scholarly journals Role of pregravid diet and metformin in the prophylaxis of gestational diabetes and its complications

2018 ◽  
Vol 67 (4) ◽  
pp. 13-18
Author(s):  
Evgeny K Komarov ◽  
Tamara A Pluzhnicova ◽  
Elena V Nicologorskaya ◽  
Ekaterina A Alabieva
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Venous Blood ◽  
Diet Therapy ◽  
Significant Loss ◽  
Oral Glucose ◽  
Normal Body Mass Index ◽  
Glucose Load

The aim of this study was to improve the method for diagnosing insulin resistance (IR) and to assess the effect of pregravid diet alone or dietary supplementation in combination with metformin on the development of gestational diabetes mellitus (GDM) and its complications in patients with pre-diabetes. At the first stage of the study, glucose level was determined in the capillary blood of 61 women and, in the second stage, in the venous blood plasma of 60 individuals. The 75 g oral glucose tolerance test was performed in all patients. Plasma insulin level and IR index were determined basal (HOMA-IR) and two hours after the glucose load. The presence of IR was found in 68 women. All of them were treated with a diet, with 34 patients additionally treated with metformin at a dose of 1500 mg per day. The duration of therapy was 3-6 months.It has been shown that the evaluation of IR index two hours after the glucose load significantly (p < 0.05) increases the diagnosis of the IR status, as in 56.5% of women with IR, the fasting IR (HOMA-IR) values were normal. The use of metformin combined with diet therapy in patients with IR, with easily assimilated carbohydrates excluded at the pregravid stage, is accompanied by a more significant loss of body weight with the achievement of a normal body mass index for pregnancy, when compared to diet therapy alone. In patients with IR after pregravid treatment with diet or diet with metformin, the frequency of obstetric complications, as well as of gestational diabetes mellitus, is comparable with that in normal women. In addition, such pregravid treatment protects patiens with IR from superfluous weight gain and fetal macrosomia. (For citation: Komarov ЕК, Pluzhnikova ТА, Nikologorskaya ЕV, Alyabyeva ЕА. Role of pregravid diet and metformin in the prophylaxis of gestational diabetes and its complications. Journal of Obstetrics and Women’s Diseases. 2018;67(4):13-18. doi: 10.17816/JOWD67413-18).

scholarly journals Role of sex hormone binding globulin as the early predictor for gestational diabetes mellitus

2019 ◽  
Vol 8 (3) ◽  
pp. 967
Author(s):  
Sujatha M. S. ◽  
Madhana S. ◽  
Shylaja P. ◽  
Priyanka S.
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Venous Blood ◽  
First Trimester ◽  
Sex Hormone Binding Globulin ◽  
Exclusion Criteria ◽  
Low Level ◽  
Early Predictor

Background:  The aim of this study was to find role of SHBG as an early predictor for gestational diabetes mellitus.Methods: A hospital based prospective/observational/diagnostic and explorative study. The necessary information was collected from the participants through the prepared set of questionnaires. Pregnant women between 11 to 14 weeks of gestation who visited JSS OPD for antenatal checkup satisfying inclusion and exclusion criteria giving informed and written consent for the study were examined clinically. 3ml of venous blood was drawn with aseptic precautions for the estimation of SHBG and adiponectin. OGTT with 75gms glucose first done at 11 to 14weeks and again at 24-28 weeks and 32-36 weeks were done to the same patient to find out whether the patient developed GDM or not. These mothers were followed periodically till delivery. The sensitivity and specificity of SHBG were assessed and compared in patients who developed GDM.Results: 100 cases were selected for the study. About 12 patients were diagnosed as gestational diabetes mellitus in present study by OGCT at 32 weeks to 36 weeks. In present study about 14 patients had low level of SHBG. Low level of SHBG is found to be statistically significant in predicting GDM in first trimester.Conclusions: The combination of SHBG can be used as predictor of GDM in first trimester.

scholarly journals Gestational diabetes mellitus - need for universal screening - a clinical study in a tertiary care centre

2021 ◽  
Vol 10 (5) ◽  
pp. 1973
Author(s):  
Kondapuram Veena ◽  
Srilakshmi Ambarkar ◽  
Srilakshmi Ambarkar
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Gestational Age ◽  
Universal Screening ◽  
Tertiary Care ◽  
Antenatal Visit ◽  
Oral Glucose ◽  
Glucose Load

