The Infant Born to a Woman with Gestational Diabetes

2017 ◽  
Vol 36 (4) ◽  
pp. 239-244 ◽  
Author(s):  
Theresa Povinelli ◽  
Caitlin Lim ◽  
Deborah A. Raines
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Amino Acids ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Glucose Intolerance ◽  
Frequent Episodes ◽  
Altered Glucose

AbstractGestational diabetes mellitus (GDM) is defined as glucose intolerance with onset during pregnancy. During pregnancy, women with GDM develop insulin resistance, which results in altered glucose tolerance. As a result, there are frequent episodes of hyperglycemia and high levels of circulating amino acids, increasing the transfer of nutrients to the fetus. This article discusses the role of the mother–baby nursing in the care of neonates born to women with gestational diabetes.

scholarly journals CTRP-1 levels are related to insulin resistance in pregnancy and gestational diabetes mellitus

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Carola Deischinger ◽  
Karoline Leitner ◽  
Sabina Baumgartner-Parzer ◽  
Dagmar Bancher-Todesca ◽  
Alexandra Kautzky-Willer ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
High Risk Population ◽  
Sensitivity Index ◽  
Phase Index ◽  
Matsuda Index ◽  
In Pregnancy

Abstract Recent studies have shown higher levels of CTRP-1 (C1QTNF-related protein) in patients with type 2 diabetes compared to controls. We aimed at investigating CTRP-1 in gestational diabetes mellitus (GDM). CTRP-1 levels were investigated in 167 women (93 with normal glucose tolerance (NGT), 74 GDM) of a high-risk population for GDM. GDM was further divided into GDM subtypes depending on a predominant insulin sensitivity issue (GDM-IR) or secretion deficit (GDM-IS). Glucose tolerance was assessed with indices [Matsuda index, Stumvoll first phase index, insulin-secretion-sensitivity-index 2 (ISSI-2), area-under-the-curve (AUC) insulin, AUC glucose] derived from an oral glucose tolerance test (oGTT) performed at < 21 and 24–28 weeks of gestation. In pregnancy, CTRP-1 levels of GDM (76.86 ± 37.81 ng/ml) and NGT (82.2 ± 35.34 ng/ml; p = 0.104) were similar. However, GDM-IR women (65.18 ± 42.18 ng/ml) had significantly lower CTRP-1 levels compared to GDM-IS (85.10 ± 28.14 ng/ml; p = 0.009) and NGT (p = 0.006). CTRP-1 levels correlated negatively with weight, AUC insulin, Stumvoll first phase index, bioavailable estradiol and positively with HbA1c, Matsuda Index and ISSI-2. A multiple regression analysis revealed bioavailable estradiol (β = − 0.280, p = 0.008) and HbA1c (β = 0.238; p = 0.018) as the main variables associated with CTRP-1 in GDM. Postpartum, waist and hip measurements were predictive of CRTP-1 levels instead. CTRP-1 levels were higher postpartum than during pregnancy (91.92 ± 47.27 vs.82.44 ± 38.99 ng/ml; p = 0.013). CTRP-1 is related to insulin resistance in pregnancy and might be a metabolic biomarker for insulin resistance in GDM. CTRP-1 levels were significantly lower during pregnancy than postpartum, probably due to rising insulin resistance during pregnancy.

scholarly journals Expression of Dual-Specificity Phosphatase 9 in Placenta and Its Relationship with Gestational Diabetes Mellitus

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Qiang Wei ◽  
Xiaomin Pu ◽  
Li Zhang ◽  
Yi Xu ◽  
Meifan Duan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Body Mass Index ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Plasma Glucose ◽  
Mrna Levels ◽  
Gestational Week

