scholarly journals Efficacy of Shenqi Jiangtang Granules-Assisted Western Medi-cine in the Treatment of Gestational Diabetes Mellitus (GDM)

Author(s):  
Juan Tang ◽  
Li Fan ◽  
Chunlei Lv ◽  
Runjie Wan ◽  
Jianjian Liu ◽  
...  

Background: We aimed to investigate the efficacy of Shenqi Jiangtang granules-assisted Western medicine in the treatment of gestational diabetes mellitus (GDM). Methods: A total of 147 patients with GDM treated in Qilu Hospital of Shandong University from Jan 2018 to Apr 2019 were enrolled. They were randomly divided into traditional Chinese medicine (TCM) combined with Western medicine group, Western medicine group and control group. The control group was treated with exercise combined with diet therapy, and the Western medicine group was additionally treated with metformin tablets. The TCM combined with Western medicine group was additionally treated with Shenqi Jiangtang granules. Results: After treatment, the levels of 10 indicators in the three groups were lower than those before treatment (P < 0.05). These indicators were the lowest in the TCM combined with Western medicine group. However, high-density lipoprotein cholesterol (HDL-C), glutathione peroxidase (GSH-PX) and superoxide dismutase (SOD) after treatment increased in the three groups compared with those before treatment (P < 0.05), which was the most obvious in the TCM combined with Western medicine group. After treatment, the number of patients with natural delivery in the TCM combined with Western medicine group was the largest. The incidences of complications in pregnant women, fetuses and newborns were the lowest in the TCM combined with Western medicine group. Conclusion: Application of Shenqi Jiangtang granules-assisted Western medicine in patients with GDM can effectively control blood glucose and lipid levels, enhance antioxidant capacity, reduce the levels of inflammatory cytokines and decrease the incidence of adverse pregnancy outcomes.

2020 ◽  
Vol 47 (10) ◽  
pp. 7537-7546 ◽  
Author(s):  
Wenting Xu ◽  
Mengyu Tang ◽  
Jiahui Wang ◽  
Lihong Wang

Abstract To investigate the effect of puerarin on insulin resistance and inflammation in rats with gestational diabetes mellitus (GDM). Gestational diabetic model rats were established by intraperitoneal injection of streptozotocin (25 mg/kg) combined with high-fat feeding and were randomly assigned to three groups: the control group, the GDM group, and the puerarin-treated group. Puerarin was intragastrically administered to rats daily until the offspring were born. The rats in both the GDM group and control group were administered the same volume of normal saline. Serum total cholesterol, triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol in all groups of rats were measured. Haematoxylin and eosin staining was used to evaluate morphological changes in the liver, pancreas, and adipose tissues around the reproductive organs. Western blotting was carried out to measure the protein expression of IRS-1 and inflammatory factors, including TNF-α, TLR4, MyD88 and phosphorylated NF-κB, in the adipose tissues around the reproductive organs. Puerarin had preventive effects on GDM-induced pathological changes and ameliorated glucose and lipid metabolism disorders in GDM rats. Puerarin upregulated IRS-1 expression and decreased the protein expression of TNF-α, TLR4, and MyD88 as well as the levels of phosphorylated NF-κB in adipose tissues around the reproductive organs in GDM rats. This study indicated that puerarin exerts anti-inflammatory effects by downregulating the important TLR4/MyD88/NF-κB inflammatory signalling pathway. Therefore, puerarin can decrease the expression of TNF-α and ameliorate insulin resistance in GDM rats, suggesting the potential efficacy of puerarin in GDM treatment.


2020 ◽  
Author(s):  
Yuan Li ◽  
Wenqing Chen ◽  
Xiaoqian Wang ◽  
Fengjuan Jiang ◽  
Xiaotian Chen

