scholarly journals Treatment of Gestational Diabetes Mellitus and Offspring Early Childhood Growth

2020 ◽  
Author(s):  
Maisa Feghali ◽  
Jacqueline Atlass ◽  
Kaleab Z Abebe ◽  
Diane Comer ◽  
Janet Catov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Nutritional Therapy ◽  
Z Score ◽  
Childhood Growth ◽  
Treatment Groups ◽  
Increased Risk ◽  
Z Scores ◽  
Growth Differences

Abstract Background Gestational diabetes mellitus (GDM) is associated with fetal overgrowth, and certain treatments are associated with an increased risk of macrosomia. However, there are limited data about the long-term effect of GDM treatment on childhood growth. Methods Cohort study of 816 women with GDM and their offspring delivered between 2009 and 2012. Childhood height and weight through age 3 were collected from the medical record and z-scores and body mass index (BMI) were calculated. We assessed the association between GDM treatment and childhood growth using linear mixed modeling. Results Treatment was divided into medical nutritional therapy (MNT) (n = 293), glyburide (n = 421), and insulin (n = 102). At delivery, birthweight, z-score, and BMI were higher in the offspring of women treated with either glyburide or insulin compared to MNT. However, weight, z-score, and BMI were similar among all offspring at 6 months and 1, 2, and 3 years of age. After controlling for covariates, there were differences in the weight z-score (P = 0.01) over the 3-year period by treatment group, but no differences in weight (P = 0.06) or change in BMI (P = 0.28). Pairwise comparisons indicated that insulin was associated with more weight gain compared with MNT (0.69 kg; 95% CI, 0.10-1.28; P = 0.02) and glyburide was associated with a trend toward lower weight z-score compared with MNT (−0.24; 95% CI, −0.47 to 0.003; P = 0.05). Conclusion Despite growth differences detected at birth, we observed no meaningful differences in childhood growth from 6 months to 3 years among treatment groups, including in the offspring of women with GDM treated with glyburide.

scholarly journals Gestational diabetes mellitus, pre-gestational BMI and offspring BMI z-score during infancy and childhood: 2004 Pelotas Birth Cohort

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e024734 ◽  
Author(s):  
Romina Buffarini ◽  
Aluisio J D Barros ◽  
Alicia Matijasevich ◽  
Christian Loret de Mola ◽  
Ina S Santos
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Birth Cohort ◽  
Early Adolescence ◽  
Small Samples ◽  
Z Score ◽  
Maternal Nutritional Status ◽  
Interaction Terms ◽  
Z Scores

ObjectiveGestational diabetes mellitus (GDM) affects a significant number of women. Evidence regarding the association between GDM and offspring body mass index (BMI) is unclear due to small samples and lack of adequate confounding control. The objective of this study was to investigate the association between GDM and offspring BMI z-scores from birth to early adolescence and to examine the role of maternal pre-gestational BMI in this relationship.DesignProspective study.SettingPelotas 2004 Birth Cohort, Brazil.ParticipantsCohort participants that were followed-up from birth up to early adolescence (~3500) and their mothers.Primary outcome measuresBMI z-scores at birth, 3, 12, 24, 48 months and 6 and 11 years of age, calculated according to the WHO growth charts.ResultsUnadjusted and adjusted linear regressions were performed and interaction terms between maternal pre-gestational BMI and GDM were included. Prevalence of self-reported GDM was 2.6% (95% CI 2.1% to 3.1%). The offspring BMI z-scores (SD) at birth, 3, 12, 24, 48 months and at 6 and 11 years were 0.10 (1.12), –0.47 (1.10), 0.59 (1.10), 0.59 (1.08), 0.78 (1.32), 0.70 (1.43) and 0.75 (1.41), respectively. Unadjusted regression models showed positive associations between GDM and offspring BMI z-scores at birth, 6 and 11 years. After adjustment, the associations attenuated towards the null. Statistical evidence of effect modification between maternal pre-gestational BMI and GDM was observed at birth (p=0.007), with the association between GDM and offspring BMI z-score being apparent only in those children born to overweight or obese mothers (β=0.72, 95% CI 0.30 to 1.14 and β=0.61, 95% CI 0.20 to 1.01, respectively).ConclusionsWe observed that in the association between GDM and offspring BMI z-scores, there is a predominant role for maternal nutritional status before pregnancy and that the association between GDM and newborn’s BMI is apparent only among those born to overweight or obese mothers.

scholarly journals Gestational Diabetes Mellitus and Infant Adiposity at Birth: A Systematic Review and Meta-Analysis of Therapeutic Interventions

