scholarly journals The Influence of First Trimester Maternal Glucose on Fetal Growth and Possible Implications in Pregnancy Evolution

2013 ◽  
Vol 20 (2) ◽  
pp. 141-148
Author(s):  
Monica Vereş ◽  
Szidonia Lacziko ◽  
Aurel Babeş
Keyword(s):  
Birth Weight ◽  
Area Under The Curve ◽  
First Trimester ◽  
Tolerance Test ◽  
Fetal Macrosomia ◽  
Control Group ◽  
Oral Glucose ◽  
Third Trimester ◽  
Maternal Characteristics ◽  
Fetal Birth Weight

AbstractBackground and Aims: Maternal hyperglycemia during the first trimester of pregnancy is frequently associated with the appearance of maternal and fetal complications. The aim of our study was to analyze the influence of the first trimester blood glucose on the glycemic values from the second and third trimester and on fetal birth weight. Material and method: We performed an observational study on a group of 46 pregnant women who finally delivered on due date. We determined glycemia values in the first and third trimester of pregnancy while an Oral Glucose Tolerance Test (OGTT) was performed during the second trimester (24 - 28 weeks of pregnancy). We divided the pregnancies in two groups: with normal glucose or hyperglycemia during the first trimester. Finally we analyzed the influence of first trimester hyperglycemia on different maternal characteristics and on fetal birth weight. Results: Third trimester glycemia was significantly increased in women with first trimester hyperglycemia in comparison with the control group (p= 0.04) but no effect of the last on OGTT values was recorded. The ROC curve for the influence of first trimester glycemia on fetal macrosomia had an Area Under the Curve (AUC) of 0.551. Conclusions: Firsttrimester glycemia has a low diagnostic accuracy in the appreciation of fetal macrosomia risk.

First trimester prediction of maternal glycemic status

2015 ◽  
Vol 43 (3) ◽  
Author(s):  
Rinat Gabbay-Benziv ◽  
Lauren E. Doyle ◽  
Miriam Blitzer ◽  
Ahmet A. Baschat
Keyword(s):  
Risk Score ◽  
Predictive Value ◽  
Challenge Test ◽  
Area Under The Curve ◽  
First Trimester ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Operating Characteristics ◽  
Maternal Characteristics ◽  
Predictive Algorithm

AbstractTo predict gestational diabetes mellitus (GDM) or normoglycemic status using first trimester maternal characteristics.We used data from a prospective cohort study. First trimester maternal characteristics were compared between women with and without GDM. Association of these variables with sugar values at glucose challenge test (GCT) and subsequent GDM was tested to identify key parameters. A predictive algorithm for GDM was developed and receiver operating characteristics (ROC) statistics was used to derive the optimal risk score. We defined normoglycemic state, when GCT and all four sugar values at oral glucose tolerance test, whenever obtained, were normal. Using same statistical approach, we developed an algorithm to predict the normoglycemic state.Maternal age, race, prior GDM, first trimester BMI, and systolic blood pressure (SBP) were all significantly associated with GDM. Age, BMI, and SBP were also associated with GCT values. The logistic regression analysis constructed equation and the calculated risk score yielded sensitivity, specificity, positive predictive value, and negative predictive value of 85%, 62%, 13.8%, and 98.3% for a cut-off value of 0.042, respectively (ROC-AUC – area under the curve 0.819, CI – confidence interval 0.769–0.868). The model constructed for normoglycemia prediction demonstrated lower performance (ROC-AUC 0.707, CI 0.668–0.746).GDM prediction can be achieved during the first trimester encounter by integration of maternal characteristics and basic measurements while normoglycemic status prediction is less effective.

Correlations Between the Values of Maternal Glycemia from the Last Trimester of Pregnancy and Fetal Birth Weight

2013 ◽  
Vol 20 (3) ◽  
pp. 259-265
Author(s):  
Monica Vereş ◽  
Aurel Babeş ◽  
Szidonia Lacziko
Keyword(s):  
First Trimester ◽  
Mean Value ◽  
Fetal Macrosomia ◽  
Entire Group ◽  
Third Trimester ◽  
The Third ◽  
Group I ◽  
Fetal Birth Weight ◽  
First Trimester Of Pregnancy ◽  
The Mean

