Development of a fasting blood glucose-based strategy to diagnose women with gestational diabetes mellitus at increased risk of adverse outcomes in a COVID-19 environment

Objective To evaluate the role of fasting blood glucose (FBG) to minimise the use of the oral glucose tolerance test in pregnancy (POGTT) for the diagnosis of gestational diabetes mellitus (GDM). Research design and methods We analysed the POGTTs of 26,242 pregnant women in Queensland, Australia, performed between 1 January 2015 and 30 June 2015. A receiver operator characteristics (ROC) assessment was undertaken to indicate the FBG level that most effectively identified women at low risk of an abnormal result. Results There were 3,946 (15.0%) patients having GDM with 2,262 (8.6%) having FBG ≥ 5.1mmol/l. The ROC identified FBG levels >4.6mmol/l having the best specificity (77%) and sensitivity (54%) for elevated 1 and/or 2hr BGLs. There were 19,321 (73.7%) women having FBG < 4.7mmol/l with a prevalence of GDM of 4.0%, less than 1/3rd the overall rate. Only 4,638 (17.7%) women having FBGs from 4.7–5.0mmol/l would require further evaluation to confirm or exclude the diagnosis. Conclusion This contemporary study of women across the state of Queensland, Australia suggests the FBG can be used effectively to define glucose tolerance in pregnancy, minimising their contact with pathology laboratories and potential exposure to the corona virus. This analysis, used in conjunction with outcome data from the HAPO study, provides reassurance to women and their health professionals that FBG < 4.7mmol/l has both a low rate of abnormal glucose tolerance and minimal adverse pregnancy-associated complications.

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GESTATIONAL DIABETES MELLITUS

The Professional Medical Journal ◽

10.29309/tpmj/2012.19.04.2258 ◽

2012 ◽

Vol 19 (04) ◽

pp. 462-468

Author(s):

M. IKRAM ◽

SYED HAIDER HASAN ALAM ◽

SHAFQAT MUKHTAR ◽

M. Saeed

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Gestational Diabetes ◽

Glucose Tolerance ◽

Gestational Diabetes Mellitus ◽

Glucose Tolerance Test ◽

Fasting Blood Glucose ◽

Tolerance Test ◽

Oral Glucose ◽

Oral Glucose Tolerance

Introduction: Gestational diabetes mellitus is common disorder in pregnancy. It is associated with adverse pregnancy outcome. There is no consensus regarding the optimal approach to screening of gestational diabetes mellitus. The present study has tried toobserve the value of fasting blood glucose in screening of gestational diabetes. Objective: To determine the frequency of patients in whomfasting blood glucose and 100gm glucose tolerance show agreement for screening of gestational diabetes mellitus at 24 -28 wks. Studydesign: Comparative cross sectional study. Settings: The study was conducted at Gynecology and Obstetrics department Shaikh ZayedFederal Post Graduate Institute Lahore. Duration of study with dates: 6 months from 12Nov 2010 to 11 May 2011. Material and method: Thestudy included 135 booked patients with positive family history of diabetes mellitus. All patients underwent fasting blood glucose at 24-28 weeksof gestation, regardless of results of fasting blood glucose on next visit they underwent 100g oral glucose tolerance test (OGTT). The agreementbetween fasting blood glucose and 100g oral glucose tolerance test was calculated in frequency and percentages. Results: The mean age ofwomen in studied population was 27.15±3.70.Out of 135 patients 86.7 %( 117) showed agreement between results of fasting blood glucose and100g OGTT while 13.31 %( 18) showed no agreement between both of the tests. Conclusions: Fasting blood glucose is a good screeningoption for gestational diabetes mellitus along with positive history. It provides a simple, cheap and more practical test for screening of gestationaldiabetes mellitus. However diagnostic confirmation with 100g OGTT should be done.

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Secretagogin is Related to Insulin Secretion but Unrelated to Gestational Diabetes Mellitus Status in Pregnancy

Journal of Clinical Medicine ◽

10.3390/jcm9072277 ◽

2020 ◽

Vol 9 (7) ◽

pp. 2277

Author(s):

Carola Deischinger ◽

Jürgen Harreiter ◽

Karoline Leitner ◽

Dagmar Bancher-Todesca ◽

Sabina Baumgartner-Parzer ◽

...

