scholarly journals Interventions for gestational diabetes: impact of assisted reproduction

2021 ◽  
Vol 10 (5) ◽  
pp. 1878
Author(s):  
Preethi Ravi ◽  
Lakshmi Shanmuga Sundaram ◽  
Kundavi Shankar
Keyword(s):  
Gestational Diabetes ◽  
Insulin Therapy ◽  
Assisted Reproduction ◽  
Life Style ◽  
Insulin Requirement ◽  
Perinatal Complications ◽  
Lifestyle Modifications ◽  
Entire Study ◽  
Iadpsg Criteria ◽  
Study Population

Background: This study was to assess whether assisted conception acts as a predictor for insulin therapy in gestational diabetes (GDM) treatment. The secondary aim of this study was to analyse the type of interventions that aided control of blood glucose. The role of ART as a risk factor that increases the risk of insulin therapy in GDM remains elusive. Many studies have established the increased association of GDM with ART conceptions. Factors like advanced maternal age, polycystic ovarian syndrome or obesity that increase GDM risk also contribute to subfertility. Increased level of  Hb A1C, elevated FBS values are considered as risk factors for antenatal insulin therapy in women with GDM. This study was to assess if assisted reproduction is an independent variable associated with insulin therapy.Methods: In this retrospective study, GDM was diagnosed by fasting blood sugar and 2 hours postprandial or 75 gms OGTT based on IADPSG criteria with FBS >90, 2hr >140. Among the 121 GDM mothers, 42 women were ART conceptions and 79 were spontaneous conceptions. The entire study population (121) was divided into 3 groups based on the treatment required. Diet and lifestyle modifications only, diet and life style modifications with OHA and OHA with or without insulin therapy. The demographic, clinical, biochemical data were compared between groups. Details were obtained from case notes and entered in an excel sheet and SSPS software was used for statistical analysis. Inclusion criteria was all GDM pregnancies in the study period (4 years; January 2014 to December 2017) for whom case notes were available. Exclusion criteria was women with diabetes prior to pregnancy, those who moved elsewhere for delivery and multiple gestations.Results: There was no difference in the insulin requirement between ART conception and spontaneous conceptions. Out of 121 women, 34 women (28%) required diet and life style management, 38 women required OHA (31%), 49 women required insulin (40%). 73% of women who were managed with diet were spontaneous conceptions. Preterm labor was the commonest complication encountered (17%). ART women had more number of perinatal complications, in all treatment groups.Conclusions: ART was not a predictor for insulin therapy in this study group. The largest group of intervention for GDM was with insulin, 40%. Perinatal complications were seen more in ART mothers with GDM compared with spontaneous conceptions. Spontaneous conceptions women had more percentage of management with diet and life style modifications.

scholarly journals Assessment of predictors of insulin therapy in patients with gestational diabetes diagnosed according to the IADPSG criteria

2016 ◽  
Vol 7 (4) ◽  
pp. 440-446
Author(s):  
Keiko Yanagisawa ◽  
Mitsue Muraoka ◽  
Koichiro Takagi ◽  
Yasuhiko Ichimura ◽  
Misa Kambara ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Insulin Therapy ◽  
Iadpsg Criteria

scholarly journals Clinical Implications of the NICE 2015 Criteria for Gestational Diabetes Mellitus

2018 ◽  
Vol 7 (10) ◽  
pp. 376 ◽  
Author(s):  
Meena Bhatia ◽  
Lucy Mackillop ◽  
Katy Bartlett ◽  
Lise Loerup ◽  
Yvonne Kenworthy ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
International Association ◽  
Fasting Blood Glucose ◽  
Large For Gestational Age ◽  
P Value ◽  
Perinatal Complications ◽  
Neonatal Complications ◽  
Iadpsg Criteria

