Hba1c levels are increased in patients with gestational diabetes carrying the T/T genotype of the rs1990760 polymorphism in the IFIH1 gene

Background: Gestational diabetes mellitus (GDM) is known as a degree of glucose intolerance that occurs for the first time during pregnancy. There is paucity of evidence regarding the effect of oat bran on GDM. Oat as a source of β-glucan can be effective in reducing the blood sugar levels. This study aimed to investigate the effect of oat bran on fasting blood sugar (FBS) and glycosylated hemoglobin (HbA1c) in patients with GDM. Method: This single-blind clinical trial was conducted on 90 pregnant women with GDM. The experimental group (EG) consumed 30 g of oat bran daily with 100 g of low-fat yogurt before lunch and dinner for 4 weeks. The control group (CG) consumed only low-fat yogurt and both groups received nutrition counseling. The present study investigated the FBS, HbA1c, and weight gain at the beginning and after four weeks of intervention. Results: Out of 90 patients, 80 completed the study. FBS decreased in the EG (P = 0.04, -2.75 ± 8.22), whereas, it increased in the CG (P = 0.003, 4.37 ± 8.72). No significant difference was observed between the two groups in terms of HbA1c levels. Weight gain was controlled more efficiently in the EG than the CG (P = 0.001). Conclusion: The use of oat bran for four weeks decreased the FBS,; whereas, it did not affect HbA1c levels. Weight gain was controlled better in the EG than the CG.

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First-Trimester Placental Growth Factor in Screening for Gestational Diabetes

Fetal Diagnosis and Therapy ◽

10.1159/000441027 ◽

2015 ◽

Vol 39 (4) ◽

pp. 287-291 ◽

Cited By ~ 3

Author(s):

Beatrice Mosimann ◽

Sophia Amylidi ◽

Lorenz Risch ◽

Ute Wiedemann ◽

Daniel Surbek ◽

...

Keyword(s):

At Risk ◽

Growth Factor ◽

Gestational Diabetes ◽

Glycosylated Hemoglobin ◽

First Trimester ◽

Placental Growth Factor ◽

Serum Concentrations ◽

Fetal Medicine ◽

Hba1c Levels ◽

Do So

Objective: The aim of this study was first to assess whether first-trimester serum concentrations of placental growth factor (PlGF) differ between patients with and without gestational diabetes (GDM) and second to test whether there is a correlation between glycosylated hemoglobin (HbA1c), a factor recently shown to be useful in predicting GDM, and PlGF. Methods: PlGF was measured at 8-14 weeks with the Kryptor Immunoassay Analyzer (Brahms, Berlin, Germany). Absolute values were converted to multiples of the median using the software provided by the Fetal Medicine Foundation London. GDM was diagnosed using internationally accepted criteria. HbA1c levels were quantified using the TOSOH G7 automated hemoglobin analyzer. Results: From January to December 2014, 328 women were included in the study, 51 (15.5%) of whom developed GDM. First-trimester PlGF quantification does not discriminate between women at risk to develop GDM and controls, while HbA1c is able to do so. No correlation was found between PlGF and HbA1c. Conclusion: Our findings do not lend support to the hypothesis that early PlGF values are different in women who later develop GDM.

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Risk Factors for Pregnancy Complications and Postpartum Glucose Intolerance in Women With Gestational Diabetes Mellitus

10.21203/rs.3.rs-116971/v1 ◽

2020 ◽

Author(s):

Naohisa Masuko ◽

Kenji Tanimura ◽

Nobue Kojima ◽

Hitomi Imafuku ◽

Masashi Deguchi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Glucose Intolerance ◽

Pregnancy Complications ◽

Glucose Tolerance Test ◽

Tolerance Test ◽

Oral Glucose ◽

Hba1c Levels

Abstract This prospective cohort study aimed to evaluate the risk factors for pregnancy complications and postpartum glucose intolerance (GI) in women with gestational diabetes mellitus (GDM). A total of 140 women with GDM were enrolled. Of these, 115 underwent a 75-g oral glucose tolerance test (OGTT) at 12 weeks after delivery. Clinical factors and parameters in the antepartum 75-g OGTT associated with pregnancy complications and postpartum GI were evaluated. Women with GDM experienced pregnancy complications, including hypertensive disorders of pregnancy (HDP, n=19), preterm delivery (PD, n=17), heavy-for-date (HFD, n=19), and light-for-date (LFD, n=12), and 22 of the 115 women with GDM developed postpartum GI. The univariate and multivariable logistic regression analyses revealed the following risk factors: histories of hypertension (odds ratio [OR], 23.8; 95% confidence interval [CI], 4.2–134.7; p<0.01) for HDP; histories of hypertension (OR, 9.8; 95% CI, 2.5–38.9; p<0.01) for PD; HbA1c levels (OR, 7.6; 95% CI, 1.5–37.9; p<0.05) for HFD; and oral deposition index (DI) (OR, 0.1; 95% CI, 0.02–0.7; p<0.01) for postpartum GI. Higher HbA1c levels and lower oral DI on the antepartum 75-g OGTT may be useful markers for identifying GDM women who are at high risk for HFD and postpartum GI, respectively.

