scholarly journals Pathophysiological and genetic changes in the body of a pregnant with gestational diabetes

2017 ◽  
Vol 66 (5) ◽  
pp. 27-36
Author(s):  
Elena S. Akhmetova
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
The Body ◽  
Scientific Development ◽  
Perinatal Complications ◽  
Genetic Changes ◽  
Perinatal Pathology ◽  
Genetic Predictors ◽  
High Incidence

Currently, the reduction of perinatal morbidity and mortality is a key challenge of maternity care in the world. An important role in the structure of perinatal pathology plays a gestational diabetes mellitus (GDM). High incidence of gestational diabetes mellitus (1-14%) and the associated perinatal mortality have not only medical but also social value. The aim of the study was to study the pathophysiological processes that occur in the body of the pregnant woman with GDM and lead to obstetric and perinatal complications, and possible genetic markers that increase execution risks of impaired glucose metabolism in pregnancy at the present stage of scientific development. Materials: literature data of domestic and foreign studies over the period 2006 to 2016. Methods: synthesis of literature data. Conclusion. It is necessary to identify the major genetic predictors of the development of gestational diabetes, with the aim of its prediction and timely prevention of obstetric and perinatal complications.

scholarly journals Maternal and Perinatal Outcome in Gestational Diabetes Mellitus Compared to Pregestational Diabetes Mellitus

2019 ◽  
Vol 9 (2) ◽  
pp. 127-132
Author(s):  
Faryal Mustary ◽  
TA Chowdhury ◽  
Ferdousi Begum ◽  
Nusrat Mahjabeen
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Birth Asphyxia ◽  
Adverse Outcomes ◽  
Intrauterine Death ◽  
Perinatal Complications ◽  
Pregestational Diabetes

Background: Diabetes mellitus is the most frequently encountered endocrine disorder in pregnancy and is associated with adverse outcomes if remain undiagnosed or untreated. This study was done to compare the maternal and perinatal outcome of pregestational diabetes mellitus (PGDM) with that of gestational diabetes (GDM). Methods: This observational analytical study with group comparison was carried out in the Department of Obstetrics and Gynaecology, BIRDEM General Hospital, Dhaka from July 2015 to June 2016. This study was conducted on two groups of pregnant women: group A (PGDM) and group B (GDM). A total of 100 cases were selected and in each group 50 pregnant women were enrolled. Singleton pregnancy and age 18 to 45 years were included. Pregnancy with hypertension, heart disease, renal disease and other metabolic disorders were excluded. Results: In this study mean gestational age of the study subjects were 35.72 ± 2.61 weeks and 36.58 ± 2.34 weeks in PGDM and GDM groups. History of GDM [34.0% vs 16.0%], intrauterine death (IUD) [14.0% vs 2.0%] and abortion [22.0% vas 6.0%] were significantly higher among PGDM patients than GDM patients. Regarding present pregnancy complications, polyhydramnios [32.0% vs 14.0%], preterm delivery [38.0% vs 20.0%], vulvovaginitis [28.0% vs 12.0%] and premature rupture of membrane (PROM) [24.0% vs 8.0%] were significantly higher in PGDM than GDM patients. Wound infection was significantly high in PGDM groups [35.7% vs 11.1%] among the patients delivered by lower uterine Cesarean section (LUCS). Regarding perinatal complications, hypoglycemia [22.0% vs 8.0%], birth asphyxia [24.0% vs 8.0%], RDS [24.0% vs 8.0%] were significantly higher among PGDM comparing GDM patients. Conclusion: The maternal and perinatal outcomes of pregestational diabetes mellitus were less favorable than those of gestational diabetes mellitus. Birdem Med J 2019; 9(2): 127-132

scholarly journals Advancements and challenges in generating accurate animal models of gestational diabetes mellitus

2013 ◽  
Vol 305 (11) ◽  
pp. E1327-E1338 ◽  
Author(s):  
Raymond C. Pasek ◽  
Maureen Gannon
Keyword(s):  
Diabetes Mellitus ◽  
Animal Models ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Well Being ◽  
Perinatal Complications ◽  
Preventative Measures ◽  
Increased Risk ◽  
Surgical Manipulation