Background: In response to concerns that the International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria labeled too many women with gestational diabetes mellitus (GDM) without evidence of clinical or economic benefit, NICE recommended a change in diagnostic criteria in 2015. Aim: To compare diabetes associated maternal and neonatal complications in pregnancies complicated by GDM diagnosed using IADPSG criteria only, to those with GDM diagnosed using both IADPSG and NICE 2015 criteria. GDM screening was risk factor based. Methods: This was a secondary analysis of a trial of women with GDM diagnosed by the IADPSG criteria (fasting blood glucose (BG) ≥ 5.1 mmol/L, 1 h ≥ 10.0 mmol/L and 2 h ≥ 8.5 mmol/L). Outcomes were compared for two groups: NICE + IADPSG defined as those with GDM diagnosed by both the NICE 2015 and IADPSG criteria (fasting BG ≥ 5.6 mmol/L, 2 h ≥ 8.5 mmol/L); and IADPSG-ONLY (fasting BG 5.1 mmol/L to 5.5 mmol/L, and/or 1-hour ≥10.0 mmol/L, and 2 h ≥ 8.5 mmol/L). We were not able to obtain data for women with a 2-h value between BG 7.8–8.4 mmol/L (i.e., NICE-ONLY; NICE 2015 positive and IADPSG negative). All women were treated for GDM using targets of fasting BG < 5.3 mmol/L and 1-h post prandial BG < 7.8 mmol/L respectively. Results: Of 159 women, 65 (40.9%) were NICE + IADPSG and 94 (59.1%) IADPSG-ONLY. Hypoglycaemic medication use was similar in both groups: 52.3% NICE + IADPSG, 46.8% IADPSG-ONLY, OR 1.0 (0.5–1.9). The IADPSG-ONLY group delivered later than the NICE + IADPSG group; 39.0 weeks (sd 1.4) compared to 38.2 weeks (sd 2.5), p value 0.02. Fewer caesarean sections occurred in IADPSG-ONLY group 30.9% vs. 52.3%, OR 0.4 (0.2–0.9). Birthweight, large for gestational age, and other neonatal complications were not significantly different between groups. Conclusions: Gestational diabetes-associated perinatal complications were similar in both groups. The IADPSG criteria detect women with evidence of ongoing hyperglycaemia who may benefit from treatment during pregnancy.

Pengaruh Kepuasan Kerja terhadap Organizational Citizenship Behavior (OCB) Alumni Diklat Kepemimpinan Tingkat IV di Provinsi Banten

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Enong Rostiawati
Keyword(s):  
Job Satisfaction ◽  
Organizational Citizenship ◽  
Organizational Citizenship Behavior ◽  
Leadership Training ◽  
Survey Methods ◽  
Citizenship Behavior ◽  
Entire Study ◽  
Analysis Technique ◽  
Study Population

Abstract: Organizational Citizenship Behavior (OCB) is a variable that can be influenced by job satisfaction. This study aims to determine the effect of job satisfaction variables on Organizational Citizenship Behavior OCB alumni level IV leadership training in Banten Province. This research uses a quantitative approach through survey methods. Data analysis technique used is simple linear regression. The population in this study were 40 respondents and the sample used was 40 respondents. Determination of the sample using total sampling techniques or samples taken from the entire study population. The results of the analysis and interpretation of research data show that the value of the regulatory coefficient of influence on job satisfaction on Organizational Citizenship Behavior (OCB) alumni of leadership training level IV is 0.740 thus it can be concluded that job satisfaction has a direct positive effect on Organizational Citizenship Behavior alumni training, meaning that improvement of satisfaction in IV level leadership training is 0.740. work has an impact on improving Organizational Citizenship Behavior for training alumni, So Organizational Citizenship Behavior for training alumni can be achieved through job satisfaction.Keywords: Job satisfaction, Organizational Citizenship Behavior, Leadership Training Alumni Level IV

The Impact of Internal Work Environment on the Retention of Healthcare Providers at Turaif General Hospital

