scholarly journals The Efficacy of an Intensive Lifestyle Modification Program on Psychosocial Outcomes among Rural Women with Prior Gestational Diabetes Mellitus: Six Months Follow-Up of a Randomized Controlled Trial

2021 ◽  
Vol 18 (4) ◽  
pp. 1519
Author(s):  
Jia Guo ◽  
Qing Long ◽  
Jundi Yang ◽  
Qian Lin ◽  
James Wiley ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Social Support ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Perceived Stress ◽  
Lifestyle Modification ◽  
Intervention Group ◽  
Control Group ◽  
Significant Group ◽  
Lifestyle Modification Program

Women with prior gestational diabetes mellitus (GDM) are at a higher risk of type 2 diabetes and other health issues after delivery. They may have a lower quality of life (QoL), experience more medical-related stress, and need more support than those without it. This study aimed to examine the six-month efficacy of an intensive lifestyle modification program on perceived stress, social support, and QoL among women with prior GDM in rural China. A total of 320 women with prior GDM were randomly assigned to an intervention group (n = 160) and a control group (n = 160). Participants in the intervention group received an intensive lifestyle modification (ILSM) program, including a series of six biweekly face-to-face sessions and five biweekly phone sessions delivered by trained local health workers. The control group received the usual care. Data about perceived stress, social support, QoL, and HbA1c were collected at baseline, at three months, and at six-month follow-ups. Generalized estimating equation analysis was used to assess the efficacy of the intervention. There were significant improvements in the psychological domain (β = 0.479 ± 0.153, p = 0.002) and environmental domain (β = 0.462 ± 0.145, p = 0.001) of QoL over six months; there were significant group effects (β = −0.718 ± 0.280, p = 0.010) and time effects (β = 0.453 ± 0.211, p = 0.032) in physiological domain, and there were significant group effects in the social relations domain (β = −0.669 ± 0.321, p = 0.037). The ILSM group had a more pronounced downward trend in HbA1c than the control group (β = −0.050 ± 0.026, p = 0.059). The ILSM program can help women with GDM improve their psychological and environmental domain of QoL. It can be recommended as a form of health promotion for improving QoL among women with prior GDM in rural primary care settings in developing countries.

scholarly journals Effect of a Mediterranean Diet-Based Nutritional Intervention on the Risk of Developing Gestational Diabetes Mellitus and Other Maternal-Fetal Adverse Events in Hispanic Women Residents in Spain

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3505
Author(s):  
Verónica Melero ◽  
Nuria García de la Torre ◽  
Carla Assaf-Balut ◽  
Inés Jiménez ◽  
Laura del Valle ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Hispanic Women ◽  
Controlled Trial ◽  
Intervention Group ◽  
Nutritional Intervention ◽  
Adverse Outcomes ◽  
Control Group ◽  
Tract Infections

Gestational diabetes mellitus (GDM) is the most frequent morbidity found in pregnancy, and it increases the risk for several maternal-fetal complications. Hispanic women are considered at high risk. The St. Carlos GDM prevention study is a randomized controlled trial (RCT) conducted from 2016–2017. Normoglycemic women were randomized at 12–14 Gestation week (WG) to an intervention group (IG) receiving recommendations based on the MedDiet (supplemented with ExtraVirgin Olive Oil/pistachios), or to a control group (CG), recommended to limit fat intake. After RCT conclusion, IG recommendations were applied to a real-world group (RW) in routine clinical practice. The primary endpoint of the current study is an assessment of the GDM rate in Hispanic participants of the aforementioned studies: 132 RCT, 128 CT, 284 RW participants. The GDM rate was lower in IG: 19/128(14.8%), p = 0.021, and RW: 38/284(13.4%), p = 0.029) than in CG: 34/132(25.8%). Adjusted RR (95%CI) for GDM: 0.72 (0.50–0.97), p = 0.037 in IG and 0.77 (0.61–0.97), p = 0.008 in RW. Rates of urinary tract infections, emergency caesarean-sections and perineal trauma were also lower in IG and RW. Other adverse outcomes were lower in IG vs. CG. In conclusion, a MedDiet-based intervention reduces the rate of GDM and several adverse maternal-fetal outcomes in Hispanic women residing in Spain.

scholarly journals Lifestyle intervention to prevent gestational diabetes mellitus and adverse maternal outcomes among pregnant women at high risk for gestational diabetes mellitus

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052097913
Author(s):  
Xueyan Lin ◽  
Ting Yang ◽  
Xueqin Zhang ◽  
Wei Wei
Keyword(s):  
Diabetes Mellitus ◽  
Logistic Regression ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Lifestyle Intervention ◽  
Intervention Group ◽  
Control Group ◽  
Maternal Outcomes ◽  
Multivariate Logistic Regression