Background: To study the prevalence of gestational diabetes mellitus among antenatal mothers and to assess the importance of universal screening to detect gestational diabetes mellitus (GDM).Methods: A total of 300 antenatal women irrespective of gestational age were screened for GDM at their antenatal visit during the period of January 2020 to June 2020. All women were screened with 75gm oral glucose load irrespective of last meal followed by blood glucose estimation by glucose oxidase peroxidase method 2 hours following glucose load. A cut-off of 140mg/dl or more were labelled as gestational diabetes mellitus as per DIPSI guidelines.Results: Out of 300 antenatal women tested, 24 women (8%) were positive for gestational diabetes mellitus. During the first, second and third trimesters 12.5%, 33.33% and 54.17% were diagnosed with gestational diabetes mellitus respectively. The number of gestational diabetes mellitus patients for the age groups ≤20 years, 21-25 years, 26-30 years and >30 years are 2 (8.33%), 3 (12.5%), 8 (33.33%) and 11 (45.83%) respectively. The number of pregnant women tested positive for gestational diabetes mellitus with BMI ≤18.5, 18.6-24.9, 25-29.9 and 30-35 are 2 (8.33%), 4(16.67%), 8(33.33%) and 10(41.67%) respectively.Conclusions: Prevalence of GDM in our study is 8%. About 29.16% of GDM did not have any risk factors. This emphasizes the importance of universal screening for GDM of all pregnant women irrespective of gestational age. There is an increased association of GDM with age, BMI, family history and parity according to our study.

scholarly journals Continuous Glucose Monitoring in Women with Normal OGTT in Pregnancy

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Linda Tartaglione ◽  
Enrico di Stasio ◽  
Angelo Sirico ◽  
Mauro Di Leo ◽  
Salvatore Caputo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Continuous Glucose Monitoring ◽  
Real Life ◽  
Glucose Monitoring ◽  
Diet Therapy ◽  
Tolerance Test ◽  
Oral Glucose ◽  
In Pregnancy

Continuous glucose monitoring (CGM) might be an effective tool to improve glycemic control in gestational diabetes mellitus (GDM). Few data are available about its utilization as a diagnostic tool to find potential alterations of glycemia in subjects with normal oral glucose tolerance test (OGTT). In this preliminary prospective real-life observational study, we aimed to analyze the glycemic pattern in normal and gestational diabetes mellitus (GDM) women by continuous glucose monitoring (CGM) in order to detect potential differences between the two groups and glycemic alterations despite a normal OGTT. After the screening for GDM, subjects were connected to a CGM system for seven consecutive days. The areas under the curve of the first 60 minutes after each meal and 60 minutes before breakfast were analyzed. Women with normal OGTT that during CGM showed impaired glycemic values (more than 95 fasting or more than 140 one hour after meals or more than 120 two hours after meals) performed one week of self-monitoring of blood glucose (SMBG). After OGTT, 53 women considered normal and 46 affected by GDM were included. CGM parameters did not show any differences between the two groups with impaired glycemic excursions found in both groups. After CGM period, 33 women with normal OGTT showed abnormal glycemic patterns. These 33 women then performed one week of SMBG. After evaluation of one week of SMBG, 21 required diet therapy and 12 required insulin treatment and were followed until the delivery. An increase in gestational weight gain was observed in normal women with normal OGTT but this was not significant. No significant data were found regarding neonatal outcomes in the two groups of women. In conclusion, CGM use in pregnancy might help to detect glycemic fluctuations in women with normal OGTT, improving their treatment and outcomes.

scholarly journals The role of dietotherapy in prevention of a diabetic fetopathy at women with gestational diabetes mellitus

2013 ◽  
Vol 62 (3) ◽  
pp. 9-15
Author(s):  
Natalia Yuryevna Arbatskaya ◽  
Nadezhda Gennadjevna Ignatova ◽  
Marina Vladislavovna Moldovanova ◽  
Elena Petrovna Melnikova ◽  
Violetta Vladimirovna Kandalina
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diet Therapy ◽  
Main Method ◽  
Gestation Age ◽  
Target Values ◽  
Food Taking ◽  
First Time