Introduction. The aim of the present study was to examine placental levels of DUSP9 mRNA and protein and to investigate the potential role of DUSP9 in the development of gestational diabetes mellitus (GDM). Methods. Placental tissues from pregnant women with GDM (n=17) and normal healthy pregnant women (n=16) were collected at delivery. The expression of DUSP9 mRNA in placental tissue was analyzed by real-time PCR, while the expression of DUPS9 protein was evaluated by immunohistochemistry and western blot. Differences in the expression levels of DUSP9 mRNA and protein between the two groups were assessed, as well as potential correlations between DUSP9 mRNA expression levels and relevant clinical indicators. Results. Blood glucose levels were significantly higher in the GDM group than in the control group, based on an oral glucose tolerance test. DUSP9 protein was expressed in the placental cytotrophoblasts in both groups, and placental levels of DUSP9 protein and mRNA were significantly higher in women with GDM. Placental DUSP9 mRNA levels in all 33 women correlated moderately with delivery gestational week (R=0.465, P=0.006), fasting plasma glucose (R=0.350, P=0.046), 1-hour postload plasma glucose (R=0.363, P = 0.038), and 2-hour postload plasma glucose (R=0.366, P=0.036), but not with maternal age, preconception body mass index, prenatal body mass index, or neonatal birth weight. Multiple linear regression analysis indicated that delivery gestational week was an influence factor of DUSP9 mRNA levels (β1=0.026, P<0.05). Conclusions. DUSP9 upregulation in the placenta of GDM pregnant women may promote insulin resistance, which may correlate with the occurrence of GDM. But there is still possibility that DUSP9 upregulation was the results of insulin resistance and/or hyperglycemia. Further research is needed to explore the role of DUSP9 in GDM.

scholarly journals Effects of Astaxanthin on Inflammation and Insulin Resistance in a Mouse Model of Gestational Diabetes Mellitus

Dose-Response ◽  
2020 ◽  
Vol 18 (2) ◽  
pp. 155932582092676
Author(s):  
Weihong Feng ◽  
Yanxia Wang ◽  
Na Guo ◽  
Pu Huang ◽  
Yang Mi
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Skeletal Muscle ◽  
Insulin Sensitivity ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Mouse Model ◽  
Gestational Diabetes Mellitus ◽  
The Body ◽  
Ros Generation

Gestational diabetes mellitus (GDM) is a condition in which a hormone made by the placenta prevents the body from using insulin effectively. It is important to find an effective treatment. A mouse model of GDM was used to testify the effects of astaxanthin on glucose tolerance and insulin sensitivity. Production of inflammatory cytokines, reactive oxygen species (ROS), and glucose transporter type 4 (GLUT4) translocation and insulin-related signaling were measured in the presence of astaxanthin both in vivo and in vitro. It was found that astaxanthin improved insulin sensitivity, glucose tolerance, and litter size of offspring and reduced birth weight of offspring and inflammation in GDM mouse. Moreover, astaxanthin increased GLUT4 translocating to membrane without altering its secretion/expression and glucose uptake and consumption in C2C12 skeletal muscle cells. Furthermore, ROS generation and insulin-related signaling inhibited by tumor necrosis factor α was restored by astaxanthin. It is concluded that astaxanthin has the potential to attenuate GDM symptoms by regulating inflammation and insulin resistance in skeletal muscle of pregnant mice. Our findings suggest that astaxanthin could be a promising and effective molecule to treat GDM.

scholarly journals Leaner Women with Impaired Insulin Secretion Accounts for about 40% of Gestational Diabetes Mellitus in Japan

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Seishi Furukawa ◽  
Yoichi Kobayashi
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Insulin Secretion ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Model Assessment ◽  
Homeostasis Model Assessment ◽  
Impaired Insulin Secretion ◽  
Impaired Insulin

