Gestational Diabetes Mellitus. At What Time Should the Postprandial Glucose Level be Monitored?

1999 ◽  
Vol 39 (4) ◽  
pp. 457-460 ◽  
Author(s):  
Robert G Moses ◽  
Elizabeths M Luca ◽  
Sallyanne Knights
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Glucose Level ◽  
Postprandial Glucose ◽  
Postprandial Glucose Level

Decreased Monocyte Count is Associated with Gestational Diabetes Mellitus Development, Macrosomia and Inflammation

2021 ◽  
Author(s):  
Xinmei Huang ◽  
Bingbing Zha ◽  
Manna Zhang ◽  
Yue Li ◽  
Yueyue Wu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Glucose Level ◽  
First Trimester ◽  
Case Control ◽  
Monocyte Count ◽  
Tnf Α ◽  
Newborn Weight

Abstract Objective The immune system plays a central role in the pathophysiology of gestational diabetes mellitus (GDM). Monocytes, the main innate immune cells, are especially important in the maintenance of a normal pregnancy. Here, we investigated the potential effect of monocytes in GDM. Materials and Methods: Monocyte count was monitored throughout pregnancy in 214 women with GDM and 926 women without in a case-control and cohort study. Circulating levels of inflammatory cytokines, placenta-derived macrophages and their products were measured. Results Throughout pregnancy, monocyte count was significantly decreased in women with GDM, and closely associated with glucose level, insulin resistance and newborn weight. First-trimester monocyte count outperformed that of the second and third trimester as a risk factor and diagnostic predictor of GDM and macrosomia in both the case-control and cohort study. In addition, our cohort study showed that as first-trimester monocyte count decreased, GDM and macrosomia incidence, glucose level and newborn weight increased in a stepwise manner. Risk of GDM started to decrease rapidly when first-trimester monocyte count exceeded 0.48 × 10 9/L. Notably, CD206 and IL-10 were significantly lower, while CD80, CD86, TNF-α and IL-6 were higher in both GDM placental tissue and peripheral blood. First-trimester monocyte count was positively related to IL-10 and CD206, but negatively related to CD80, CD86, TNF-α and IL-6. Conclusions Decreased monocyte count throughout pregnancy was closely-associated with the development of GDM, macrosomia and the chronic inflammatory state of GDM. First-trimester monocyte count has great potential as an early diagnostic marker of GDM.

scholarly journals Prevalence of gestational diabetes mellitus and its feto-maternal outcome in Kamla Nehru state hospital for mother and child, IGMC, Shimla, India

2018 ◽  
Vol 7 (11) ◽  
pp. 4662
Author(s):  
Aleeza Pal ◽  
Bishan Dhiman ◽  
Rita Mittal ◽  
Bhaskar J. Paul
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
State Hospital ◽  
Glucose Level ◽  
Plasma Glucose ◽  
Plasma Glucose Level ◽  
Maternal Outcome ◽  
Vaginal Candidiasis ◽  
Mother And Child

Background: Gestational Diabetes Mellitus (GDM) is defined as carbohydrate intolerance of variable severity with the onset or first recognition during pregnancy. It is a disease entity that adversely affects maternal as well as fetal outcome. DIPSI guideline having suggested one-time plasma glucose level has emerged as a simple, practical and cheap method to detect GDM. This study was done to evaluate the prevalence of gestational diabetes using Diabetes in Pregnancy Study Group India (DIPSI) criteria and further assess its feto maternal outcome in Kamla Nehru State Hospital for Mother and Child, IGMC, Shimla.Methods: This study was conducted in 500 patients between 24 and 28 weeks of gestation, attending the antenatal OPD. These patients were given 75g oral glucose irrespective of last meal and their plasma glucose was estimated at 2h. Patients with plasma glucose ≥140mg/dl were diagnosed as GDM and the rest as control or the non GDM group. The GDM patients were followed up and treated with medical nutrition therapy (MNT) and/or insulin therapy till delivery and maternal and fetal outcomes were then noted.Results: The prevalence of GDM in this study was 6%. Maternal and fetal complications were more in the GDM patients. Vaginal candidiasis and PROM were the common maternal complications, while hypoglycemia and hyperbilirubinemia were common in the fetuses.Conclusions: GDM adversely affects the mother as well as fetus. DIPSI guideline having suggested a single plasma glucose level test has emerged as a practical and economical method to detect GDM.

scholarly journals Physical Activity Programs during Pregnancy Are Effective for the Control of Gestational Diabetes Mellitus

2020 ◽  
Vol 17 (17) ◽  
pp. 6151 ◽  
Author(s):  
José Alberto Laredo-Aguilera ◽  
María Gallardo-Bravo ◽  
Joseba Aingerun Rabanales-Sotos ◽  
Ana Isabel Cobo-Cuenca ◽  
Juan Manuel Carmona-Torres
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Postprandial Glucose ◽  
Moderate Intensity ◽  
Randomized Controlled Studies ◽  
Sufficient Intensity ◽  
Type Of Exercise

