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 ◽  
...  

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.

Diabetes Care ◽  
2020 ◽  
Vol 43 (4) ◽  
pp. 793-798 ◽  
Author(s):  
Sylvia H. Ley ◽  
Jorge E. Chavarro ◽  
Mengying Li ◽  
Wei Bao ◽  
Stefanie N. Hinkle ◽  
...  

Author(s):  
Cara Trivett ◽  
Zoe J. Lees ◽  
Dilys J. Freeman

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.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jiyu Sun ◽  
Gyu Ri Kim ◽  
Su Jin Lee ◽  
Hyeon Chang Kim

AbstractRecent studies have shown that gestational diabetes mellitus (GDM) is associated with an increased risk for cardiovascular disease. GDM has also been shown to be a risk factor for type 2 diabetes (T2DM) after pregnancy. However, there is limited evidence regarding the role of intercurrent T2DM on the relationship between GDM and future CVD. Thus, we investigated the risks of incident cardiovascular events among women with GDM during pregnancy compared to women without GDM and whether the increased CVD risk is dependent on intercurrent development of T2DM. We conducted a population-based retrospective cohort study using the Korean National Health Insurance Service claims database. Outcomes were the first occurrence of any CVD (myocardial infarction, treatment with coronary revascularization, heart failure, and cerebrovascular disease). Cox proportional hazard models were used to assess the association between GDM and incident CVD events, using landmark analysis at 4 years. A total of 1,500,168 parous women were included in the analysis, of which 159,066 (10.60%) had GDM. At a median follow-up of 12.8 years, 13,222 incident cases of total CVD were observed. Multivariable-adjusted hazard ratio for total CVD among women with prior GDM, compared with those without GDM, was 1.08 (95% CI 1.02–1.14). Further classifying GDM by progression to T2DM in relation to total CVD risk indicated a positive association for GDM with progression to T2DM vs no GDM or T2DM (HR 1.74; 95% CI 1.40–2.15), and no statistically significant association for GDM only (HR 1.06; 95% CI 1.00–1.12). GDM with subsequent progression to T2DM were linked with an increased risk of cardiovascular diseases. These findings highlight the need for more vigilant postpartum screening for diabetes and the implementation of diabetes interventions in women with a history of GDM to reduce future CVD risk.


EMJ Diabetes ◽  
2020 ◽  

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.


Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 337-343
Author(s):  
Manoharan Renugasundari ◽  
Pal GopalKrushna ◽  
Latha Chaturvedula ◽  
Nivedita Nanda ◽  
K. T. Harichandrakumar ◽  
...  

Introduction and Aim: Gestational diabetes mellitus (GDM), which is defined as diabetes diagnosed in the second and third trimesters of pregnancy, has emerged as a global public health concern. It has been associated with short-term and long-term adverse health outcomes for both mothers and their new-borns. Women with GDM are known to have decreased quality of life and increased risks of caesarean section, gestational hypertension, preeclampsia, and type 2 diabetes. In babies, GDM has been found to be associated with macrosomia or larger than normal gestational-aged infants, neonatal hypoglycemia, and type 2 diabetes mellitus later in life. Though yoga is known to improve the quality of life of diabetic patients, its role in the management of GDM has not been adequately assessed. Therefore, the present study was conducted to evaluate the effectiveness of Yoga on cardiometabolic parameters, psychophysical health and maternal and fetal outcomes in GDM patients at JIPMER hospital, Puducherry.   Methods: Fifteen pregnant women diagnosed to have GDM, admitted to Obstetrics Ward of JIPMER Hospital were recruited for the study. The intervention package of a thirty minutes Yoga module consisting of Sukshma Vyayama (2 min), Tadasana (1 min), Utthitapadasana (1 min),  Savasana in the left lateral posture (3 min), Nadisodhana or Anuloma-viloma pranayama (5 min), Chandranadi pranayama (5 min), Sheetali pranayama (5 min) and Bhramari pranayama (5 min) and Relaxation (3 min) was administered along with hospital routine treatment for 10 days during 35th/36th week (depending on the gestational week of admission to hospital), or until delivery. Cardiometabolic parameters including heart rate (HR), blood pressure (BP), rate pressure product (RPP) and glycemic status assessed by random blood sugar (RBS) were investigated. JIPMER hospital tool for the maternal and fetal outcome variables were used to assess the feto-maternal parameters. Perceived Stress Score (PSS) and Quality of Life Score (QoL) were used to assess the psychophysical health of the GDM patients. All the parameters were assessed before and after yoga intervention. Paired t test was used for statistical analysis of data. P value of <0.05 were considered to indicate significant statistical difference. Results: Statistically significant decrease in HR, BP, RPP, RBS, PSS, and increase in QoL, and improvement of fetomaternal outcomes (based on the normative data available in the department) were observed in GDM patients after yoga intervention for a period of seven to ten days during their hospital stay. Conclusion: A short-course yoga practice for 7-10 days is adequate to reduce cardiometabolic risks, psychological stress, and improve quality of life and feto-maternal outcomes in GDM patients.  Antenatal mother with GDM can use yoga as an adjunct therapy in the later part of pregnancy to prevent or reduce the complications and to improve the maternal and fetal outcomes of gestational diabetes mellitus.


Author(s):  
Muhas C. ◽  
Naseef P. P.

Diabetes mellitus is a chronic illness that requires continuing medical care and ongoing patient self-management education and support to prevent acute complications and to reduce the long-term complications. Moderate to severe maternal hyperglycemia in pregnancy has unique diabetes-related risks to mother and her unborn baby. So Gestational Diabetes mellitus (GDM) is a carbohydrate intolerance that is not diabetes that has developed or been discovered for the first time during pregnancy. Approximately 7% of pregnancies are affected by GDM. Patient with GDM are at higher risk for excessive weight gain, preeclampsia, and cesarean sections. Infants born to mothers with GDM are at higher risk for macrosomia, birth trauma, and shoulder dystocia. After delivery, these infants have a higher risk of developing hypoglycemia, hypocalcemia, hyperbilirubinemia, respiratory distress syndrome, polycythemia and subsequent obesity and type 2 diabetes. So the management of GDM is very important, and its management remains a challenge for the obstetricians and endocrinologists. MNT is the most common therapy which suffices for GDM, but when required. The pharmacological treatment becomes necessary, and the treatment of choice is human insulin. OHAs have also reached the high tables in the management of GDM. Glyburide and metformin have been found to be safe, effective and economical for the treatment of gestational diabetes. Let us join hands to manage the GDM effectively, not only for the present generation but also for the generations to come.


Diabetes ◽  
2012 ◽  
Vol 61 (12) ◽  
pp. 3167-3171 ◽  
Author(s):  
A.-G. Ziegler ◽  
M. Wallner ◽  
I. Kaiser ◽  
M. Rossbauer ◽  
M. H. Harsunen ◽  
...  

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