2021 ◽  
Vol 10 (4) ◽  
pp. 835
Author(s):  
Manoja P. Herath ◽  
Jeffrey M. Beckett ◽  
Andrew P. Hills ◽  
Nuala M. Byrne ◽  
Kiran D. K. Ahuja
Keyword(s):  
Diabetes Mellitus ◽  
Adipose Tissue ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Fat Mass ◽  
Metabolic Disorders ◽  
Later Life ◽  
Therapeutic Interventions ◽  
Increased Risk ◽  
The Impact

Exposure to untreated gestational diabetes mellitus (GDM) in utero increases the risk of obesity and type 2 diabetes in adulthood, and increased adiposity in GDM-exposed infants is suggested as a plausible mediator of this increased risk of later-life metabolic disorders. Evidence is equivocal regarding the impact of good glycaemic control in GDM mothers on infant adiposity at birth. We systematically reviewed studies reporting fat mass (FM), percent fat mass (%FM) and skinfold thicknesses (SFT) at birth in infants of mothers with GDM controlled with therapeutic interventions (IGDMtr). While treating GDM lowered FM in newborns compared to no treatment, there was no difference in FM and SFT according to the type of treatment (insulin, metformin, glyburide). IGDMtr had higher overall adiposity (mean difference, 95% confidence interval) measured with FM (68.46 g, 29.91 to 107.01) and %FM (1.98%, 0.54 to 3.42) but similar subcutaneous adiposity measured with SFT, compared to infants exposed to normal glucose tolerance (INGT). This suggests that IGDMtr may be characterised by excess fat accrual in internal adipose tissue. Given that intra-abdominal adiposity is a major risk factor for metabolic disorders, future studies should distinguish adipose tissue distribution of IGDMtr and INGT.

scholarly journals The Childhood Growth of Twin Children

1995 ◽  
Vol 44 (3-4) ◽  
pp. 169-178 ◽  
Author(s):  
B. Luke ◽  
S. Leurgans ◽  
L. Keith ◽  
D. Keith
Keyword(s):  
Gestational Age ◽  
Growth Retardation ◽  
Z Score ◽  
Cross Sectional ◽  
Childhood Growth ◽  
Severe Stunting ◽  
Increased Risk ◽  
Z Scores ◽  
Twin Children ◽  
Current Weight

AbstractThe objective of this study was to assess the childhood growth of twin children in terms of the effects of intrauterine growth retardation (IUGR) and discordancy at birth on the incidence and severity of stunting and discordancy in current height and weight. The study was part of a cross-sectional field project conducted at the Annual Twins Days Festival in Twinsburg. Ohio, USA, during 1990, 1991, and 1993, and including all twin children between 2 and 12 years of age. Mothers of twins were interviewed regarding their children's birthweights and gestational age; the twin children were measured for their current heights and weights. The study population included 990 twin children, including 555 boys and 435 girls, of which there were 254 boy pairs and 194 girl pairs. Birthweight for gestational age and current weight and height were each converted into Z-scores and characterized as severe (Z-score <−2,0), or moderate IUGR or stunting (Z-score > −2.0 and < −1.2). For the present study discordancy in birthweight, and current height and weight was calculated for like-gender twin pairs. Only twin children with severe IUGR at birth showed an increased risk of stunting in their current height or weight, and this risk was only for moderate, not severe, stunting. Boy twins with severe IUGR at birth were at increased risk of moderate stunting in their current weight (OR 2.67, 95% CI 1.55, 4.58, P = 0.002), while girl twins with severe IUGR at birth were at increased risk of moderate stunting in their current height (OR 4,09, 95% CI 1.49, 10.99, p = 0.003). Among like-gender twin pairs, there were no differences in mean or categories of birthweight or current weight discordancy, but boy twin pairs did show a significantly greater proportion of current weight discordancy compared to girl twin pairs (p = 0.005). Overall, there was a significant tendency for differences in height and weight between like-gender twin pairs to disappear over time, with the effect being greater for boy twin pairs. We conclude from these findings that twin children tend to overcome growth retardation and discordancy present at birth, and although children who had severe IUGR or discordancy at birth were more likely to have some residual moderate stunting or discordancy in height or weight, they still tended to be within normal values for their gender and current age.

