scholarly journals No Effect of Lifestyle Intervention during Third Trimester on Brain Programming in Fetuses of Mothers with Gestational Diabetes

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 556
Author(s):  
Franziska Schleger ◽  
Katarzyna Linder ◽  
Louise Fritsche ◽  
Jan Pauluschke-Fröhlich ◽  
Martin Heni ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Gestational Diabetes ◽  
Lifestyle Intervention ◽  
Fetal Brain ◽  
Postprandial Blood Glucose ◽  
Measurement Time ◽  
Third Trimester ◽  
Time Points ◽  
Maternal Metabolism

Maternal metabolism and intrauterine conditions influence development of health and disease in offspring, leading to metabolic, physiologic, and/or epigenetic adaptation of the fetus. Maternal gestational diabetes (GDM) leads to higher incidence of obesity and type 2 diabetes in offspring. We have previously shown that fetuses of insulin-resistant mothers with GDM have a delayed reaction to auditory stimuli in the postprandial state, indicating a fetal central insulin resistance. We tested whether this effect could be influenced by a lifestyle intervention in mothers with GDM, including diet counselling and regular blood glucose measurements. We measured fetal brain activity over the course of a maternal glucose challenge, at two measurement time points (baseline at an average of 29 weeks of gestation and follow-up after 4 weeks) in mothers with GDM and mothers with normal glucose tolerance (NGT). Data from eight mothers were able to be included. Fetuses of GDM mothers showed longer latencies than those of NGT mothers postprandially at both measurement time points during the third trimester and did not show a difference in response patterns between baseline and after 4 weeks. Maternal postprandial blood glucose and insulin values did not change from baseline to follow-up either. While the overall intervention seems to have been effective, it does not appear to have influenced the fetal postprandial brain responses. This might have been because interventions for GDM take place relatively late in pregnancy. Future research should focus on maternal lifestyle interventions as early as possible during gestation, or even prenatally.

scholarly journals African plant foods rich in non-starch polysaccharides reduce postprandial blood glucose and insulin concentrations in healthy human subjects

1998 ◽  
Vol 80 (5) ◽  
pp. 419-428 ◽  
Author(s):  
Uchenna A. Onyechi ◽  
Patricia A. Judd ◽  
Peter R. Ellis
Keyword(s):  
Blood Glucose ◽  
Human Subjects ◽  
Physiological Activity ◽  
Venous Blood ◽  
Area Under The Curve ◽  
Water Soluble ◽  
Postprandial Blood Glucose ◽  
Wheat Bread ◽  
Healthy Human ◽  
Time Points

The effects of two vegetable flours, prepared from the African plants Detarium senegalense Gmelin, a legume, and Cissus rotundifolia, a shrub, on postprandial blood glucose and insulin concentrations in human subjects, were investigated. Chemical analysis indicated that these flours contained significant amounts of NSP. The detarium in particular was found to be a rich source of water-soluble NSP (SNSP). The flours were incorporated into two types of breakfast meal, a stew meal and a wheat bread meal, containing 50 g and 70 g available carbohydrate respectively. Both meals also contained 10–12g NSP, the major fraction of which was SNSP. Control and fibre-rich meals were consumed on separate days in randomized order by two different groups of subjects (n 5, stew meals; n 10, bread meals). Venous blood samples were taken at fasting (0 min) and postprandially at 30 min intervals for 2·5 h and the plasma analysed for glucose and insulin. Compared with the controls, detarium and cissus meals elicited significant reductions (P < 0·006) in plasma glucose levels at most postprandial time points and for area-under-the-curve (AUC) values (AUC reductions 38–62%). Significant reductions (P < 0·002) in plasma insulin levels at various postprandial time points and for AUC values were also seen after detarium and cissus breads (AUC reductions 43 and 36% respectively), but not after the fibre-rich stew meals. SNSP and starch are possibly the main, but not the only, components responsible for the glucose- and insulin-lowering effects of cissus flour. The main SNSP fraction of detarium, identified as a high-molecular-weight xyloglucan, is likely to be a primary factor in determining the physiological activity of detarium flour.