Aim. To identify the involvement of leanness and impaired insulin secretion with Japanese gestational diabetes mellitus (GDM). Method. A cross-sectional study was conducted comprising 219 at-risk pregnant women who underwent a 75g glucose tolerance test at a single institute in Tokyo, Japan. We identified GDM and normal glucose tolerance (NGT). The cut-off value of the homeostasis model assessment insulin resistance (HOMA-IR) for detecting GDM was determined. The GDM group was divided into subgroups according to insulin resistance based on the cut-off value of HOMA-IR. We compared the prepregnancy body mass index (BMI) and homeostasis model assessment of β-cell function (HOMA-β) between the group comprising low insulin resistance (LIR) and the group comprising high insulin resistance (HIR). Results. Seventy GDM cases and 149 NGT cases were identified. By using receiver operating characteristic curve analysis, the HOMA-IR cut-off value was determined to be 1.41. Twenty-five GDM cases (36%) were classified as LIR and forty-five GDM cases (64%) were classified as HIR. The background including indications for having 75gOGTT and the gestational age having 75gOGTT did not differ between groups. The BMI of the LIR group was significantly lower than that of the HIR group (20.9±2.8 vs. 24.4 ± 5.5, p<0.01), and the HOMA-β of the LIR group was significantly lower than that of the HIR group (95.5±30.3 vs. 146.0±70.1, p<0.01). A positive linear correlation was found between BMI and HOMA-β in cases of GDM (r=0.27, p=0.02). Conclusion. Leanness with impaired insulin secretion is deeply involved in Japanese gestational diabetes mellitus.

scholarly journals Declined GDCA is Correlated With Adverse Clinical Outcome For Gestational Diabetes Mellitus

2020 ◽  
Author(s):  
Bo Zhu ◽  
Zhixin Ma ◽  
Yuning Zhu ◽  
Lei Fang ◽  
Hong Zhang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Gestational Diabetes ◽  
Clinical Outcome ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Bile Acids ◽  
Gestational Age ◽  
Resistance Index ◽  
Oral Glucose

Abstract BackgroundGestational diabetes mellitus (GDM) is characterized by glycemia and insulin disorders. Bile acids (Bas) have emerged as vital signaling molecules in glucose metabolic regulation. Bas change in GDM are still unclear, it exerts great significance to illustrate the change of Bas in GDM.MethodsWe organized GDM patient (n = 67) and normal pregnant women (n = 48) around the oral glucose tolerance test (OGTT) screening period, fasting serums were collected for the measurement of Bas. Clinical data were collected and Bas metabolism profiles were analyzed in GDM and normal glucose tolerance (NGT). Delivery characteristics, delivery gestational age and infant birthweight were abstracted from medical record.ResultsGDM patients exert the distinctive features compared with NGT, including higher BMI, glucose, insulin (both fasting and OGTT) and HbA1c levels. GDM also gained higher insulin resistance index (HOMA-IR) and decreased β-cell compensation (DIo). Total bile acids (TBA) remained stable, but glycodeoxycholic acid (GDCA) and taurodeoxycholic acid (TDCA) declined significantly in GDM. GDCA was inversely correlated with HOMA-IR and positively correlated with DIo. There exists no obvious difference in clinical outcome between GDM and NGT. However, GDM patients with high HOMA-IR and low DIo are inclined to suffering higher cesarean delivery rate and earlier delivery gestational age.ConclusionsGDCA could be a valuable biomarker to evaluate insulin resistance and DIo, decreased GDCA predicts worse clinical outcome of GDM.

scholarly journals The role of obesity and adipose tissue dysfunction in gestational diabetes mellitus

2018 ◽  
Vol 238 (2) ◽  
pp. R63-R77 ◽  
Author(s):  
Patrik Šimják ◽  
Anna Cinkajzlová ◽  
Kateřina Anderlová ◽  
Antonín Pařízek ◽  
Miloš Mráz ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Adipose Tissue ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Current Knowledge ◽  
Peripheral Insulin Resistance ◽  
Adipose Tissue Dysfunction ◽  
History Of