2019 ◽  
Vol 10 (12) ◽  
pp. 1183-1199
Author(s):  
Mohammed Alrouili ◽  
Keyword(s):  
Work Environment ◽  
General Hospital ◽  
Professional Growth ◽  
Healthcare Providers ◽  
Entire Study ◽  
Internal Work ◽  
Research Findings ◽  
Study Population ◽  
The Right ◽  
The Impact

This study attempted to identify the impact of internal work environment on the retention of healthcare providers at Turaif General Hospital in the Kingdom of Saudi Arabia. In particular, the study aimed to identify the dimensions of work circumstances, compensation, and relationship with colleagues, professional growth, and the level of healthcare providers’ retention. In order to achieve the study goals, the researcher used the descriptive analytical approach. The researcher used the questionnaire as the study tool. The study population comprised all the healthcare providers at Turaif General Hospital. Questionnaires were distributed to the entire study sample that consisted of 220 individuals. The number of questionnaires valid for study was 183 questionnaires. The research findings were as follows: the participants’ estimate of the work circumstances dimension was high (3.64), the participants’ estimate of the compensation dimension was moderate (3.32), the participants’ estimate of the relationship with colleagues dimension was high (3.62), the participants’ estimate of the professional growth dimension was weak (2.39), and the participants’ estimate of healthcare providers’ retention level was intermediate (2.75). Accordingly, the researcher’s major recommendations are: the need to create the right atmosphere for personnel in hospitals, the interest of the hospital to provide the appropriate conditions for the staff in terms of the physical and moral aspects for building the work adjustment in the staff, and conducting training courses and educational lectures for personnel in hospitals on how to cope with the work pressures.

1387-P: Risk of Perinatal Complications across Gestational Blood Pressure Levels in Women with and without Gestational Diabetes (GDM)

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1387-P
Author(s):  
YEYI ZHU ◽  
JUANRAN FENG ◽  
AMANDA NGO ◽  
CHARLES QUESENBERRY ◽  
ASSIAMIRA FERRARA
Keyword(s):  
Blood Pressure ◽  
Gestational Diabetes ◽  
Perinatal Complications

scholarly journals The Impact of Diagnostic Criteria for Gestational Diabetes Mellitus on Adverse Maternal Outcomes: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (4) ◽  
pp. 666
Author(s):  
Fahimeh Ramezani Tehrani ◽  
Marzieh Saei Ghare Naz ◽  
Razieh Bidhendi Yarandi ◽  
Samira Behboudi-Gandevani
Keyword(s):  
Systematic Review ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Diagnostic Criteria ◽  
Meta Analysis ◽  
Population Based ◽  
Maternal Outcomes ◽  
Care Providers ◽  
Iadpsg Criteria ◽  
The Impact

This systematic review and meta-analysis aimed to examine the impact of different gestational-diabetes (GDM) diagnostic-criteria on the risk of adverse-maternal-outcomes. The search process encompassed PubMed (Medline), Scopus, and Web of Science databases to retrieve original, population-based studies with the universal GDM screening approach, published in English language and with a focus on adverse-maternal-outcomes up to January 2020. According to GDM diagnostic criteria, the studies were classified into seven groups. A total of 49 population-based studies consisting of 1409018 pregnant women with GDM and 7,667,546 non-GDM counterparts were selected for data analysis and knowledge synthesis. Accordingly, the risk of adverse-maternal-outcomes including primary-cesarean, induction of labor, maternal-hemorrhage, and pregnancy-related-hypertension, overall, regardless of GDM diagnostic-criteria and in all diagnostic-criteria subgroups were significantly higher than non-GDM counterparts. However, in meta-regression, the increased risk was not influenced by the GDM diagnostic-classification and the magnitude of the risks among patients, using the IADPSG criteria-classification as the most strict-criteria, was similar to other criteria. In conclusion, a reduction in the diagnostic-threshold increased the prevalence of GDM, but the risk of adverse-maternal-outcome was not different among those women who were diagnosed through more or less intensive strategies. Our review findings can empower health-care-providers to select the most cost-effective approach for the screening of GDM among pregnant women.

