Design of FitFor2 study: the effects of an exercise program on insulin sensitivity and plasma glucose levels in pregnant women at high risk for gestational diabetes

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.

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A defect in insulin release in women at risk of future non-insulin-dependent diabetes

Clinical Science ◽

10.1042/cs0810195 ◽

1991 ◽

Vol 81 (2) ◽

pp. 195-199 ◽

Cited By ~ 18

Author(s):

Anne Dornhorst ◽

Simon G. M. Edwards ◽

Jonathan S. D. Nicholls ◽

Victor Anyaoku ◽

Duncan Mclaren ◽

...

Keyword(s):

Insulin Sensitivity ◽

Gestational Diabetes ◽

Plasma Glucose ◽

Fasting Glucose ◽

Glucose Production ◽

Tolerance Test ◽

Oral Glucose ◽

Glucose Levels ◽

Control Subjects ◽

Previous Gestational Diabetes

1. A study on seven Caucasian glucose-tolerant women with previous gestational diabetes and seven matched control subjects is presented. The insulin response to oral glucose, insulin sensitivity and fasting glucose production rates were measured by using a 75 g oral glucose tolerance test, an insulin tolerance test and a non-radioactive tracer, [6,6-2H]glucose, respectively. 2. Fasting plasma glucose levels were similar between the women with previous gestational diabetes and the control subjects (4.8 ± 0.3 versus 4.7 ± 0.2 mmol/l), as were fasting plasma insulin levels (median 4 m-units/l, range 1–13 m-units/l versus median 4 m-units/l, range 1–24 m-units/l). After oral glucose the 60 min plasma glucose levels in the women with previous gestational diabetes were significantly higher (8.5 ± 0.6 versus 6.7 ± 0.8 mmol/l, P < 0.05), whereas the plasma insulin level was significantly lower at both 30 min (median 23 m-units/l, range 4–47 m-units/l versus median 55 m-units/l, range 23–100 m-units/l, P < 0.02) and at 60 min (median 23 m-units/l, range 4–43 m-units/l versus median 60 m-units/l, range 16–126 m-units/l, P< 0.02). 3. Insulin sensitivity, expressed as the slope of the regression line of plasma glucose level against time after intravenous infusion of insulin (0.05 unit/kg), was similar in the women with previous gestational diabetes and the control subjects (mean slope, −0.17 ± 0.01 versus −0.17 ± 0.01). 4. Fasting glucose production rates were similar in the women with previous gestational diabetes and the control subjects (2.2 ± 0.3 versus 1.9 ± 0.1 mg min−1 kg−1). 5. Women with previous gestational diabetes, a group at risk of future non-insulin-dependent diabetes, have abnormalities of insulin release at a time when insulin sensitivity and fasting glucose production are normal.

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Insulin sensitivity and plasma glucose response to aerobic exercise in pregnant women at risk for gestational diabetes mellitus

Ethiopian Journal of Health Sciences ◽

10.4314/ejhs.v26i5.2 ◽

2016 ◽

Vol 26 (5) ◽

pp. 409 ◽

Cited By ~ 10

Author(s):

Heba Embaby ◽

Enas Elsayed ◽

Mohamed Fawzy

Keyword(s):

Diabetes Mellitus ◽

At Risk ◽

Insulin Sensitivity ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Aerobic Exercise ◽

Pregnant Women ◽

Plasma Glucose ◽

Glucose Response

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The correlation between the prevalence of gestational diabetes mellitus and maternal age in Southern China

Journal of Laboratory Medicine ◽

10.1515/labmed-2021-0068 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Jia-Yi Zhao ◽

