Increased DNA Damage is Related to Maternal Blood Glucose Levels in the Offspring of Women With Diabetes and Mild Gestational Hyperglycemia

Infant birth weight has increased in Ireland in recent years along with levels of childhood overweight and obesity. The present article reviews the current literature on maternal glycaemia and the role of the dietary glycaemic index (GI) and its impact on pregnancy outcomes. It is known that maternal weight and weight gain significantly influence infant birth weight. Fetal macrosomia (birth weight >4000 g) is associated with an increased risk of perinatal trauma to both mother and infant. Furthermore, macrosomic infants have greater risk of being obese in childhood, adolescence and adulthood compared to normal-sized infants. There is evidence that there is a direct relationship between maternal blood glucose levels during pregnancy and fetal growth and size at birth, even when maternal blood glucose levels are within their normal range. Thus, maintaining blood glucose concentrations within normal parameters during pregnancy may reduce the incidence of fetal macrosomia. Maternal diet, and particularly its carbohydrate (CHO) type and content, influences maternal blood glucose concentrations. However, different CHO foods produce different glycaemic responses. The GI was conceived by Jenkins in 1981 as a method for assessing the glycaemic responses of different CHO. Data from clinical studies in healthy pregnant women have documented that consuming a low-GI diet during pregnancy reduces peaks in postprandial glucose levels and normalises infant birth weight. Pregnancy is a physiological condition where the GI may be of particular relevance as glucose is the primary fuel for fetal growth.

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CHANGES IN BLOOD GLUCOSE AND LIVER CARBOHYDRATE AFTER INTRAUTERINE INJECTION OF GLUCAGON INTO FOETAL RATS

Journal of Endocrinology ◽

10.1677/joe.0.0450367 ◽

1969 ◽

Vol 45 (3) ◽

pp. 367-374 ◽

Cited By ~ 14

Author(s):

D. J. S. HUNTER

Keyword(s):

Blood Glucose ◽

Liver Glycogen ◽

Maternal Blood ◽

Uterine Wall ◽

Control Group ◽

Hepatic Glycogen ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Carbohydrate Levels ◽

Foetal Blood

SUMMARY Maternal blood glucose, foetal blood glucose and liver carbohydrate levels were estimated after foetuses were injected with glucagon through the uterine wall on days 19½, 20½ and 21½ of gestation in the rat. Glucagon had a hyperglycaemic effect in the foetus on all the days studied but the response was greater and more rapid on day 21½ of gestation. Glucagon was shown to decrease liver glycogen on day 20½ and 21½ but again the response was more rapid and more pronounced on day 21½. The normal levels of foetal liver glycogen were similar to those previously found but the normal foetal blood glucose values are lower than previous results. Decrease in liver glycogen observed in the control group of foetuses on day 21½ of gestation together with a loss in foeto-maternal blood glucose relationship on that day of gestation suggest that on day 21½ the foetal rat develops the ability to mobilize hepatic glycogen and thereby to alter its blood glucose level independently from the mother. The significance of the low blood glucose levels found in the foetus is discussed.

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Seasonality of gestational diabetes mellitus and maternal blood glucose levels

Medicine ◽

10.1097/md.0000000000022684 ◽

2020 ◽

Vol 99 (41) ◽

pp. e22684

Author(s):

Panchalli Wang ◽

Chung-Shing Wu ◽

Chung-Yi Li ◽

Chun-Pai Yang ◽

Mei-Chun Lu

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Maternal Blood ◽

Glucose Levels ◽

Blood Glucose Levels

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Associations of exposure to fine particulate matter during pregnancy with maternal blood glucose levels and gestational diabetes mellitus: Potential effect modification by ABO blood group

Ecotoxicology and Environmental Safety ◽

10.1016/j.ecoenv.2020.110673 ◽

2020 ◽

Vol 198 ◽

pp. 110673

Author(s):

Jiawei Kang ◽

Jiaqiang Liao ◽

Shunqing Xu ◽

Wei Xia ◽

Yuanyuan Li ◽

...

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Fine Particulate Matter ◽

Maternal Blood ◽

Potential Effect ◽

Effect Modification ◽

Abo Blood Group ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Fine Particulate

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The Relationship between Gestational Diabetes Metabolic Control and Fetal Autonomic Regulation, Movement and Birth Weight

Journal of Clinical Medicine ◽

10.3390/jcm10153378 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3378

Author(s):

Janine Zöllkau ◽

Laura Swiderski ◽

Alexander Schmidt ◽

Friederike Weschenfelder ◽

Tanja Groten ◽

...

