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 Prevalence and cause of gestational diabetes mellitus in a tertiary care center in Kolar district: a population based study

2019 ◽  
Vol 8 (7) ◽  
pp. 2709
Author(s):  
Poojita Tummala ◽  
Munikrishna M. ◽  
Kiranmayee P.
Keyword(s):  
Diabetes Mellitus ◽  
Family History ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Tertiary Care ◽  
Oral Glucose ◽  
Care Hospital ◽  
Family History Of Diabetes ◽  
History Of

Background: Gestational diabetes mellitus (GDM) is carbohydrate intolerance at the onset of pregnancy which induces pathological short term or long term outcomes for both mother and baby. The aim of the present study was to know the prevalence of GDM in pregnant women who were attending the antenatal care (ANC) center at a tertiary care hospital in Kolar, Karnataka, India.Methods: This prospective study was conducted in Department of Obstetrics and Gynecology, Sri Devaraj Urs Medical College, a constituent of Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India. The duration of the study was two months. In this study, 108 pregnant women above 24 weeks of gestation were screened for GDM by oral glucose tolerance test. Fasting 2 milli liter blood was collected and were given 75 grams of glucose in 200 milli liters of water and asked to drink within 5 minutes. Again 2 milli liters venous blood was collected after 1 hour and 2 hours from all participants. Plasma sample was used for the estimation of glucose by glucose oxidase and peroxidase (GOD-POD) method.Results: Out of 108, 12 women (11.1%) were diagnosed with GDM. The prevalence rate was higher in the age group of 26-30 years (41.6%).  Among 12 diabetic women, five (47.2%) exercised regularly and seven (58.3%) did not doing exercise. Out of 12 GDM subjects, eight of them had family history of diabetes in first degree relatives; among which one was hypertensive and five were suffering from thyroid problems.Conclusions: In the present study, the prevalence of GDM was found to be 11.1%. Prevalence of GDM might be influenced by increasing age, pre pregnancy weight, family history of diabetes, past history of pregnancy complications, status of literacy and exercise.

Lipid Profile in Pregnant Women with and without Gestational Diabetes Mellitus: A Case-Control Study

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Zeynab Farsangi ◽  
Ghazal Zoghi ◽  
Masoumeh Kheirandish ◽  
Roghayeh Shahbazi ◽  
Masoumeh Mahmoudi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Lipid Profile ◽  
Gestational Age ◽  
Demographic Data ◽  
Density Lipoprotein ◽  
Tolerance Test ◽  
Oral Glucose

Background: Gestational diabetes mellitus (GDM), the most common metabolic disorder of pregnancy, is associated with alterations in circulating lipids. Objectives: The aim of this study was to compare lipid profiles in women with and without GDM. Methods: This study was performed on 84 pregnant women at 26 - 30 weeks of gestation (42 pregnant women with GDM as cases and 42 healthy pregnant women as controls). After obtaining informed consent and gathering demographic data, subjects underwent a 75 g oral glucose tolerance test, and lipid profile was also measured in all subjects. Results: We found that high-density lipoprotein (HDL) levels were significantly higher in the GDM group (53.10 ± 1.72 vs. 46.64 ± 1.70 mg/dL, P = 0.008). Total cholesterol (228.96 ± 52.03 vs. 211.59 ± 41.83 mg/dL) and triglyceride (TG) levels (225.58 ± 89.84 vs 208.38 ± 80.66 mg/dL) were also higher in the GDM group; however, the differences were not statistically significant (P = 0.770 and P = 0.327, respectively). On the contrary, low-density lipoprotein was found to be non-significantly higher in the healthy group (144.54 ± 26.01 vs 122.41 ± 4.82 mg/dL, P = 0.709). Besides, there was a significant association between HDL levels and GDM (OR 1.049; CI 95% (1.009 - 1.090), P = 0.015). This association remained significant when adjusted for age, BMI, and gestational age (OR 1.010; CI 95% (1.002 - 1.017), P = 0.009). No significant association was found between GDM and TG, cholesterol, and LDL levels. Conclusions: HDL levels are significantly higher in pregnant women with GDM compared to pregnant women without GDM. HDL level is significantly associated with GDM even after adjustment for age, BMI, and gestational age.

