The interplay of Marine exposure in Gestational Diabetes

2020 ◽  
Vol 16 ◽  
Author(s):  
Ekta Khare

Background: Gestational diabetes mellitus is a common medical disorder of pregnancy-associated with adverse outcomes for the mother and infant. This disease may result in maternal and fetal morbidity and mortality. Although therapies are available for the management of diabetes, which includes anti-diabetic drugs and insulin injections, yet continuous use of synthetic drugs provides lower healing with many side effects. Objective: In the continuing search for effective anti-diabetic drugs from a natural source are the main reasons behind exploring marine resources as a source of the therapeutic and nutritional compound. Methods: I found major articles of interest in the field of marine flora in gestational diabetes and proposed review based on relevant information. Description of the studies included in the review. Results: Marine bio-resources produce several novel scaffolds, which show their good efficacy and bioavailability in the treatment of gestational diabetes. Thus, marine resources have attracted much interest from the scientific community. Conclusion: This mini-review article presents some potential approaches from different marine sources such as algae, sponges together with their specific activity. Concerning the maternal risk factor, additional study is required.

Author(s):  
Jolanta Lis-Kuberka ◽  
Magdalena Orczyk-Pawiłowicz

Gestational diabetes mellitus (GDM) is a multifaceted disease and is associated with complications for newborns and mothers. The aim of the study was to assess Polish women’s knowledge concerning GDM and their attitude to breastfeeding. As a research tool, an anonymous online survey that included 33 questions, grouped into three main sections—sociodemographic and obstetric variables, risk factors for GDM and neonatal adverse outcomes, and knowledge about breastfeeding—was used and administered online. A total of 410 women aged from 18 to 45 participated in this study. Based on the survey, it was demonstrated that the women had moderate knowledge concerning the maternal risk factors and adverse neonatal outcomes associated with GDM and, additionally, the short- and long-term effects of breastfeeding. Significantly deeper knowledge about GDM, including breastfeeding by GDM mothers, was observed among hyperglycemic mothers in comparison to normoglycemic mothers. However, knowledge concerning the health benefits of breastfeeding was not related to the mothers’ glycemic status. In conclusion, educational programs must include pre-pregnancy education of women and place emphasis on explaining the mechanism of development of GDM and the transformation of GDM to type 2 diabetes. This is crucial for changing the public’s perception of GDM as a temporary, reversible clinical entity.


2021 ◽  
Vol 10 (4) ◽  
pp. 843
Author(s):  
Anne Timm ◽  
Karoline Kragelund Nielsen ◽  
Ulla Christensen ◽  
Helle Terkildsen Maindal

Gestational diabetes mellitus (GDM) increases the risk of adverse outcomes during and after pregnancy, including a long-term risk of type 2 diabetes. Women with GDM are treated by numerous healthcare professionals during pregnancy and describe a lack of preventive care after pregnancy. We aim to investigate healthcare professionals’ perspectives on the cross-sectoral treatment pathway for women with GDM—during and after pregnancy. A qualitative study was conducted using systematic text condensation. Nine healthcare professionals (two general practitioners, four midwives, two obstetricians and one diabetes nurse) were interviewed and eight health visitors participated in two focus group discussions., Three major themes emerged: (1) “professional identities”, which were identified across healthcare professionals and shaped care practices; (2) ”unclear guidelines on type 2 diabetes prevention after GDM”, which contributed to uncertainty about tasks and responsibilities during and after pregnancy; and (3) “cross-sectoral collaboration”, which relied heavily on knowledge transfers between hospitals, general practice and the local municipality. The findings implicate that clear, transparent guidelines for all sectors should be prioritized to strengthen cross-sectoral care to women with GDM during and after pregnancy. As a result, strong cross-sectoral care throughout the GDM care pathway may improve maternal health by supporting healthy behaviors, facilitate weight loss and reduce the risk of subsequent GDM and early onset diabetes.


Diabetes Care ◽  
2015 ◽  
Vol 38 (5) ◽  
pp. 844-851 ◽  
Author(s):  
Ravi Retnakaran ◽  
Caroline K. Kramer ◽  
Chang Ye ◽  
Simone Kew ◽  
Anthony J. Hanley ◽  
...  

