scholarly journals Pathophysiology Underpinning Gestational Diabetes Mellitus and the Role of Biomarkers for its Prediction

EMJ Diabetes ◽  
2020 ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Current Evidence ◽  
Diagnostic Strategies ◽  
Prevalence Of Obesity ◽  
Maternal And Neonatal Outcomes ◽  
Potential Biomarkers

Gestational diabetes mellitus (GDM) is a frequent complication of pregnancy, with an increasing incidence that has been attributed to an ageing maternal population, an increasing prevalence of obesity, and alterations in diagnostic criteria. The consequences of GDM are far-reaching and impact both the mother and their offspring. It is associated with poor maternal and neonatal outcomes compared with non-GDM pregnancies. Furthermore, it is associated with long-term poor metabolic health in both mother and offspring. Current diagnostic strategies centre on clinical risk factors, however these can lack specificity. This has spurred investigations into identifying potential biomarkers to aid in diagnosis and risk stratification. In this review, the current evidence around potential biomarkers, their role in understanding pathophysiologic pathways for GDM development, and the possibility of their use in clinical practice is explored.

scholarly journals Myo-inositol supplementation as a preventive consideration for gestational diabetes mellitus

2020 ◽  
Vol 19 (1) ◽  
pp. 45-50
Author(s):  
George Asimakopoulos ◽  
Panagiotis Antsaklis ◽  
Mariana Theodora ◽  
Michael Sindos ◽  
Alexandros Rodolakis ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Current Evidence ◽  
Insulin Resistant ◽  
Improve Insulin Resistance ◽  
Prevalence Of Obesity ◽  
Ovarian Syndrome

Gestational diabetes mellitus (GDM) is defined as impaired glucose tolerance with onset or first recognition during pregnancy, which is characterized by increased insulin resistance. GDM affects about 10% of pregnancies and its prevalence is rising worldwide mainly due to the advancing maternal age and the increased prevalence of obesity. GDM is associated with pregnancy-related maternal and fetal morbidity (both antenatal and perinatal). Traditional treatments for the GDM include diet and, if it is necessary, insulin. However, the percentage of macrosomic newborns does not appear to be significantly reduced. Safe and effective preventive interventions are therefore, needed in an attempt to lower the incidence of gestational diabetes. Myo-inositol has been suggested to improve insulin resistance in women with insulin resistant syndromes such as GDM, polycystic ovarian syndrome, type 2 diabetes and metabolic syndrome. Several studies report a significant decrease in GDM incidence in women at risk for GDM comparing to the placebo group. However, the option of myo-inositol supplementation needs to be further explored as the current evidence is relatively limited.

scholarly journals Adipose tissue function in healthy pregnancy, gestational diabetes mellitus and pre-eclampsia

2021 ◽  
Author(s):  
Cara Trivett ◽  
Zoe J. Lees ◽  
Dilys J. Freeman
Keyword(s):  
Diabetes Mellitus ◽  
Adipose Tissue ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Maternal Obesity ◽  
Sudden Onset ◽  
Healthy Pregnancy ◽  
Short And Long Term

AbstractGestational diabetes mellitus (GDM) is a common disorder of pregnancy with short- and long-term consequences for mother and baby. Pre-eclampsia is of major concern to obstetricians due to its sudden onset and increased morbidity and mortality for mother and baby. The incidence of these conditions continues to increase due to widespread maternal obesity. Maternal obesity is a risk factor for GDM and pre-eclampsia, yet our understanding of the role of adipose tissue and adipocyte biology in their aetiology is very limited. In this article, available data on adipose tissue and adipocyte function in healthy and obese pregnancy and how these are altered in GDM and pre-eclampsia are reviewed. Using our understanding of adipose tissue and adipocyte biology in non-pregnant populations, a role for underlying adipocyte dysfunction in the pathological pathways of these conditions is discussed.

scholarly journals Gestational Diabetes Mellitus: A Harbinger of the Vicious Cycle of Diabetes

2020 ◽  
Vol 21 (14) ◽  
pp. 5003
Author(s):  
Emilyn U. Alejandro ◽  
Therriz P. Mamerto ◽  
Grace Chung ◽  
Adrian Villavieja ◽  
Nawirah Lumna Gaus ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Clinical Care ◽  
Cell Dysfunction ◽  
Maternal And Neonatal Outcomes ◽  
Health Complications ◽  
Underlying Pathophysiology ◽  
And Child Health

Gestational diabetes mellitus (GDM), characterized by a transitory form of diabetes induced by insulin resistance and pancreatic β-cell dysfunction during pregnancy, has been identified as one of the major obstacles in achieving improved maternal and child health. Approximately 9–25% of pregnancies worldwide are impacted by the acute, long-term, and transgenerational health complications of this disease. Here, we discuss how GDM affects longstanding maternal and neonatal outcomes, as well as health risks that likely persist into future generations. In addition to the current challenges in the management and diagnosis of and the complications associated with GDM, we discuss current preclinical models of GDM to better understand the underlying pathophysiology of the disease and the timely need to increase our scientific toolbox to identify strategies to prevent and treat GDM, thereby advancing clinical care.

scholarly journals Exosomes Could Offer New Options to Combat the Long-Term Complications Inflicted by Gestational Diabetes Mellitus

Cells ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. 675 ◽  
Author(s):  
Juliana Ferreira Floriano ◽  
Gareth Willis ◽  
Francesco Catapano ◽  
Patrícia Rodrigues de Lima ◽  
Fabiana Vieira Duarte Souza Reis ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Therapeutic Agents ◽  
Health Costs ◽  
Cell Sources