scholarly journals One step procedure for screening and diagnosis of gestational diabetes mellitus by diabetes in pregnancy study group of India

2019 ◽  
Vol 8 (8) ◽  
pp. 3344
Author(s):  
Dwarakanath L. ◽  
Hema K. R. ◽  
Hemashree P.
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Universal Screening ◽  
Glucose Load ◽  
Diabetes In Pregnancy ◽  
Step Procedure ◽  
One Step ◽  
Screening And Diagnosis

Background: In the Indian context, screening for Diabetes is essential in all pregnant women, as the Indian women have an eleven-fold increased risk of developing glucose intolerance during pregnancy. For this, we need a simple procedure which is economical and feasible. Hence this study was undertaken as a screening as it is acceptable, economical and feasible to perform. Aim of this study was to assess the feasibility of one step procedure for screening and diagnosis of Gestational Diabetes Mellitus by Diabetes in Pregnancy Study Group of India (DIPSI).aim of the study was to study the occurrence of Gestational Diabetes mellitus, Tumkur, to assess the sensitivity and specificity of glucose challenge test, to assess the need for universal screening and to study the maternal and perinatal outcomes in patient with Gestational Diabetes Mellitus.Method: Type of study was prospective study. this study included 200 pregnant women attending the antenatal OPD in Sri Siddhartha Medical College, Tumkur. Data collection was in a predesigned proforma. Pregnant women with 24-28 weeks of gestation were given 75 grams of oral glucose load, irrespective of their meal and venous blood sample drawn after 2 hours. If blood glucose value was ≥140mg/dl, the screening was considered as DIPSI positive. These patients underwent OGTT.Results: Incidence of GDM was found to be 3.5% in the patients studied. 40% of cases did not have risk factors, hencethere is a need for universal screening. DIPSI was positive in 10 cases, of which 7 were OGTT positive. Patients were managed with diet and insulin. The maternal and perinatal outcome of pregnancy was good.Conclusion: For universal screening, DIPSI performed irrespective of last meal timing with 75g glucose load is a patient friendly approach. This method recommended by WHO serves both as a one-step screening and diagnostic procedure & is easy to perform besides being economical.

scholarly journals Pregnancy course and outcome peculiarities in women with gestational diabetes mellitus

2018 ◽  
Vol 26 (1) ◽  
pp. 96-105 ◽  
Author(s):  
S. V. Yankina ◽  
N. V. Shatrova ◽  
S. V. Berstneva ◽  
D. N. Pavlov
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Adverse Outcomes ◽  
Chronic Pyelonephritis ◽  
Oral Glucose ◽  
Threatened Miscarriage ◽  
Perinatal Center ◽  
Adverse Pregnancy