Keyword(s):

Diabetes Mellitus ◽

Insulin Secretion ◽

Gestational Diabetes ◽

Glucose Tolerance ◽

Gestational Diabetes Mellitus ◽

Plasma Concentrations ◽

High Risk Population ◽

Oral Glucose ◽

Second Phase ◽

In Pregnancy

Secretagogin (SCGN) is a calcium binding protein related to insulin release in the pancreas. Although SCGN is not co-released with insulin, plasma concentrations have been found to be increased in type 2 diabetes mellitus patients. Until now, no study on SCGN levels in pregnancy or patients with gestational diabetes mellitus (GDM) has been published. In 93 women of a high-risk population for GDM at the Medical University of Vienna, secretagogin levels of 45 GDM patients were compared to 48 women with a normal glucose tolerance (NGT). Glucose tolerance, insulin resistance and secretion were assessed with oral glucose tolerance tests (OGTT) between the 10th and 28th week of gestation (GW) and postpartum. In all women, however, predominantly in women with NGT, there was a significant positive correlation between SCGN levels and Stumvoll first (rp = 0.220, p = 0.032) and second phase index (rp = 0.224, p = 0.028). SCGN levels were not significantly different in women with NGT and GDM. However, SCGN was higher postpartum than during pregnancy (postpartum: 88.07 ± 35.63 pg/mL; pregnancy: 75.24 ± 37.90 pg/mL, p = 0.004). SCGN was directly correlated with week of gestation (rp = 0.308; p = 0.021) and triglycerides (rp = 0.276; p = 0.038) in women with GDM. Therefore, SCGN is related to insulin secretion and hyperinsulinemia during pregnancy; however, it does not display differences between women with NGT and GDM.

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Spontaneous Abortions and Gestational Diabetes Mellitus- A Study from Pakistan

Journal of Shalamar Medical & Dental College - JSHMDC ◽

10.53685/jshmdc.v2i2.75 ◽

2021 ◽

Vol 2 (2) ◽

pp. 58-63

Author(s):

Aasia Kanwal ◽

Asma Salam ◽

Aisha Bashir

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Fasting Blood Glucose ◽

Categorical Variables ◽

Spontaneous Abortions ◽

Rural And Urban ◽

Increased Risk

Background: Gestational diabetes mellitus leads to adverse pregnancy outcomes. Objectives: The objective of the study was to explore the relationship of spontaneous abortions with gestational diabetes mellitus in pregnant women from rural and urban Lahore. Methods: This cross-sectional study was conducted at University of Health Sciences, Lahore in 2019. Among 60 pregnant women sampled, 30 had gestational diabetes mellitus (GDM) and 30 were normal pregnant controls. Pregnant women were sampled from different hospitals of rural and urban areas of Lahore. Independent sample t-test was applied for analyzing the data. Chi- square test was used to analyze the categorical variables. Association of fasting blood glucose (FBG) and abortions was checked. Odd ratio and relative risk were calculated. Results: Mean fasting blood sugar levels were significantly higher in GDM group (105 mg/dL) as compared to non-GDM group (80.50 mg/dL) at p<0.001. The proportions of the women with increased number of abortions had significantly higher blood glucose levels (OR 5.091, 95% CI, RR 1.27). Conclusions: Gestational diabetes mellitus is associated with an increased risk of spontaneous abortions.

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Association of WISP1/CCN4 with Risk of Overweight and Gestational Diabetes Mellitus in Chinese Pregnant Women

Disease Markers ◽

10.1155/2020/4934206 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Lei Liu ◽

Jiajin Hu ◽

Liu Yang ◽

Ningning Wang ◽

Yang Liu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Fasting Blood Glucose ◽

Adverse Outcomes ◽

Obese Women ◽

Complement C1q

Background. Obese women with gestational diabetes mellitus (GDM) have a higher risk of adverse outcomes than women with obesity or GDM alone. Our study is aimed at investigating the discriminatory power of circulatory Wnt1-inducible signaling pathway protein-1 (WISP1), a novel adipocytokine, on the copresence of prepregnancy overweight/obesity and GDM and at clarifying the relationship between the WISP1 level and clinical cardiometabolic parameters. Methods. A total of 313 participants were screened from a multicenter prospective prebirth cohort: Born in Shenyang Cohort Study (BISCS). Subjects were examined with a 2×2 factorial design for body mass index BMI≥24 and GDM. Between 24 and 28 weeks of pregnancy, follow-up individuals underwent an OGTT and blood sampling for cardiometabolic characterization. Results. We observed that the WISP1 levels were elevated in prepregnancy overweight/obesity patients with GDM, compared with nonoverweight subjects with normal blood glucose (3.45±0.89 vs. 2.91±0.75 ng/mL). Multilogistic regression analyses after adjustments for potential confounding factors revealed that WISP1 was a strong and independent risk factor for prepregnancy overweight/obesity with GDM (all ORs>1). In addition, the results of the ROC analysis indicated that WISP1 exhibited the capability to identify individuals with prepregnancy overweight/obesity and GDM (all AUC>0.5). Finally, univariate and multivariate linear regression showed that WISP1 level was positively and independently correlated with fasting blood glucose, systolic blood pressure, and aspartate aminotransferase and was negatively correlated with HDL-C and complement C1q. Conclusions. WISP1 may be critical for the prediction, diagnosis, and therapeutic strategies against obesity and GDM in pregnant women.

