scholarly journals A study of gestational diabetes mellitus and fetal outcome in a tertiary care center

2020 ◽  
Vol 9 (8) ◽  
pp. 3417
Author(s):  
Aashka M. Mashkaria ◽  
Babulal S. Patel ◽  
Aastha M. Mashkaria ◽  
Akshay C. Shah ◽  
Shashwat K. Jani ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Early Diagnosis ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Care Center ◽  
Tertiary Care ◽  
Tolerance Test ◽  
Fetal Outcome ◽  
Oral Glucose ◽  
Glucose Levels

Background: Modern desk-bound lifestyle and unhealthy dietary changes have brought a rise in the prevalence of obesity and gestational diabetes mellitus (GDM). It is associated with severe hazards to the mother and the baby. It is mandatory that early diagnosis ensues and timely and congruous management is undertaken.Methods: In this observational study, 1250 women were included. A standardized questionnaire was formed and their details were noted. Tests for glucose levels, complete blood picture, urine examination were performed. An oral glucose tolerance test was performed on all the patients. Neonatal outcomes in terms of birth weight and the presence of complications were noted.Results: A total 201 (16.1%) of all women were having gestational diabetes mellitus (GDM). Most mothers were in the 25-30 age group. The majority of the women had a BMI between 26-30. 21.9% of babies were having weight >3.5 kgs. 11.4% of babies were <2.5 kgs. Out of 201 neonates, 90 babies were having complications. Major complications in neonates were macrosomia and respiratory distress. Therefore, early diagnosis, glycemic control, and timely and congruous management are advantageous to both mother and baby.Conclusions: GDM complicating the pregnancy results in a higher prevalence of complications in the mother and the neonate. Therefore, appropriate control of the sugar level in mothers is necessary and it decreases the morbidity and mortality rates in the babies as well as the mothers. 

scholarly journals Gestational diabetes and fetal outcome: a study in a tertiary care centre

2017 ◽  
Vol 6 (10) ◽  
pp. 4458
Author(s):  
V. G. Vanamala
Keyword(s):  
Birth Weight ◽  
Gestational Diabetes ◽  
Tertiary Care ◽  
Tolerance Test ◽  
Fetal Outcome ◽  
Oral Glucose ◽  
Tertiary Care Centre ◽  
Glucose Levels ◽  
The People ◽  
Urine Examination

Background: Due to urbanization and sedentary lifestyle, dietary changes, and increased obesity of the people, the incidence of GDM is steadily on the rise. It is associated with severe morbidity to the mother and the child. It is therefore imperative that an early diagnosis needs to be done so that appropriate treatment can be given.Methods: 1654 women who were included in the study were in their 24 – 28 weeks of gestation. A standardized questionnaire was formatted and details regarding the age, weight, body mass index (BMI), parity, previous medical and obstetrics history and familial history of diabetes, tests for glucose levels, complete blood picture, routine urine examination. Oral glucose tolerance test was done for all the patients after fasting overnight.Results: 87 (5.3%) of them were positive for OGTT and were considered to have Gestational Diabetes mellitus. 67.8% of the patients were in the 25-30 age group. 41.4% were pregnant for the first time and 58.6% were multi gravid. The majority of the patients had a BMI between 26-30. Most of the babies had a birth weight of above 3kgs. Out of them, 39 (44.8%) had a birth weight between 3.1-3.5kgs. <2kgs were seen in 7 (8.0%) patients.Conclusions: GDM complicates pregnancy and results in higher frequency of adverse effects in the mother and new born. Thereby, early detection can result in prompt treatment and lowering the morbidity of the fetal outcomes.

