scholarly journals Most Women with Previous Gestational Diabetes Mellitus Have Impaired Glucose Metabolism after a Decade

2018 ◽  
Vol 19 (12) ◽  
pp. 3724
Author(s):  
Wahlberg Jeanette ◽  
Ekman Bertil ◽  
Arnqvist Hans
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Glucose Metabolism ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Impaired Glucose Metabolism

Of 1324 women diagnosed with gestational diabetes mellitus (GDM) in Sweden, 25% reported >10 years after the delivery that they had developed diabetes mellitus. We assessed the long-term risk of all glucose metabolic abnormalities in a subgroup of these women. Women (n = 51) previously diagnosed with GDM by capillary blood glucose ≥9.0 mmol/L (≈plasma glucose ≥10.0 mmol/L) after a 2 h 75 g oral glucose tolerance test (OGTT) were included. All underwent a clinical and biochemical evaluation, including a second 2 h 75 g OGTT. Individuals with known type 1 diabetes were excluded. At the follow-up, 12/51 (24%) reported previously diagnosed type 2 diabetes. Another four cases were diagnosed after the second OGTT, increasing the prevalence to 16/51 cases (31%). Impaired fasting plasma glucose (IFG) was diagnosed in 13/51 women and impaired glucose tolerance (IGT) in 10/51 women, leaving only 12 women (24%) with normal glucose tolerance. In addition, 2/51 women had high levels of glutamic acid decarboxylase (GAD) antibodies; of these, one woman classified as type 2 diabetes was reclassified as type 1 diabetes, and the second GAD-positive woman was diagnosed with IGT. Of the women diagnosed with GDM by a 2 h 75 g OGTT, a large proportion had impaired glucose metabolism a decade later, including type 1 and type 2 diabetes.

scholarly journals A prospective cohort study of postpartum glucose metabolic disorders in early versus standard diagnosed gestational diabetes mellitus

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Valeria Cosma ◽  
Jeanne Imbernon ◽  
Léonore Zagdoun ◽  
Pierre Boulot ◽  
Eric Renard ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Glucose Metabolism ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Glucose Metabolism Disorders

AbstractEarly gestational diabetes mellitus (eGDM) is diagnosed when fasting plasma glucose before 24 weeks of gestation (WG) is ≥ 5.1 mmol/L, whilst standard GDM is diagnosed between 24 and 28 WG by oral glucose tolerance test (OGTT). eGDM seems to have worse obstetric outcomes than standard GDM. We compared the rates of postpartum glucose metabolism disorders between women with early versus standard GDM in this prospective study on women with GDM from three university hospitals between 2014 and 2016. Patients were included if they were < 24 WG with at least one risk factor for GDM and excluded if they had type 2 diabetes. Patients were assigned to Group 1 (G1) for eGDM according to IADPSG: fasting blood glucose < 24 WG between 5.1 and 7 mmol/L. Group 2 (G2) consisted of patients presenting a standard GDM at 24–28 WG on OGTT results according to IADPSG: T0 ≥ 5.1 mmol/L or T60 ≥ 10.0 mmol g/L or T120 ≥ 8.5 mmol/L. The primary outcome was postpartum OGTT result. Five hundred patients were analysed, with 273 patients undergoing OGTT at 4–18 weeks postpartum: 192 patients in G1 (early) and 81 in G2 (standard). Patients in G1 experienced more insulin therapy during pregnancy than G2 (52.2% versus 32.5%, p < 0.001), but no patients were taking insulin postpartum in either group. G1 patients experienced less preterm labour (2.6% versus 9.1%, p = 0.043), more induced deliveries (38% versus 25%, p = 0.049) and reduced foetal complications (29.2% versus 42.0%, p = 0.048). There was no significant difference in the rate of postpartum glucose metabolism disorders (type 2 diabetes, impaired glucose tolerance, impaired fasting glycaemia) between groups: 48/192 (25%) in G1 and 17/81 (21%) in G2, p = 0.58. Thus the frequency of early postpartum glucose metabolism disorders is high, without difference between eGDM and standard GDM. This supports measurement of fasting plasma glucose before 24 WG and the threshold of 5.1 mmol/L seems appropriate until verification in future studies.Trial registration: NCT01839448, ClinicalTrials.gov on 22/04/2013.

scholarly journals High Prevalence of Type 2 Diabetes and Pre-Diabetes in Adult Offspring of Women With Gestational Diabetes Mellitus or Type 1 Diabetes: The role of intrauterine hyperglycemia

