scholarly journals Diabetes in Pregnancy: Maternal Profile and Neonatal Outcome

2016 ◽  
Vol 4 (2) ◽  
pp. 83-88
Author(s):  
Nahid Sultana ◽  
Shahana Shermin ◽  
Nurun Naher ◽  
Fatheha Ferdous ◽  
Shayla Farjana
Keyword(s):  
Diabetes Mellitus ◽  
Metabolic Disorders ◽  
Perinatal Care ◽  
Diabetes In Pregnancy ◽  
Neonatal Complications ◽  
Increased Risk ◽  
Group A ◽  
Diabetic Mothers ◽  
Live Baby ◽  
In Pregnancy

Background: Diabetes in pregnancy is associated with increased risk to the woman and to the developing fetus. Historically, infants born to mother with diabetes (IDM) have significantly greater risk for spontaneous abortion, stillbirth, congenital malformations and perinatal mortality and morbidity.Objective: To evaluate the complications associated with diabetes in pregnancy in the periconceptional, fetal, neonatal and postnatal period.Materials and method: This observational study was carried out in the department of Obstetrics & Gynaecology of Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine & Metabolic Disorders (BIRDEM), Dhaka, Bangladesh, from July 2013 to December 2013. Data of 100 patients with pregestational diabetes mellitus (PGDM) and gestational diabetes mellitus (GDM) delivering live baby after 37 completed weeks were evaluated during the period. They were divided into two groups: patients with PGDM in group-A and patients with GDM in group-B.Results: Majority of the PGDM patients were in 31-35 years age group whereas 50% of the GDM patients were from younger group (26-30). A major proportion of the patients of both the groups required Caesarean section with a higher rate in group-A. Diabetic mothers had more macrosomic babies than GDM mothers (14% vs 4%). Most commonly found neonatal complications were hyperbilirubinaemia followed by RDS and hypoglycaemia in both the groups with a higher proportion in PGDM group.Conclusion: Almost similar maternal and neonatal complications were observed in both PGDM and GDM group in our study despite of integrated antenatal, intranatal and perinatal care with a higher proportion in PGDM patients.Delta Med Col J. Jul 2016 4(2): 83-88

scholarly journals Diabetes in Pregnancy and Risk of Antepartum Depression: A Systematic Review and Meta-Analysis of Cohort Studies

2020 ◽  
Vol 17 (11) ◽  
pp. 3767 ◽  
Author(s):  
Kai Wei Lee ◽  
Siew Mooi Ching ◽  
Navin Kumar Devaraj ◽  
Seng Choi Chong ◽  
Sook Yee Lim ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Cohort Studies ◽  
Pregnant Women ◽  
Meta Analysis ◽  
Diabetes In Pregnancy ◽  
Antepartum Depression ◽  
Increased Risk ◽  
In Pregnancy

Previous literature has reported that patients with diabetes in pregnancy (DIP) are at risk of developing antepartum depression but the results have been inconsistent in cohort studies. We conducted a systematic review and performed a meta-analysis to quantify the association between DIP and risk of antepartum depression in cohort studies. Medline, Cinahl, and PubMed databases were searched for studies investigating DIP involving pregnant women with pre-existing diabetes and gestational diabetes mellitus and their risk of antepartum depression that were published in journals from inception to 27 December 2019. We derived the summary estimates using a random-effects model and reported the findings as pooled relative risks (RR) and confidence interval (CI). Publication bias was assessed using a funnel plot and was quantified by Egger and Begg’s tests. Ten studies, involving 71,036 pregnant women were included in this meta-analysis. The pooled RR to develop antepartum depression was (RR = 1.430, 95% CI: 1.251–1.636) among women with gestational diabetes mellitus. Combining pregnant women with pre-existing diabetes mellitus and gestational diabetes mellitus, they had a significant increased risk of developing antepartum depression (RR = 1.431, 95% CI: 1.205–1.699) compared with those without it. In comparison, we found no association between pre-existing diabetes mellitus in pregnancy (RR = 1.300, 95% CI: 0.736–2.297) and the risk of developing antepartum depression. This study has a few limitations: first, different questionnaire and cut-off points were used in evaluation of depression across the studies. Second, there was a lack of data on history of depression prior to pregnancy, which lead to confounding bias that could not be solved by this meta-analysis. Third, data were dominated by studies in Western countries; this is due to the studies from Eastern countries failing to meet our inclusion criteria for statistical analysis. Women with gestational diabetes mellitus have an increased risk of developing antepartum depression compared to those without the disease. Therefore, more attention on the mental health status should be given on pregnant women diagnosed with pre-existing diabetes mellitus and gestational diabetes mellitus.