Gestational Diabetes Mellitus: A Prospective Study

2010 ◽  
Vol 2 (2) ◽  
pp. 109-113
Author(s):  
Paban K Sharma ◽  
Ashis Shrestha
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Tertiary Care ◽  
Challenge Test ◽  
Tolerance Test ◽  
Study Data ◽  
Oral Glucose ◽  
Family History Of Diabetes ◽  
History Of

ABSTRACT Background Maternal hyperglycemia is considered a risk factor for both fetus and mother which can lead to significant morbidity and sometimes, even mortality. Here, we present a two years study of gestational diabetes which was intended to see the incidence and its determinants in the Patan Hospital, Kathmandu, Nepal. Patan Hospital is a tertiary care level teaching hospital. Subjects and Methods All pregnant women visiting ANC clinic or admitted to the ward with the diagnosis of GDM from July 2005 to June 2007 at Patan Hospital were taken for the study. In Patan Hospital, pregnant ladies are routinely screened for diabetes with 50 gm glucose challenge test (GCT) and if the value is more than 140 mg/dl, they are subjected to 100 gm Oral Glucose Tolerance Test (OGTT). If two or more than two values are increased, they are managed as gestational diabetes. These cases of gestational diabetes are enrolled for the study. Data was collected by interview and laboratory investigations using standard set of questioner. Results Out of 13,382 consecutive deliveries, 53 patients were admitted with the diagnosis of gestational diabetes mellitus (GDM). Among them, 40.4% were Brahmin, 38.5% Newar, 11.5% Chettri and 9.6% from other cast. GDM was more common in the age group 26 to 35 years and was more prevalent in urban population than rural (urban 84.6% vs rural 15.4%). Similarly, it was more common in multipara patients. Only 28.8% of the cases were having polyhydramnios on ultrasound. Mean weight gain in pregnancy was 8.96 kg with a range of 3 to 20 kg approximately, 58% of patients had family history of diabetes, 48.7% of patients had history of GDM in previous pregnancy and 7.7% of patients had overt diabetes. Most of the patients needed insulin (92.3%) and only 7.7% of patients were managed with only diet and exercise. No significant fetomaternal complication was observed in our study. Conclusion There was significant number of cases diagnosed as GDM. All patients who were diagnosed early and treated accordingly had less complications related to mother and child.

scholarly journals Outcome of pregnancy in gestational diabetes as compared to overt diabetes

2020 ◽  
Vol 9 (2) ◽  
pp. 630
Author(s):  
Chirag R. Banker ◽  
Latika R. Mehta
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Economic Status ◽  
Care Center ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Intrauterine Fetal Death ◽  
Family History Of Diabetes ◽  
Overt Diabetes

Background: Diabetes mellitus is a chronic metabolic disorder characterised by polyuria, polyphagia, polydipsia and glycosuria. Diabetes in pregnancy can be defined as pregestational (pre-existing) diabetes or gestational diabetes have type 1 (T1DM) or type 2 (T2DM) diabetes mellitus. Present study was carried to compare the maternal and perinatal outcome of overt diabetes mellitus as compared to gestational diabetes mellitus (PGDM) with that of gestational diabetes (GDM).Methods: An observational study was conducted at obstetrics and gynaecology department of a tertiary care center from July 2010 to October 2012 among 23 diabetic women. Seven of them were cases of overt diabetes while 16 were diagnosed during pregnancy. Maternal and fetal outcome were studied. All patients were followed from time of admission to discharge from hospital.Results: mean age of the participants were 26.71±4.89 in overt diabetes as compared to 27.56±4.41 among gestational diabetes. Illiteracy, low socio-economic status, rural residence, family history of diabetes was also high in overt diabetes mellitus as compared to GDM but none of them was statistically significant (P < 0.05). Intrauterine fetal death was more among GDM (37.5%) as compared to overt diabetes (28.57%). Prematurity and LBW were also high in overt diabetes as compared to GDM but none of them were statistically significant. Oligohydramnios, polyhydramnios and premature rupture of membrane were higher in gestational diabetes mellitus as compared to overt diabetes among women. Rate of LSCS were higher in gestational diabetes.Conclusions: Diabetes whether over or gestational is responsible for the poor outcome of the pregnancy so tight control is needed. 