Abstract Background Dyslipidemia during pregnancy in women with gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) has been extensively studied in western countries. However, similar researches have rarely been conducted in Asia. The present study aimed to evaluate maternal lipid profile changes in relation to pregnancy complications and clinical outcomes.Methods The medical records of 668 pregnant women were retrospectively analyzed. Maternal fasting serum lipids were assayed for total cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), apolipoprotein A1 (Apo A1) and Apo B concentrations during the second trimesters. The atherogenic index of plasma (AIP) was calculated. The pregnancy complications included GDM and HDP. The clinical outcomes were collected by evaluating delivery mode, postpartum hemorrhage, macrosomia, birth weight, body length and neonatal Apgar score.Results Levels of TG and AIP were elevated while decreased TC and HDL-C was observed in women with GDM compared with that of the control group (p < 0.05). TG and AIP in HDP group were higher than in control group (p < 0.05). Significant differences were observed in postpartum hemorrhage, birth weight and body length between control group and women with GDM or HDP (p < 0.05). Compared with women with serum TG ≥ 2.5 mmol/L or TC ≥ 6.2 mmol/L, the incidence of GDM, cesarean section and macrosomia was lower in normal lipid group (p < 0.05). Spearman correlation analysis showed that the incidence of GDM was positively correlated with levels of TG (r = 0.226, p < 0.01) and AIP (r = 0.250, p < 0.01), while negative correlated with TC (r = -0.106, p < 0.01) and HDL-C (r = -0.190, p < 0.01). AIP was correlated positively with the incidence of HDP (r = 0.115, p = 0.043). According to the logistic regression analysis, each unit elevation in AIP increased the risk of GDM by 6.943 times (OR = 6.943, 95% CI: 1.761–27.374).Conclusions Lipid control, especially for women with GDM and HDP, might be a potential strategy for improving the pregnancy outcomes.


Author(s):  
Wardah Ajaz Qazi ◽  
Muhammad Naveed Babur ◽  
Arshad Nawaz Malik ◽  
Nadia Ahmed Bokhari ◽  
Mirza Shamim Baig ◽  
...  

Abstract Objectives: To determine the effects of structured exercise regime on biochemical markers of patients of gestational diabetes mellitus during the third trimester. Methods: The two-arm pilot study was conducted at the Fauji Foundation Hospital, Rawalpindi, Pakistan, from March to July 2019, and comprised women aged 20-40 years with gestational age >20 weeks who were diagnosed with gestational diabetes mellitus and who were able to do 6min walk test under severity level on the 0-10 Borg scale. The subjects were randomized into two groups using the sealed envelope method. The intervention group received 5 weeks of structured exercise programme. including aerobics, stabilisation and pelvic floor muscle training, while the control group only received postural education. Data was noted at baseline and after intervention, and was analysed using SPSS 20. Results: Of the 16 subjects, there were 8(50%) in each of the two groups. The mean age was 31.5±4.17 years in the interventional group and it was 35.0±6.30 years in the control group. Serum low-density lipoprotein and serum creatinine showed significant differences between the groups (p<0.05), while the rest of markers were non-significant (p>0.05). Conclusion: Structured exercise regime was found to have a positive effect in reducing serum low-density lipoprotein and serum creatinine levels in gestational diabetes mellitus during the third trimester. Key Words: Gestational diabetes mellitus, Lipid profile, Renal function tests, Structured exercise regime, Third trimester.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yuan Li ◽  
Xiaoqian Wang ◽  
Fengjuan Jiang ◽  
Wenqing Chen ◽  
Jie Li ◽  
...  

Abstract Background Research on dyslipidemia during pregnancy in women with gestational diabetes mellitus (GDM) has rarely been conducted in Asia. The present study aimed to evaluate maternal mid-trimester lipid profile in relation to GDM and clinical outcomes in these high-risk populations. Methods The medical records of 632 pregnant women in the second trimester were retrospectively analyzed. Maternal fasting serum lipids were assayed for total cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), apolipoprotein A1 (Apo A1) and Apo B concentrations during the second trimester. The atherogenic index of plasma (AIP) was calculated as log (TG/HDL). The clinical outcomes were collected by evaluating delivery mode, postpartum hemorrhage, prematurity, macrosomia, birth weight, body length and neonatal Apgar 5 min score. Results Levels of TG and AIP were elevated while decreased HDL-C was observed in women with GDM compared with that of the control group. Significant differences were observed in gestational weeks at birth, cesarean section, postpartum hemorrhage, birth weight, body length, prematurity and macrosomia between the two groups. Compared with women with hyperlipidemia, the incidence of GDM and cesarean section was lower in normal lipid group. Women in the hyperlipidemia group had smaller gestational weeks at birth than those in the control group. According to the logistic regression analysis, each unit elevation in AIP increased the risk of GDM by 18.48 times (OR = 18.48, CI: 2.38–143.22). Besides, age (OR = 1.11, CI: 1.06–1.16) and pre-pregnancy BMI (OR = 1.15, CI: 1.07–1.24) were the risk factors of GDM. Conclusions These findings suggested that reasonable lipid control in the second trimester might reduce the incidence of GDM and be a potential strategy for improving clinical outcomes in these high-risk women.