Abstract Background and aims: Gestational diabetes represents a form of diabetes diagnosed during pregnancy that is not clearly overt diabetes. In the last trimester of gestation the growth of fetoplacental unit takes place, thus maternal hyperglycemia will determine an increased transplacental passage, hyperinsulinemia and fetal macrosomia. The aim of our study was that o analyzing the effect of maternal glycemia from the last trimester of pregnancy over fetal weight. Material and method: We run an observational study on a group of 46 pregnant women taken into evidence from the first trimester of pregnancy, separated in two groups according to blood glucose determined in the third trimester (before birth): group I normoglycemic and group II with hyperglycemia (>92mg/dl). Results: The mean value of third trimester glycemia for the entire group was of 87.13±22.03. The mean value of the glycemia determined in the third trimester of pregnancy was higher in the second group (109.17 mg/dl) in comparison to the first group (74.,21 mg/dl). The ROC curve for third trimester glycemia as fetal macrosomia appreciation test has an AUC of 0.517. Conclusions: Glycemia determined in the last trimester of pregnancy cannot be used alone as the predictive factor for fetal macrosomia.

scholarly journals Evaluating the Effects of Gestational Diabetes Mellitus on Fetal Birth Weight

2020 ◽  
Vol 29 (2) ◽  
pp. 209-218
Author(s):  
Ahmed Faisal Sumit ◽  
Anindya Das ◽  
Shouvik Sarker ◽  
Joyshree Das
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Maternal Age ◽  
Control Group ◽  
Oral Glucose ◽  
Glucose Intake ◽  
Fetal Birth Weight ◽  
Positive Effect ◽  
Maternal Bmi ◽  
Duration Of Pregnancy

This study was aimed at evaluating the association between gestational diabetes mellitus (GDM) and fetal birth weight considering duration of pregnancy, maternal age and body mass index (BMI). This was a retrospective cross-sectional study followed by cohort type of study. Initially, pregnant women in their 24 to 28th week of gestation were selected for determining their fasting blood glucose (FBG) level and blood glucose level 2 hrs after 75 g oral glucose intake. The cut-off value for the diagnosis of GDM was > 5.3 mmol/l for FBG level and > 8.6 mmol/l for taking 75 g oral glucose intake after 2 hrs. Both GDM and control group subjects were followed up to neonatal period to find out neonatal outcomes. Among the total 215 subjects, 84 pregnant women were selected with GDM and rest 131 were control. It is found that GDM alone had a significant (p = 0.05) positive effect on both the duration of pregnancy and fetal birth weight, but not on maternal BMI. Both the effects of duration of pregnancy and GDM are considered together on fetal birth weight, only GDM had significant impact on fetal birth weight compared to the control group. Similarly, when the effect of maternal BMI and GDM is considered together on fetal birth weight, only GDM group was found to have significant effect on fetal birth weight. Parallel results were observed for the effect of both maternal age and GDM on fetal birth weight. In binary logistic regression analysis, when the differences are considered in maternal age, duration of pregnancy and maternal BMI along with GDM, both maternal age ≥ 35 years (OR: 9.43, p = 0.001) and GDM (OR: 10.60, p = 0.003) was found to have significant positive effect on fetal birth weight. It was found that the GDM showed significant influence on fetal birth weight considering the effects of maternal age, duration of pregnancy and maternal BMI. Dhaka Univ. J. Biol. Sci. 29(2): 209-218, 2020 (July)

scholarly journals The Effects of Hyperemesis Gravidarum on the Oral Glucose Tolerance Test Values and Gestational Diabetes

2021 ◽  
Vol 122 (4) ◽  
pp. 285-293
Author(s):  
Burak Bayraktar ◽  
Meric Balikoglu ◽  
Miyase Gizem Bayraktar ◽  
Ahkam Goksel Kanmaz
Keyword(s):  
Blood Glucose ◽  
Gestational Diabetes ◽  
Glucose Tolerance Test ◽  
Hyperemesis Gravidarum ◽  
First Trimester ◽  
Tolerance Test ◽  
Control Group ◽  
Oral Glucose ◽  
Second Trimester ◽  
Oral Glucose Tolerance