Objective We assessed the effects of a lifestyle intervention on gestational diabetes mellitus (GDM) incidence and risk of adverse maternal outcomes among pregnant women at high risk for GDM. Methods From July to December 2018, we enrolled 1822 eligible pregnant women; of these, 304 had at least one risk factor for GDM. Participants were randomly allocated to the intervention or control group. Usual prenatal care was offered to both groups; the intervention group also received individually modified education on diet, physical activity, and weight control. The GDM diagnosis was based on an oral glucose tolerance test at 24–28 gestational weeks. Multivariate logistic regression was used to evaluate the effects of the lifestyle intervention on risk of GDM and adverse maternal outcomes. Results A total of 281 women (139 in the intervention group and 142 controls) were included. Incidences of GDM and adverse maternal outcomes were all significantly lower in the intervention than in the control group. Multivariate logistic regression indicated that women in the intervention group had a lower risk of GDM and adverse maternal outcomes, after adjusting potential confounding factors. Conclusion The present lifestyle intervention was associated with lower risks of GDM and adverse maternal outcomes.

scholarly journals Benefits of Adhering to a Mediterranean Diet Supplemented with Extra Virgin Olive Oil and Pistachios in Pregnancy on the Health of Offspring at 2 Years of Age. Results of the San Carlos Gestational Diabetes Mellitus Prevention Study.

2020 ◽  
Vol 9 (5) ◽  
pp. 1454
Author(s):  
Verónica Melero ◽  
Carla Assaf-Balut ◽  
Nuria García de la Torre ◽  
Inés Jiménez ◽  
Elena Bordiú ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Mediterranean Diet ◽  
Hospital Admissions ◽  
Controlled Trial ◽  
Virgin Olive Oil ◽  
Intervention Group ◽  
Control Group ◽  
Prevention Study

The intrauterine environment may be related to the future development of chronic diseases in the offspring. The St. Carlos gestational diabetes mellitus (GDM) prevention study, is a randomized controlled trial that evaluated the influence of the early (before 12th gestational week) Mediterranean diet (MedDiet) on the onset of GDM and adverse gestational outcomes. Out of 874 women assessed after delivery (440 control group (CG)/434 intervention group (IG)), 703 children were followed (365/338; CG/IG), with the aim to assess whether the adherence to a MedDiet during pregnancy induces health benefits for the offspring during the first two years of life. Logistic regression analysis showed that the IG in children of mothers with pre-gestational body mass index (BMI) < 25 kg/m2 and normal glucose tolerance (NGT), was associated with a lower risk (RR(95% CI)) of suffering from severe events requiring hospitalization due to bronchiolitis/asthma (0.75(0.58–0.98) and 0.77(0.59–0.99), respectively) or other diseases that required either antibiotic (0.80(0.65–0.98) and 0.80(0.65–0.99), respectively), corticosteroid treatment (0.73(0.59–0.90) and 0.79(0.62–1.00) respectively) or both (all p < 0.05). A nutritional intervention based on the MedDiet during pregnancy is associated with a reduction in offspring’s hospital admissions, especially in women with pre-gestational BMI < 25 kg/m2 and NGT.

scholarly journals The Effect of a Single Mega dose Injection of Vitamin D on serum Adiponectin concentration at First Gestational Diabetes Mellitus: A Randomized Controlled Clinical Trial

2019 ◽  
Author(s):  
Mahdieh Hosseinzadeh ◽  
Elham Razmpush ◽  
Elham Shareghfarid ◽  
Elham Hosseinzadeh ◽  
Hossein Hadinedoushan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Clinical Trial ◽  
Vitamin D ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Intramuscular Injection ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Adiponectin Concentration

Abstract Background: vitamin D is being increasingly recognized for its important non-skeletal functions including endocrine actions. This study investigated if a single, large, intramuscular post‐artum injection of vitamin D improve adiponectin levels among women with gestational diabetes mellitus (GDM). Methods: A total of 45 pregnant women with GDM participated in this randomized clinical trial. They were randomly divided into intervention and control group. The intervention group received an intramuscular injection of 300,000 IU of vitamin D during 3 to 10 days after their child delivery, but controls did not. Serum 25‐hydroxyvitamin D, fasting blood glucose, HbA1c and serum adiponectin were measured at baseline and after 3 months of intervention. Results: Serum 25 OH vitamin D increase significantly in the intervention but not in the control group from 24.25 to 62.10 (nmol/l) (p-value< 0.01). Comparison in within group showed that adiponectin level increased significantly only among intervention group after the vitamin D injection from 7.45 to 8.98 (ngr/dl) (P-value=0.01), while between group comparisons showed no significant differences in adiponectin concentration after the intervention (P-value<0.05). Between and within group comparisons reported no significant alterations in the levels of glycated hemoglobin (HbA1c) and FPG (fasting plasma glucose), as well. Conclusions: The 300,000 IU single dose of intramuscular injection of vitamin D is regarded as an effective procedure to improve vitamin D status which significantly increased the adiponectin levels among mothers with gestational diabetes after delivery. Trial registration: The trial was registered in Iranian Registry of Clinical Trials available at http://www.irct.ir. The reference number is IRCT138902113840N1.

