scholarly journals Molecular pathways disrupted by gestational diabetes mellitus

2019 ◽  
Vol 63 (3) ◽  
pp. R51-R72 ◽  
Author(s):  
Caitlyn Nguyen-Ngo ◽  
Nanthini Jayabalan ◽  
Carlos Salomon ◽  
Martha Lappas
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Endothelial Cell ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Glycogen Synthase ◽  
Low Grade ◽  
Endothelial Cell Dysfunction ◽  
Cell Dysfunction

Gestational diabetes mellitus (GDM) imposes serious short- and long-term health problems for mother and baby. An effective therapeutic that can reduce the incidence of GDM and improve long-term maternal and fetal outcomes is a major research priority, crucially important for public health. A lack of knowledge about the underlying pathophysiology of GDM has hampered the development of such therapeutics. What we do know, however, is that maternal insulin resistance, low-grade inflammation and endothelial cell dysfunction are three central features of pregnancies complicated by GDM. Indeed, data generated over the past decade have implicated a number of candidate regulators of insulin resistance, inflammation and endothelial cell dysfunction in placenta, maternal adipose tissue and skeletal muscle. These include nuclear factor-κB (NF-κB), peroxisome proliferator-activated receptors (PPARs), sirtuins (SIRTs), 5′ AMP-activated protein kinase (AMPK), glycogen synthase kinase 3 (GSK3), PI3K/mTOR, inflammasome and endoplasmic reticulum (ER) stress. In this review, the identification of these as key modulators of GDM will be discussed. The biochemical pathways involved in the formation of these may represent potential sites for intervention that may translate to therapeutic interventions to prevent the development of GDM.

Role of Insulin and Adenosine in the Human Placenta Microvascular and Macrovascular Endothelial Cell Dysfunction in Gestational Diabetes Mellitus

2014 ◽  
Vol 21 (1) ◽  
pp. 26-37 ◽  
Author(s):  
Enrique Guzmán-Gutiérrez ◽  
Pablo Arroyo ◽  
Rocío Salsoso ◽  
Bárbara Fuenzalida ◽  
Tamara Sáez ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Endothelial Cell ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Human Placenta ◽  
Endothelial Cell Dysfunction ◽  
Cell Dysfunction

scholarly journals Adiponectin , ?-Cell Dysfunction in Iraqi Women with Gestational Diabetes

2016 ◽  
Vol 13 (2) ◽  
pp. 366-374
Author(s):  
Baghdad Science Journal
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Control Group ◽  
Low Grade ◽  
C Reactive Protein ◽  
Cell Dysfunction ◽  
Reactive Protein

Gestational diabetes mellitus (GDM) is a complication of gestation that is characterized by impaired glucose tolerance with first recognition during gestation. It develops when ?- cell of pancreas fail to compensate the diminished insulin sensitivity during gestation. This study aims to investigate the relationship between mother adiponectin level and ?- cell dysfunction with development gestational diabetes mellitus (GDM) and other parameters in the last trimester of pregnancy. This study includes (80) subjects ( pregnant women) in the third trimester of pregnancy, (40) healthy pregnant individuals as control group aged between (17 - 42) years and (40) gestational diabetes mellitus patients with aged between (20 - 42) years. The following biochemical investigation is studied: oral glucose tolerance test (OGTT), adiponectin , insulin, C-reactive protein (CRP),body mass index (BMI), and homeostasis model assessment- insulin resistance (HOMA – IR). The adiponectin levels are significantly lesser in females who develop GDM than the control group (P?0.01), while the insulin and OGTT concentrations were significantly higher in females with GDM than control group (P?0.01).The concentrations of CRP are non significantly different between the females who develop GDM and the control group.Conclusions: Lower adiponectin concentrations are associated with an increased risk of the development of gestational diabetes mellitus and females, who develop gestational diabetes mellitus, have higher levels of insulin resistance from normal females, Obesity is a shape of persistent low grade inflammation which causes elevated concentrations of C- reactive protein.

scholarly journals GESTATIONAL DIABETES MELLITUS: GENETIC MARKERS OF INSULIN RESISTANCE, DIAGNOSTIC CRITERIA AND MANAGEMENT TACTICS

2020 ◽  
Vol 18 (6) ◽  
pp. 732-738
Author(s):  
L. V. Nikonova ◽  
◽  
S. V. Tishkovskiy ◽  
O. S. Butrim ◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Diagnostic Criteria ◽  
Genetic Markers ◽  
Metabolic Disorder ◽  
Depth Study

Gestational diabetes mellitus is the most common metabolic disorder in pregnant women. An in-depth study of the pathogenetic mechanisms of the development of gestational diabetes mellitus will allow more accurate prediction of the course, adverse perinatal and long-term metabolic consequences, and will also contribute to the development of effective technologies for the prevention and management of this pathology.

scholarly journals Gestational Diabetes Mellitus: A Harbinger of the Vicious Cycle of Diabetes