Keyword(s):

Heart Rate ◽

Blood Glucose ◽

Birth Weight ◽

Gestational Diabetes ◽

Metabolic Control ◽

Maternal Blood ◽

Autonomic Control ◽

Glucose Levels ◽

Blood Glucose Levels ◽

The Relationship

(1) Background: Maternal metabolic control in gestational diabetes is suggested to influence fetal autonomic control and movement activity, which may have fetal outcome implications. We aimed to analyze the relationship between maternal metabolic control, fetal autonomic heart rate regulation, activity and birth weight. (2) Methods: Prospective noninterventional longitudinal cohort monitoring study accompanying 19 patients with specialist clinical care for gestational diabetes. Monthly fetal magnetocardiography with electro-physiologically-based beat-to-beat heart rate recording for analysis of heart rate variability (HRV) and the ‘fetal movement index’ (FMI) was performed. Data were compared to 167 healthy pregnant women retrieved from our pre-existing study database. (3) Results: Fetal vagal tone was increased with gestational diabetes compared to controls, whereas sympathetic tone and FMI did not differ. Within the diabetic population, sympathetic activation was associated with higher maternal blood-glucose levels. Maternal blood-glucose levels correlated positively with birth weight z scores. FMI showed no correlation with birth weight but attenuated the positive correlation between maternal blood-glucose levels and birth weight. (4) Conclusion: Fetal autonomic control is altered by gestational diabetes and maternal blood-glucose level, even if metabolic adjustment and outcome is comparable to healthy controls.

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Management of Diabetes in the Intrapartum and Postpartum Patient

American Journal of Perinatology ◽

10.1055/s-0038-1629903 ◽

2018 ◽

Vol 35 (11) ◽

pp. 1119-1126 ◽

Cited By ~ 7

Author(s):

Charlotte Niznik ◽

Emily Szmuilowicz ◽

Alan Peaceman ◽

Lynn Yee ◽

Annie Dude

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Maternal Blood ◽

Intrapartum Care ◽

Neonatal Hypoglycemia ◽

Glucose Levels ◽

Insulin Requirements ◽

Standardized Protocol ◽

Blood Glucose Levels ◽

Maternal Glucose

AbstractAchieving maternal euglycemia in women with pregestational and gestational diabetes mellitus is critical to decreasing the risk of neonatal hypoglycemia, as maternal blood glucose levels around the time of delivery are directly related to the risk of hypoglycemia in the neonate. Many institutions use continuous insulin and glucose infusions during the intrapartum period, although practices are widely variable. At Northwestern Memorial Hospital, the “Management of the Perinatal Patient with Diabetes” policy and protocol was developed to improve consistency of management while also allowing individualization appropriate for the patient's specific diabetic needs. This protocol introduced standardized algorithms based on maternal insulin requirements to drive real-time maternal glucose control during labor as well as provided guidelines for postpartum glycemic control. This manuscript describes the development and implementation of this protocol to encourage other institutions to adopt a standardized protocol that allows highly individualized intrapartum care to women with diabetes.

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Study of glucose levels in newborn with reference to hypoglycemia

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20194750 ◽

2019 ◽

Vol 6 (6) ◽

pp. 2661

Author(s):

Gaddam Zion Eluzai ◽

K. Poojitha

Keyword(s):

Blood Glucose ◽

Mode Of Delivery ◽

Maternal Blood ◽

Physical Growth ◽

Blood Glucose Monitoring ◽

Time Points ◽

Glucose Levels ◽

Blood Glucose Levels ◽

The Mean ◽

Mean Blood Glucose

Background: Hypoglycemia is one of the common metabolic problems in neonatal medicine. Early diagnosis and treatment of neonatal hypoglycemia is important as many studies found that, hypoglycaemic episodes in neonates lead to neurodevelopmental and physical growth deficits. In this study, blood glucose levels at different time points were assessed and the influence of maternal blood glucose, mode of delivery, gestational age on neonatal blood glucose levels were studied.Methods: Blood glucose levels were low at 0 and 6th hour and maximum at 24th hour. The blood glucose levels ranged from 27 mg/dl to 140 mg/dl. Neonates with high maternal blood glucose were hypoglycaemic, showing a negative correlation.Results: The mean blood glucose levels were low in pre-term and post term babies compared to term and the range was wide in pre-term and term babies compared to post-term. The mean blood glucose levels were high and range was wide in babies delivered vaginally at all the time points compared to the babies delivered by LSCS. 17% babies were hypoglycaemic at birth but none of them had signs. The major signs noted were jitteriness (88%), high cry (88%), lethargy (55%), tremors (55%), limpness (22%), apathy (22%), weak cry (11%) and poor feeding (11%).Conclusions: 0 and 6th hour are the vulnerable time points for hypoglycaemia. Neonates with high maternal blood glucose, pre-term, post-term and babies delivered by LSCS were more prone for hypoglycaemia requiring blood glucose monitoring. There is a wide variation in signs of hypoglycaemia and babies showing signs require monitoring.

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