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Circulating Spexin levels in pregnant women with and without gestational diabetes

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20194380 ◽

2019 ◽

Vol 8 (10) ◽

pp. 4056

Author(s):

Coskun Simsir ◽

Muberra Namli Kalem ◽

Ziya Kalem ◽

Turgut Var ◽

Batuhan Bakirarar ◽

...

Keyword(s):

Weight Gain ◽

Blood Glucose ◽

Gestational Diabetes ◽

Fasting Blood Glucose ◽

Appetite Control ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Lipid Parameters ◽

Weight Gain During Pregnancy ◽

Hba1c Levels

Background: Several previous studies suggest that SPX plays a role in appetite control and body weight and blood glucose regulation. The aim of this study to determine SPX levels in healthy pregnancies and in gestational diabetes (GDM) and to investigate the association of SPX levels with weight gain and lipid and glucose metabolism in subjects with and without GDM.Methods: A total of 44 women with GDM and 44 women without GDM were randomly enrolled who applied for GDM screening during the 24-28th week of pregnancy. Demographics, blood glucose and lipid profiles and Spexin levels were compared between groups.Results: The mean age, BMI, and weight gain during pregnancy were higher in the GDM group. The LDL cholesterol, Hba1c, SPX and glucose levels in response to OGTT were higher in the GDM group. The SPX levels were correlated with Hba1c and blood glucose levels after OGTT, and were not correlated with the age, BMI, weight gain during pregnancy, lipid parameters, and fasting blood glucose levels in the whole study population.Conclusions: SPX levels were higher in the GDM group compared with non-GDM group and SPX levels were correlated with HbA1c levels and post-OGTT glucose levels but not with fasting glucose levels.

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Elevated Midtrimester Triglycerides as a Biomarker for Postpartum Hyperglycemia in Gestational Diabetes

Journal of Diabetes Research ◽

10.1155/2020/3950652 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Mengyu Lai ◽

Fang Fang ◽

Yuhang Ma ◽

Jiaying Yang ◽

Jingjing Huang ◽

...

Keyword(s):

Gestational Diabetes ◽

Tolerance Test ◽

Oral Glucose ◽

Second Trimester ◽

Lipid Levels ◽

Severe Insulin Resistance ◽

Abnormal Glucose Metabolism ◽

Previous Gestational Diabetes Mellitus ◽

Hba1c Levels ◽

Previous Gestational Diabetes

Background. Whether elevated triglyceride (TG) levels during pregnancy were a biomarker for postpartum abnormal glucose metabolism (AGM) in women with previous gestational diabetes mellitus (GDM) remained unknown. The aim of this study was to investigate the association between TG levels during the second trimester and postpartum AGM in GDM women. Methods. This was a retrospective cohort study including 513 GDM women. A 75 g oral glucose tolerance test (OGTT) was performed, and lipid levels were determined during pregnancy and the postpartum period. GDM patients were categorized into tertiles according to their TG levels at 24–28 weeks of gestation (TG<2.14 mmol/L, TG: 2.14–2.89 mmol/L, and TG>2.89 mmol/L). A logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs). Results. During pregnancy, women in the high TG tertile showed higher HbA1c levels (5.47±0.58% versus 5.28±0.49%, p=0.006), higher total cholesterol (TC) levels (5.85±1.23 mmol/L versus 5.15±0.97 mmol/L, p=0.026), and higher HOMA-IR (2.36 (1.62-3.45) versus 1.49 (0.97-2.33), p<0.001) than the participants in the low TG tertile. After delivery, the prevalence rates of AGM based on above tertiles of TG levels during pregnancy were 26.90%, 33.33%, and 43.27%, respectively (p=0.006). High TG tertile during the second trimester was associated with the presence of postpartum AGM (adjusted OR: 2.001, 95% CI: 1.054-3.800, p=0.034). Conclusions. The elevated midtrimester TG levels were not only accompanied by higher glucose and lipid levels and more severe insulin resistance at the time of the measurement but were a biomarker for postpartum AGM as well.