Qing Yu ◽

Xiao-Ming Yang ◽

Xiang-Xin Li

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Plasma Glucose ◽

Maternal Age ◽

Southern China ◽

Oral Glucose ◽

Glucose Levels ◽

Iadpsg Criteria

Abstract Objectives The present study aimed to survey the prevalence of gestational diabetes mellitus (GDM) in Southern China and further to analyze the correlation between the prevalence of GDM and maternal age. Methods A retrospective cross-sectional study was carried out at the Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, Foshan, China between January and April 2020. Oral glucose tolerance tests (OGTT) was performed, using a 75 g glucose load and venous samples were drawn at 0 h, 1 h and 2 h at 24–28 weeks of gestation. GDM was diagnosed by International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Results The prevalence of GDM was 14.87% by IADPSG criteria. The incidence of GDM outcome increased and plasma glucose levels remained high among the age subgroups (<20, 20–24, 25–29, 30–34, 35–39, ≥40 years old) in pregnant women. Moreover, the levels of plasma glucose levels after OGTT kept rising among the pregnant women with non-gestational diabetes mellitus (non-GDM). Furthermore, pregnant women were inclined to have abnormal plasma glucose values at 1 h and 2 h than initial fasting plasma glucose (FPG) after OGTT as the age increased. Conclusions Our findings demonstrate that the incidence of GDM outcome and plasma glucose levels increase as the maternal age increase.

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Segmentation and Pattern Analyses for Three Meals of Postprandial Plasma Glucose Values and Associated Carbs/Sugar Amounts Using GH-Method: Math-Physical Medicine (No. 326)

10.47363/jcrr/2020(2)118 ◽

2020 ◽

Vol 2 (2) ◽

pp. 1-4

Author(s):

Gerald C Hsu ◽

Keyword(s):

Plasma Glucose ◽

Research Work ◽

Exercise Program ◽

Management Program ◽

Conversion Ratio ◽

Lifestyle Management ◽

Postprandial Plasma Glucose ◽

Sugar Intake ◽

Glucose Levels ◽

Segmentation Analysis

The author describes the results of segmentation and pattern analyses of postprandial plasma glucose levels (PPG) and carbs/sugar intake amount (carbs), which are associated with his three daily meals. In this paper, there are three consistent ranges of low, medium, and high for PPG values and carbs/sugar amounts that are used for each meal but with different units. One of the final objectives for this analysis is to calculate the most reasonable and effective conversion ratio between measured PPG in mg/dL and carbs/sugar intake amount in grams, by discovering how much PPG amount would be generated from 1 gram of carbs/sugar intake. This investigation utilized the PPG data and carbs/sugar amount collected during a period of 2+ years from 5/5/2018 to 9/6/2020 with a breakdown of 855 days, including 2,565 meals, 33,345 glucose data, and 33,345 carbs/sugar data. By using the segmentation analysis of his 33,345 PPG data and 2,565 carbs/sugar data, the author has conducted a pattern recognition and segmentation analysis from his PPG profiles with its associated carbs/sugar intake of his food and meals in the past 855 days. Since 12/8/2015, he ceased taking any diabetes medications. In other words, his diabetes control is 100% dependent on his lifestyle management program with no chemical intervention from any medications. Subsequently, he has maintained a stringent exercise program after each meal; therefore, the development of his simplified PPG prediction model, excluding the exercise factor, can be expressed solely with carbs/sugar intake amount. Predicted PPG = (baseline glucose) + (conversion ratio * carbs/sugar amount) In his research work, he found the reasonable and effective conversion ratio between PPG and carbs that ranges from 1.8 mg/dL per gram to 2.5 mg/dL per gram. This simple equation could assist many type 2 diabetes (T2D) patients in controlling their diabetes via carbs/sugar intake amount. During this particular time period, his PPG control via a stringent lifestyle management without medication is highly successful. His estimated mathematically derived HbA1C values should be between 5.56% to 6.05%, which is a satisfactory HbA1C level for a 73-year-old male with a 25-year history of severe diabetes. It should be mentioned that he had an average daily glucose of 280 mg/dL and HbA1C of 11% in 2010. This segmented pattern analyses based on his PPG data and carbs/sugar intake amount offer a useful tool for analyzing other types of biomarkers in a deeper investigation with a wider entry point of research.

