scholarly journals A Review of the Current Status of Gestational Diabetes Mellitus in Australia—The Clinical Impact of Changing Population Demographics and Diagnostic Criteria on Prevalence

2020 ◽  
Vol 17 (24) ◽  
pp. 9387
Author(s):  
Josephine G Laurie ◽  
H. David McIntyre
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Models Of Care ◽  
Overweight And Obesity ◽  
Current Status ◽  
Research Education ◽  
Acute Response ◽  
Future Challenges ◽  
Maternal Overweight

The current status of gestational diabetes mellitus in Australia reveals an almost quadrupling prevalence over the last decade. A narrative review of the current Australian literature reveals unique challenges faced by Australian maternity clinicians when addressing this substantial disease burden in our diverse population. Rising rates of maternal overweight and obesity, increasing maternal age and the diversity of ethnicity are key epidemiological impactors, overlaid by the 2015 changes in screening and diagnostic parameters. Our vast land mass and the remote location of many at risk women requires innovative and novel ideas for pathways to diagnose and effectively manage women with gestational diabetes mellitus. By modifying and modernizing models of care for women with gestational diabetes mellitus, we have the ability to address accessibility, resource management and our acute response to global events such as the COVID 19 pandemic. With continuing research, education and robust discourse, Australia is well placed to meet current and future challenges in the management of gestational diabetes mellitus.

scholarly journals Racial/ethnic differences in the prevalence of gestational diabetes mellitus and maternal overweight and obesity, by Nativity, Florida, 2004-2007

Obesity ◽  
2013 ◽  
Vol 21 (1) ◽  
pp. E33-E40 ◽  
Author(s):  
Shin Y. Kim ◽  
William Sappenfield ◽  
Andrea J. Sharma ◽  
Hoyt G. Wilson ◽  
Connie L. Bish ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Ethnic Differences ◽  
Overweight And Obesity ◽  
Maternal Overweight ◽  
Racial Ethnic

scholarly journals Screening of gestational diabetes mellitus using fasting plasma glucose before the 24th gestational week in women with different pre-pregnancy body mass index

2020 ◽  
Vol 7 (2) ◽  
pp. 218
Author(s):  
Sambit Das ◽  
Mahesh Rath ◽  
Lipsa Das ◽  
Kasturi Bharadwaj
Keyword(s):  
Diabetes Mellitus ◽  
Body Mass Index ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Body Mass ◽  
Gestational Age ◽  
Overweight And Obesity ◽  
Oral Glucose ◽  
Gestational Week ◽  
Overweight Or Obesity

Background: Gestational Diabetes Mellitus (GDM) is usually diagnosed between 24th and 28th gestational week using the 75-g Oral Glucose Tolerance Test (OGTT). It is controversial that if FPG ≥92 mg/dL before 24th gestational week should be intervened or not. The aim of this study was to evaluate the value of FPG to screen GDM before 24th gestational week in women with different pre-pregnancy Body Mass Index (BMI).Methods: This was a hospital based retrospective cohort study done at CHC Balipatna, Khurdha, Odisha. Women who had a singleton live birth between June 20, 2016 and June 30, 2019, resided in Balipatna block area and received prenatal care in the Community Health Centre, were included in this study. Pre-pregnancy BMI, FPG before the 24th gestational week, and one-step GDM screening with 75 g-OGTT at the 24th to 28th gestational weeks were extracted from medical records and analyzed. The pregnant women were classified into four groups based on pre-pregnancy BMI: Group A (underweight), Group B (normal), Group C (overweight) and Group D (obesity). Statistical analysis using independent sample t-test, Analysis of Variance (ANOVA) and Pearson Chi-square test was done.Results: The prevalence of GDM was 20.0% (68/341) in the study population. FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week. The incidence of GDM in women with FPG ≥92 mg/dL in the 19th to 24th gestational weeks and pre-pregnancy overweight or obesity was significantly higher than that in women with FPG ≥92 mg/dL and pre-pregnancy BMI <24.0 kg/m2.Conclusions: FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week. Pre-pregnancy overweight or obesity was associated with an increased FPG value before the 24th gestational week. FPG ≥92 mg/dL between 19 and 24 gestational weeks should be treated as GDM in women with pre-pregnancy overweight and obesity.

scholarly journals Hypocalcaemia, Hypoglycaemia, Macrosomia and Congenital Cryptorchidism in a Male Offspring of a Mother with Overweight and Gestational Diabetes Mellitus

2016 ◽  
Vol 23 (4) ◽  
pp. 353-359
Author(s):  
Alphonsus N. Onyiriuka ◽  
Sandra O. Edorhe
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Male Infant ◽  
Total Serum ◽  
Left Testis ◽  
Family History Of Diabetes ◽  
Total Serum Calcium ◽  
The Right ◽  
Maternal Overweight

