scholarly journals Unmet needs of women with GDM: a health needs assessment in Sandwell, West Midlands

2019 ◽  
Vol 42 (4) ◽  
pp. e516-e524
Author(s):  
Nicola Plant ◽  
Dana Šumilo ◽  
Rachel Chapman ◽  
Jonathan Webber ◽  
Ponnusamy Saravanan ◽  
...  
Keyword(s):  
Public Health ◽  
Diabetes Mellitus ◽  
Lifestyle Modification ◽  
Ethnically Diverse ◽  
High Body Mass Index ◽  
Risk Groups ◽  
Service Development ◽  
Self Assessment ◽  
Glucose Testing ◽  
Health Visitors

ABSTRACT Background Gestational diabetes mellitus (GDM) affects over 4% of pregnancies in England. We investigated GDM epidemiology within ethnically diverse population and the current offer of services to women with previous GDM to reduce their type 2 diabetes mellitus (T2DM) risk. Methods (i) Analysis of routinely collected maternity data examining GDM incidence and risk factors; (ii) local authority self-assessment questionnaire on public health interventions targeting women with previous GDM and (iii) service development discussions regarding the current pathway and areas for improvement. Results Of 9390 births between 2014 and 2018, 6.8% had a record of GDM. High body mass index (BMI), maternal age, and ethnicity (South Asian and some mixed ethnic backgrounds) were independent predictors of GDM. There were no public health commissioned services specifically targeting women with previous GDM. Weaknesses in transition from secondary to primary care and areas for improvement when screening for GDM were identified. Conclusions GDM burden in this population was high. Awareness should be raised on the importance of regular glucose testing and lifestyle modification to delay or prevent progression to T2DM, particularly within high risk groups. The potential for health visitors to contribute to this should be explored. Commissioners should review evidence to develop a flexible lifestyle services model to meet the specific needs of these women.

scholarly journals COVID-19: gender characteristics of the course, perinatal risks and possible ways to prevent complications

2021 ◽  
pp. 14-24
Author(s):  
I.A. Zhabchenko ◽  
I.S. Lishchenko ◽  
N.V. Gerevich
Keyword(s):  
Diabetes Mellitus ◽  
Pregnant Women ◽  
High Body Mass Index ◽  
Risk Groups ◽  
Reproductive Age ◽  
Self Assessment ◽  
Obesity And Diabetes ◽  
Inflammatory Phenotype ◽  
Acquired Immunodeficiency ◽  
The Impact

The article contains modern data of the characteristics, course and impact on pregnant women, postpartum women, fetus and newborn of the SARS-CoV-2. The opinions of experts from different countries of the world on the consequences of coronavirus disease depending on racial, ethnic, age differences and delivery time. Immunological and hormonal protection during pregnancy against viral influences is noted. In the context of a pandemic, the number of premature births (for various reasons) and the birth of children with low birth weight significantly increased, but their relationship with COVID-19 infection has not been proven. Risk factors for the hospitalization of pregnant woman infected with COVID-19 are high body mass index, obesity and concomitant diseases (diabetes mellitus, hypertension. Women in older reproductive age also need hospitalization more often. During pregnancy, innate and adaptive immune responses shift from an inflammatory to an anti-inflammatory phenotype to prevent affection of the fetus and promote passive transmission of maternal antibodies to the fetus. These COVID-19 protection effects are largely mediated by estradiol and progesterone. New data on the impact of COVID-19 on erythropoiesis, hemoglobin and ferritin levels are presented, and risk groups of a more severe course of the disease are identified: elderly adults, patients, patients with arterial hypertension, obesity and diabetes mellitus, pregnant women, patients with primary and acquired immunodeficiency, with oppression of the hematopoiesis, HIV-infected and with cancer. The algorithm of outpatient monitoring of pregnant women during a pandemic (self-assessment of the state, online control, etc.) is given.Some current world protocols for the COVID-19 prevention and treatment have been analyzed and a modification adapted for Ukrainian pregnant women has been proposed. A method is proposed for the prevention miscarriage and nutritional deficits – one of the frequent and dangerous COVID-19 complications in pregnant women.

scholarly journals Swāsthya, an integrated chronic condition management programme for families of patients with hypertension and diabetes mellitus: a study protocol for a randomised controlled trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
M D Saju ◽  
Bindiya M Varghese ◽  
Lorane Scaria ◽  
Anuja Maria Benny ◽  
Shilpa V Yohannan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Randomised Controlled Trial ◽  
Social Cohesion ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Controlled Trial ◽  
Risk Groups ◽  
Care Model ◽  
Randomised Controlled

Abstract Background Kerala is known as the diabetes mellitus (DM) and hypertension (HTN) capital of the world, thus compelling health professionals to model strategies, addressing their social, behavioural, and cognitive risk factors and eliminating various barriers to management. This paper describes the protocol of our study that aims to examine the effectiveness and sustainability of an integrated care model for the management of chronic conditions and their risk factors through a family-based intervention. The proposed care model targets to modify systems and processes that predispose to chronic conditions by enhancing social cohesion and social networks, preventing lifestyle risks, developing iterative cognitive interventions, and engaging the family into customised treatment adherence strategies navigated by community health social workers (CHSWs). Methods A cluster randomised controlled trial (RCT) in selected participants will be conducted involving additional assessments prior to the baseline assessment. The assessment will identify and categorise patients into four risk groups, namely behavioural, social, cognitive, and multiple, based on dominant risks identified. Eligible participants will be randomly allocated (at a ratio of 1:1) into the intervention or control arm. The intervention arm will receive social, behavioural, and cognitive or multiple interventions corresponding to the identified risk groups, whereas the control arm will receive general intervention. Both the groups will be followed up at 6 months and 12 months post baseline to measure outcomes. The primary outcome will be the control of HTN and DM, and secondary outcomes include decreased depression and anxiety and improved functioning, social cohesion, and social network linkages. The sustainability and scalability of this intervention will be assessed through cost effectiveness, acceptability, and user friendliness of the integrated approach by performing a qualitative evaluation. Discussion This RCT will inform the potential paradigm shift from a medical model of chronic condition management to a multidimensional, multisystem, and multidisciplinary convergence model navigated by CHSWs. Such a model is not currently considered in the management of chronic conditions in Kerala. Trial registration Trial has been prospectively registered on Clinical Trial Registry of India- CTRI/2020/12/029474 on 1st December 2020.