scholarly journals Gestational Diabetes Mellitus and Infant Adiposity at Birth: A Systematic Review and Meta-Analysis of Therapeutic Interventions

2021 ◽  
Vol 10 (4) ◽  
pp. 835
Author(s):  
Manoja P. Herath ◽  
Jeffrey M. Beckett ◽  
Andrew P. Hills ◽  
Nuala M. Byrne ◽  
Kiran D. K. Ahuja
Keyword(s):  
Diabetes Mellitus ◽  
Adipose Tissue ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Fat Mass ◽  
Metabolic Disorders ◽  
Later Life ◽  
Therapeutic Interventions ◽  
Increased Risk ◽  
The Impact

Exposure to untreated gestational diabetes mellitus (GDM) in utero increases the risk of obesity and type 2 diabetes in adulthood, and increased adiposity in GDM-exposed infants is suggested as a plausible mediator of this increased risk of later-life metabolic disorders. Evidence is equivocal regarding the impact of good glycaemic control in GDM mothers on infant adiposity at birth. We systematically reviewed studies reporting fat mass (FM), percent fat mass (%FM) and skinfold thicknesses (SFT) at birth in infants of mothers with GDM controlled with therapeutic interventions (IGDMtr). While treating GDM lowered FM in newborns compared to no treatment, there was no difference in FM and SFT according to the type of treatment (insulin, metformin, glyburide). IGDMtr had higher overall adiposity (mean difference, 95% confidence interval) measured with FM (68.46 g, 29.91 to 107.01) and %FM (1.98%, 0.54 to 3.42) but similar subcutaneous adiposity measured with SFT, compared to infants exposed to normal glucose tolerance (INGT). This suggests that IGDMtr may be characterised by excess fat accrual in internal adipose tissue. Given that intra-abdominal adiposity is a major risk factor for metabolic disorders, future studies should distinguish adipose tissue distribution of IGDMtr and INGT.

scholarly journals Assessment of Health Seeking Behavior of Gestational Diabetes in Pregnancy among Elderly Primi Mother

2021 ◽  
pp. 261-267
Author(s):  
Prachi Dhale ◽  
Pragati Dhawale ◽  
Amrin Dosani ◽  
Gaurav Dongare ◽  
Bali Thool
Keyword(s):  
Blood Glucose ◽  
Gestational Diabetes ◽  
Adverse Pregnancy Outcome ◽  
The Elderly ◽  
Diabetes In Pregnancy ◽  
Health Seeking ◽  
Health Seeking Behavior ◽  
Increased Risk ◽  
Seeking Behavior ◽  
In Pregnancy

Introduction: Gestational diabetes mellitus (GDM) is diagnosed by elevated blood glucose in pregnancy though the definition has changed repeatedly since its first description in the 1960’s. The most frequently reported perinatal consequence of GDM is macrosomia (usually defined as a neonate weighing over 4 kg) which can increase the risk of caesarean section and shoulder dystocia. For the mother, there are also potential longer-term consequences including an increased risk of type 2 diabetes post-pregnancy and/or in later life. The investigators of a large international Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study aimed to identify a cut-point in the continuum to decide the blood glucose level (BGL) thresholds that should be used to define GDM. Objective: To assess the incidence rate of gestational diabetes in pregnancy among the elderly primi mother. To assess the health seeking behavior of gestational diabetes in elderlyprimimothers.  To associate the demographic variables of gestational diabetes in elderly primi mothers. Materials and Methods: A Descriptive research study was to assess the incidence and Health seeking behavior of gestational diabetes in pregnancy among the elderly primi mother. The target population for the study includes all antenatal women (12-36 weeks of gestation) who attend the antenatal clinics of AVBRH Out Patient Department. Sample consists of sub set of units that compose accessible population. In this study sample size was 100 elderly primi mother of selected area of community of Wardha. A tool is an instrument or equipment used for collection of data. A blue print was prepared prior to the construction of knowledge questionnaire based on which items were developed. Results: A finding shows that (41%) were having good, (40%) were having very good, (17%) were having average and (2%) were having excellent knowledge score. The minimum score was 05 and maximum score was 14, the mean score for the test was 8.93 ± 2.23 and mean percentage of knowledge was 59.54%. There was no significant association in relation to age, education, occupation, No.of gravida, income etc.