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Lactobacillus bulgaricus improves antioxidant capacity of black garlic in the prevention of gestational diabetes mellitus: a randomized control trial

Bioscience Reports ◽

10.1042/bsr20182254 ◽

2019 ◽

Vol 39 (8) ◽

Cited By ~ 1

Author(s):

Lihui Si ◽

Ruixin Lin ◽

Yan Jia ◽

Wenwen Jian ◽

Qing Yu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Antioxidant Capacity ◽

Controlled Trial ◽

Fasting Blood Glucose ◽

Lactobacillus Bulgaricus ◽

Oral Glucose ◽

13C Nuclear Magnetic Resonance

AbstractObjectives: Lactobacillus bulgaricus may improve antioxidant capacity of black garlic in the prevention of gestational diabetes mellitus (GDM).Methods: Black garlic was prepared with or without L. bulgaricus. Volatile and polysaccharides were analyzed by using LC-MS, Fourier Transform infrared (FTIR) and 13C nuclear magnetic resonance (NMR). The study design was parallel randomized controlled trial and 226 GDM patients were randomly assigned into BG (black garlic and L. bulgaricus) and CG (black garlic) groups, and allocation ratio was 1:1. The treatment duration was 40 weeks. Fasting blood glucose (FBG) and 1- and 2-h blood glucose (1hBG and 2hBG) after oral glucose tolerance test (OGTT) were detected. Antioxidant function of black garlic was determined by measuring plasma malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-PX) and total antioxidant capacity (T-AOC) in GDM patients. The comparison between two groups was made using two independent samples t test.Results: The intake of nutrients was similar between two groups (P>0.05). L. bulgaricus promoted the transformation of the glucopyranoside to glucofuranoside. L. bulgaricus increased the abilities of black garlic for scavenging hydroxyl radicals, 2,2′-azino-bis (3-ethylbenzenthiazoline-6-sulfonic) acid (ABTS) and DPPH free radicals. L. bulgaricus reduced the levels of FBG, 1hBG and 2hBG, and incidence of perinatal complications (P<0.01). Plasma MDA level in the BG group was lower than in the CG group, whereas the levels of SOD, GSH-PX and T-AOC in the BG group were higher than in the CG group (P<0.01).Conclusions: L. bulgaricus improves antioxidant capacity of black garlic in the prevention of GDM.

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Dietary supplementation of inulin alleviates metabolism disorders in gestational diabetes mellitus mice via RENT/AKT/IRS/GLUT4 pathway

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-021-00768-8 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Miao Miao ◽

Yongmei Dai ◽

Can Rui ◽

Yuru Fan ◽

Xinyan Wang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Gestational Diabetes ◽

Glucose Tolerance ◽

Gestational Diabetes Mellitus ◽

Glucose Homeostasis ◽

Molecular Mechanisms ◽

Fasting Blood Glucose ◽

High Dose ◽

Dependent Manner

Abstract Background Gestational diabetes mellitus (GDM) has significant short and long-term health consequences for both the mother and child. There is limited but suggestive evidence that inulin could improve glucose tolerance during pregnancy. This study assessed the effect of inulin on glucose homeostasis and elucidated the molecular mechanisms underlying the inulin-induced antidiabetic effects during pregnancy. Method Female C57BL/6 mice were randomized to receive either no treatment, high-dose inulin and low-dose inulin for 7 weeks with measurement of biochemical profiles. A real-time2 (RT2) profiler polymerase chain reaction (PCR) array involved in glycolipid metabolism was measured. Results Inulin treatment facilitated glucose homeostasis in a dose-dependent manner by decreasing fasting blood glucose, advanced glycation end products and total cholesterol, and improving glucose tolerance. Suppressing resistin (RETN) expression was observed in the inulin treatment group and the expression was significantly correlated with fasting blood glucose levels. The ratios of p-IRS to IRS and p-Akt to Akt in liver tissue and the ratio of p-Akt to Akt in adipose tissue as well as the expression level of GLUT4 increased significantly after inulin treatment. Conclusions Our findings indicated improvement of glucose and lipid metabolism by inulin was to activate glucose transport through the translocation of GLUT4 which was mediated by insulin signaling pathway repairment due to decreased expression of RETN and enhanced phosphorylation of IRS and Akt in GDM mice.