scholarly journals How the Heart Was Involved in COVID-19 during the First Pandemic Phase: A Review

Epidemiologia ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 124-139
Author(s):  
Andrea Canalella ◽  
Ermanno Vitale ◽  
Francesca Vella ◽  
Paola Senia ◽  
Emanuele Cannizzaro ◽  
...  
Keyword(s):  
Public Health ◽  
Diabetes Mellitus ◽  
Scientific Community ◽  
Respiratory Virus ◽  
Clinical Manifestations ◽  
Hubei Province ◽  
Public Health Emergency ◽  
Converting Enzyme ◽  
Pathophysiological Mechanisms ◽  
Cardiovascular Involvement

Coronavirus disease (COVID-19) was first observed in Wuhan, Hubei Province (China) in December 2019, resulting in an acute respiratory syndrome. Only later was COVID-19 considered a public health emergency of international concern and, on 11 March 2020, the WHO classified it as pandemic. Despite being a respiratory virus, the clinical manifestations are also characterized by cardiological involvement, especially in patients suffering from previous comorbidities such as hypertension and diabetes mellitus, its complications being potentially serious or fatal. Despite the efforts made by the scientific community to identify pathophysiological mechanisms, they still remain unclear. A fundamental role is played by the angiotensin 2 converting enzyme, known for its effects at the cardiovascular level and for its involvement in COVID-19 pathogenesis. The goal of this paper was to highlight the mechanisms and knowledge related to cardiovascular involvement during the first pandemic phase, as well as to emphasize the main cardiological complications in infected patients.

Searching for Utopia, the Challenge of Standardized Medical Nutrition Therapy Prescription in Gestational Diabetes Mellitus Management: A Critical Review

2021 ◽  
Author(s):  
Nina Meloncelli ◽  
Shelley A. Wilkinson ◽  
Susan de Jersey
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Lifestyle Modification ◽  
Nutrition Therapy ◽  
Medical Nutrition Therapy ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Medical Nutrition

AbstractGestational diabetes mellitus (GDM) is a common pregnancy disorder and the incidence is increasing worldwide. GDM is associated with adverse maternal outcomes which may be reduced with proper management. Lifestyle modification in the form of medical nutrition therapy and physical activity, as well as self-monitoring of blood glucose levels, is the cornerstone of GDM management. Inevitably, the search for the “ultimate” diet prescription has been ongoing. Identifying the amount and type of carbohydrate to maintain blood glucose levels below targets while balancing the nutritional requirements of pregnancy and achieving gestational weight gain within recommendations is challenging. Recent developments in the area of the gut microbiota and its impact on glycemic response add another layer of complexity to the success of medical nutrition therapy. This review critically explores the challenges to dietary prescription for GDM and why utopia may never be found.

scholarly journals Approach to the Patient with Diabetes during Pregnancy

2010 ◽  
Vol 95 (8) ◽  
pp. 3578-3585 ◽  
Author(s):  
Jennifer Hone ◽  
Lois Jovanovič
Keyword(s):  
Public Health ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Weight Gain ◽  
Preconception Care ◽  
Fetal Outcomes ◽  
Optimal Outcomes

The epidemics of obesity and type 2 diabetes mellitus (T2DM) globally are paralleling an increase in the number of women with T2DM becoming pregnant. Because T2DM is frequently undiagnosed before pregnancy, the risk of major malformations in the developing fetus is increased due to uncontrolled hyperglycemia. The lack of preconception care and the increase in complications of pregnancy due to the coexistence of obesity and T2DM are of concern from both an individual and a public health standpoint. Rapid achievement of normoglycemia with limited weight gain is critical to optimize maternal and fetal outcomes in all women with diabetes during pregnancy, regardless of the type of diabetes. This article will focus on T2DM preceding pregnancy due to its increasing prevalence and potentially dire fetal and maternal consequences. Euglycemia before, during, and after all pregnancies complicated by diabetes results in the best opportunity for optimal outcomes for mother and infant.

Problems Of Metabolic Syndrome

2021 ◽  
Vol 03 (06) ◽  
pp. 52-55
Author(s):  
Maksuda Ahmedjanovna Karimova ◽  
◽  
Dilnoza Kakhramanovna Kurbanbaeva ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Metabolic Syndrome ◽  
Lifestyle Modification ◽  
Syndrome X ◽  
Steady Increase ◽  
The Third ◽  
Calorie Content ◽  
Single Term ◽  
Life Threatening

At the beginning of the third millennium, for mankind, which overcame the epidemic of life-threatening infections during its centuries-old history, the problem of cardiovascular diseases (CVD) came to the fore in relevance among all causes of morbidity and mortality. A significant role in this was played by lifestyle modification associated with limiting physical activity, increasing the calorie content of food, and a steady increase in emotional stress. All of this potentiates the main risk factors for CVD, which are a “negative asset of progress,” namely increased blood pressure (BP), dyslipidemia, diabetes mellitus (DM) and obesity. Since 1988, after G. Reaven's Banting lecture, it is customary to designate the interconnected combination of these pathologies by the single term "metabolic syndrome X".

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