This study is aimed at determination whether pregnant women who develop hyperemesis gravidarum in the first trimester have a tendency to develop gestational diabetes mellitus (GDM). It is also aimed at identification of effects of hyperemesis gravidarum and GDM on prenatal and neonatal status in case they were detected together. Hyperemesis gravidarum diagnose was based on the following signs and symptoms. To diagnose GDM, first trimester fasting blood glucose measurement and subsequent blood glucose monitoring and 75-g oral glucose tolerance test (OGTT) were performed in the second trimester. A total of 949 singleton pregnant women (95 with and 852 without hyperemesis gravidarum) who met our criteria were included in the study. In the first trimester, plasma blood glucose and positive GDM screening were found to be significantly higher in the hyperemesis gravidarum group compared to the control group (p=0.042 and p<0.001, respectively). However, actual GDM cases were similar between both groups. The positive predictive value was significantly lower in the hyperemesis gravidarum group (28.5% vs. 72.7%, p=0.003). In the second trimester, the prevalence of GDM was 6.6% in the hyperemesis gravidarum group and 7.3% in the control group, with no significant difference (p=0.218) between-groups. In this study, hyperemesis gravidarum was found to cause changes in maternal metabolism in the first trimester of pregnancy due to limited calorie intake and fasting; in the presence of hyperemesis gravidarum, it should be known that the positive predictive value of first trimester gestational diabetes screening may decrease and the diagnosis of pseudo-GDM may increase.

scholarly journals Pregnancy Profile and Perinatal outcome in Gestational Diabetes Mellitus: A Hospital Based Study’

2016 ◽  
Vol 33 (2) ◽  
pp. 79-85
Author(s):  
Fahmida Naz Mustafa
Keyword(s):  
Blood Glucose ◽  
Birth Weight ◽  
Pregnant Women ◽  
Analytical Study ◽  
First Trimester ◽  
Oral Glucose ◽  
Third Trimester ◽  
Gestational Period ◽  
Gestational Week ◽  
The Mean

Objective: The objective of the study was to measure the proportion of GDM in antenatal outdoor of a hospital, to find out the mean gestational period at which most delivery occurred in GDM and to assess the perinatal outcome.Study design : It was a prospective analytical study conducted in BSMMU, from March,2010 to February,2011.Method: 1489 pregnant women, not known to be diabetic previously, were selected by consecutive sampling in first trimester from Obstetrics outdoor, BSMMU. Their FBS and blood glucose 2hrs after 75gm oral glucose were recorded. We investigated blood glucose in first, second and third trimester in the same pregnant women for screening GDM. Cut off GDM values in fasting stage was e” 6.1mmol/l and 2 hrs after 75gm oral glucose was e” 7.8mmol/l .Result: The proportion of GDM in Obstetrics Outdoor of BSMMU was 6.85%. The mean gestational period at which delivery occurred was lower in GDM ( 36.9 ± 2.2 wks ) than that in non-GDM (39 ± 1.6 wks ) .The most common (31.4%) gestational week during delivery in GDM was 37 completed weeks. Birth weight of 40.2% babies were in the range of 2.5kg to 3.0kg, 31.4% in the range of 3.1 to 3.5 kg and 1% neonate died after birth in GDM.Conclusion: Presently GDM is diagnosed early. The mean gestational period at delivery in GDM is 36.9±2.2 wks. Majority neonatal birth weight is of normal range. Neonatal mortality rate is not increased and is not significantly different from non-GDM women.J Bangladesh Coll Phys Surg 2015; 33(2): 79-85

scholarly journals Effect of a Chronic Intake of the Natural Sweeteners Xylitol and Erythritol on Glucose Absorption in Humans with Obesity

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3950
Author(s):  
Valentine Bordier ◽  
Fabienne Teysseire ◽  
Götz Schlotterbeck ◽  
Frank Senner ◽  
Christoph Beglinger ◽  
...  
Keyword(s):  
Glucose Tolerance Test ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Glucose Absorption ◽  
Control Group ◽  
Oral Glucose ◽  
Post Intervention ◽  
Before And After ◽  
Acute Ingestion ◽  
Intestinal Glucose Absorption

In patients with obesity, accelerated nutrients absorption is observed. Xylitol and erythritol are of interest as alternative sweeteners, and it has been shown in rodent models that their acute ingestion reduces intestinal glucose absorption. This study aims to investigate whether a chronic intake of xylitol and erythritol impacts glucose absorption in humans with obesity. Forty-six participants were randomized to take either 8 g of xylitol or 12 g of erythritol three times a day for five to seven weeks, or to be part of the control group (no substance). Before and after the intervention, intestinal glucose absorption was assessed during an oral glucose tolerance test with 3-Ortho-methyl-glucose (3-OMG). The effect of xylitol or erythritol intake on the area under the curve for 3-OMG concentration was not significant. Neither the time (pre or post intervention), nor the group (control, xylitol, or erythritol), nor the time-by-group interaction effects were significant (p = 0.829, p = 0.821, and p = 0.572, respectively). Therefore, our results show that a chronic intake of the natural sweeteners xylitol and erythritol does not affect intestinal glucose absorption in humans with obesity.