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Correlation of HbA1c levels in late pregnancy with maternal and perinatal outcome in patients with gestational diabetes mellitus

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20193794 ◽

2019 ◽

Vol 8 (9) ◽

pp. 3664

Author(s):

Navjot Kaur ◽

Poonam Goel ◽

Reeti Mehra ◽

Jasbinder Kaur

Keyword(s):

Diabetes Mellitus ◽

Birth Weight ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Perinatal Outcome ◽

Late Pregnancy ◽

Large For Gestational Age ◽

Third Trimester ◽

Hba1c Levels

Background: Estimation of HbA1c in gestational diabetes mellitus patients is not being recommended by any societies/guidelines as studies regarding the role of HbA1c for monitoring of euglycemic control and predicting the maternal and perinatal outcomes in GDM patients (unlike overt diabetes) are conflicting and sparse.Methods: This was a prospective study with an aim to evaluate the role of HbA1c estimation in late pregnancy (early and late third trimester) for prediction of pregnancy outcomes in GDM patients. 53 patients with GDM (diagnosed before third trimester) were recruited for the study. HbA1c levels were estimated in late pregnancy (at 28-32 weeks and again repeated at 37 - 39 weeks or at the time of delivery). Correlation of HbA1c levels in third trimester with maternal and perinatal outcome was studied in patients with gestational diabetes mellitus and cut off taken was 5.8%.Results: Of the total 53 patients 54.7% had HbA1c levels <5.8% and 45.3% had HbA1c ≥5.8% done at 28-32 weeks. Also when HbA1c levels done at 37-39 weeks POG/ at the time of delivery, 52.8% patients had <5.8% and 47.2% had HbA1c ≥5.8%. Approximately one-fourth of the patients had HbA1c ≥ 5.8% even with normal blood sugar levels (euglycemic) control. There was statistically significant increased incidence of polyhydramnios, LGA (large for gestational age babies) and increased mean birth weight in patients with HbA1c ≥ 5.8%, done in late pregnancy. However there was no statistically significant difference in the incidence of preterm labour, gestational hypertension or preeclampsia, urinary tract infections, vulvovaginal infections, caesarean deliveries and postpartum haemorrhage in patients with HbA1c ≥5.8% compared to patients with HbA1c <5.8%.Conclusions: The study revealed that in patients of GDM with HbA1c levels ≥5.8% done in third trimester was statistically significantly associated with increased incidence of polyhydramnios, large for gestational age babies and increased mean birth weight when compared to patients with HbA1c <5.8%.

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Well-managed gestational diabetes mellitus is no longer a risk factor for neonatal RDS — a case-control study

10.21203/rs.2.23966/v2 ◽

2020 ◽

Author(s):

Guannan Xi ◽

Qian Ying ◽

Xuefeng Wang ◽

Fei Luo ◽

Chengqiu Lu ◽

...

Keyword(s):

Risk Factor ◽

Gestational Diabetes ◽

Subgroup Analysis ◽

Case Control Study ◽

Diabetes Management ◽

Significant Risk ◽

Case Control ◽

Control Group ◽

Control Study ◽

Hba1c Levels

Abstract Abstract BACKGROUND Diabetes in pregnancy used to be considered associated with a higher risk of respiratory distress syndrome(RDS) in neonates. However, as antenatal examinations have improved, whether well-managed gestational diabetes remains an independent risk factor is unclear. This study was to determine the associations of well-managed gestational diabetes with morbidity and complications of RDS. Method This was a case-control study conducted at the Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China. We collected data from 101 RDS infants and 101 RDS infants from among 1749 infants, through a standardized protocol with predefined inclusion and exclusion criteria. Assessment of diabetes management was based on HbA1c and random blood glucose measurements. Univariable and multivariable logistic regression was performed to calculate the odds ratio (OR). An intergroup analysis was conducted between RDS infants and those without RDS, and a subgroup analysis was conducted between RDS neonates born to women with gestational diabetes and those born to women without gestational diabetes. RESULTS The mean (±SD) gestational age of the RDS infants was 35.9 (1.9) weeks, which was similar to that of the non-RDS infants (35.7 (±1.3) weeks). The HbA1c levels at diabetes diagnosed, the HbA1c levels right before delivery and the RBG levels before delivery had no significant differences, and all of them were below a well-controlled level. In the intergroup analysis, the morbidity of gestational diabetes between the two groups showed no significant differences in the adjusted analyses (adjusted OR 1.40, 95% CI 0.59-3.36). However, the case group had significantly more placental abnormalities (adjusted OR 3.61, 95% CI 1.63-8.00), fetal distress (adjusted OR 4.20, 95% CI 1.87-9.46), and asphyxia (adjusted OR 3.74, 95% CI 1.59-8.81) than the control group. In the subgroup analysis, the total dose of the PS applications, incidence of complications, and need for respiratory support (total and separate) were not significantly different between the two groups. CONCLUSIONS Well managed gestational diabetes is no longer a significant risk factor for RDS, while acute or chronic ischemia factors are. With regards to most GDM, diet and exercise are sufficient for maintaining an HbA1c below 6.5%

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Study of maternal and fetal outcomes in patients with gestational diabetes mellitus

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20190888 ◽

2019 ◽

Vol 8 (3) ◽

pp. 1106

Author(s):