scholarly journals Evaluation of “Diabetes in Pregnancy Study Group of India” (DIPSI) Criterion as a Diagnostic Test for Gestational Diabetes Mellitus

2021 ◽  
Vol 11 (6) ◽  
pp. 1-5
Author(s):  
Aradhana Singh ◽  
Raj K Singh ◽  
Vani Aditya
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Antenatal Clinic ◽  
Oral Glucose ◽  
Study Group ◽  
Diabetes In Pregnancy ◽  
Inclusion Criteria ◽  
Capillary Glucose ◽  
In Pregnancy

Introduction: In view of the alarmingly increasing incidence of Gestational Diabetes Mellitus (GDM), worldwide, as well as in India, a consensus to bring about standardization for diagnosis of GDM is needed. Internationally, the WHO 2013 criteria is being widely used, while (Diabetes In Pregnancy Study Group of India) DIPSI non fasting criteria is popularly used in India. There still remains many missed cases of GDM in India, which is a cause of concern. This study was done to compare the DIPSI non fasting, with WHO 2013 criteria for diagnosis of GDM. Methods: this cross-sectional study included 530 pregnant women, attending antenatal clinic of a tertiary care center, of North India, from Feb. 2018 to March 2019 and fulfilling inclusion criteria. All women attending antenatal clinic, during the study period, were subjected to capillary glucose evaluation, 2 hours after 75g oral glucose load, irrespective of the timing of last meal (DIPSI), as part of routine antenatal checkup. After 7 days, only those 530 women, who turned up in fasting state, and fulfilled inclusion criteria, were enrolled in the study and subjected to fasting 75g, oral glucose tolerance test (OGTT) (WHO 2013). Accuracy of DIPSI test was compared, to the fasting WHO 2013 criteria. Capillary glucose was measured using regular, well calibrated, point of care, “Optium Free Style” glucometer. Results: Out of 107 women diagnosed to have GDM by WHO 2013 criteria, only 89 were diagnosed by the DIPSI criteria. DIPSI had a low sensitivity (83.18%) when compared to the WHO 2013 criteria, Conclusion: This study showed that when non fasting DIPSI criteria was used as diagnostic criteria, 10.58% women with GDM, missed the diagnosis. Considering the adverse maternal and perinatal outcome of GDM, implication of missed diagnosis would be grave, especially in a developing country, like India. Hence, use of DIPSI criteria for diagnosing GDM should be reconsidered. Key words: GDM, DIPSI, OGTT, Diabetes in Pregnancy.

scholarly journals Insulin Glulisine in Pregnancy – Experience from Clinical Trials and Post-marketing Surveillance

2015 ◽  
Vol 11 (1) ◽  
pp. 17 ◽  
Author(s):  
Zoran Doder ◽  
Demi Vanechanos ◽  
Manfred Oster ◽  
Wolfgang Landgraf ◽  
Stephen Lin ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Clinical Trials ◽  
Congenital Malformations ◽  
Safety Data ◽  
Live Births ◽  
Post Marketing Surveillance ◽  
Increased Risk ◽  
Post Marketing ◽  
Insulin Glulisine ◽  
In Pregnancy

