Diet and Nutritional Interventions with the Special Role of Myo-Inositol in Gestational Diabetes Mellitus Management. An Evidence-Based Critical Appraisal

2019 ◽  
Vol 25 (22) ◽  
pp. 2467-2473 ◽  
Author(s):  
Enrique Reyes-Muñoz ◽  
Federica Di Guardo ◽  
Michal Ciebiera ◽  
Ilker Kahramanoglu ◽  
Thozhukat Sathyapalan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Metabolic Diseases ◽  
Nutritional Intervention ◽  
Attractive Alternative ◽  
Special Role ◽  
Dose Frequency ◽  
Nutritional Interventions

Background: Gestational Diabetes Mellitus (GDM), defined as glucose intolerance with onset or first recognition during pregnancy, represents one of the most common maternal-fetal complications during pregnancy and it is associated with poor perinatal outcomes. To date, GDM is a rising condition over the last decades coinciding with the ongoing epidemic of obesity and Type 2 Diabetes Mellitus (T2DM). Objective: The aim of this review is to discuss the role of diet and nutritional interventions in preventing GDM with the explanation of the special role of myo-inositol (MI) in this matter. Methods: We performed an overview of the most recent literature data on the subject with particular attention to the effectiveness of diet and nutritional interventions in the prevention of GDM with the special role of MI. Results: Nutritional intervention and physical activity before and during pregnancy are mandatory in women affected by GDM. Moreover, the availability of insulin-sensitizers such as different forms of inositol has dramatically changed the scenario, allowing the treatment of several metabolic diseases, such as those related to glucose dysbalance. Although the optimal dose, frequency, and form of MI administration need to be further investigated, diet supplementation with MI appears to be an attractive alternative for the GDM prevention as well as for the reduction of GDM-related complications. Conclusion: More studies should be conducted to prove the most effective nutritional intervention in GDM. Regarding the potential effectiveness of MI, further evidence in multicenter, randomized controlled trials is needed to draw firm conclusions.

scholarly journals Novel Biomolecules in the Pathogenesis of Gestational Diabetes Mellitus

2021 ◽  
Vol 22 (21) ◽  
pp. 11578
Author(s):  
Monika Ruszała ◽  
Magdalena Niebrzydowska ◽  
Aleksandra Pilszyk ◽  
Żaneta Kimber-Trojnar ◽  
Marcin Trojnar ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Metabolic Diseases ◽  
Fibroblast Growth Factor 21 ◽  
Lipocalin 2 ◽  
Fatty Acid Binding ◽  
Clear Cut

Gestational diabetes mellitus (GDM) is one of the most common metabolic diseases in pregnant women. Its early diagnosis seems to have a significant impact on the developing fetus, the course of delivery, and the neonatal period. It may also affect the later stages of child development and subsequent complications in the mother. Therefore, the crux of the matter is to find a biopredictor capable of singling out women at risk of developing GDM as early as the very start of pregnancy. Apart from the well-known molecules with a proven and clear-cut role in the pathogenesis of GDM, e.g., adiponectin and leptin, a potential role of newer biomolecules is also emphasized. Less popular and less known factors with different mechanisms of action include: galectins, growth differentiation factor-15, chemerin, omentin-1, osteocalcin, resistin, visfatin, vaspin, irisin, apelin, fatty acid-binding protein 4 (FABP4), fibroblast growth factor 21, and lipocalin-2. The aim of this review is to present the potential and significance of these 13 less known biomolecules in the pathogenesis of GDM. It seems that high levels of FABP4, low levels of irisin, and high levels of under-carboxylated osteocalcin in the serum of pregnant women can be used as predictive markers in the diagnosis of GDM. Hopefully, future clinical trials will be able to determine which biomolecules have the most potential to predict GDM.