Author(s):  
Petrikovsky BM ◽  
Zharov EV ◽  
Plotkin D ◽  
Petrikovsky E

Regular physical activity during pregnancy improves or maintains physical fitness, helps with weight management, reduces the risk of gestational diabetes, and enhances patient’s psychological well-being. We studied the possibility to use maternal exercise to test placental reserves in diabetic mothers. We used a motorized treadmill in a moderate exercise regimen (15-minute fast walk at a speed of 3 mph with an incline of 15-25 degrees). Fetal monitoring was provided by using standard Phillips equipment (Avalon CTS and FM40). Adverse fetal outcomes were considered if one or more of the following were present: Category III Fetal Heart Rate (FHR) tracing, 5-minute Apgar score of less than 7, admission to the neonatal intensive care nursery, fetal growth restriction, and fetal and early neonatal death. A total of 819 fetal assessments were performed: 160 patients had gestational diabetes, 80 had pregestational diabetes. The most common complication in fetuses with positive prenatal test results was abnormal FHR in labor (36%) followed by low Apgar score (21%) and need for NICU admission (19%). Most of the adverse outcomes had good correlation with positive results of the exercise test. In conclusion, it appears that maternal exercise causes changes in FHR, which may be used to assess placental and fetal reserves.


2018 ◽  
Vol 26 (1) ◽  
pp. 96-105 ◽  
Author(s):  
S. V. Yankina ◽  
N. V. Shatrova ◽  
S. V. Berstneva ◽  
D. N. Pavlov

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.


2021 ◽  
Vol 15 (5) ◽  
pp. 1270-1275
Author(s):  
S. Ferdousmakan ◽  
Namitha K.B ◽  
M. Etesami

Objective: The present study is aimed at Medication Safety in Obstetrics and Gynecology Ward in Jayanagar General Hospital, Bangalore, India Methodology: It is a prospective observational study, conducted in the inpatient obstetrics and gynecology ward in Jayanagar General Hospital. The study was conducted for 6 months. CRF (Case record form) was designed to record the clinical profile and treatment pattern which contains patient demography, family history, past medication history, obstetric history and follow up and further medication safety was assessed in the patient according to WHO and US-FDA guidelines. The patient demographics and all medically relevant information were noted in a predefined data collection form. Alternatively, these case charts were reviewed for prescription legibility and completeness, unaccepted abbreviations, the capture of relevant information in case sheets, contraindication, drug interactions, and adverse drug events. Result: The data of 150 pregnant women admitted to obstetrics and gynecology ward for delivery related care during the period October 2018 to April 2019 were analyzed. It was observed that 20.67% had Hypertension, 14.67% had Gestational diabetes mellitus, and 8.67% had urinary tract infections as major comorbidities. Among the study population most of them 20.67% had oligohydramnios as a major pregnancy risk factor followed by 12% of preeclampsia and 3.33% of small for gestational age. A total of 1950 drugs were prescribed, and thus the average number of drugs per patient was 13.28. Iron, folic acid, calcium, and vitamins were the most frequently used drugs during the pregnancy. Category A drug constituted 623(54.50%) followed by category B drug 398(34.82%) out of 1950 drugs used in pregnant subjects. Another category C, D and X were 6.99%, 3.5% and 0.1% respectively. The most common drug interaction was found to be between Metronidazole and ondansetron, which may be due to high usage of tramadol and metoclopramide in pregnancy. Conclusion: Among the study patients most them 75.33% were in the age group of 21-30 years. Most of the 20.67% and 14.67% had hypertension and gestational diabetes mellitus as co- morbidities. On the review of 150 prescriptions, the average number of drugs prescribed was found to be 7.62. Iron, folic acid, calcium, and vitamins were the most frequently used drugs during the pregnancy. Most of the used drugs were from Category A (54.50%). Only 0.1% of the drug were from Category X. There were 183 possible risks of major potential drug interactions. The most common interaction was between Metronidazole and ondansetron. The majority of the drugs were prescribed as per FDA category A, the safest category during pregnancy. Keywords: Medication Safety, Obstetrics, Gynecology, pregnancy


Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 353 ◽  
Author(s):  
Delphine Mitanchez ◽  
Cécile Ciangura ◽  
Sophie Jacqueminet