Gestational diabetes mellitus (GDM) is a serious medical and social problem, because it greatly increases the frequency of adverse pregnancy outcomes for mother and fetus. The frequency of GDM in the general population of different countries varies from 1% to 14% and average 7%, in Russia this figure is estimated at 4.5%. Aim. To evaluate the prevalence of GDM in Ryazan Regional clinical perinatal center for the last 3 years and examine its influence on the course and outcome of pregnancy. Materials and Methods. The analysis of the birth history data and exchange cards of 1690 pregnant women from 2015 to 2017 at Ryazan Regional clinical perinatal center. Results. GDM was diagnosed in 193 women (prevalence – 11.4%), with 62 pregnant women on the basis of the results of oral glucose tolerance test performed in the period of 24-30 weeks. It was established that the course of pregnancy and delivery in patients with GDM was characterized by a high percentage of complications (late gestosis – 18.1%, anemia – 11.3%, swelling – 11.9%, early toxicosis – 4.6%, poly-hydramnios – 12.4%, chronic pyelonephritis – 5.1% and threatened miscarriage – 3.6%). Pregnancy outcome study revealed that the majority – 60.6% of pregnancies ended in natural births. Preterm birth was noted in 15% of cases, of which 2 cases were of perinatal fetal death. The frequency of delivery by cesarean section – 39.4%. The frequency of childbirth large fetus was 21.8%, higher than in women with normal blood glucose levels. Conclusions. The prevalence of GDM in Ryazan Regional clinical perinatal center for the last 3 years was 11.4%. Complications during pregnancy were observed in 153 women (79.2%) of with GDM. The most frequent complications were; late gestosis, pregnancy anemia, edema, early toxemia, polyhydramnios, chronic pyelonephritis, and threatened miscarriage. In pregnant women with GDM, adverse outcomes of pregnancy were more common than in women with normoglycemia. Significant differences were obtained in the frequency of premature birth, macrosomia of the fetus and asphyxia during childbirth.

scholarly journals Screening of gestational diabetes mellitus using fasting plasma glucose before the 24th gestational week in women with different pre-pregnancy body mass index

2020 ◽  
Vol 7 (2) ◽  
pp. 218
Author(s):  
Sambit Das ◽  
Mahesh Rath ◽  
Lipsa Das ◽  
Kasturi Bharadwaj
Keyword(s):  
Diabetes Mellitus ◽  
Body Mass Index ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Body Mass ◽  
Gestational Age ◽  
Overweight And Obesity ◽  
Oral Glucose ◽  
Gestational Week ◽  
Overweight Or Obesity

Background: Gestational Diabetes Mellitus (GDM) is usually diagnosed between 24th and 28th gestational week using the 75-g Oral Glucose Tolerance Test (OGTT). It is controversial that if FPG ≥92 mg/dL before 24th gestational week should be intervened or not. The aim of this study was to evaluate the value of FPG to screen GDM before 24th gestational week in women with different pre-pregnancy Body Mass Index (BMI).Methods: This was a hospital based retrospective cohort study done at CHC Balipatna, Khurdha, Odisha. Women who had a singleton live birth between June 20, 2016 and June 30, 2019, resided in Balipatna block area and received prenatal care in the Community Health Centre, were included in this study. Pre-pregnancy BMI, FPG before the 24th gestational week, and one-step GDM screening with 75 g-OGTT at the 24th to 28th gestational weeks were extracted from medical records and analyzed. The pregnant women were classified into four groups based on pre-pregnancy BMI: Group A (underweight), Group B (normal), Group C (overweight) and Group D (obesity). Statistical analysis using independent sample t-test, Analysis of Variance (ANOVA) and Pearson Chi-square test was done.Results: The prevalence of GDM was 20.0% (68/341) in the study population. FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week. The incidence of GDM in women with FPG ≥92 mg/dL in the 19th to 24th gestational weeks and pre-pregnancy overweight or obesity was significantly higher than that in women with FPG ≥92 mg/dL and pre-pregnancy BMI <24.0 kg/m2.Conclusions: FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week. Pre-pregnancy overweight or obesity was associated with an increased FPG value before the 24th gestational week. FPG ≥92 mg/dL between 19 and 24 gestational weeks should be treated as GDM in women with pre-pregnancy overweight and obesity.

scholarly journals Circulating progranulin levels in women with gestational diabetes mellitus and healthy controls during and after pregnancy

2012 ◽  
Vol 167 (4) ◽  
pp. 561-567 ◽  
Author(s):  
Jelena Todoric ◽  
Ammon Handisurya ◽  
Thomas Perkmann ◽  
Bernhard Knapp ◽  
Oswald Wagner ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Post Partum ◽  
Oral Glucose ◽  
Positive Correlation