Author(s):  
Huri Güvey ◽  
Samettin Çelik ◽  
Canan Soyer Çalışkan ◽  
Zehra Yılmaz ◽  
Merve Yılmaz ◽  
...  

We investigated the question of how serum zonulin levels change in intrahepatic cholestasis of pregnancy (ICP) and gestational diabetes mellitus (GDM) and, in the case of the coexistence of ICP and GDM, evaluated the eventual increase in zonulin plasmatic levels. Participants were enrolled for the study between 25 February 2021 and 20 August 2021. The prospective case-control study included: group 1 of 95 pregnant women diagnosed with ICP; group 2 of 110 pregnant women diagnosed with GDM; group 3 of 16 women diagnosed with both GDM and ICP; group 4 of 136 healthy pregnant women as the control group. The groups were compared in terms of age, body mass index (BMI), gravidity, parity, gestational week of delivery, plasma zonulin levels, delivery type, birth weight, first- and fifth-minute APGAR scores, newborn intensive care unit (NICU) admission, and meconium staining of amniotic fluid parameters. The results suggested that the plasma zonulin levels of ICP (group 1), GDM (group 2), and GDM with ICP (group 3) patients were higher than those of the healthy pregnant women of group 4 (p < 0.001). Among the patient groups, the highest median plasma zonulin levels were found in group 3 (110.33 ng/mL). Zonulin levels were also associated with the severity of ICP and adverse pregnancy outcomes. High serum zonulin levels were related to GDM, ICP, and adverse perinatal outcomes. The coexistence of GDM and ICP led to higher serum zonulin concentrations.


2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Yaer Chen ◽  
Chunbo Qiu ◽  
Jie Chen ◽  
Lu Li ◽  
Jichao Xu ◽  
...  

Abstract Background Gestational diabetes mellitus (GDM) is the most frequent medical complication of pregnancy. This condition is manifested by glucose intolerance resulting in hyperglycemia of variable severity during pregnancy. One of the most important clinical tools for efficiently regulating maternal blood glucose is strictly monitoring blood glucose levels. However, due to a lack of appropriate intervention tools, managing the occurrence of GDM is still unfeasible. This study aimed to determine clinical efficacy of the internet combined with exercise-based individualized nursing intervention in patients with gestational diabetes mellitus (GDM). Methods In total, 139 patients with GDM were divided into two groups, with 79 patients in the observation group (internet combined with exercise-based individualized nursing intervention) and 60 patients in the control group (routine nursing intervention only). The two groups were given specified nursing intervention for 8 weeks and then compared for changes in their blood glucose, blood lipids, blood pressure, insulin resistance (IR), and rate of adverse pregnancy outcomes. Additionally, the psychological state was analyzed, and their nursing satisfaction with the care from nurses that they received was investigated before and after the nursing intervention. Results Compared with the control group, the following indices of the observation group were lowered: blood glucose-related indices (FBG and 2 h PG), blood lipids and blood pressure associated indices (TG, TC, and HbA1c, DBP, SBP, and MAP), and IR-related indices (FINS, 2 h INS, and HOMA -IR) (all P < 0.05). The observation group also showed a lower rate of adverse pregnancy outcomes than the control group (7.59% vs. 20.00%; P < 0.05). In addition, SAS and SDS scores of the observation group were both lower than the control group (P < 0.05). Accordingly, the nursing satisfaction score also displayed that the observation group (93.67%) had a higher satisfaction outcome than the control group (76.67%; P < 0.05). Conclusions Internet combined with exercise-based individualized nursing intervention in GDM patients can effectively improve their blood glucose, IR, and psychological status, thus significantly improving their pregnancy outcomes and mental condition.


2021 ◽  
Vol 14 (03) ◽  
pp. 197-201
Author(s):  
B Swathi ◽  
A Deepthi ◽  
B Sravani ◽  
Rekha ◽  
S Namratha ◽  
...  