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High Prevalence of Gestational Diabetes Mellitus in Rural Tanzania—Diagnosis Mainly Based on Fasting Blood Glucose from Oral Glucose Tolerance Test

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17093109 ◽

2020 ◽

Vol 17 (9) ◽

pp. 3109 ◽

Cited By ~ 1

Author(s):

Louise Groth Grunnet ◽

Line Hjort ◽

Daniel Thomas Minja ◽

Omari Abdul Msemo ◽

Sofie Lykke Møller ◽

...

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Glucose Tolerance Test ◽

Fasting Blood Glucose ◽

Tolerance Test ◽

Oral Glucose ◽

Rural Tanzania ◽

High Prevalence

Gestational diabetes mellitus (GDM) is associated with poor pregnancy outcomes and increased long-term risk of metabolic diseases for both mother and child. In Tanzania, GDM prevalence increased from 0% in 1991 to 19.5% in 2016. Anaemia has been proposed to precipitate the pathogenesis of GDM. We aimed to examine the prevalence of GDM in a rural area of Tanzania with a high prevalence of anaemia and to examine a potential association between haemoglobin concentration and blood glucose during pregnancy. The participants were included in a population-based preconception, pregnancy and birth cohort study. In total, 538 women were followed during pregnancy and scheduled for an oral glucose tolerance test (OGTT) at week 32–34 of gestation. Gestational diabetes mellitus was diagnosed according to the WHO 2013 guidelines. Out of 392 women screened, 39% (95% CI: 34.2–44.1) had GDM, the majority of whom (94.1%) were diagnosed based solely on the fasting blood sample from the OGTT. No associations were observed between haemoglobin or ferritin and glucose measurements during pregnancy. A very high prevalence of GDM was found in rural Tanzania. In view of the laborious, costly and inconvenient OGTT, alternative methods such as fasting blood glucose should be considered when screening for GDM in low- and middle-income countries.

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Dietary Supplementation of Inulin on Glycolipid Metabolism in Gestational Diabetes Mellitus via RENT/AKT/IRS Pathway

10.21203/rs.3.rs-818583/v2 ◽

2021 ◽

Author(s):

Miao Miao ◽

Yongmei Dai ◽

Can Rui ◽

Yuru Fan ◽

Xinyan Wang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Gestational Diabetes ◽

Glucose Tolerance ◽

Gestational Diabetes Mellitus ◽

Glucose Homeostasis ◽

Fasting Blood Glucose ◽

High Dose ◽

Dependent Manner ◽

Glycolipid Metabolism

Abstract Background: Gestational diabetes mellitus (GDM) has significant short and long-term health consequences for both the mother and child. There is limited but suggestive evidence that inulin could improve glucose tolerance during pregnancy. This study assessed the effect of inulin on glucose homeostasis and elucidated the molecular mechanisms underlying the inulin-induced antidiabetic effects during pregnancy. Method: Female C57BL/6 mice were randomized to receive either no treatment, high-dose inulin and low-dose inulin for 7 weeks with measurement of biochemical profiles. A real-time2 (RT2) profiler polymerase chain reaction (PCR) array involved in glycolipid metabolism was measured. Results: Inulin treatment facilitated glucose homeostasis in a dose-dependent manner by decreasing fasting blood glucose and total cholesterol, and improving glucose tolerance. Suppressing resistin (RETN) expression was observed in the inulin treatment group and the expression was significantly correlated with fasting blood glucose levels. The ratios of p-IRS to IRS and p-Akt to Akt in liver tissue and the ratio of p-Akt to Akt in adipose tissue increased significantly after inulin treatment. Conclusions: Our findings indicated the observed decreased glucose level may be due to insulin signaling pathway repairment due to decreased expression of RETN and enhanced phosphorylation of IRS and Akt in GDM mice.

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