A prospective study of early-pregnancy thyroid markers, lipid species, and risk of gestational diabetes mellitus

2021 ◽  
Author(s):  
Yi Wang ◽  
Fengjiang Sun ◽  
Ping Wu ◽  
Yichao Huang ◽  
Yi Ye ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Early Pregnancy ◽  
Maternal Serum ◽  
Thyroid Peroxidase ◽  
Free Triiodothyronine ◽  
Composite Effect ◽  
Lipid Species ◽  
Increased Risk

Abstract Context While the associations between thyroid markers and gestational diabetes mellitus (GDM) have been extensively studied, the results are inconclusive and the mechanisms remain unclear. Objective We aimed to investigate the prospective associations of thyroid markers in early gestation with GDM risk, and examine the mediating effects through lipid species. Methods This study included 6068 pregnant women from the Tongji-Shuangliu Birth Cohort. Maternal serum thyroid markers (free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone, thyroid peroxidase antibody, and thyroglobulin antibody) were measured before 15 weeks. Deiodinase activity was assessed by fT3/fT4 ratio. Plasma lipidome were quantified in a subset of 883 participants. Results Mean age of the participants was 26.6 ± 3.7 years, and mean gestational age was 10.3 ± 2.0 weeks. Higher levels of fT4 were associated with a decreased risk of GDM (OR=0.73 comparing the extreme quartiles; 95% CI 0.54, 0.98, Ptrend =0.043), while higher fT3/fT4 ratio was associated with an increased risk of GDM (OR=1.43 comparing the extreme quartiles; 95% CI 1.06, 1.93, Ptrend =0.010) after adjusting for potential confounders. Multiple linear regression suggested that fT3/fT4 ratio was positively associated with alkylphosphatidylcholine 36:1, phosphatidylethanolamine plasmalogen 38:6, diacylglyceride 18:0/18:1, sphingomyelin 34:1, and phosphatidylcholine 40:7 (false discovery rate adjusted P&lt;0.05). Mediation analysis indicated 67.9% of the association between fT3/fT4 ratio and GDM might be mediated through the composite effect of these lipids. Conclusions Lower concentration of serum fT4 or higher fT3/fT4 ratio in early pregnancy was associated with an increased risk of GDM. The association of fT3/fT4 ratio with GDM was largely mediated by specific lipid species.

scholarly journals Childhood maltreatment and inflammation among pregnant women with gestational diabetes mellitus: A pilot study

2017 ◽  
Vol 10 (3) ◽  
pp. 120-124 ◽  
Author(s):  
Margaret Bublitz ◽  
Suzanne De La Monte ◽  
Susan Martin ◽  
Lucia Larson ◽  
Ghada Bourjeily
Keyword(s):  
Diabetes Mellitus ◽  
Pilot Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
Childhood Maltreatment ◽  
Secondary Data ◽  
Past Research ◽  
Increased Risk

Background Women with childhood maltreatment histories are at increased risk for adverse birth outcomes. Mechanisms explaining this link are poorly understood. Past research is limited by sampling pregnant women at low risk for adverse maternal and neonatal outcomes. Methods This pilot study was a secondary data analysis of 24 women with gestational diabetes mellitus; 17% of the sample also reported a maltreatment history. Women provided a blood sample to measure inflammatory cytokines and insulin resistance, and saliva samples to measure diurnal cortisol. Birth outcomes for past and current pregnancies were recorded. Results Histories of maltreatment were associated with elevated interleukin-15 and a marginally greater incidence of preterm delivery in current and past pregnancies. Conclusions This pilot study was the first to demonstrate an association between childhood maltreatment history and inflammatory cytokine levels in pregnant women diagnosed with gestational diabetes mellitus.

scholarly journals The Role of HIV Infection in the Pathophysiology of Gestational Diabetes Mellitus and Hypertensive Disorders of Pregnancy

2021 ◽  
Vol 8 ◽  
Author(s):  
Wendy N. Phoswa
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Hiv Infection ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Post Exposure Prophylaxis ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Hiv Aids

Purpose of the Review: The main objective of this study is to investigate mechanisms associated with gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) in HIV infected pregnant women by looking how placental hormones such as (progesterone and prolactin) and basic haemostatic parameters are regulated in HIV infected pregnancies.Recent Findings: HIV/AIDS are a major global obstetric health burden that lead to increased rate of morbidity and mortality. HIV/AIDS has been associated with the pathophysiology of GDM and HDP. Increased risk of GDM due to highly active antiretroviral therapy (HAART) usage has been reported in HIV infected pregnancies, which causes insulin resistance in both pregnant and non-pregnant individuals. HAART is a medication used for lowering maternal antepartum viral load and pre-exposure and post-exposure prophylaxis of the infant. In pregnant women, HAART induces diabetogenic effect by causing dysregulation of placental hormones such as (progesterone and prolactin) and predispose HIV infected women to GDM. In addition to HIV/AIDS and GDM, Studies have indicated that HIV infection causes haemostatic abnormalities such as hematological disorder, deregulated haematopoiesis process and the coagulation process which results in HDP.Summary: This study will help on improving therapeutic management and understanding of the pathophysiology of GDM and HDP in the absence as well as in the presence of HIV infection by reviewing studies reporting on these mechanism.