The Gestational Diabetes Mellitus (GDM) is the disease, being characterized a hyperglycemia for the first time revealed during pregnancy. The main method of GDM treatment is diet. During our research we compared efficiency of different recommendations about a diet therapy in prevention of macrosomia, the birth with large gestation age (LGA) and other diabetic fetopathy (DF) manifestations. Our results showed that a diet with a low and medium glycemic index of products, a fractional food taking into account physiological secretion of insulin and insulinoresistance during pregnancy allows to achieve a target values of glucose from pregnant women with GDM, decrease the frequency of purpose of insulin therapy because of pre-natal manifestations of DF, decrease the risk of macrosomia development and frequency of cesarean section in connection with the LGA a fetus.

Diagnostics and laboratory monitoring of gestational diabetes mellitus in Russia. The authors' view of the problem and controversial issues

2014 ◽  
Vol 63 (4) ◽  
pp. 98-103
Author(s):  
Vladimir Vladimirovich Dorofeykov ◽  
Natalia Evgenyevna Androsova
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Glycosylated Hemoglobin ◽  
Venous Blood ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Laboratory Services ◽  
Blood Glucose Test ◽  
Glucose Test

Despite the existence of the Russian Consensus on gestational diabetes mellitus (GDM) since 2012 in the Russian Federation, its implementation into clinical practice has been slow, partially because its creation took place without the participation of laboratory services. In this review issues of preanalytical and analytical considerations of such laboratory tests as the blood glucose test, oral glucose tolerance test (OGTT), glycosylated hemoglobin test are discussed. If the presence of prandial hyperglycemia from 5.1 to 5.6 mmol/l is identified, testing should be repeated to confirm the diagnosis of GDM. OGTT must be performed using venous blood samples with fluoride in a specialized laboratory with fast transportation of samples.

scholarly journals Reduced GLP-1 Secretion at 30 Minutes After a 75-g Oral Glucose Load Is Observed in Gestational Diabetes Mellitus: A Prospective Cohort Study

Diabetes ◽  
2018 ◽  
Vol 67 (12) ◽  
pp. 2650-2656 ◽  
Author(s):  
Nithya Sukumar ◽  
Christos Bagias ◽  
Ilona Goljan ◽  
Yonas Weldeselassie ◽  
Seley Gharanei ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Oral Glucose ◽  
Oral Glucose Load ◽  
Glucose Load

Diet and Nutritional Interventions with the Special Role of Myo-Inositol in Gestational Diabetes Mellitus Management. An Evidence-Based Critical Appraisal

2019 ◽  
Vol 25 (22) ◽  
pp. 2467-2473 ◽  
Author(s):  
Enrique Reyes-Muñoz ◽  
Federica Di Guardo ◽  
Michal Ciebiera ◽  
Ilker Kahramanoglu ◽  
Thozhukat Sathyapalan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Metabolic Diseases ◽  
Nutritional Intervention ◽  
Attractive Alternative ◽  
Special Role ◽  
Dose Frequency ◽  
Nutritional Interventions

Background: Gestational Diabetes Mellitus (GDM), defined as glucose intolerance with onset or first recognition during pregnancy, represents one of the most common maternal-fetal complications during pregnancy and it is associated with poor perinatal outcomes. To date, GDM is a rising condition over the last decades coinciding with the ongoing epidemic of obesity and Type 2 Diabetes Mellitus (T2DM). Objective: The aim of this review is to discuss the role of diet and nutritional interventions in preventing GDM with the explanation of the special role of myo-inositol (MI) in this matter. Methods: We performed an overview of the most recent literature data on the subject with particular attention to the effectiveness of diet and nutritional interventions in the prevention of GDM with the special role of MI. Results: Nutritional intervention and physical activity before and during pregnancy are mandatory in women affected by GDM. Moreover, the availability of insulin-sensitizers such as different forms of inositol has dramatically changed the scenario, allowing the treatment of several metabolic diseases, such as those related to glucose dysbalance. Although the optimal dose, frequency, and form of MI administration need to be further investigated, diet supplementation with MI appears to be an attractive alternative for the GDM prevention as well as for the reduction of GDM-related complications. Conclusion: More studies should be conducted to prove the most effective nutritional intervention in GDM. Regarding the potential effectiveness of MI, further evidence in multicenter, randomized controlled trials is needed to draw firm conclusions.

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