Aim: The aim of this study was to compare the effect of Myo-inositol plus diet and diet alone in patients with gestational diabetes mellitus. Materials and methods: A Randomized Prospective study was carried out in Gestational Diabetes Mellitus patients to evaluate the efficacy of Myoinositol+diet vs Diet alone in the department of Gynaecology, Durgabhai Deshmukh Hospital, a 300 bedded multispecialty hospital from September 2018-April 2019.OGTT test was conducted to measure blood glucose levels. Results: Among the total number of patients (60), Myoinositol + diet is given in 50% and diet is given in 50% of the patients. Among 30 patients on diet, 19 patients couldn’t control rising blood glucose levels and were prescribed insulin for reduction of blood glucose levels. Among 30 patients on myoinositol+ diet, 4 patients couldn’t control 1 hr blood glucose levels and were prescribed insulin to control blood glucose levels. Conclusion: This study showed that Myoinositol + diet is effective than only diet with respect to decrease in blood glucose levels and safety among patients with Gestational Diabetes Mellitus. Therefore, we conclude that myoinositol + diet is safe and effective in reducing fasting and 2hr blood glucose levels.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yan Wang ◽  
Biru Luo ◽  
Jie Xiang

Abstract Background The association between soy intake and adverse pregnancy outcomes remains unclear. The objectives of this study were to investigate the soy consumption of pregnant women in the second trimester and explore the prospective association between soy intake and the risk of adverse pregnancy outcomes. Methods Pregnant women between 13 and 24 weeks of gestation were recruited at a women’s and children’s hospital in southwest China from June to December 2019. Dietary intakes in the middle trimester were assessed by a semi-quantitative food frequency questionnaire. Participants were divided into the insufficient group (< 40 g/day) and the control group (≥40 g/day) according to daily soy consumption. Participants were followed up until delivery. Pregnancy outcomes including gestational diabetes mellitus (GDM), cesarean section, and macrosomia were obtained. Multiple logistic regression was used to analyze the association between soy intake and risk of adverse pregnancy outcomes. Sociodemographic information, histories of diseases, and duration of physical activities were obtained and used for covariate adjustments. Results A total of 224 participants were included in this study, of which identified 36 (16.1%) cases of GDM, and 120 (53.6%) cases of cesarean section. More than half (125, 55.8%) pregnant women consumed less soy than 40 g/day. Daily soy intake less than 40 g was associated with the increased risk of GDM (OR = 2.755 95%CI 1.230-6.174, P = 0.014) and cesarean section (OR = 1.792 95%CI 1.035-3.101, P = 0.037) without adjustment for confounders such as age, pre-pregnancy body mass index, parity, daily intake of vegetables, fruits, seafood and, nuts. After adjusting for these factors, daily soy intake of less than 40 g increased 2.116-fold risk of GDM (95%CI 1.228-7.907, P = 0.017), but not with the significantly increased risk of cesarean section. Conclusion Insufficient soy intake may increase the risk of GDM, suggesting adequate soy intake may have a beneficial role in the prevention of GDM. Trial registration Registration number: ChiCTR1900023721. Date of registration: June 9, 2019.


2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Yuwei Wang ◽  
Qianjin Feng ◽  
Xin Niu ◽  
Kaixia Xu ◽  
Yingli Wang ◽  
...  

In this experiment, we used streptozotocin (STZ) to establish a model of gestational diabetes mellitus (GDM) rats, where Zuogui Wan was given to GDM rats. After pregnancy, offspring rats were divided into 4 groups: control group, high fat and sugar as the control group, GDM group, and Zuogui Wan GDM group. Rats in high fat and sugar as the control group, GDM group, and Zuogui Wan GDM group were fed with high fat and sugar diet. Rats in control group were fed the basic diet. The means of 2hPG were higher than 7.8 mmol·L−1and lower than 11.1 mmol·L−1on the rats of GDM group on week 15, and IGT models were successful. Body weight, abdominal fat weight, the ratio of abdominal fat weight and body weight, fasting plasma glucose, 2hPG, insulin, leptin, total cholesterol, and low density lipoprotein (LDL) of Zuogui Wan GDM group were significantly lower than GDM group. The level of adiponectin in Zuogui Wan GDM group was significantly higher than GDM group. And we concluded that giving Zuogui Wan to GDM rats can have a preventive effect on the offsprings’ IGT induced by high fat and sugar diet.


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