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Preliminary validation of an exercise program suitable for pregnant women with abnormal glucose metabolism: inhibitory effects of Tai Chi Yuttari-exercise on plasma glucose elevation

Journal of Physical Therapy Science ◽

10.1589/jpts.28.3411 ◽

2016 ◽

Vol 28 (12) ◽

pp. 3411-3415 ◽

Cited By ~ 1

Author(s):

Sachina Yamamoto ◽

Kyoko Kagawa ◽

Naohi Hori ◽

Yoshiteru Akezaki ◽

Kohei Mori ◽

...

Keyword(s):

Glucose Metabolism ◽

Pregnant Women ◽

Plasma Glucose ◽

Tai Chi ◽

Exercise Program ◽

Inhibitory Effects ◽

Abnormal Glucose Metabolism ◽

Preliminary Validation

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Gravidanza e diabete: una rassegna della letteratura

PSICOLOGIA DELLA SALUTE ◽

10.3280/pds2009-003005 ◽

2009 ◽

pp. 73-86

Author(s):

Renata Tambelli ◽

Manuela Errante

Keyword(s):

Diabetes Mellitus ◽

High Risk ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Clinical Studies ◽

Child Relationship ◽

Risk Pregnancy ◽

Mother Child Relationship

- In this review are discussed the main researches about high-risk pregnancy and, particularly, gestational diabetes mellitus (GDM). The results of these researches highlight that pregnant women with GDM are extremely vulnerable, anxious and worried. However there are not many clinical studies about the effect of GDM on the quality of mother-child relationship.

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Predictive metabolomic profiling within a diverse population of pregnant women at low or high risk of gestational diabetes

Proceedings of The Nutrition Society ◽

10.1017/s002966512000765x ◽

2020 ◽

Vol 79 (OCE3) ◽

Author(s):

H. Fuller ◽

J.B. Moore ◽

M. Iles ◽

M. Zulyniak

Keyword(s):

High Risk ◽

Gestational Diabetes ◽

Pregnant Women ◽

Diverse Population ◽

Metabolomic Profiling

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Expression of Dual-Specificity Phosphatase 9 in Placenta and Its Relationship with Gestational Diabetes Mellitus

Journal of Diabetes Research ◽

10.1155/2019/1963178 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Qiang Wei ◽

Xiaomin Pu ◽

Li Zhang ◽

Yi Xu ◽

Meifan Duan ◽

...

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Body Mass Index ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Plasma Glucose ◽

Mrna Levels ◽

Gestational Week

Introduction. The aim of the present study was to examine placental levels of DUSP9 mRNA and protein and to investigate the potential role of DUSP9 in the development of gestational diabetes mellitus (GDM). Methods. Placental tissues from pregnant women with GDM (n=17) and normal healthy pregnant women (n=16) were collected at delivery. The expression of DUSP9 mRNA in placental tissue was analyzed by real-time PCR, while the expression of DUPS9 protein was evaluated by immunohistochemistry and western blot. Differences in the expression levels of DUSP9 mRNA and protein between the two groups were assessed, as well as potential correlations between DUSP9 mRNA expression levels and relevant clinical indicators. Results. Blood glucose levels were significantly higher in the GDM group than in the control group, based on an oral glucose tolerance test. DUSP9 protein was expressed in the placental cytotrophoblasts in both groups, and placental levels of DUSP9 protein and mRNA were significantly higher in women with GDM. Placental DUSP9 mRNA levels in all 33 women correlated moderately with delivery gestational week (R=0.465, P=0.006), fasting plasma glucose (R=0.350, P=0.046), 1-hour postload plasma glucose (R=0.363, P = 0.038), and 2-hour postload plasma glucose (R=0.366, P=0.036), but not with maternal age, preconception body mass index, prenatal body mass index, or neonatal birth weight. Multiple linear regression analysis indicated that delivery gestational week was an influence factor of DUSP9 mRNA levels (β1=0.026, P<0.05). Conclusions. DUSP9 upregulation in the placenta of GDM pregnant women may promote insulin resistance, which may correlate with the occurrence of GDM. But there is still possibility that DUSP9 upregulation was the results of insulin resistance and/or hyperglycemia. Further research is needed to explore the role of DUSP9 in GDM.

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