Diabetes Care ◽  
2007 ◽  
Vol 31 (2) ◽  
pp. 340-346 ◽  
Author(s):  
T. D. Clausen ◽  
E. R. Mathiesen ◽  
T. Hansen ◽  
O. Pedersen ◽  
D. M. Jensen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Adult Offspring ◽  
High Prevalence

scholarly journals Maternal Gestational Diabetes Mellitus, Type 1 Diabetes, and Type 2 Diabetes During Pregnancy and Risk of ADHD in Offspring

Diabetes Care ◽  
2018 ◽  
Vol 41 (12) ◽  
pp. 2502-2508 ◽  
Author(s):  
Anny H. Xiang ◽  
Xinhui Wang ◽  
Mayra P. Martinez ◽  
Darios Getahun ◽  
Kathleen A. Page ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diabetes Mellitus Type 1 ◽  
Diabetes Mellitus Type

Placental morphology in different types of diabetes mellitus

2021 ◽  
Vol 70 (2) ◽  
pp. 13-26
Author(s):  
Roman V. Kapustin ◽  
Ekaterina V. Kopteyeva ◽  
Tatyana G. Tral ◽  
Gulrukhsor Kh. Tolibova
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Type 1 Diabetes Mellitus ◽  
Different Types

AIM: The aim of this study was to compare placental morphological features from women with different types of diabetes mellitus considering method of DM correction. MATERIALS AND METHODS: A retrospective, single-center, cohort study was carried out. We analyzed morphological examination results of 3300 placentas, which made uр the following comparison groups: type 1 diabetes mellitus on continuous subcutaneous insulin infusion (n = 60), type 1 diabetes mellitus on multiple subcutaneous insulin injections (n = 446), type 2 diabetes mellitus on diet (n = 95), type 2 diabetes mellitus on insulin therapy (n = 134), gestational diabetes mellitus on diet (n = 1652), gestational diabetes mellitus on insulin therapy (n = 735), preeclampsia (n = 39), and the control group (n = 139). The examined placentas were weighed, with their sizes (two diameters and thickness), cotyledon structure and defects assessed. We determined the umbilical cord junction and external characteristics of extraembryonic membranes. Fragments of the placenta (5 pieces) were fixed in 10% neutral buffered formalin (pH 7.2), processed with the Leica TP1020 tissue processor and embedded in paraffin. Histological sections (3-4 m thick) were prepared and stained with hematoxylin-eosin. Statistical analysis was performed using the SPSS 23.0 and GraphPad Prism 8.0 software. RESULTS: Following characteristics were typical for all types of diabetes mellitus: increased placental mass metrics, chronic placental insufficiency, dissociated villous maturation disorder with prevalent immaturity, as well as involutive-dystrophic and circulatory disorders of varying severity. Placentas from women with type 1 diabetes mellitus had the specific sings: the predominance of intermediate immature villi and stem villi stromal fibrosis. The frequency of placental infarcts and fibrinoid content in the intervillous space were comparable to those in placentas from women with type 2 diabetes mellitus. Inflammatory changes and moderate placental calcification were most consistently associated with type 2 diabetes mellitus, while gestational diabetes mellitus was characterized by soft damages. Placentas with preeclampsia showed higher prevalence of premature villous maturation, compensated placental insufficiency, and fibrinoid depositions in the intervillous and subchorionic spaces. CONCLUSIONS: Understanding relationships between placental histological features and clinical aspects of diabetes mellitus makes it possible not only to clarify the pathophysiological processes occurring in this pathology but also to optimize the algorithm for the rational management of the neonatal period of children from mothers with diabetes mellitus.

scholarly journals Circulating progranulin levels in women with gestational diabetes mellitus and healthy controls during and after pregnancy

2012 ◽  
Vol 167 (4) ◽  
pp. 561-567 ◽  
Author(s):  
Jelena Todoric ◽  
Ammon Handisurya ◽  
Thomas Perkmann ◽  
Bernhard Knapp ◽  
Oswald Wagner ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Post Partum ◽  
Oral Glucose ◽  
Positive Correlation