ObjectiveProgranulin (PGRN) was recently introduced as a novel marker of chronic inflammatory response in obesity and type 2 diabetes capable of directly affecting the insulin signaling pathway. This study aimed to investigate the role of PGRN in gestational diabetes mellitus (GDM), which is regarded as a model for early type 2 diabetes.MethodsPGRN serum levels were measured in 90 pregnant women (45 GDM and 45 normal glucose tolerance (NGT)). In addition, PGRN was measured during a 2-h, 75 g oral glucose tolerance test in 20 pregnant women (ten GDM and ten NGT) and in 16 of them post partum (ten GDM and six NGT).ResultsPGRN concentrations were significantly higher in pregnant women compared with post partum levels (536.79±31.81 vs 241.53±8.86, P<0.001). Multivariate regression analyses showed a strong positive correlation of PGRN with estrogen and progesterone. The insulinogenic index, a marker of early insulin secretion, displayed a positive correlation with PGRN, both during and after pregnancy (R=0.47, P=0.034; R=0.63, P=0.012). HbA1c and the oral glucose insulin sensitivity index showed significant post partum associations with PGRN (R=0.43, P=0.049; R=−0.65, P=0.009).ConclusionsPGRN concentrations are markedly lower after pregnancy regardless of the gestational glucose tolerance state. PGRN levels per se do not discriminate between mild GDM and NGT in pregnant women. Therefore, the development of GDM appears to be due to impaired β-cell function that is not related to PGRN effect.

scholarly journals Differential Changes in Akt and AMPK Phosphorylation Regulating mTOR Activity in the Placentas of Pregnancies Complicated by Fetal Growth Restriction and Gestational Diabetes Mellitus With Large-For-Gestational Age Infants

2021 ◽  
Vol 8 ◽  
Author(s):  
Tai-Ho Hung ◽  
Chung-Pu Wu ◽  
Szu-Fu Chen
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Gestational Age ◽  
Fetal Growth Restriction ◽  
Large For Gestational Age ◽  
Mtor Phosphorylation ◽  
Mtor Activity

Background: Dysregulation of placental mechanistic target of rapamycin (mTOR) activity has been implicated in the pathophysiology of pregnancies complicated by idiopathic fetal growth restriction (FGR) and gestational diabetes mellitus (GDM) with large-for-gestational-age (LGA) infants. However, the underlying mechanisms remain unclear.Methods: We obtained placentas from women with normal pregnancies (n = 11) and pregnancies complicated by FGR (n = 12) or GDM with LGA infants (n = 12) to compare the levels of total and phosphorylated forms of Akt, AMPK, TSC2, and mTOR among the three groups and used primary cytotrophoblast cells isolated from 30 normal term placentas to study the effects of oxygen–glucose deprivation (OGD) and increasing glucose concentrations on the changes of these factors in vitro.Results: Placentas from FGR pregnancies had lower phosphorylated Akt (p-Akt) levels (P &lt; 0.05), higher p-AMPKα levels (P &lt; 0.01), and lower mTOR phosphorylation (P &lt; 0.05) compared to that of normal pregnant women. Conversely, women with GDM and LGA infants had higher p-Akt (P &lt; 0.001), lower p-AMPKα (P &lt; 0.05), and higher p-mTOR levels (P &lt; 0.05) in the placentas than normal pregnant women. Furthermore, primary cytotrophoblast cells subjected to OGD had lower p-Akt and p-mTOR (both P &lt; 0.05) and higher p-AMPKα levels (P &lt; 0.05) than those cultured under standard conditions, but increasing glucose concentrations had opposite effects on the respective levels. Administering compound C, an AMPK inhibitor, did not significantly affect Akt phosphorylation but partially reversed mTOR phosphorylation. Administering LY294002, an Akt inhibitor, decreased p-mTOR levels, but did not change the levels of total and phosphorylated AMPKα.Conclusion: These results suggest that Akt and AMPK are involved in the regulation of trophoblast mTOR activity in the placentas of pregnancies complicated by FGR and GDM with LGA infants.

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