312: First trimester HbA1c, at clinically normal values, may be an early predictor of third trimester gestational diabetes

2015 ◽  
Vol 212 (1) ◽  
pp. S168-S169 ◽  
Author(s):  
Erica Berggren ◽  
Kim Boggess ◽  
Leny Mathew ◽  
Jennifer Culhane
Author(s):  
Sujatha M. S. ◽  
Madhana S. ◽  
Shylaja P. ◽  
Priyanka S.

Background:  The aim of this study was to find role of SHBG as an early predictor for gestational diabetes mellitus.Methods: A hospital based prospective/observational/diagnostic and explorative study. The necessary information was collected from the participants through the prepared set of questionnaires. Pregnant women between 11 to 14 weeks of gestation who visited JSS OPD for antenatal checkup satisfying inclusion and exclusion criteria giving informed and written consent for the study were examined clinically. 3ml of venous blood was drawn with aseptic precautions for the estimation of SHBG and adiponectin. OGTT with 75gms glucose first done at 11 to 14weeks and again at 24-28 weeks and 32-36 weeks were done to the same patient to find out whether the patient developed GDM or not. These mothers were followed periodically till delivery. The sensitivity and specificity of SHBG were assessed and compared in patients who developed GDM.Results: 100 cases were selected for the study. About 12 patients were diagnosed as gestational diabetes mellitus in present study by OGCT at 32 weeks to 36 weeks. In present study about 14 patients had low level of SHBG. Low level of SHBG is found to be statistically significant in predicting GDM in first trimester.Conclusions: The combination of SHBG can be used as predictor of GDM in first trimester.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 645-645
Author(s):  
Lauren McMichael ◽  
Catherine Johnson ◽  
Rob Fanter ◽  
Alex Brito ◽  
Noemi Alarcon ◽  
...  

Abstract Objectives Gestational Diabetes Mellitus (GDM) is present in up to 10% of pregnancies in the United States. The occurrence of GDM causes severe short- and long-term complications for the mother and offspring. baby pre- and post-partum. Identification of the metabolites and potential biomarkers involved in GDM could improve the prediction of its occurence. The integration of food data with metabolite results could provide innovative diet intervention strategies. The objective of this study is to identify metabolites that differed in the first and third trimesters of GDM versus Non-GDM pregnancies. Methods Participants were 68 OW/OB pregnant women enrolled in the Healthy Beginnings Trial and completed blood draws at first (10–16 weeks) and third trimester (28–35 weeks).  Participants from the control and dietary intervention group who developed GDM (n = 34; GDM group) were matched on age, BMI, ethnicity, and treatment group with those who did not develop GDM (n = 34; Non-GDM group). Plasma samples were analyzed by ultra-high-performance liquid chromatography-hybrid triple-quadrupole linear ion trap mass spectrometry (UPLC-QTRAP) using three targeted metabolomics assays for primary metabolomics, aminomics and lipdomics. Dietary intake was estimated using 24 hour recalls in order to assess potential dietary differences between groups. Results A total of 243 metabolites were identified in the plasma samples. At first trimester, several complex lipids, including cholestryl esters and phospholipids, were higher in the GDM group (P < 0.05). Furthermore, the purine derivative hypoxanthine was also higher in GDM subjects (P < 0.05). At third trimester, multiple acylcarnitines, associated with utilization of fat for energy, were lower in the GDM group (P < 0.05). Conclusions Metabolite differences between GDM and Non-GDM groups in plasma samples collected during first trimester may predict the development of GDM. Further research is required to identify the roles these metabolite changes play in the development of this disease. Funding Sources NIH National Heart, Lung, and Blood Institute (NHLBI; HL114377), ARI #58,875, Cal Poly CAFES SURP.


2020 ◽  
Vol 08 (11) ◽  
pp. 5081-5088
Author(s):  
Swati S. Mohite ◽  
Rahul Gajare ◽  
Namrata B. Khose