ObjectiveProgranulin (PGRN) was recently introduced as a novel marker of chronic inflammatory response in obesity and type 2 diabetes capable of directly affecting the insulin signaling pathway. This study aimed to investigate the role of PGRN in gestational diabetes mellitus (GDM), which is regarded as a model for early type 2 diabetes.MethodsPGRN serum levels were measured in 90 pregnant women (45 GDM and 45 normal glucose tolerance (NGT)). In addition, PGRN was measured during a 2-h, 75 g oral glucose tolerance test in 20 pregnant women (ten GDM and ten NGT) and in 16 of them post partum (ten GDM and six NGT).ResultsPGRN concentrations were significantly higher in pregnant women compared with post partum levels (536.79±31.81 vs 241.53±8.86, P<0.001). Multivariate regression analyses showed a strong positive correlation of PGRN with estrogen and progesterone. The insulinogenic index, a marker of early insulin secretion, displayed a positive correlation with PGRN, both during and after pregnancy (R=0.47, P=0.034; R=0.63, P=0.012). HbA1c and the oral glucose insulin sensitivity index showed significant post partum associations with PGRN (R=0.43, P=0.049; R=−0.65, P=0.009).ConclusionsPGRN concentrations are markedly lower after pregnancy regardless of the gestational glucose tolerance state. PGRN levels per se do not discriminate between mild GDM and NGT in pregnant women. Therefore, the development of GDM appears to be due to impaired β-cell function that is not related to PGRN effect.

scholarly journals A case of euglyacemic diabetic ketoacidosis in a patient with gestational diabetes mellitus

2014 ◽  
Vol 7 (4) ◽  
pp. 174-176 ◽  
Author(s):  
UM Graham ◽  
IE Cooke ◽  
DR McCance
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diabetic Ketoacidosis ◽  
Plasma Glucose ◽  
Fetal Movement ◽  
Intravenous Dextrose

A 30-year old woman at 30 weeks gestation with insulin-controlled gestational diabetes was admitted with nausea and vomiting. Plasma glucose was 3.3 mmol/l with pH 7.23 and raised capillary ketones at 6.1 mmol/l. She was diagnosed with euglycaemic diabetic ketoacidosis. Cardiotocography showed good fetal movement and accelerations. She was given intramuscular betamethasone and started on intravenous dextrose, insulin and 0.9% saline with potassium chloride with resolution of ketosis. Euglycaemic diabetic ketoacidosis has been reported during pregnancy in patients with type 1 and type 2 diabetes. We believe that this is a report of such an occurrence in a patient with gestational diabetes.

scholarly journals Fetal Macrosomia in the Diabetic Woman

2012 ◽  
Vol 19 (1) ◽  
pp. 41-48
Author(s):  
Marlena Pascu ◽  
Ruxandra Miulescu ◽  
C. Ionescu-Tîrgoviste
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
General Population ◽  
Gestational Diabetes ◽  
Fetal Macrosomia ◽  
Diabetic Woman

Fetal Macrosomia in the Diabetic WomanDiabetes mellitus complicates up to 10% of pregnancies, while in Romania the incidence is this under 5%. In most of the cases we are talking about gestational diabetes, while only in 0.1 - 0.3% of the cases, the diabetes was pregestational (mainly Type 1 diabetes and rarely Type 2 diabetes or Mody). The study we conducted concerned the incidence of macrosomia in the general population; in the study we investigated 3,000 pregnant patients who gave birth in the Unit of Obstetrics & Gynecology of ‘Dr Cantacuzino’ Hospital from 13th January 2007 to 30th March 2010. The 7.1% of incidence of diabetes mellitus highlighted by the study which aimed to trace gestational diabetes conducted in 2007-2010 period with the assistance of the ‘Dr Cantacuzino’ Hospital, represents just the tip of the iceberg. The positive diagnosis of gestational diabetes identified not only women who had diabetes mellitus pre-existing the pregnancy, without their being aware of it, but also women with a pathology of carbohydrate metabolism who will in the future run a higher risk of developing type 2 diabetes mellitus.

scholarly journals Relationship between type 2 diabetes and pancreatic cancer

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
M. Temel Yilmaz ◽  
Ali Osman Gürol
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Pancreatic Cancer ◽  
Type 1 Diabetes ◽  
Glucose Metabolism ◽  
Animal Experiments ◽  
Main Factors ◽  
Increase In Risk

Diabetes mellitus and cancer are conditions that constitute a serious problem for the health of the world’s population, and their co-existence in the same person is becoming increasingly common. Glucose metabolism and the presence of insulin in inflammatory situations appear to be the main factors driving this association, where hyperinsulinemia has been shown to contribute to an increase in risk of association between type 2 diabetes and cancer. Therefore, administering lower levels of exogenously administered insulin to patients with type 1 diabetes would decrease their risk of developing cancer when compared to patients with type 2 diabetes. The results from animal experiments seem promising in terms of pharmacological treatment.

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