. Birth weight was inversely associated with the risk of GDM; for each decrease in birth weight of 500 g, the risk increased by 11% (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.02-1.21). Birth weight was a strong predictor of GDM independent of other risk factors (OR, 1.19; 95% CI, 1.09-1.31), and it was positively correlated with pregravid weight (R = 0.21; P obesity (OR, 1.17; 95% CI, 1.01-1.34 and OR, 1.35; 95% CI 1.11-1.64, respectively). Each of the traditional risk factors for GDM were also strong predictors of pregravid obesity: age (P diabetes (P obesity is associated with high birth weight. Traditional risk factors for GDM, including maternal (but not paternal) history of diabetes, are also risk factors for pregravid obesity. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Contraception and postpartum follow-up in patients with gestational diabetes.

    Science.gov (United States)

    Rosenthal, Emily W; Easter, Sarah Rae; Morton-Eggleston, Emma; Dutton, Caryn; Zera, Chloe

    2017-04-01

    We sought to review the effect of immediate provision of postpartum contraception on postpartum follow-up and screening for type 2 diabetes in women with gestational diabetes mellitus (GDM). We performed multivariate logistic regression to identify the association between immediate provision of postpartum contraception and attendance at the 6-week postpartum visit and performance of a 6- to 12-week oral glucose tolerance test, controlling for age, type of insurance, parity and race. Women who received contraception prior to hospital discharge were less likely to attend their postpartum visit [adjusted odds ratio (aOR) 0.59, 95% confidence interval (CI) 0.39-0.88], but just as likely to participate in postpartum diabetes screening (adjusted odds ratio (aOR) 1.27, 95% confidence interval (CI) 0.78-2.06). Attendance at the postpartum visit was associated with private insurance (OR 1.93, 95% CI 1.31-2.99). Receiving contraception while admitted postpartum did not affect follow-up for diabetes screening for women with GDM. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. High Prevalence of Diabetes-Predisposing Variants in MODY Genes Among Danish Women With Gestational Diabetes Mellitus

    DEFF Research Database (Denmark)

    Gjesing, Anette P; Rui, Gao; Lauenborg, Jeannet

    2017-01-01

    Context: Gestational diabetes mellitus (GDM), defined as any degree of glucose intolerance with first recognition during pregnancy, is a heterogeneous form of diabetes characterized by various degrees of β-cell dysfunction. Objectives: We aimed to estimate the prevalence of possibly pathogenic...... variant prevalence of 5.9% (95% confidence interval: 3.5% to 8.4%). At follow-up, 15 out of 135 women with diabetes (11%) were carriers of variants in GCK, HNF1A, HNF4A, HNF1B, or INS. Conclusions: Almost 6% of Danish women with diet-treated GDM have possibly pathogenic variants in GCK, HNF1A, HNF4A, HNF1...... variants in the maturity-onset diabetes of the young genes GCK, HNF1A, HNF4A, HNF1B, and INS among women with GDM. Furthermore, we examined the glucose tolerance status in variant carriers vs noncarriers at follow-up. Design Setting and Patients: We sequenced the coding regions and intron/exon boundaries...

  13. Complex interventions for preventing diabetic foot ulceration

    NARCIS (Netherlands)

    Hoogeveen, Ruben C; Dorresteijn, Johannes A N; Kriegsman, Didi M W; Valk, Gerlof D.

    2015-01-01

    BACKGROUND: Ulceration of the feet, which can lead to the amputation of feet and legs, is a major problem for people with diabetes mellitus, and can cause substantial economic burden. Single preventive strategies have not been shown to reduce the incidence of foot ulceration to a significant extent.

  14. Prevention of Diabetic Nephropathy | Saleh | Nigerian Medical ...

    African Journals Online (AJOL)

    Early detection and prompt treatment of diabetic nephropathy is of utmost importance in the prevention of renal failure. In addition to tight glycaemic control, other factors that constitute an insult to the kidneys (like urinary tract infection and analgesic abuse) should be attended to diligently. Hypertension is quite outstanding ...

  15. Placental peptides metabolism and maternal factors as predictors of risk of gestational diabetes in pregnant women. A case-control study

    OpenAIRE

    Ngala, Robert Amadu; Fondjo, Linda Ahenkorah; Gmagna, Peter; Ghartey, Frank Naku; Awe, Martin Akilla

    2017-01-01

    Background Gestational diabetes is a risk factor for perinatal complications; include shoulder dystocia, birth injuries such as bone fractures and nerve palsies. It is associated with later development of type 2 diabetes, the risk of macrosomia and other long-term health effects of infants born to diabetic mothers. The study assesses placental peptides and maternal factors as potential predictors of gestational diabetes among pregnant women. Material and methods A total of 200 pregnant women ...