AbstractThis paper reports a case of a male infant born to a 32-year-old multiparous mother with overweight (BMI 28.5kg/m2) and gestational diabetes mellitus (GDM). The mother had fasting hyperglycaemia (range 5.7- 6.0mmol/L) noted at 24 weeks of pregnancy and was managed with diet alone. There is no family history of diabetes mellitus and the mother did not have pre-eclampsia. Physical examination of the infant revealed macrosomia (birthweight, 4600g) and bilateral congenital cryptorchidism. The baby suffered severe hypoglycaemia (blood glucose 1.7mmol/L) and hypocalcaemia (total serum calcium 1.03mmol/L), manifesting with seizures. He was successfully managed with 10% dextrose water and calcium gluconate infusion, using standard protocol. His karyotype is 46 XY. The patient was discharged from admission at the age of 10 days and was referred to the paediatric endocrinologist at the tertiary hospital. By 8 weeks of age, the right testis was noticed to have descended into the right scrotum. At the age of 3 months, the left testis was still not palpable either in the inguinal canal or the scrotal sac. The patient was lost to follow up. Conclusion: Diet-treated maternal overweight in association with GDM could potentially increase the risk for hypocalcaemia, hypoglycaemia, macrosomia and congenital cryptorchidism in the offspring, highlighting the need for physicians to assess for the presence of these morbidities in such infants.

scholarly journals The Role of Arachidonic and Linoleic Acid Derivatives in Pathological Pregnancies and the Human Reproduction Process

2020 ◽  
Vol 21 (24) ◽  
pp. 9628
Author(s):  
Małgorzata Szczuko ◽  
Justyna Kikut ◽  
Natalia Komorniak ◽  
Jacek Bilicki ◽  
Zbigniew Celewicz ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Fatty Acids ◽  
Linoleic Acid ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Overweight And Obesity ◽  
Male Reproduction ◽  
Human Reproduction ◽  
In Pregnancy

The aim of the available literature review was to focus on the role of the proinflammatory mediators of AA and LA derivatives in pathological conditions related to reproduction and pregnancy. Arachidonic (AA) and linoleic acid (LA) derivatives play important roles in human fertility and the course of pathological pregnancies. Recent studies have demonstrated that uncontrolled inflammation has a significant impact on reproduction, spermatogenesis, endometriosis, polycystic ovary syndrome (PCOS) genesis, implantation, pregnancy and labor. In addition, cyclooxygenase-mediated prostaglandins and AA metabolite levels are higher in women’s ovarian tissue when suffering from PCOS. It has been demonstrated that abnormal cyclooxygenase-2 (COX-2) levels are associated with ovulation failure, infertility, and implantation disorders and the increase in 9-HODE/13-HODE was a feature recognized in PCOS patients. Maintaining inflammation without neutrophil participation allows pregnant women to tolerate the fetus, while excessive inflammatory activation may lead to miscarriages and other pathological complications in pregnancies. Additionally AA and LA derivatives play an important role in pregnancy pathologies, e.g., gestational diabetes mellitus, preeclampsia (PE), and fetal growth, among others. The pathogenesis of PE and other pathological states in pregnancy involving eicosanoids have not been fully identified. A significant expression of 15-LOX-1,2 was found in women with PE, leading to an increase in the synthesis of AA and LA derivatives, such as hydroxyeicozatetraenoic acids (HETE) and hydroxyoctadecadiene acids (HODE). Synthesis of the metabolites 5-, 8-, 12-, and 15-HETE increased in the placenta, while 20-HETE increased only in umbilical cord blood in women with preeclampsia compared to normal pregnancies. In obese women with gestational diabetes mellitus (GDM) an increase in epoxygenase products in the cytochrome P450 (CYP) and the level of 20-HETE associated with the occurrence of insulin resistance (IR) were found. In addition, 12- and 20-HETE levels were associated with arterial vasoconstriction and epoxyeicosatrienoic acids (EETs) with arterial vasodilatation and uterine relaxation. Furthermore, higher levels of 5- and 15-HETE were associated with premature labor. By analyzing the influence of free fatty acids (FFA) and their derivatives on male reproduction, it was found that an increase in the AA in semen reduces its amount and the ratio of omega-6 to omega-3 fatty acids showed higher values in infertile men compared to the fertile control group. There are several studies on the role of HETE/HODE in relation to male fertility. 15-Hydroperoxyeicosatetraenoic acid may affect the integrity of the membrane and sperm function. Moreover, the incubation of sperm with physiologically low levels of prostaglandins (PGE2/PGF2α) improves the functionality of human sperm. Undoubtedly, these problems are still insufficiently understood and require further research. However, HETE and HODE could serve as predictive and diagnostic biomarkers for pregnancy pathologies (especially in women with risk factors for overweight and obesity). Such knowledge may be helpful in finding new treatment strategies for infertility and the course of high-risk pregnancies.