The maintenance of glucose homeostasis during pregnancy is critical to the health and well-being of both the mother and the developing fetus. Strikingly, approximately 7% of human pregnancies are characterized by insufficient insulin production or signaling, resulting in gestational diabetes mellitus (GDM). In addition to the acute health concerns of hyperglycemia, women diagnosed with GDM during pregnancy have an increased incidence of complications during pregnancy as well as an increased risk of developing type 2 diabetes (T2D) later in life. Furthermore, children born to mothers diagnosed with GDM have increased incidence of perinatal complications, including hypoglycemia, respiratory distress syndrome, and macrosomia, as well as an increased risk of being obese or developing T2D as adults. No single environmental or genetic factor is solely responsible for the disease; instead, a variety of risk factors, including weight, ethnicity, genetics, and family history, contribute to the likelihood of developing GDM, making the generation of animal models that fully recapitulate the disease difficult. Here, we discuss and critique the various animal models that have been generated to better understand the etiology of diabetes during pregnancy and its physiological impacts on both the mother and the fetus. Strategies utilized are diverse in nature and include the use of surgical manipulation, pharmacological treatment, nutritional manipulation, and genetic approaches in a variety of animal models. Continued development of animal models of GDM is essential for understanding the consequences of this disease as well as providing insights into potential treatments and preventative measures.

scholarly journals The Feasibility and Preliminary Efficacy of an eHealth Lifestyle Program in Women with Recent Gestational Diabetes Mellitus: A Pilot Study

2020 ◽  
Vol 17 (19) ◽  
pp. 7115
Author(s):  
Megan E. Rollo ◽  
Jennifer N. Baldwin ◽  
Melinda Hutchesson ◽  
Elroy J. Aguiar ◽  
Katie Wynne ◽  
...  
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Density Lipoprotein ◽  
Diabetes Risk ◽  
The Body ◽  
Secondary Outcome ◽  
Body Balance ◽  
Waitlist Control

Self-administered eHealth interventions provide a potential low-cost solution for reducing diabetes risk. The aim of this pilot randomised controlled trial (RCT) was to evaluate the feasibility, including recruitment, retention, preliminary efficacy (primary outcome) and acceptability (secondary outcome) of the “Body Balance Beyond” eHealth intervention in women with previous gestational diabetes mellitus (GDM). Women with overweight/obesity who had recent GDM (previous 24 months) were randomised into one of three groups: 1) high personalisation (access to “Body Balance Beyond” website, individual telehealth coaching via video call by a dietitian and exercise physiologist, and text message support); 2) low personalisation (website only); or 3) waitlist control. To evaluate preliminary efficacy, weight (kg), glycosylated hemoglobin, type A1C (HbA1c), cholesterol (total, low-density lipoprotein (LDL) and high-density lipoprotein (HDL)), diet quality and moderate–vigorous physical activity were analysed at baseline and at 3 and 6 months using generalised linear mixed models. To investigate acceptability, process evaluation was conducted at 3 and 6 months. Of the 327 potential participants screened, 42 women (mean age 33.5 ± 4.0 years and BMI 32.4 ± 4.3 kg/m2) were randomised, with 30 (71%) completing the study. Retention at 6 months was 80%, 54% and 79% for high personalisation, low personalisation and waitlist control, respectively (reasons: personal/work commitments, n = 4; started weight-loss diet, n = 1; pregnant, n = 1; resources not useful, n = 1; and not contactable, n = 5). No significant group-by-time interactions were observed for preliminary efficacy outcomes, with the exception of HDL cholesterol, where a difference favoured the low personalisation group relative to the control (p = 0.028). The majority (91%) of women accessed the website in the first 3 months and 57% from 4–6 months. The website provided useful information for 95% and 92% of women at 3 and 6 months, respectively, although only a third of women found it motivating (30% and 25% at 3 and 6 months, respectively). Most women agreed that the telehealth coaching increased their confidence for improving diet (85%) and physical activity (92%) behaviours, although fewer women regarded the text messages as positive (22% and 31% for improving diet and physical activity, respectively). The majority of women (82% at 3 months and 87% at 6 months) in the high personalisation group would recommend the program to other women with GDM. Recruiting and retaining women with a recent diagnosis of GDM is challenging. The “Body Balance Beyond” website combined with telehealth coaching via video call is largely acceptable and useful for women with recent GDM. Further analysis of the effect on diabetes risk reduction in a larger study is needed.

Gestational Diabetes Mellitus: A Survey of Perinatal Complications in the 1980s

Diabetes ◽  
1991 ◽  
Vol 40 (Supplement_2) ◽  
pp. 74-78 ◽  
Author(s):  
M. Hod ◽  
P. Merlob ◽  
S. Friedman ◽  
A. Schoenfeld ◽  
J. Ovadia
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Perinatal Complications

Perinatal complications following gestational diabetes mellitus how ‘sweet’ is ill?