scholarly journals Ghrelin in Serum and Urine of Post-Partum Women with Gestational Diabetes Mellitus

2018 ◽  
Vol 19 (10) ◽  
pp. 3001 ◽  
Author(s):  
Żaneta Kimber-Trojnar ◽  
Jolanta Patro-Małysza ◽  
Katarzyna Skórzyńska-Dziduszko ◽  
Jan Oleszczuk ◽  
Marcin Trojnar ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Body Composition ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Post Partum ◽  
Enzyme Linked Immunosorbent Assay ◽  
Hydration Status ◽  
Increased Risk ◽  
Serum Ghrelin ◽  
Serum And Urine

Women with a previous history of gestational diabetes mellitus (GDM) have a significantly increased risk of developing type 2 diabetes, obesity, and cardiovascular diseases in the future. The aim of the study was to evaluate ghrelin concentrations in serum and urine in the GDM group in the early post-partum period, with reference to laboratory results, body composition, and hydration status. The study subjects were divided into two groups, that is, 28 healthy controls and 26 patients with diagnosed GDM. The maternal body composition and hydration status were evaluated by the bioelectrical impedance analysis (BIA) method. The concentrations of ghrelin in the maternal serum and urine were determined via enzyme-linked immunosorbent assay (ELISA). The laboratory and BIA results of the mothers with GDM were different from those without GDM. Urine ghrelin positively correlated with serum ghrelin and high-density lipoprotein cholesterol (HDL) levels in healthy mothers. There were direct correlations between urine ghrelin and HDL as well as triglycerides levels in the GDM group. Neither the lean tissue index nor body cell mass index were related to the serum ghrelin concentrations in this group. Only the urine ghrelin of healthy mothers correlated with the fat tissue index. Our results draw attention to urine as an easily available and appropriable biological material for further studies.

Predictive Value of Immunological Parameters in the Risk of Gestational Diabetes Mellitus: A Pilot Study

2020 ◽  
Author(s):  
Adnette Fagninou ◽  
Magloire Pandoua Nekoua ◽  
Salomon Ezéchiel Mahougnon Fiogbe ◽  
Kabirou Moutairou ◽  
Akadiri YESSOUFOU
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Biochemical Parameters ◽  
Predictive Power ◽  
Glycosylated Hemoglobin ◽  
Operating Characteristics ◽  
Immunological Parameters ◽  
Increased Risk

Abstract Background : Immunological and biochemical parameters are gaining more and more importance in the prognosis of diabetes and its complications. Here we assessed the predictive power of immunological parameters correlated with biochemical ones in gestational diabetes mellitus (GDM). Material and Methods : 217 pregnant women were screened for GDM between the 2 nd and the 3 rd trimester of gestation, based on IAGDP methods in this cross-sectional descriptive study. Immunological and biochemical parameters were determined using appropriate methods. Receiver operating characteristics (ROC) curve analyses were conducted to assess the optimal cutoff and value of immunological to biochemical parameter ratios for predicting GDM. Results : 11.90% of pregnant women were diagnosed GDM positive. Serum glucose levels, total cholesterol, LDL-cholesterol, triglycerides and total proteins were significantly increased while HDL-cholesterol decreased in women with GDM compared to controls. The levels of glycosylated hemoglobin and creatinine, as well as transaminase (AST and ALT) activities did not significantly differ between GDM and pregnant controls. Total leucocytes (white blood cell), lymphocyte and platelet numbers were significantly higher in women with GDM than in pregnant controls. We also found that the lymphocyte:HDL-C, monocyte:HDL-C and granulocyte:HDL-C ratios were significantly higher in women with GDM than in pregnant controls ( p = 0.001; p = 0.009 and p = 0.004 respectively). Women with a lymphocyte:HDL-C ratio greater than 3.66 had a 4-fold increased risk of developing GDM than those with lower ratios (odds ratio 4.00; 95% CI: 1.094 – 14.630; p =0.041). Conclusion : The lymphocyte:HDL-C, monocyte:HDL-C and granulocyte:HDL-C ratios may represent valuable makers, and the lymphocyte:HDL-C ratio in particular may have strong predictive power for GDM. This ratio can be easily assessed in patients.

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