scholarly journals The Pathophysiology of Gestational Diabetes Mellitus

2018 ◽  
Vol 19 (11) ◽  
pp. 3342 ◽  
Author(s):  
Jasmine Plows ◽  
Joanna Stanley ◽  
Philip Baker ◽  
Clare Reynolds ◽  
Mark Vickers
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Molecular Mechanisms ◽  
Overweight And Obesity ◽  
Chronic Hyperglycemia ◽  
Increased Risk

Gestational diabetes mellitus (GDM) is a serious pregnancy complication, in which women without previously diagnosed diabetes develop chronic hyperglycemia during gestation. In most cases, this hyperglycemia is the result of impaired glucose tolerance due to pancreatic β-cell dysfunction on a background of chronic insulin resistance. Risk factors for GDM include overweight and obesity, advanced maternal age, and a family history or any form of diabetes. Consequences of GDM include increased risk of maternal cardiovascular disease and type 2 diabetes and macrosomia and birth complications in the infant. There is also a longer-term risk of obesity, type 2 diabetes, and cardiovascular disease in the child. GDM affects approximately 16.5% of pregnancies worldwide, and this number is set to increase with the escalating obesity epidemic. While several management strategies exist—including insulin and lifestyle interventions—there is not yet a cure or an efficacious prevention strategy. One reason for this is that the molecular mechanisms underlying GDM are poorly defined. This review discusses what is known about the pathophysiology of GDM, and where there are gaps in the literature that warrant further exploration.

scholarly journals Gestational Diabetes Mellitus: Impact of Maternal Blood Sugar Level and BMI on Foetal Birth Weight

2019 ◽  
Vol 4 (02) ◽  
Author(s):  
Dr. Bipul Prasad Deka ◽  
Dr. Dimpy Begum
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Fasting Blood Glucose ◽  
Maternal Blood ◽  
Overweight And Obesity ◽  
Medical College ◽  
Control Study ◽  
Diabetic Mothers

Gestational diabetes mellitus (GDM) is defined as glucose intolerance of variable degrees with an onset, or first recognized, during pregnancy. About 15-45% of babies born to diabetic mothers can have macrosomia. This prospective case control study was conducted in the department of Obstetrics and Gynaecology of Gauhati medical college and hospital, Guwahati, Assam during the period of 2013-2015. A total of 160 patients were included in the study. 100 patients without any glucose abnormality were taken as control and 60 patients with gestational diabetes mellitus were included in the study as cases. In this study it was found that mean birth weight in GDM cases is more than normoglycemic control. The overweight and obesity group (BMI>25) have maximum birth weight. In this study it was found that the fasting blood glucose level is maximum in mothers with baby birth weight >3.5 kg.

Exercise, pregnancy, and insulin sensitivity – what is new?

2007 ◽  
Vol 32 (3) ◽  
pp. 537-540 ◽  
Author(s):  
Peter Damm ◽  
Bettina Breitowicz ◽  
Hanne Hegaard
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Insulin Sensitivity ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnancy Complications ◽  
Overweight And Obesity

Pregnancy is characterized by a marked physiological insulin resistance. Overweight and obesity or lack of physical activity can aggravate this reduced insulin sensitivity further. Increased insulin resistance has been associated with serious pregnancy complications, such as gestational diabetes mellitus (GDM) and pre-eclampsia. Recent studies clearly indicate that physical activity before and during pregnancy can reduce the risk of GDM and pre-eclampsia.

scholarly journals Effects of pre-pregnancy maternal body mass index on gestational diabetes mellitus

2018 ◽  
Vol 7 (1.9) ◽  
pp. 279 ◽  
Author(s):  
Priya Shirley Muller ◽  
M Nirmala
Keyword(s):  
Diabetes Mellitus ◽  
Body Mass Index ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Body Mass ◽  
Overweight And Obesity ◽  
Maternal Body Mass Index ◽  
Maternal Body ◽  
Good Glycaemic Control ◽  
Fetal Complications

The prevalence of both obesity and Gestational Diabetes Mellitus (GDM) is increasing worldwide. Overweight and obesity are abnormal or excessive fat accumulation that presents a risk to health. The presence of obesity has, in particular, a significant impact on both maternal and fetal complications associated with GDM. These complications can be addressed, at least in part, by good glycaemic control during pregnancy. The objective of the study is to classify GDM and non-GDM patients based on pre-pregnancy maternal Body Mass Index (BMI) and to assess and quantify the risk for GDM according to BMI.

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