2020 ◽  
Vol 21 (14) ◽  
pp. 5003
Author(s):  
Emilyn U. Alejandro ◽  
Therriz P. Mamerto ◽  
Grace Chung ◽  
Adrian Villavieja ◽  
Nawirah Lumna Gaus ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Clinical Care ◽  
Cell Dysfunction ◽  
Maternal And Neonatal Outcomes ◽  
Health Complications ◽  
Underlying Pathophysiology ◽  
And Child Health

Gestational diabetes mellitus (GDM), characterized by a transitory form of diabetes induced by insulin resistance and pancreatic β-cell dysfunction during pregnancy, has been identified as one of the major obstacles in achieving improved maternal and child health. Approximately 9–25% of pregnancies worldwide are impacted by the acute, long-term, and transgenerational health complications of this disease. Here, we discuss how GDM affects longstanding maternal and neonatal outcomes, as well as health risks that likely persist into future generations. In addition to the current challenges in the management and diagnosis of and the complications associated with GDM, we discuss current preclinical models of GDM to better understand the underlying pathophysiology of the disease and the timely need to increase our scientific toolbox to identify strategies to prevent and treat GDM, thereby advancing clinical care.

scholarly journals Plasma retinol-binding protein 4 in the first and second trimester and risk of gestational diabetes mellitus in Chinese women: a nested case-control study

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Chuyao Jin ◽  
Lizi Lin ◽  
Na Han ◽  
Zhiling Zhao ◽  
Zheng Liu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Binding Protein ◽  
First Trimester ◽  
Retinol Binding Protein ◽  
Second Trimester ◽  
Retinol Binding Protein 4 ◽  
Plasma Retinol

Abstract Background To assess the association between plasma retinol-binding protein 4 (RBP4) levels both in the first trimester and second trimester and risk of gestational diabetes mellitus (GDM). Methods Plasma RBP4 levels and insulin were measured among 135 GDM cases and 135 controls nested within the Peking University Birth Cohort in Tongzhou. Multivariable linear regression analysis was conducted to assess the influence of RBP4 levels on insulin resistance. Conditional logistic regression models were used to compute the odds ratio (OR) and 95% confidence interval (CI) between RBP4 levels and risk of GDM. Results The GDM cases had significantly higher levels of RBP4 in the first trimester than controls (medians: 18.0 μg/L vs 14.4 μg/L; P < 0.05). Plasma RBP4 concentrations in the first and second trimester were associated with fasting insulin, homeostasis model assessment for insulin resistance (HOMA-IR), and the quantitative insulin sensitivity check index (QUICKI) in the second trimester (all P < 0.001). With adjustment for diet, physical activity, and other risk factors for GDM, the risk of GDM increased with every 1-log μg/L increment of RBP4 levels, and the OR (95% CI) was 3.12 (1.08–9.04) for RBP4 in the first trimester and 3.38 (1.03–11.08) for RBP4 in the second trimester. Conclusions Plasma RBP4 levels both in the first trimester and second trimester were dose-dependently associated with increased risk of GDM.

scholarly journals Breastfeeding Duration and Development of Dysglycemia in Women Who Had Gestational Diabetes Mellitus: Evidence from the GUSTO Cohort Study

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 408
Author(s):  
Sumali S. Hewage ◽  
Xin Yu Hazel Koh ◽  
Shu E. Soh ◽  
Wei Wei Pang ◽  
Doris Fok ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Tolerance Test ◽  
Diabetes Risk ◽  
Breastfeeding Duration ◽  
Oral Glucose ◽  
Inverse Association ◽  
Index Pregnancy

(1) Background: Breastfeeding has been shown to support glucose homeostasis in women after a pregnancy complicated by gestational diabetes mellitus (GDM) and is potentially effective at reducing long-term diabetes risk. (2) Methods: Data from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study were analyzed to understand the influence of breastfeeding duration on long-term dysglycemia (prediabetes and diabetes) risk in women who had GDM in the index pregnancy. GDM and dysglycemia four to seven years postpartum were determined by the oral glucose tolerance test (OGTT). A Poisson regression model with a robust error variance was used to estimate incidence rate ratios (IRRs) for dysglycemia four to seven years post-delivery according to groupings of the duration of any breastfeeding (<1, ≥1 to <6, and ≥6 months). (3) Results: Women who had GDM during the index pregnancy and complete breastfeeding information and OGTT four to seven years postpartum were included in this study (n = 116). Fifty-one women (44%) had postpartum dysglycemia. Unadjusted IRRs showed an inverse association between dysglycemia risk and ≥1 month to <6 months (IRR 0.91; 95% confidence interval [CI] 0.57, 1.43; p = 0.68) and ≥6 months (IRR 0.50; 95% CI 0.27, 0.91; p = 0.02) breastfeeding compared to <1 month of any breastfeeding. After adjusting for key confounders, the IRR for the ≥6 months group remained significant (IRR 0.42; 95% CI 0.22, 0.80; p = 0.008). (4) Conclusions: Our results suggest that any breastfeeding of six months or longer may reduce long-term dysglycemia risk in women with a history of GDM in an Asian setting. Breastfeeding has benefits for mothers beyond weight loss, particularly for those with GDM.

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