Gestational diabetes mellitus is defined as diabetes diagnosed in the second or third trimester of pregnancy in patients with no history of diabetes prior to gestation. It is the most common complication of pregnancy. The underlying pathophysiology shares some common features with type 2 diabetes mellitus (T2DM) combining relatively insufficient insulin secretion with increased peripheral insulin resistance. While a certain degree of insulin resistance is the physiological characteristics of the second half of pregnancy, it is significantly more pronounced in patients with gestational diabetes. Adipose tissue dysfunction and subclinical inflammation in obesity are well-described causes of increased insulin resistance in non-pregnant subjects and are often observed in individuals with T2DM. Emerging evidence of altered adipokine expression and local inflammation in adipose tissue in patients with gestational diabetes suggests an important involvement of adipose tissue in its etiopathogenesis. This review aims to summarize current knowledge of adipose tissue dysfunction and its role in the development of gestational diabetes. We specifically focus on the significance of alterations of adipokines and immunocompetent cells number and phenotype in fat. Detailed understanding of the role of adipose tissue in gestational diabetes may provide new insights into its pathophysiology and open new possibilities of its prevention and treatment.

scholarly journals Gestational Diabetes Mellitus a Dysfunctional Metabolic State-A Perspective

2019 ◽  
Vol 1 (2) ◽  
pp. 24-28
Author(s):  
Dhastagir Sultan Sheriff ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Beta Cell ◽  
Glucose Intolerance ◽  
Fat Deposition ◽  
Fine Tuning ◽  
Lipid Deposition ◽  
Metabolic State

Pregnancy is considered as a test for beta cell reserve. If there is a good function, insulin resistance will overcome. If not, gestational diabetes will occur. Insulin resistance (IR) present in normal pregnancy is required to provide nutrients to the growing fetus. There is a rapid increase of insulin in such an insulin resistant state. The possibility of lipid deposition in muscle fibers (intramyocellular) could be one of the possible mechanism of IR in gestational diabetes mellitus (GDM). The poor response of insulin release, possible fat deposition in the skeletal muscle or ectopic fat deposition may cause dysfunctional homeostasis in GDM. This will definitely influence the fine tuning of metabolic machinery of a growing fetus. Children born with such subtle metabolic state will probably be more prone to glucose intolerance and ectopic lipid deposition. The finding that children born to GDM mothers are prone to glucose intolerance may be an eye-opener to monitor such children for beta cell function.

scholarly journals Adiponectin , ?-Cell Dysfunction in Iraqi Women with Gestational Diabetes

2016 ◽  
Vol 13 (2) ◽  
pp. 366-374
Author(s):  
Baghdad Science Journal
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Control Group ◽  
Low Grade ◽  
C Reactive Protein ◽  
Cell Dysfunction ◽  
Reactive Protein

Gestational diabetes mellitus (GDM) is a complication of gestation that is characterized by impaired glucose tolerance with first recognition during gestation. It develops when ?- cell of pancreas fail to compensate the diminished insulin sensitivity during gestation. This study aims to investigate the relationship between mother adiponectin level and ?- cell dysfunction with development gestational diabetes mellitus (GDM) and other parameters in the last trimester of pregnancy. This study includes (80) subjects ( pregnant women) in the third trimester of pregnancy, (40) healthy pregnant individuals as control group aged between (17 - 42) years and (40) gestational diabetes mellitus patients with aged between (20 - 42) years. The following biochemical investigation is studied: oral glucose tolerance test (OGTT), adiponectin , insulin, C-reactive protein (CRP),body mass index (BMI), and homeostasis model assessment- insulin resistance (HOMA – IR). The adiponectin levels are significantly lesser in females who develop GDM than the control group (P?0.01), while the insulin and OGTT concentrations were significantly higher in females with GDM than control group (P?0.01).The concentrations of CRP are non significantly different between the females who develop GDM and the control group.Conclusions: Lower adiponectin concentrations are associated with an increased risk of the development of gestational diabetes mellitus and females, who develop gestational diabetes mellitus, have higher levels of insulin resistance from normal females, Obesity is a shape of persistent low grade inflammation which causes elevated concentrations of C- reactive protein.

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