1996 ◽  
Vol 75 (9) ◽  
pp. 809-815 ◽  
Author(s):  
Moshe Hod ◽  
David Rabinerson ◽  
Bari Kaplan ◽  
Yoav Peled ◽  
Jacob Bar ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Perinatal Complications

Comparison of Insulin, Metformin, and Glyburide on Perinatal Complications of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-13
Author(s):  
Xian Wang ◽  
Wanting Liu ◽  
Huizhen Chen ◽  
Qiu Chen
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Lower Incidence ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Perinatal Complications ◽  
Neonatal Hypoglycemia

<b><i>Aim:</i></b> This systematic and meta-analysis was conducted to evaluate the efficacy and safety of insulin, metformin, and glyburide on perinatal complications for gestational diabetes mellitus (GDM). <b><i>Methods:</i></b> Medline (PubMed), EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials [CENTRAL], and Cochrane Methodology Register), Web of Science (Science and Social Science Citation Index), and ClinicalTrials (Clinicaltrials.gov) were searched, as well as manual searching. We included randomized controlled trials comparing efficacy and safety of metformin versus glyburide, metformin versus insulin, and glyburide versus insulin in patients with GDM. <b><i>Results:</i></b> We included 32 articles including 5,964 patients published from inception to July 2020. Compared with insulin, metformin was more effective at lower incidence of macrosomia (RR: 0.66, 95% CI: 0.50–0.88, <i>p</i> = 0.005), lower incidence of neonatal intensive care unit admission (RR: 0.78, 95% CI: 0.67–0.91, <i>p</i> = 0.002), less neonatal hypoglycemia (RR: 0.67, 95% CI: 0.56–0.80, <i>p</i> &#x3c; 0.0001), decreased birth weight (BW) (SMD: −0.37, 95% CI: −0.62 to −0.12, <i>p</i> = 0.004), lower incidence of large for gestational age (RR: 0.76, 95% CI: 0.50–0.90, <i>p</i> = 0.002), shorter gestation age at delivery (MD: −0.22, 95% CI: −0.34 to −0.10, <i>p</i> = 0.0002), lower maternal weight gain (MD: −1.41, 95% CI: −2.28 to −0.55, <i>p</i> = 0.001), less incidence of caesarean section delivery (RR: 0.86, 95% CI: 0.78–0.95, <i>p</i> = 0.0004), lower maternal postprandial blood glucose (SMD: −0.41, 95% CI: −0.72 to −0.11, <i>p</i> = 0.008), and lower incidence of pregnancy-induced hypertension (RR: 0.47, 95% CI: 0.27–0.83, <i>p</i> = 0.01). However, glyburide, compared with insulin, was associated with higher BW (MD: 54.95, 95% CI: 3.87–106.03, <i>p</i> = 0.03) and increased the incidence of neonatal hypoglycemia (RR: 1.52, 95% CI: 1.12–2.07, <i>p</i> = 0.007). Meanwhile, compared to glyburide, metformin was associated with higher maternal fasting blood glucose (SMD: 0.20, 95% CI: 0.05–0.36, <i>p</i> = 0.01) and lower incidence of induction of labor (RR: 0.76, 95% CI: 0.59–0.97, <i>p</i> = 0.03). <b><i>Conclusions:</i></b> This review suggests that metformin can decrease the incidence of perinatal complications, and it should be considered as a generally safe alternative to insulin.

scholarly journals Associations of Body Mass Index (Maternal BMI) and Gestational Diabetes Mellitus with Neonatal and Maternal Pregnancy Outcomes in a Multicentre European Database (Diabetes and Pregnancy Vitamin D and Lifestyle Intervention for Gestational Diabetes Mellitus Prevention)

ISRN Obesity ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Akke Vellinga ◽  
A. Zawiejska ◽  
J. Harreiter ◽  
B. Buckley ◽  
G. Di Cianni ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Caesarean Section ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnancy Outcomes ◽  
Perinatal Complications ◽  
Obesity And Diabetes ◽  
Independent Risk Factors ◽  
The Impact

Objective. Assess the impact of Gestational Diabetes Mellitus (GDM) and obesity on neonatal and maternal pregnancy outcomes. Methods. Cross-sectional data (3343 pregnancies) from seven European centres were included in a multilevel analysis of the association between GDM/obesity and caesarean section, macrosomia and neonatal morbidities. Results. Comparison of databases identified reporting differences between countries due to the inclusion of true population based samples or pregnancies from specialised tertiary centres, resulting in higher prevalences of GDM for some countries. The analysis showed that obesity and GDM were independent risk factors of perinatal complications. Only BMI had a dose-dependent effect on the risk of macrosomia and caesarean section. Both obesity (BMI > 30 kg/m2) and GDM were independent risk factors of neonatal morbidities. Conclusions. Obesity and GDM were independent risk factors of perinatal complications. The effect of the worldwide obesity and diabetes epidemic is extending to the next generation.

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