Smruti Gedam ◽

Sanjay Ponde

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Perinatal Outcomes ◽

Antenatal Clinic ◽

Medical Problem ◽

Normal Delivery ◽

Study Centre ◽

Sugar Levels ◽

Hba1c Levels

Background: Diabetes mellitus is the commonest medical problem complicating pregnancy, with possibility of grave consequences. With the present study, incidence, management and perinatal outcomes in the cases of GDM were studied.Methods: All the pregnant patients attending antenatal clinic at the study centre during study period of three years were studied. Those with positive history were screened for GDM as early as possible and rest screened at 24-28 weeks gestation. Carpenter and Coustan criteria were used for the diagnosis of gestational diabetes mellitus. All the diagnosed cases of gestational diabetes mellitus were followed up throughout the course of gestation and complications, if any, recorded.Results: A total of 39 patients were diagnosed as GDM. Majority were multigravida (69.3%, 27) and weighed over 75 kg (56%, 22). Patients were mostly diagnosed at the gestational age of 31-35 weeks (n-15) and 21-25 weeks (n-11). Fifteen patients (38.4%) had HbA1c values between 6-7%, 14 patients (35.8%) between 7-8% and 3 patients had HBA1c levels more than 10%. Twenty-three percent (9) patients had PIH, 13% (5) polyhydramnios and 7.6% (3) had PROM. Three mothers had babies suffering from IUGR. Sixteen (41%) had full term normal delivery while 2 (5.1%) patients had preterm labor and delivered normally. Twenty-one mothers (53.84%) had LSCS, out of which 3 had preterm LSCS.Conclusions: Diabetes during pregnancy is associated with risk factors as well as high maternal and foetal morbidity. GDM has good maternal and foetal outcomes depending upon how well the blood sugar levels are controlled.

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The role of Umbilical Cord thickness, Interventricular Septum thickness and HbA1c levels in the prediction of Fetal Macrosomia in patients with Gestational Diabetes Mellitus

Journal of Gynecological Research and Obstetrics ◽

10.17352/jgro.000057 ◽

2018 ◽

pp. 039-043

Author(s):

Abdelrahman RM ◽

Salama MM

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Umbilical Cord ◽

Interventricular Septum ◽

Fetal Macrosomia ◽

Hba1c Levels

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Well-managed gestational diabetes mellitus is no longer a risk factor for neonatal RDS — a case-control study

10.21203/rs.2.23966/v1 ◽

2020 ◽

Author(s):

Guannan Xi ◽

Qian Ying ◽

Xuefeng Wang ◽

Fei Luo ◽

Chengqiu Lu ◽

...

Keyword(s):

Risk Factor ◽

Gestational Diabetes ◽

Subgroup Analysis ◽

Case Control Study ◽

Diabetes Management ◽

Significant Risk ◽

Case Control ◽

Control Group ◽

Control Study ◽

Hba1c Levels

Abstract BACKGROUND Diabetes in pregnancy used to be considered associated with a higher risk of respiratory distress syndrome(RDS) in neonates. However, whether well-managed gestational diabetes remains an independent risk factor is unclear. This study was to determine the associations of them.METHOD This was a case-control study conducted at the Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China. We collected data from 101 RDS infants and 101 RDS infants from among 1749 infants, through a standardized protocol with predefined inclusion and exclusion criteria. Two investigators enrolled in recording same datas twice to minimize bias. Assessment of diabetes management was based on HbA1c and random blood glucose measurements. Univariable and multivariable logistic regression was performed to calculate the odds ratio (OR). An intergroup analysis was conducted between RDS infants and those without RDS, and a subgroup analysis was conducted between RDS neonates born to women with gestational diabetes and those born to women without gestational diabetes.RESULTS The mean (±SD) gestational age of the RDS infants was 35.9 (±1.9) weeks, which was similar to that of the non-RDS infants (35.7±1.3)weeks). The HbA1c levels at diabetes diagnosed, the HbA1c levels right before delivery and the RBG levels before delivery had no significant differences, and all of them were below a well-controlled level. In the intergroup analysis, the morbidity of gestational diabetes between the two groups showed no significant differences in the adjusted analyses (adjusted OR 1.40, 95% CI 0.59-3.36). However, the case group had significantly more placental abnormalities (adjusted OR 3.61, 95% CI 1.63-8.00), fetal distress (adjusted OR 4.20, 95% CI 1.87-9.46), and asphyxia (adjusted OR 3.74, 95% CI 1.59-8.81) than the control group. In the subgroup analysis, the total dose of the PS applications, incidence of complications, and need for respiratory support (total and separate) were not significantly different between the two groups.CONCLUSIONS Well managed gestational diabetes is no longer a significant risk factor for RDS, while acute or chronic ischemia factors are. Diet and exercise are sufficient for the GDM management target of HbA1c below 6.5%.

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