Gestational Diabetes Mellitus is a metabolic disorder during pregnancy. It is defined by WHO as carbohy-drate intolerance resulting in hyperglycemia of variable severity with onset or first recognition during preg-nancy. The entity usually present late in second and third trimester. The factors which constitute good health, i.e. balanced Dosha, Dhatu and Mala, optimally functioning Indriyas or sense organs, a happy con-tented soul and a balanced mind are the very factors that go towards a smooth pregnancy, labour and healthy progeny and this is what Ayurveda treatment focuses on. Pregnancy is a particular time for all women. This condition becomes even more delicate when there is diagnosis of GDM which makes neces-sary controls and therapies that will inevitably affect the women’s life. GDM can lead to potential risk for mother, fetus and child’s development. There is no direct reference of GDM in Ayurveda. But we get ref-erence of Garbhavriddhi excessive increase in size of abdomen and perspiration. Garbhavriddhi or mac-rosomia condition can be interpreted as complication of GDM. In current scenario GDM in pregnancy is one of the major complications during pregnancy. Overt maternal diabetes mellitus can adversely influence intrauterine development. Spontaneous abortions and major congenital anomalies may be induced in the first trimester. Excessive foetal growth, neonatal hypoglycemia, still birth may be induced during second and third trimester. Gestational Diabetes may lead to gangrene, damage of retina, kidneys. If diabetes is not properly controlled, then in the long run fat gets deposited on inner layer of arteries and the possibilities of occurrence of paralysis increase. Complications of diabetes include eye problems and blindness, heart dis-ease, stroke, neurological problems, amputation, and impotence It is needed to cure maternal diabetes as soon as it is diagnosed. Adopting pre-conceptional and thorough antenatal care through Ayurveda; this aims that a woman enters pregnancy in healthy state of body and mind. While describing Garbhadhan vidhi acharyas have advised certain body purifying measures (Sanshodhana karma) followed by special dietet-ics and mode of life for the couple. Ayurveda focuses on change in lifestyle of the Garbhini which helps in maternal health and fetal growth minimizing the complications related to pregnancy. Ayurveda efforts of having healthy baby commences with pre-conception care and management. Pre-conception counselling, Diet, Herbs, Yoga, Asanas are useful as a supportive therapy together with modern medication under su-pervision. The best way to improve your diet is by eating a variety of healthy foods. Various vegetables, pulses, spices, cereals, fruits, dry fruits are helpful in GDM patients. Daily 20 mins walk is also helpful. Ayurvedic herbs like Guduchi, Amalaki, Haritaki, Haridra, Bilva, Neem, Jamun are also useful in GDM. They are having antidiabetic, antioxidant properties. Tinospora Cordifolia are potential therapeutics that act as anti-diabetic drug in the prevention and treatment of GDM. Metformin is safe and effective drug in treatment of GDM. Combination of metformin, diet, Ayurvedic herbs, preconception counselling, Yoga, Pranayama and meditation can give best result in GDM.


Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 86-LB
Author(s):  
TIANGE SUN ◽  
FANHUA MENG ◽  
RUI ZHANG ◽  
ZHIYAN YU ◽  
SHUFEI ZANG ◽  
...  

2013 ◽  
Vol 20 (3) ◽  
pp. 259-265
Author(s):  
Monica Vereş ◽  
Aurel Babeş ◽  
Szidonia Lacziko

Abstract Background and aims: Gestational diabetes represents a form of diabetes diagnosed during pregnancy that is not clearly overt diabetes. In the last trimester of gestation the growth of fetoplacental unit takes place, thus maternal hyperglycemia will determine an increased transplacental passage, hyperinsulinemia and fetal macrosomia. The aim of our study was that o analyzing the effect of maternal glycemia from the last trimester of pregnancy over fetal weight. Material and method: We run an observational study on a group of 46 pregnant women taken into evidence from the first trimester of pregnancy, separated in two groups according to blood glucose determined in the third trimester (before birth): group I normoglycemic and group II with hyperglycemia (>92mg/dl). Results: The mean value of third trimester glycemia for the entire group was of 87.13±22.03. The mean value of the glycemia determined in the third trimester of pregnancy was higher in the second group (109.17 mg/dl) in comparison to the first group (74.,21 mg/dl). The ROC curve for third trimester glycemia as fetal macrosomia appreciation test has an AUC of 0.517. Conclusions: Glycemia determined in the last trimester of pregnancy cannot be used alone as the predictive factor for fetal macrosomia.


2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Chuyao Jin ◽  
Lizi Lin ◽  
Na Han ◽  
Zhiling Zhao ◽  
Zheng Liu ◽  
...  

Abstract Background To assess the association between plasma retinol-binding protein 4 (RBP4) levels both in the first trimester and second trimester and risk of gestational diabetes mellitus (GDM). Methods Plasma RBP4 levels and insulin were measured among 135 GDM cases and 135 controls nested within the Peking University Birth Cohort in Tongzhou. Multivariable linear regression analysis was conducted to assess the influence of RBP4 levels on insulin resistance. Conditional logistic regression models were used to compute the odds ratio (OR) and 95% confidence interval (CI) between RBP4 levels and risk of GDM. Results The GDM cases had significantly higher levels of RBP4 in the first trimester than controls (medians: 18.0 μg/L vs 14.4 μg/L; P < 0.05). Plasma RBP4 concentrations in the first and second trimester were associated with fasting insulin, homeostasis model assessment for insulin resistance (HOMA-IR), and the quantitative insulin sensitivity check index (QUICKI) in the second trimester (all P < 0.001). With adjustment for diet, physical activity, and other risk factors for GDM, the risk of GDM increased with every 1-log μg/L increment of RBP4 levels, and the OR (95% CI) was 3.12 (1.08–9.04) for RBP4 in the first trimester and 3.38 (1.03–11.08) for RBP4 in the second trimester. Conclusions Plasma RBP4 levels both in the first trimester and second trimester were dose-dependently associated with increased risk of GDM.


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