Dietary Intakes in the Nutritional Management Of Gestational Diabetes Mellitus

2014 ◽  
Vol 75 (2) ◽  
pp. 64-71 ◽  
Author(s):  
Anne-Sophie Morisset ◽  
Julie Anne Côté ◽  
Andréanne Michaud ◽  
Julie Robitaille ◽  
Marie-Christine Dubé ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Group Interaction ◽  
Nutritional Intervention ◽  
P Value ◽  
Institute Of Medicine ◽  
Dietary Intakes ◽  
Post Intervention

Purpose: Changes were examined in energy intakes and percentage of energy from macronutrients in response to nutritional intervention in women with gestational diabetes mellitus (GDM). Methods: The study included 17 women with GDM and 27 women with normal glucose tolerance (controls). Women with GDM were followed by a multidisciplinary team; they received dietary counselling by a registered dietitian, and were prescribed diets with 40% to 45% energy from carbohydrate (CHO), 20% to 25% from protein, and 30% to 35% from fat. Dietary intakes were assessed with food frequency questionnaires before the intervention (26.9 ± 3.8 weeks) and after the intervention (32.6 ± 0.6 weeks). Results: After the intervention, women with GDM reduced their total energy intake to reach lower values than did controls (P value for time-group interaction ≤0.05). A concomitant reduction in total CHO and glucose intakes in women with GDM led to significantly lower values compared with intakes in controls (P values for time-group interaction ≤0.001 for all). The post-intervention rate of weight gain in women with GDM was within the Institute of Medicine (IOM)-recommended values, while the post-intervention rate of weight gain in controls was above IOM-recommended values (0.30 ± 0.27 versus 0.61 ± 0.50 kg/week, P≤0.05). Conclusions: These results suggest that this multidisciplinary medical and nutritional intervention was effective in the achievement of prescribed macronutrient distribution and controlling gestational weight gain in Canadian women with GDM.

scholarly journals The Role of IL-37 and IL-38 in Obstetrics Abnormalities

2021 ◽  
Vol 8 ◽  
Author(s):  
Mei Wang
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Inflammatory Mediator ◽  
Inflammatory Responses ◽  
Medical Practitioners ◽  
Minimal Difference ◽  
Anti Inflammatory ◽  
Umbilical Cords

There are two fairly common complications during pregnancy, i.e., gestational diabetes mellitus (GDM) and pre-eclampsia, which are independent, but are also closely linked in prevalence in pregnant women, with potential serious adverse consequences. IL-37 and IL-38, which belong to the IL-1 superfamily, participate in anti-inflammatory responses. Dysregulation of IL-37 and IL-38 has been observed in many auto-immune diseases. IL-37 is substantially reduced in the umbilical cords and placentas of GDM subjects, but IL-37 is significantly induced in the placentas of pre-eclampsia patients, suggesting there are differential regulatory roles of IL-37 in obstetrics, despite IL-37 being an anti-inflammatory mediator. Furthermore, IL-38 is substantially increased in the umbilical cords and placentas of GDM subjects, but minimal difference is observed in the placentas from pre-eclampsia patients. These data imply that IL-38 is also regulated independently within the diseased placentas. This review provides some insight for both basic scientists and medical practitioners to manage these patients effectively.

The Role of Oxidative Stress in the Pathophysiology of Gestational Diabetes Mellitus

2011 ◽  
Vol 15 (12) ◽  
pp. 3061-3100 ◽  
Author(s):  
Martha Lappas ◽  
Ursula Hiden ◽  
Gernot Desoye ◽  
Julia Froehlich ◽  
Sylvie Hauguel-de Mouzon ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus

The effects of gut microbiota on metabolic outcomes in pregnant women and their offspring

2018 ◽  
Vol 9 (9) ◽  
pp. 4537-4547 ◽  
Author(s):  
You Lv ◽  
Zi Yan ◽  
Xue Zhao ◽  
Xiaokun Gang ◽  
Guangyu He ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gut Microbiota ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Metabolic Diseases ◽  
Health Issues ◽  
Metabolic Outcomes

Metabolic diseases such as gestational diabetes mellitus and obesity during pregnancy have become severe health issues due to adverse pregnant outcomes in recent years.