scholarly journals The Utility of Glycated Hemoglobin, Determined in the Second Trimester of Pregnancy, in Diagnosing Gestational Diabetes

2015 ◽  
Vol 22 (3) ◽  
pp. 233-240
Author(s):  
Monica Vereș ◽  
Doru Ioan Crăiuț ◽  
Johann Trutz ◽  
Aurel Babeș
Keyword(s):  
Gestational Diabetes ◽  
Area Under The Curve ◽  
First Trimester ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Second Trimester ◽  
Mortality And Morbidity ◽  
Average Value ◽  
Study Results ◽  
First Trimester Of Pregnancy

Abstract Background and Aims: Gestational diabetes (GD) identifies a pregnancy with high obstetrical risk due to the possible complications that may appear and which are associated with significant perinatal mortality and morbidity. The role of HbA1c in diagnosing GD is still debatable. Our aim was to evaluate the clinical utility of HbA1c assessed in the second trimester of pregnancy (before performing the oral glucose tolerance test - OGTT) in establishing the macrosomia risk, and also for diagnosing GD. Material and methods: This was an observational study on a group of 165 pregnant women followed from the first trimester of pregnancy in whom we measured HbA1c in the second trimester, before running an OGTT with 100 grams of glucose and who delivered at term (37 - 41 weeks of pregnancy). Finally, HbA1c and OGTT were performed only in 132 women, these being the subjects of our study. Results: The average value of HbA1c was 4.85±1.23%. HbA1c was higher in the group having gestational diabetes (6.58±0.74%) in comparison to the group not having GD (4.52±0,80%). The Receiver Operating Characteristic (ROC) curve for HbA1c determined in the second trimester, for diagnosis of GD, has an area under the curve (AUC) of 0.939. Conclusions: HbA1c value could be considered as a sensitive and specific predictive factor in appreciating the macrosomia risk and could be set as an extra criterion in GD diagnosis.

scholarly journals Altered fasting and postprandial plasma ghrelin levels in patients with liver failure are normalized after liver transplantation

2010 ◽  
Vol 163 (4) ◽  
pp. 609-616 ◽  
Author(s):  
Maria Teresa Diz-Lois ◽  
Jesús Garcia-Buela ◽  
Francisco Suarez ◽  
Susana Sangiao-Alvarellos ◽  
Ovidio Vidal ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Failure ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Hepatic Tissue ◽  
Control Group ◽  
Oral Glucose ◽  
Before And After ◽  
Design And Methods ◽  
Overweight Subjects

ContextAnorexia is a problem of paramount importance in patients with advanced liver failure. Ghrelin has important actions on feeding and weight homeostasis. Experimental data exist, which suggest that ghrelin could protect hepatic tissue. Both fasting and post-oral glucose tolerance test (OGTT) ghrelin concentrations are controversial in liver cirrhosis and are unknown after liver transplantation.ObjectiveOur aim was to study fasting ghrelin concentrations and their response to an OGTT in liver failure patients before and after liver transplantation.Design and methodsWe included 21 patients with severe liver failure studied before (pretransplantation, PreT) and 6 months after liver transplantation (posttransplantation, PostT), and 10 age- and body mass index-matched healthy or overweight subjects as the control group (Cont). After an overnight fast, 75 g of oral glucose were administered; glucose, insulin, and ghrelin were obtained at baseline and at times 30, 60, 90, and 120 min.ResultsFasting ghrelin (median and range, pg/ml) levels were lower in PreT: 539 (309–1262) than in Cont: 643 (523–2163),P=0.045. Fasting ghrelin levels increased after liver transplantation, 539 (309–1262) vs 910 (426–3305), for PreT and PostT respectively,P=0.001. The area under the curve (AUC) of ghrelin (pg/ml min) was lower in PreT: 63 900 (37 260–148 410) than in Cont: 76 560 (56 160–206 385),P=0.027. The AUC of ghrelin increased in PostT, 63 900 (37 260–148 410) vs 107 595 (59 535–357 465), for PreT and PostT respectively,P=0.001. Fasting levels and the AUC of ghrelin were similar in PosT and Cont.ConclusionsDecreased fasting and post-OGTT ghrelin levels in liver failure patients were normalized after liver transplantation.