The Association between Maternal/Fetal Insulin Receptor Substrate 1 Gene Polymorphism rs1801278 and Gestational Diabetes Mellitus in a Chinese Population

2021 ◽  
pp. 1-8
Author(s):  
Lingling Wu ◽  
Changping Fang ◽  
Jun Zhang ◽  
Yanchou Ye ◽  
Haiyan Zhao
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gene Polymorphism ◽  
Gestational Diabetes Mellitus ◽  
Insulin Receptor ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Insulin Receptor Substrate ◽  
Single Center ◽  
Insulin Receptor Substrate 1

<b><i>Objectives:</i></b> Insulin receptor substrate 1 (IRS1) is a crucial factor in the insulin signaling pathway. IRS1 gene polymorphism rs1801278 in mothers has been reported to be associated with gestational diabetes mellitus (GDM). However, it is not clear whether IRS1 gene polymorphism rs1801278 in fetuses is associated with their mothers’ GDM morbidity. The purpose of this study is to analyze the association between maternal, fetal, or maternal/fetal <i>IRS1</i> gene polymorphism rs1801278 and GDM risk. <b><i>Design:</i></b> The study was a single-center, prospective cohort study. In total, 213 pairs of GDM mothers/fetuses and 191 pairs of control mothers/fetuses were included in this study. They were recruited after they underwent oral glucose tolerance test during 24–28 weeks of gestation and followed up until delivery. All participants received the conventional interventions (diet and exercise), and no special therapy except routine treatment. <b><i>Methods:</i></b> A total of 213 pairs of GDM mothers/fetuses and 191 pairs of normal blood glucose pregnant mothers/fetuses were ge­notyped using PCR and DNA sequencing from January 2015 to September 2016. Maternal/fetal <i>IRS1</i> gene polymorphism rs1801278 was analyzed and compared between 2 groups. <b><i>Results:</i></b> There were no significant differences in the frequency of individual mothers’ or fetuses’ <i>IRS1</i> rs1801278 polymorphisms between 2 groups; if both the mothers and fetuses carried A allele, significantly lower GDM morbidity was observed in the mothers. <b><i>Limitations:</i></b> The sample size was relatively small as a single-center study. <b><i>Conclusions:</i></b> Our study suggested that maternal/fetal rs1801278 polymorphism of <i>IRS1</i> is a modulating factor in GDM; both mothers/fetuses carrying the A allele of rs1801278 may protect the mothers against the development 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.

scholarly journals GESTATIONAL DIABETES MELLITUS

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.

scholarly journals Effect of antenatal dietary myo-inositol supplementation on the incidence of gestational diabetes mellitus and fetal outcome: protocol for a double-blind randomised controlled trial

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e055314
Author(s):  
Ibrahim Ibrahim ◽  
Hala Abdullahi ◽  
Yassin Fagier ◽  
Osman Ortashi ◽  
Annalisa Terrangera ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Controlled Trial ◽  
Tolerance Test ◽  
Dietary Advice ◽  
Controlled Clinical Trial ◽  
Oral Glucose ◽  
Double Blind ◽  
Registration Number

IntroductionGestational diabetes mellitus (GDM) affects 23.6% of Qatari women and is associated with maternal and perinatal morbidity and long-term risk of developing type 2 diabetes. A number of challenges exist with current interventions, including non-compliance with dietary advice, the reluctance of mothers to ingest metformin tablets or use insulin injections. These challenges highlight the importance of pursuing evidence-based prevention strategies. Myo-inositol is readily available as an US Food and Drug Administration-approved food supplement with emerging but limited evidence suggesting it may be beneficial in reducing the incidence of GDM. Further studies, such as this one, from different ethnic contexts and with differing risk factors, are urgently needed to assess myo-inositol effects on maternal and neonatal outcomes.Methods and analysisThis study is a prospective, randomised, double-blinded, placebo controlled clinical trial to either myo-inositol supplementation or placebo.We plan to enrol 640 pregnant women attending antenatal care at Sidra Medicine, Doha, Qatar, 320 in each arm. All participants will complete at least 12 weeks of supplementation prior to undertaking the Oral Glucose Tolerance Test at 24–28 weeks. The daily use of the trial supplementation will continue until the end of pregnancy. All outcome measures will be collected from the electronic medical records.Ethics and disseminationEthical approval for the study was obtained on 12 April 2021 from Sidra Medicine (IRB number 1538656). Results of the primary trial outcome and secondary endpoints will be submitted for publication in a peer-reviewed journal.Trial registration numberProspectively registered on 26 May 2021. Registration number ISRCTN16448440 (ISRCTN registry).

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