Improved Insulin Resistance through Cajanus cajan extract in Gestational Diabetes Mellitus of Wistar Rat

2019 ◽  
Vol 15 (4) ◽  
pp. 257-269
Author(s):  
Nikita Saraswat ◽  
Pranay Wal ◽  
Ankita Wal ◽  
Rashmi Saxena Pal
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Ethyl Acetate ◽  
Cajanus Cajan ◽  
Intervention Group ◽  
Chloroform Extract ◽  
Control Group ◽  
Pregnant Rats

Background: Gestational Diabetes Mellitus (GDM) has a serious impact on maternal health as well as on the health of the infant. This is also very closely related to adverse outcomes in pregnancy. A mother suffering from gestational diabetes mellitus (GDM) has high incidences of showing significant risks to the fetus health, growth and development. As the incidences of GDM are increasing day by day, therefore, maternal health, age and obesity parameters are of major concern for reflecting GDM during their pregnancy conditions. It has been studied and investigated that IR (Insulin Resistance) is a common pathway in GDM and T2DM (Type 2 Diabetes Mellitus). Objective: To explore the effect of Cajanus cajan in treating gestational diabetes mellitus (GDM) in Wistar rats. Methods: The study was conducted on 30 female rats which were caged along with male rats. We obtained 26 pregnant rats which were weighed. The pregnant rats in the control group, intervention group, and GDM group were equally randomized. When the pregnancy was verified, the Intervention and the GDM (Gestational Diabetes Mellitus) group were given 45 mg/kg streptozotocin by the peritoneal injection for inducing GDM while the control group was given an equal volume of the citrate buffer. When the model was established accurately then the intervention group was administered orally with the extracts of leaves of Cajanus cajan chloroform extract (270mg/kg), Methanol extract (270mg/kg) and Ethyl acetate extract (270mg/kg). Whereas the other groups were administered with water and diet. The blood samples were collected and the fetal rats along with placental weight were recorded on the 19th day of the pregnancy. The serum glucose levels, serum insulin levels, and lipid levels were recorded in pregnant rats before the delivery. Results: The rats were weighed before and after delivery, fetal weight was recorded, placental weight of the GDM group was found to be lower than the control group as well as the intervention groups. Treating with (Chloroform extract, Methanol extract, Ethyl acetate extract (270mg/kg) different extracts of Cajanus cajan leaf in the intervention groups the lipid levels of the intervention group significantly increased in case of the Methanolic extract whereas the other extracts were also effective. The levels of antioxidant enzymes of the GDM group in pancreas and liver tissue were lower in intervention groups as compared to control and GDM group whereas the antioxidant enzyme levels in the liver and pancreas were equivalent to the control group. : The results showed that the ethyl acetate and methanol extracts of the Cajanus cajan leaves might have bioactive and hypoglycemic nature. Further research is required for the complete evaluation of the active compound in various animal models to justify the nature of the compound. Conclusion: Cajanus cajan leaf extract suppresses oxidative stress and insulin resistance, therefore, improves the blood glucose levels in GDM rats.

Thyroid Dysfunction in Pregnant Women with Gestational Diabetes Mellitus

2020 ◽  
Vol 16 (8) ◽  
pp. 895-899 ◽  
Author(s):  
Shahin Safian ◽  
Farzaneh Esna-Ashari ◽  
Shiva Borzouei
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Thyroid Dysfunction ◽  
Control Group ◽  
Thyroid Peroxidase ◽  
Free T4 ◽  
Significant Difference ◽  
Experimental Group

Aims: Investigation thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes mellitus. Background: This article was written to evaluate the thyroid function and anti-thyroid peroxidase (anti- TPO) antibodies in pregnant women with gestational diabetes mellitus (GDM). Method: A total of 252 women with GDM and 252 healthy pregnant women were enrolled. Thyroid tests, including TSH, FreeT3, Free T4, and anti-TPO were performed for all women at 24–28 weeks of gestation. Data analysis was then carried out using SPSS ver. 22. Result: There was a significant difference between the experimental group (38.4%) and the control group (14.06%) in terms of the prevalence of subclinical hypothyroidism (p= 0.016). The frequency of anti-TPO was higher in the experimental group than the control group and positive anti-TPO was observed in 18.6% of women with GDM and 10.3% of healthy pregnant women (P= 0.008). Conclusion: Thyroid disorders are observed in pregnant women with GDM more frequently than healthy individuals and it may be thus reasonable to perform thyroid tests routinely.