Pregnancies complicated by gestational diabetes or pre-existing type 1 or type 2 diabetes mellitus are associated with a higher rate of adverse outcomes compared with pregnancies in the background population. These outcomes include miscarriage, pre-term delivery, pre-eclampsia, perinatal mortality and congenital malformations. Insulin glulisine (ApidraR, Sanofi) is a rapid-acting insulin analogue indicated for the treatment of adults, adolescents and children 6 years or older with diabetes mellitus where treatment with insulin is required. Here, all post-marketing and clinical trials safety data with insulin glulisine in pregnancy available to Sanofi up to June 2014 are summarised together with the findings of a comprehensive literature search. Cumulatively, a total of 303 pregnancy exposures to insulin glulisine were received. Of these 303 pregnancy exposures, there were 116 live births, 12 spontaneous abortions, two late foetal intra-uterine deaths (>28 weeks), three elective abortions and 170 cases without a known pregnancy outcome. There were six cases of congenital malformations; of these, there were five live births; in the other case a live birth was not confirmed. The congenital malformations reported to date do not reveal a pattern of defects. In conclusion, the evidence to date does not suggest a causal association between insulin glulisine and an increased risk of pregnancy complications or congenital malformations.

scholarly journals Elevated Anthropometric and Metabolic Indicators among Young Adult Offspring of Mothers with Pregestational Diabetes: Early Results from the Transgenerational Effect on Adult Morbidity Study (the TEAM Study)

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Katherine Bowers ◽  
Shelley Ehrlich ◽  
Lawrence M. Dolan ◽  
Resmi Gupta ◽  
Mekibib Altaye ◽  
...  
Keyword(s):  
Young Adult ◽  
In Utero ◽  
Adult Offspring ◽  
Diabetes In Pregnancy ◽  
Pregestational Diabetes ◽  
Metabolic Outcomes ◽  
Early Results ◽  
Increased Risk ◽  
Maternal Glucose ◽  
In Pregnancy

Exposure to maternal diabetes in utero increases the risk in the offspring for a range of metabolic disturbances. However, the timing and variability of in utero hyperglycemic exposure necessary to cause impairment have not been elucidated. The TEAM Study was initiated to evaluate young adult offspring of mothers with pregestational diabetes mellitus. This paper outlines the unique enrollment challenges of the TEAM Study and preliminary analysis of the association between exposure to diabetes in pregnancy and adverse metabolic outcomes. The TEAM Study enrolls offspring of women who participated in a Diabetes in Pregnancy (DiP) Program Project Grant between 1978 and 1995. The DiP Study collected medical and obstetric data across pregnancy. The first 96 eligible offspring of women with pregestational diabetes were age-, sex-, and race-matched to adults from the National Health and Nutrition Examination Survey (NHANES) 2015-2016 with an OGTT. Descriptive and regression analyses were employed to compare TEAM participants to NHANES participants. Among a subset of TEAM participants, we compared the metabolic outcomes across maternal glucose profiles using a longitudinal data clustering technique that characterizes level and variability, in maternal glucose across pregnancy. By comparing categories of BMI, TEAM Study participants had over 2.0 times the odds of being obese compared to matched NHANES participants (for class III obesity, OR = 2.81 ; 95% confidence interval (CI): 1.15, 6.87). Increasing levels of two-hour glucose were also associated with in utero exposure to pregestational diabetes in matched analyses. Exposure to pregestational diabetes in utero may be associated with an increased risk of metabolic impairment in the offspring with clinical implications.

scholarly journals Mechanisms linking hyperglycemia in pregnancy to the offspring cardiovascular system dysfunction

STEMedicine ◽  
2021 ◽  
Vol 2 (7) ◽  
pp. e91
Author(s):  
Zemeng Xiao ◽  
Yifang Wang ◽  
Phung N. Thai ◽  
Xuxia Li ◽  
Xiyuan Lu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Premature Birth ◽  
Metabolic Disorders ◽  
Adult Offspring ◽  
Pathophysiological Mechanism ◽  
Transcription Level ◽  
Adverse Impacts ◽  
In Pregnancy

Hyperglycemia in pregnancy (HIP) is a high-glycemic state that occurs during pregnancy, and gestational diabetes mellitus (GDM) is the major cause of it. Studies reveal that GDM has long-term adverse impacts on mothers and offspring, such as maternal type 2 diabetes, premature birth and stillbirth in newborns, cardiovascular disease, and metabolic disorders in adult offspring. In recent years, studies on the transcription level of GDM and metabonomics have provided new insights into the pathophysiological mechanism of GDM. This article reviews the transcriptional levels and metabolomics studies involving GDM and cardiovascular dysfunction in the offspring, which may provide insight to the long-term health of pregnant women and offspring.