Antidiabetic Effects of Ethanolic Extract of Ficus glomerata (L.) Roots

2020 ◽  
Vol 16 (1) ◽  
pp. 33-41
Author(s):  
Mohini C. Upadhye ◽  
Uday Deokate ◽  
Rohini Pujari ◽  
Vishnu Thakare
Keyword(s):  
Body Weight ◽  
Glucose Tolerance ◽  
Density Lipoprotein ◽  
Ethanolic Extract ◽  
Tolerance Test ◽  
Diabetic Rats ◽  
Antidiabetic Activity ◽  
Control Group ◽  
Oral Glucose ◽  
Ficus Glomerata

Background: Ficus glomerata (F. glomerata) Linn. Family Moraceace is a large tree found all over India including outer Himalayan ranges, Punjab, Chota Nagpur, Bihar, Orissa, West Bengal, Rajasthan, Deccan and also as a common plant in South India. It is planted around the home and temples. It is cultivated throughout the year, distributed in evergreen forests and moist localities. Objective: The Ethanolic Extract of roots of F. Glomerata (EEFG) belonging to the family Moraceace, was investigated for its antidiabetic activity using alloxan induced diabetic rats. Methods: Thirty rats were divided into 5 groups having 6 rats in each group. The alloxan was administered to the rats of all groups except normal control group through intraperitoneal route at a concentration of 140mg/kg body weight. A dose of 100mg/kg and 200 mg/kg body weight of EEFG was administered to alloxan induced diabetic rats. The administration of the extract was lasted for 11 days. Effectiveness of the extract on glucose, cholesterol, triglycerides, and high density lipoprotein and protein concentrations was analyzed. Results: Significant (p<0.05) reduction in the levels of glucose, cholesterol, triglyceride of the diabetic rats was observed after treatment with ethanolic extract. After subjecting to oral glucose tolerance test EEFG also showed significant improvement in glucose tolerance. Conclusion: F. glomerata root ethanolic extract showed that it possesses antidiabetic effect and can be found useful for the management of diabetes mellitus.

Comparison of streptozotocin-induced diabetes at different moments of the life of female rats for translational studies

2021 ◽  
pp. 002367722110018
Author(s):  
Yuri K Sinzato ◽  
Eduardo Klöppel ◽  
Carolina A Miranda ◽  
Verônyca G Paula ◽  
Larissa F Alves ◽  
...  
Keyword(s):  
Adult Life ◽  
Tolerance Test ◽  
Full Term ◽  
Female Rats ◽  
Lower Percentage ◽  
Control Group ◽  
Oral Glucose ◽  
Postnatal Life ◽  
Sprague Dawley ◽  
Term Pregnancy

Animal models are widely used for studying diabetes in translational research. However, methods for induction of diabetes are conflicting with regards to their efficacy, reproducibility and cost. A comparison of outcomes between the diabetic models is still unknown, especially full-term pregnancy.To understand the comparison, we analyzed the streptozotocin (STZ)-induced diabetes at three life-different moments during the neonatal period in Sprague–Dawley female rats: at the first (D1), second (D2) and fifth (D5) day of postnatal life. At adulthood (90 days; D90), the animals were submitted to an oral glucose tolerance test (OGTT) for diabetic status confirmation. The diabetic and control rats were mated and sacrificed at full-term pregnancy for different analyses. Group D1 presented a higher mortality percentage after STZ administration than groups D2 and D5. All diabetic groups presented higher blood glucose levels as compared to those of the control group, while group D5 had higher levels of glycemia compared with other groups during OGTT. The diabetic groups showed impaired reproductive outcomes compared with the control group. Group D1 had lower percentages of mated rats and D5 showed a lower percentage of a full-term pregnancy. Besides that, these two groups also showed the highest percentages of inadequate fetal weight. In summary, although all groups fulfill the diagnosis criteria for diabetes in adult life, in our investigation diabetes induced on D5 presents lower costs and higher efficacy and reproducibility for studies involving diabetes-complicated pregnancy.

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