scholarly journals Associations between gestational diabetes mellitus and the neurodevelopment of offspring from 1 month to 72 months: study protocol for a cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e040305
Author(s):  
Chao Li ◽  
Ping Zhou ◽  
Yixi Cai ◽  
Bin Peng ◽  
Yongfang Liu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Public Health Problem ◽  
Multiple Linear Regression Model ◽  
Preschool Age ◽  
Control Group ◽  
Global Public Health ◽  
Open Access Journals

IntroductionGestational diabetes mellitus (GDM) is a common gestational disease and an important global public health problem. GDM may affect the short-term and long-term health of offspring, but the associations between GDM and the neurodevelopment of offspring of mothers with GDM (OGDM) are still unclear, and studies based on the Chinese population are lacking. We aim to determine the associations between GDM and the neurodevelopment of OGDM by studying a cohort of OGDM and offspring of non-GDM mothers.Methods and analysisThe single-centre prospective cohort study is being conducted in China over 7 years. A total of 490 OGDM (GDM group) and 490 fromof healthy mothers (control group) will be enrolled during the same period. Baseline characteristics, neuropsychological development scores and clinical data at specific time points (at 0, 1, 3, 6, 12, 24, 36, 48, 60 and 72 months old) will be collected from the children in both groups until the age of 6 years. The associations between GDM and the neurodevelopment of OGDM from infancy to preschool age will be analysed using a multiple linear regression model adjusted for confounders. In addition, we will compare longitudinal data to further assess the effects of GDM on neurodevelopmental trajectories.Ethics and disseminationThe study has been approved by the Ethics Committee of the Children’s Hospital of Chongqing Medical University (Approval Number: (2019) Institutional Review Board (IRB) (STUDY) No. 85). The findings of this study will be disseminated through open access journals, peer-reviewed journals and scientific meetings.Trial registration numberNCT03997396.

Searching for Utopia, the Challenge of Standardized Medical Nutrition Therapy Prescription in Gestational Diabetes Mellitus Management: A Critical Review

2021 ◽  
Author(s):  
Nina Meloncelli ◽  
Shelley A. Wilkinson ◽  
Susan de Jersey
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Lifestyle Modification ◽  
Nutrition Therapy ◽  
Medical Nutrition Therapy ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Medical Nutrition

AbstractGestational diabetes mellitus (GDM) is a common pregnancy disorder and the incidence is increasing worldwide. GDM is associated with adverse maternal outcomes which may be reduced with proper management. Lifestyle modification in the form of medical nutrition therapy and physical activity, as well as self-monitoring of blood glucose levels, is the cornerstone of GDM management. Inevitably, the search for the “ultimate” diet prescription has been ongoing. Identifying the amount and type of carbohydrate to maintain blood glucose levels below targets while balancing the nutritional requirements of pregnancy and achieving gestational weight gain within recommendations is challenging. Recent developments in the area of the gut microbiota and its impact on glycemic response add another layer of complexity to the success of medical nutrition therapy. This review critically explores the challenges to dietary prescription for GDM and why utopia may never be found.

scholarly journals Management of postprandial hyperglycaemia and weight gain in women with gestational diabetes mellitus using a novel telemonitoring system

2018 ◽  
Vol 47 (2) ◽  
pp. 754-764 ◽  
Author(s):  
Ebtisam A. Al-ofi ◽  
Hala H. Mosli ◽  
Kholoud A. Ghamri ◽  
Sarah M. Ghazali
Keyword(s):  
Diabetes Mellitus ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Dietary Advice ◽  
Control Group ◽  
Close Monitoring ◽  
Pregnancy Weight Gain ◽  
Glucose Levels ◽  
Pregnancy Weight

Objectives The purpose of this study was to investigate the effect of remotely delivered telemedicine dietary advice on monitoring of blood glucose levels and weight gain of women with gestational diabetes mellitus (GDM). Methods Women with GDM were recruited and randomly allocated into two groups: a Tele-GDM group that received a telemonitoring device, and a control group that was followed-up traditionally. A telemonitoring service calculated the ratio of reaching or exceeding the pregnancy weight gain target (according to pre-pregnancy weight), following Institute of Medicine guidelines for healthy pregnancy weight gain. Results The sample comprised 27 women in the Tele-GDM group and 30 in the control group. At the end of pregnancy, the Tele-GDM group showed significantly lower 2-hour postprandial glucose levels than the control group. Most women in the Tele-GDM group reached their recommended range of weight gain at the end of pregnancy. Additionally, the Tele-GDM group showed significantly lower weight gain than the control group. Conclusions Telemonitoring can facilitate close monitoring of women with GDM and motivate patients to adopt a healthy lifestyle.

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