Role of Fibroblast growth factor 21 (FGF-21) as a prognostic marker for fetal and maternal complications in patients with gestational diabetes mellitus

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Reda Halawa ◽  
Magdy Hassan Kolaib ◽  
Salah Hussein El-Halawany ◽  
Dina Ahmed Marwan ◽  
Ola Mohamed Mostafa Shaheen
Keyword(s):  
Diabetes Mellitus ◽  
Growth Factor ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Fibroblast Growth Factor ◽  
Prognostic Marker ◽  
Diagnostic Marker ◽  
Fibroblast Growth Factor 21 ◽  
Fibroblast Growth

Abstract Background Gestational diabetes mellitus (GDM) defined as glucose intolerance with onset or first diagnosis during pregnancy. While GDM usually resolves following delivery, it can have long-lasting health consequences, including increased risk for type 2 diabetes (T2DM) and cardiovascular disease (CVD) in the mother, and future obesity, CVD, T2DM, and/or GDM in the child. This contributes to a vicious intergenerational cycle of obesity and diabetes that impacts the health of the population as a whole. Fibroblast growth factor 21 (FGF21) is a hormone that is expressed predominantly in the liver, but also in other metabolically active tissues such as pancreas, skeletal muscle and adipose tissue. An elevated FGF21 level is also an independent predictor of T2DM. GDM and T2DM are proposed to have similar underlying pathophysiologies, raising the question of whether a similar relationship exists between FGF21 and GDM as it does with T2DM. Objectives assess the role of Fibroblast growth factor 21 (FGF-21) as a prognostic marker for maternal and fetal complications in patients with gestational diabetes mellitus (GDM). Patients and Methods A case control study that was conducted on 50 patients diagnosed with Gestational Diabetes Mellitus and 50 control subjects at Diabetes and Obstetrics outpatient clinic and inpatient ward at Ain Shams university hospitals in the period between December 2018 and July 2019. Patients diagnosed with gestational diabetes mellitus (GDM) at 24-28 weeks of gestation were included in this study. Results FGF 21 levels varied significantly with blood sugar values where higher levels of FGF 21 levels were found in patients with GDM with study results showing that FGF 21 can be used as a diagnostic marker for GDM at levels above 121 pg/ml with sensitivity 84% and specificity 92%. Conclusion FGF 21 can be used as a diagnostic marker for gestational diabetes. Further studies needed for better correlation between FGF 21 levels during pregnancy and maternal outcome.

scholarly journals miR-657 Promotes Macrophage Polarization toward M1 by Targeting FAM46C in Gestational Diabetes Mellitus

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Pingping Wang ◽  
Zengfang Wang ◽  
Guojie Liu ◽  
Chengwen Jin ◽  
Quan Zhang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Macrophage Polarization ◽  
Vital Role ◽  
Luciferase Reporter ◽  
M2 Macrophage ◽  
And Migration

MicroRNA (miRNA) has been widely suggested to play a vital role of in the pathogenesis of gestational diabetes mellitus (GDM). We have previously demonstrated that miR-657 can regulate macrophage inflammatory response in GDM. However, the role of miR-657 on M1/M2 macrophage polarization in GDM pathogenesis is not clear yet. This study is aimed at elucidating this issue and identifying novel potential GDM therapeutic targets based on miRNA network. miR-657 is found to be upregulated in placental macrophages demonstrated by real-time PCR, which can enhance macrophage proliferation and migration in vitro. Luciferase reporter assay shows the evidence that FAM46C is a target of miR-657. In addition, miR-657 can promote macrophage polarization toward the M1 phenotype by downregulating FAM46C in macrophages. The present study strongly suggests miR-657 is involved in GDM pathogenesis by regulating macrophage proliferation, migration, and polarization via targeting FAM46C. miR-657/FAM46C may serve as promising targets for GDM diagnosis and treatment.

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