  16. Health economic modeling to assess short-term costs of maternal overweight, gestational diabetes, and related macrosomia - a pilot evaluation.

    Science.gov (United States)

    Lenoir-Wijnkoop, Irene; van der Beek, Eline M; Garssen, Johan; Nuijten, Mark J C; Uauy, Ricardo D

    2015-01-01

    Despite the interest in the impact of overweight and obesity on public health, little is known about the social and economic impact of being born large for gestational age or macrosomic. Both conditions are related to maternal obesity and/or gestational diabetes mellitus (GDM) and associated with increased morbidity for mother and child in the perinatal period. Poorly controlled diabetes during pregnancy, pre- pregnancy maternal obesity and/or excessive maternal weight gain during pregnancy are associated with intermittent periods of fetal exposure to hyperglycemia and subsequent hyperinsulinemia, leading to increased birth weight (e.g., macrosomia), body adiposity, and glycogen storage in the liver. Macrosomia is associated with an increased risk of developing obesity and type 2 diabetes mellitus later in life. Provide insight in the short-term health-economic impact of maternal overweight, GDM, and related macrosomia. To this end, a health economic framework was designed. This pilot study also aims to encourage further health technology assessments, based on country- and population-specific data. The estimation of the direct health-economic burden of maternal overweight, GDM and related macrosomia indicates that associated healthcare expenditures are substantial. The calculation of a budget impact of GDM, based on a conservative approach of our model, using USA costing data, indicates an annual cost of more than $1,8 billion without taking into account long-term consequences. Although overweight and obesity are a recognized concern worldwide, less attention has been given to the health economic consequences of these conditions in women of child-bearing age and their offspring. The presented outcomes underline the need for preventive management strategies and public health interventions on life style, diet and physical activity. Also, the predisposition in people of Asian ethnicity to develop diabetes emphasizes the urgent need to collect more country

  17. Health economic modelling to assess short-term costs of maternal overweight, gestational diabetes and related macrosomia – a pilot evaluation

    Directory of Open Access Journals (Sweden)

    Irene eLenoir-Wijnkoop

    2015-05-01

    Full Text Available Background: Despite the interest in the impact of overweight and obesity on public health, little is known about the social and economic impact of being born large for gestational age or macrosomic. Both conditions are related to maternal obesity and/or gestational diabetes (GDM and associated with increased morbidity for mother and child in the perinatal period. Poorly controlled diabetes during pregnancy, pre- pregnancy maternal obesity and/or excessive maternal weight gain during pregnancy are associated with intermittent periods of fetal exposure to hyperglycemia and subsequent hyperinsulinemia, leading to increased birth weight (e.g. macrosomia, body adiposity and glycogen storage in the liver. Macrosomia is associated with an increased risk of developing obesity and type 2 diabetes mellitus later in life.Objective: Provide insight in the short-term health-economic impact of maternal overweight, gestational diabetes (GDM and related macrosomia. To this end, a health economic framework was designed. This pilot study also aims to encourage further health technology assessments, based on country- and population-specific data. Results: The estimation of the direct health-economic burden of maternal overweight, GDM and related macrosomia indicates that associated healthcare expenditures are substantial. The calculation of a budget impact of GDM, based on a conservative approach of our model, using USA costing data, indicates an annual cost of more than $1,8 billion without taking into account long-term consequences.Conclusion: Although overweight and obesity are a recognized concern worldwide, less attention has been given to the health economic consequences of these conditions in women of child-bearing age and their offspring. The presented outcomes underline the need for preventive management strategies and public health interventions on life style, diet and physical activity. Also, the predisposition in people of Asian ethnicity to develop

  18. Alcohol consumption and diabetes risk in the Diabetes Prevention Program.

    Science.gov (United States)

    Crandall, Jill P; Polsky, Sarit; Howard, Andrea A; Perreault, Leigh; Bray, George A; Barrett-Connor, Elizabeth; Brown-Friday, Janet; Whittington, Tracy; Foo, Sandra; Ma, Yong; Edelstein, Sharon L

    2009-09-01

    Moderate alcohol consumption is associated with a decreased risk of type 2 diabetes in the general population, but little is known about the effects in individuals at high risk of diabetes. The objectives were to determine associations between alcohol consumption and diabetes risk factors and whether alcoho