Gestational diabetes Mellitus (GDM) is a complex clinical condition that promotes pelvic floor myopathy, thus predisposing sufferers to urinary incontinence (UI). GDM usually regresses after birth. Nonetheless, a GDM history is associated with higher risk of subsequently developing type 2 diabetes, cardiovascular diseases (CVD) and UI. Some aspects of the pathophysiology of GDM remain unclear and the associated pathologies (outcomes) are poorly addressed, simultaneously raising public health costs and diminishing women’s quality of life. Exosomes are small extracellular vesicles produced and actively secreted by cells as part of their intercellular communication system. Exosomes are heterogenous in their cargo and depending on the cell sources and environment, they can mediate both pathogenetic and therapeutic functions. With the advancement in knowledge of exosomes, new perspectives have emerged to support the mechanistic understanding, prediction/diagnosis and ultimately, treatment of the post-GMD outcomes. Here, we will review recent advances in knowledge of the role of exosomes in GDM and related areas and discuss the possibilities for translating exosomes as therapeutic agents in the GDM clinical setting.

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 Breastfeeding Duration and Development of Dysglycemia in Women Who Had Gestational Diabetes Mellitus: Evidence from the GUSTO Cohort Study

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 408
Author(s):  
Sumali S. Hewage ◽  
Xin Yu Hazel Koh ◽  
Shu E. Soh ◽  
Wei Wei Pang ◽  
Doris Fok ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Tolerance Test ◽  
Diabetes Risk ◽  
Breastfeeding Duration ◽  
Oral Glucose ◽  
Inverse Association ◽  
Index Pregnancy

(1) Background: Breastfeeding has been shown to support glucose homeostasis in women after a pregnancy complicated by gestational diabetes mellitus (GDM) and is potentially effective at reducing long-term diabetes risk. (2) Methods: Data from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study were analyzed to understand the influence of breastfeeding duration on long-term dysglycemia (prediabetes and diabetes) risk in women who had GDM in the index pregnancy. GDM and dysglycemia four to seven years postpartum were determined by the oral glucose tolerance test (OGTT). A Poisson regression model with a robust error variance was used to estimate incidence rate ratios (IRRs) for dysglycemia four to seven years post-delivery according to groupings of the duration of any breastfeeding (<1, ≥1 to <6, and ≥6 months). (3) Results: Women who had GDM during the index pregnancy and complete breastfeeding information and OGTT four to seven years postpartum were included in this study (n = 116). Fifty-one women (44%) had postpartum dysglycemia. Unadjusted IRRs showed an inverse association between dysglycemia risk and ≥1 month to <6 months (IRR 0.91; 95% confidence interval [CI] 0.57, 1.43; p = 0.68) and ≥6 months (IRR 0.50; 95% CI 0.27, 0.91; p = 0.02) breastfeeding compared to <1 month of any breastfeeding. After adjusting for key confounders, the IRR for the ≥6 months group remained significant (IRR 0.42; 95% CI 0.22, 0.80; p = 0.008). (4) Conclusions: Our results suggest that any breastfeeding of six months or longer may reduce long-term dysglycemia risk in women with a history of GDM in an Asian setting. Breastfeeding has benefits for mothers beyond weight loss, particularly for those with GDM.

scholarly journals Lactation Duration and Long-term Risk for Incident Type 2 Diabetes in Women With a History of Gestational Diabetes Mellitus

Diabetes Care ◽  
2020 ◽  
Vol 43 (4) ◽  
pp. 793-798 ◽  
Author(s):  
Sylvia H. Ley ◽  
Jorge E. Chavarro ◽  
Mengying Li ◽  
Wei Bao ◽  
Stefanie N. Hinkle ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Incident Type ◽  
Incident Type 2 Diabetes ◽  
History Of ◽  
Lactation Duration

Long Term Predictors of Post-Partum Glucose Metabolism in Women with Gestational Diabetes Mellitus

2010 ◽  
Vol 118 (08) ◽  
pp. 485-489 ◽  
Author(s):  
G. Seghieri ◽  
F. Tesi ◽  
A. De Bellis ◽  
R. Anichini ◽  
G. Fabbri ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glucose Metabolism ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Post Partum

scholarly journals Recent Advances in Gestational Diabetes Mellitus

2021 ◽  
Vol 10 (10) ◽  
pp. 2202
Author(s):  
Katrien Benhalima
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Clinical Medicine ◽  
Metabolic Risk ◽  
Special Issue ◽  
Recent Advances ◽  
Adverse Pregnancy ◽  
New Biomarkers

The incidence of gestational diabetes mellitus (GDM) and overt diabetes in pregnancy is rising globally. GDM leads to increased risks for maternal and neonatal adverse pregnancy outcomes. In addition, GDM is also associated with an increased long-term metabolic risk in mothers and offspring [1]. Although much is known about GDM, evidence gaps persist. For instance, more research is needed on how to prevent GDM, on whether screening and treatment of GDM in early pregnancy are beneficial, on non-fasting biomarkers to screen for GDM, on new biomarkers to predict pregnancy complications, and on how to reduce the long-term metabolic risk in mothers and infants after delivery. To address this important health issue, the present Special Issue in the Journal of Clinical Medicine was dedicated to recent advances in the field of GDM. This Special Issue published 16 articles on this topic. [...]

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