Gestational diabetes mellitus has an incidence of 14% worldwide and nursing is responsible for its monitoring during pregnancy. Excessive weight gain during pregnancy is directly related to gestational diabetes mellitus development. Gestational diabetes mellitus (GDM) has negative repercussions on the evolution of the pregnancy and the fetus. The objective of this systematic review is to establish how physical activity influences pregnant women with gestational diabetes mellitus and to analyze what benefits physical activity has in the control of gestational diabetes mellitus. A systematic search was carried out in different databases (Cochrane, Superior Council of Scientific Investigations (CSIC), EBSCOhost, Pubmed, Scopus, Web os Science, and Proquest) for papers published within the last 12 years, taking into account different inclusion and exclusion criteria. Six randomized controlled studies and one observational case-control study of a high quality were selected. Fasting, postprandial glucose and HbcA1 were assessed, as well as the requirement and amount of insulin used. Thus, there is a positive relationship between the performance of physical activity and the control of gestational diabetes mellitus. Resistance, aerobic exercise, or a combination of both are effective for the control of glucose, HbcA1, and insulin. Due to the variability of the exercises of the analyzed studies and the variability of the shape of the different pregnant women, it does not permit the recommendation of a particular type of exercise. However, any type of physical activity of sufficient intensity and duration can have benefits for pregnant women with GDM. Pregnant women with gestational diabetes mellitus should exercise for at least 20–50 min a minimum of 2 times a week with at a least moderate intensity.

scholarly journals The Association of Gene Variants in the Vitamin D Metabolic Pathway and Its Interaction with Vitamin D on Gestational Diabetes Mellitus: A Prospective Cohort Study

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4220
Author(s):  
Minjia Mo ◽  
Bule Shao ◽  
Xing Xin ◽  
Wenliang Luo ◽  
Shuting Si ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Vitamin D ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
First Trimester ◽  
Postprandial Glucose ◽  
Gene Variants ◽  
Fasting Plasma

The present prospective study included 2156 women and investigated the effect of gene variants in the vitamin D (VitD) metabolic and glucose pathways and their interaction with VitD levels during pregnancy on gestational diabetes mellitus (GDM). Plasma 25(OH)D concentrations were measured at the first and second trimesters. GDM subtype 1 was defined as those with isolated elevated fasting plasma glucose; GDM subtype 2 were those with isolated elevated postprandial glucose at 1 h and/or 2 h; and GDM subtype 3 were those with both elevated fasting plasma glucose and postprandial glucose. Six Gc isoforms were categorized based on two GC gene variants rs4588 and rs7041, including 1s/1s, 1s/2, 1s/1f, 2/2, 1f/2 and 1f/1f. VDR-rs10783219 and MTNR1B-rs10830962 were associated with increased risks of GDM and GDM subtype 2; interactions between each other as well as with CDKAL1-rs7754840 were observed (Pinteraction < 0.05). Compared with the 1f/1f isoform, the risk of GDM subtype 2 among women with 1f/2, 2/2, 1s/1f, 1s/2 and 1s/1s isoforms and with prepregnancy body mass index ≥24 kg/m2 increased by 5.11, 10.01, 10, 14.23, 19.45 times, respectively. Gene variants in VitD pathway interacts with VitD deficiency at the first trimester on the risk of GDM and GDM subtype 2.

scholarly journals Relationships Among Pre-Pregnancy BMI, Gestational, and Postpartum Oral Glucose Tolerance Results in Women With Gestational Diabetes Mellitus

2021 ◽  
Vol 8 ◽  
Author(s):  
Chunmei Mi ◽  
Hong Liu ◽  
Hongying Peng ◽  
Chunxia Cheng ◽  
Meng Wang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Clinical Characteristics ◽  
Glucose Tolerance Test ◽  
Postprandial Glucose ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance

Background and Aims: To investigate the relationship among maternal demographic and clinical characteristics, gestational and postpartum oral glucose tolerance test (ppOGTT) results in patients with gestational diabetes mellitus (GDM).Methods: Patients with gestational diabetes mellitus from January 1, 2016, to August 31, 2019, were enrolled. General characteristics, dietary energy intake, pre-gestational body mass index (BMI), gestational oral glucose tolerance test (gOGTT), and 42 days ppOGTT results of all participants were collected. The relationships among maternal clinical characteristics, fasting glucose of gOGTT (gOGTT-FPG), 1 h postprandial glucose of gOGTT (gOGTT-1h PG), 2 h postprandial glucose of gOGTT (gOGTT-2h PG), and maternal postpartum glucose outcomes were evaluated.Results: A total of 156 patients with GDM were included in this study. Among them, 73.7% had inadequate daily total energy intake, an insufficient ratio of carbohydrates and protein, and an excessive fat ratio. Most of the patients (81.4%) were normal in their ppOGTT examination. Less than 20% of the patients (16.7%) were in the pre-diabetic situation, and 3 patients (1.9%) had diabetes. Pre-pregnancy BMI of patients with GDM was a risk factor for increased gOGTT-FPG levels. Those who were overweight before pregnancy had a greater risk for a higher gOGTT-FPG compared to those who had normal pre-pregnancy BMI (P = 0.021, odds ratio [OR] = 4.583). Abnormal gOGTT-2hPG was a risk factor for abnormal ppOGTT (P = 0.04). Those who had an elevated gOGTT-2hPG (≧8.5 mmol/L) had a 2.426 times higher risk for abnormal ppOGTT than those who had normal gOGTT-2hPG (&lt;8.5 mmol/L) results.Conclusion: For women who are overweight before pregnancy, it is better to control their BMI to normal before getting pregnant. Women who had abnormal gOGTT-2h PG should pay more attention to the ppOGTT results.

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