EXPRESS: Monitoring Motherhood: monitoring and optimising glycaemia in women with pre-existing diabetes in pregnancy

2021 ◽  
pp. 000456322110358
Author(s):  
Claire L Meek
Keyword(s):  
Glycaemic Control ◽  
Continuous Glucose Monitoring ◽  
Multiple Pregnancy ◽  
Glucose Monitoring ◽  
Insulin Dosage ◽  
Diabetes In Pregnancy ◽  
Short Term ◽  
Increased Risk ◽  
Mother And Child ◽  
In Pregnancy

Despite recent advances in care, women with diabetes in pregnancy are still at increased risk of multiple pregnancy complications. Offspring exposed to hyperglycaemia in utero also experience long-term health sequelae affecting neurocognitive and cardiometabolic status. Many of these adverse consequences can be prevented or ameliorated with good medical care, specifically to optimise glycaemic control. The accurate assessment of glycaemia in pregnancy is therefore vital to safeguard the health of mother and child. However, there is no consensus about the best method of monitoring glycaemic control in pregnancy. Short-term changes in insulin dosage and lifestyle, with altered appetite, insulin sensitivity and red cell turnover create difficulties in interpretation of standard laboratory measures such as HbA1c. The ideal marker would provide short-term feedback on daily or weekly glycaemic control, with additional capability to predict pregnancies at high risk of suboptimal outcomes. Several novel biochemical markers are available which allow assessment of dynamic changes in glycaemia over weeks rather than months. Continuous glucose monitoring devices have advanced in accuracy and provide new opportunities for robust assessment of glycaemia in pregnancy. Recent work from the continuous glucose monitoring in pregnant women with type 1 diabetes trial (CONCEPTT) has provided information about the ability of different markers of glycaemia to predict pregnancy outcomes. The aim of this review is to summarise the care for women with pre-existing diabetes in pregnancy, and to highlight the important role of glycaemic monitoring in pregnancy.

Type 1 Diabetes in Pregnancy: A Review of Complications and Management

2021 ◽  
Vol 18 ◽  
Author(s):  
Farah Jaffar ◽  
Kate Laycock ◽  
Mohammed S.B. Huda
Keyword(s):  
Type 1 Diabetes ◽  
Microvascular Disease ◽  
Evidence Based ◽  
Current Guideline ◽  
Diabetes In Pregnancy ◽  
Fetal Outcomes ◽  
Increased Risk ◽  
Fetal Complications ◽  
In Pregnancy

Background: Pre-gestational diabetes can pose significant risk to the mother and infant, thus requiring careful counselling and management. Since Saint Vincent’s declaration in 1989, adverse maternal and fetal outcomes, such as preeclampsia, perinatal mortality, congenital anomalies, and macrosomia, continue to be associated with type 1 diabetes. Although pregnancy is not considered an independent risk factor for the development of new onset microvascular complications, it is known to exacerbate pre-existing microvascular disease. Strict glycaemic control is the optimal management for pre-existing type 1 diabetes in pregnancy, as raised HbA1C is associated with increased risk of maternal and fetal complications. More recently, time in range on Continuous Glucose Monitoring glucose profiles has emerged as another useful evidence-based marker of fetal outcomes. Objective: This review summarises the complications associated with pre-gestational type 1 diabetes, appropriate evidence-based management, including preparing for pregnancy, intrapartum and postpartum care. Methods: A structured search of the PubMed and Cochrane databases was conducted. Peer-reviewed articles about complications and management guidelines on pre-gestational type 1 diabetes were selected and critically appraised. Results: One hundred and twenty-three manuscripts were referenced and appraised in this review, and international guidelines were summarised. Conclusion: This review provides a comprehensive overview of the recurring themes in the literature pertaining to type 1 diabetes in pregnancy: maternal and fetal complications, microvascular disease progression, and an overview of current guideline-specific management.

Sign in / Sign up

Export Citation Format

Share Document