Gestational diabetes (GDM) has deleterious effects on the offspring. Maternal obesity and excessive gestational weight gain (GWG), often associated with diabetes, also contribute to these adverse outcomes. Objectives: To assess the benefit for the offspring of maternal lifestyle interventions, including diets and physical activity, to prevent or to improve GDM and to limit excessive GWG. Method: Systematic review of meta-analyses published in English between December 2014 and November 2019. Results: Lifestyle interventions to reduce the risk of GDM reported a decreased risk of 15% to 40%, with a greater effect of exercise compared to diet. Combined lifestyle interventions specifically designed to limit GWG reduced GWG by 1.6 kg in overweight and obese women, and on average by 0.7 to 1 kg in all pregnant women. In these trials, adverse neonatal outcomes were poorly studied. Combined lifestyle interventions in women with GDM significantly reduced fetal growth. Altogether, lifestyle interventions reduced the risk of preterm birth and shoulder dystocia, but individually, diets or exercise alone had no effect on neonatal adverse outcomes. Conclusion: Specific maternal, neonatal and offspring benefits of lifestyle interventions during pregnancy to prevent or improve GDM control or to limit GWG still require clarification.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Juma Alkaabi ◽  
Raya Almazrouei ◽  
Taoufik Zoubeidi ◽  
Fatema M. Alkaabi ◽  
Fatima Rashid Alkendi ◽  
...  

Abstract Background Gestational diabetes mellitus (GDM) in singleton pregnancies represent a high-risk scenario. The incidence, associated factors and outcomes of GDM in twin pregnancies is not known in the UAE. Methods This was five years retrospective analysis of hospital records of twin pregnancies in the city of Al Ain, Abu Dhabi, UAE. Relevant data with regards to the pregnancy, maternal and birth outcomes and incidence of GDM was extracted from two major hospitals in the city. Regression models assessed the relationship between socio-demographic and pregnancy-related variables and GDM, and the associations between GDM and maternal and fetal outcomes at birth. Results A total of 404 women and their neonates were part of this study. The study population had a mean age of 30.1 (SD: 5.3), overweight or obese (66.5%) and were majority multiparous (66.6%). High incidence of GDM in twin pregnancies (27.0%). While there were no statistical differences in outcomes of the neonates, GDM mothers were older (OR: 1.09, 95% CI: 1.06–1.4) and heavier (aOR: 1.02, 95% CI: 1.00 -1.04). They were also likely to have had GDM in their previous pregnancies (aOR: 7.37, 95% CI: 2.76–19.73). The prognosis of mothers with twin pregnancies and GDM lead to an independent and increased odds of cesarean section (aOR: 2.34, 95% CI: 1.03–5.30) and hospitalization during pregnancy (aOR: 1.60, 95% CI: 1.16–2.20). Conclusion More than a quarter of women with twin pregnancies were diagnosed with GDM. GDM was associated with some adverse pregnancy outcomes but not fetal outcomes in this population. More studies are needed to further investigate these associations and the management of GDM in twin pregnancies.


2019 ◽  
Vol 9 (2) ◽  
pp. 127-132
Author(s):  
Faryal Mustary ◽  
TA Chowdhury ◽  
Ferdousi Begum ◽  
Nusrat Mahjabeen

Background: Diabetes mellitus is the most frequently encountered endocrine disorder in pregnancy and is associated with adverse outcomes if remain undiagnosed or untreated. This study was done to compare the maternal and perinatal outcome of pregestational diabetes mellitus (PGDM) with that of gestational diabetes (GDM). Methods: This observational analytical study with group comparison was carried out in the Department of Obstetrics and Gynaecology, BIRDEM General Hospital, Dhaka from July 2015 to June 2016. This study was conducted on two groups of pregnant women: group A (PGDM) and group B (GDM). A total of 100 cases were selected and in each group 50 pregnant women were enrolled. Singleton pregnancy and age 18 to 45 years were included. Pregnancy with hypertension, heart disease, renal disease and other metabolic disorders were excluded. Results: In this study mean gestational age of the study subjects were 35.72 ± 2.61 weeks and 36.58 ± 2.34 weeks in PGDM and GDM groups. History of GDM [34.0% vs 16.0%], intrauterine death (IUD) [14.0% vs 2.0%] and abortion [22.0% vas 6.0%] were significantly higher among PGDM patients than GDM patients. Regarding present pregnancy complications, polyhydramnios [32.0% vs 14.0%], preterm delivery [38.0% vs 20.0%], vulvovaginitis [28.0% vs 12.0%] and premature rupture of membrane (PROM) [24.0% vs 8.0%] were significantly higher in PGDM than GDM patients. Wound infection was significantly high in PGDM groups [35.7% vs 11.1%] among the patients delivered by lower uterine Cesarean section (LUCS). Regarding perinatal complications, hypoglycemia [22.0% vs 8.0%], birth asphyxia [24.0% vs 8.0%], RDS [24.0% vs 8.0%] were significantly higher among PGDM comparing GDM patients. Conclusion: The maternal and perinatal outcomes of pregestational diabetes mellitus were less favorable than those of gestational diabetes mellitus. Birdem Med J 2019; 9(2): 127-132


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