scholarly journals Gestational Diabetes Mellitus in Southeast Asia: A Scoping Review

2021 ◽  
Vol 18 (3) ◽  
pp. 1272
Author(s):  
Thubasni Kunasegaran ◽  
Vinod R. M. T. Balasubramaniam ◽  
Valliammai Jayanthi Thirunavuk Arasoo ◽  
Uma Devi Palanisamy ◽  
Amutha Ramadas
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Southeast Asia ◽  
Scoping Review ◽  
Economic Status ◽  
Lifestyle Changes ◽  
Population Characteristics ◽  
Research Trend ◽  
Lifestyle Modifications

A rapid increase in the prevalence of gestational diabetes mellitus (GDM) has been associated with various factors such as urbanization, lifestyle changes, adverse hyperglycemic intrauterine environment, and the resulting epigenetic changes. Despite this, the burden of GDM has not been well-assessed in Southeast Asia. We comprehensively reviewed published Southeast Asian studies to identify the current research trend in GDM in this region. Joanna Briggs Institute’s methodology was used to guide the scoping review. The synthesis of literature findings demonstrates almost comparable clinical evidence in terms of risk factors and complications, challenges presented in diagnosing GDM, and its disease management, given the similarities of the underlying population characteristics in Southeast Asia. Evidence suggests that a large proportion of GDM risk in women may be preventable by lifestyle modifications. However, the GDM burden across countries is expected to rise, given the heterogeneity in screening approaches and diagnostic criteria, mainly influenced by economic status. There is an urgent need for concerted efforts by government and nongovernmental sectors to implement national programs to prevent, manage, and monitor the disease.

Multicentre Study of Endo-Ectoparasite Infection in Italian Cats

2021 ◽  
Author(s):  
Marco Genchi ◽  
ALICE VISMARRA ◽  
STEFANIA ZANET ◽  
SIMONE MORELLI ◽  
ROBERTA GALUPPI ◽  
...  
Keyword(s):  
Risk Factors ◽  
Geographic Area ◽  
Human Infection ◽  
Diagnostic Methods ◽  
Effective Control ◽  
Entire Study ◽  
Private Households ◽  
Health Concept ◽  
Study Population ◽  
The One

Abstract BackgroundParasites infecting cats include protozoa, helminths and arthropods. Many are also transmissible to humans. Effective control relies on knowledge of parasite distribution and risk factors for infection. The present study was aimed at evaluating prevalence of major feline parasites in Italy and risk factors associated with their occurrence.MethodsOver a 12-month study period, thirteen study centers across Italy analyzed feces, hair and ectoparasites from naturally infected cats coming from feral colonies, shelters and private households. Samples from cats (n=987) were analyzed by all centers using the same diagnostic methods. Prevalence values and risk factors were evaluated statistically for identification of predictors of risk. ResultsThe overall prevalence of gastro-intestinal (GI) and bronco-pulmonary (BP) nematodes was 35.9% (354/987). T. cati was the most prevalent species (253/987; 25.6%), followed by hookworms (98/987; 9.9%). Among BP nematodes, A. abstrusus was the most common (76/987; 7.7%). Approximately 35.7% (352/987) of the study population was infested by ectoparasites. The most common were fleas 29.4% (290/987), followed by ear mites O. cynotis 9.8% (97/987).Predictors of risk for parasite infection included age, a predominantly or exclusively outdoor lifestyle, geographic area and lack of anti-parasitic treatment.ConclusionBoth ecto- and endoparasites are still common in cats throughout Italy, many of them being of zoonotic concern and vectors of pathogens to humans. Given the presence of parasites throughout the entire study period, year-round treatment should be considered. Furthermore, data confirm the need to protect the human-animal bond using proper endo- and ecto-parasiticides to reduce the risk of human infection, in application of the One-Health concept.

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