scholarly journals Can the Onset of Type 2 Diabetes Be Delayed by a Group-Based Lifestyle Intervention in Women with Prediabetes following Gestational Diabetes Mellitus (GDM)? Findings from a Randomized Control Mixed Methods Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Angela O’Dea ◽  
Marie Tierney ◽  
Brian E. McGuire ◽  
John Newell ◽  
Liam G. Glynn ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Mixed Methods ◽  
Gestational Diabetes ◽  
Lifestyle Intervention ◽  
Intervention Group ◽  
Outcome Variable ◽  
Control Group ◽  
One Year

Objective. To evaluate a 12-week group-based lifestyle intervention programme for women with prediabetes following gestational diabetes (GDM).Design. A two-group, mixed methods randomized controlled trial in which 50 women with a history of GDM and abnormal glucose tolerance postpartum were randomly assigned to intervention (n=24) or wait control (n=26) and postintervention qualitative interviews with participants.Main Outcome Measures. Modifiable biochemical, anthropometric, behavioural, and psychosocial risk factors associated with the development of type 2 diabetes. The primary outcome variable was the change in fasting plasma glucose (FPG) from study entry to one-year follow-up.Results. At one-year follow-up, the intervention group showed significant improvements over the wait control group on stress, diet self-efficacy, and quality of life. There was no evidence of an effect of the intervention on measures of biochemistry or anthropometry; the effect on one health behaviour, diet adherence, was close to significance.Conclusions. Prevention programmes must tackle the barriers to participation faced by this population; home-based interventions should be investigated. Strategies for promoting long-term health self-management need to be developed and tested.

scholarly journals Expression of IRS1 Gene in Pregnant Women with Gestational Diabetes Mellitus, in The Third Trimester

2021 ◽  
pp. 787-792
Author(s):  
Zainab k. Hussain ◽  
Jabbar H. Yenzeel ◽  
Hayfa H. Hassani
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Lipid Profile ◽  
Fasting Blood Glucose ◽  
Rna Extraction ◽  
Third Trimester ◽  
Healthy Women ◽  
And Control

To study the genetic effect of gestational diabetes mellitus by study IRS1gene expression in female with Gestational diabetes mellitus. It is characterized high level of blood glucose, especially during first trimester then increased during the 2nd and 3rd trimester of the pregnancy period. The blood samples taken from one hundred twenty healthy women and female with gestational diabetes mellitus in 3rd trimester period of pregnancy, level of fasting blood glucose (FBG) also HbA1c% measured to diagnose GDM, in addition to lipid profile (cholesterol, triglyceride, HDL, LDL, and VLDL), molecular study consist of RNA extraction and qRT- PCR for IRS1gene expression determination. The fasting blood glucose mg/dl and HbA1c% level was increased highly significantly (P<0.01) between patients and control (healthy women) in 3rd trimester stage in addition lipid profile included )serum cholesterol, serum triglyceride, LDL and VLDL( (mg/dl) but level of HDL (mg/dl) was decreased highly significantly (P<0.01) between patients and control. The result showed high significant of IRS1 expression gene in control (1.00 ± 0.00) while in patients (0.147 ± 0.02). The low expression of IRS1 gene was connected with gestational diabetes mellitus comparison in control (healthy women) in Iraqi female in third trimester of pregnancy

scholarly journals Blood Glucose Level, Gestational Diabetes Mellitus and Maternal Birth Season: A Retrospective Cohort Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Dongjian Yang ◽  
Jingbo Qiu ◽  
An Qin ◽  
Lei Chen ◽  
Ya Yang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Confidence Interval ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Retrospective Cohort ◽  
Postprandial Blood Glucose ◽  
Birth Season

BackgroundPrevious evidence indicates that birth season is associated with type 2 diabetes in adults. However, information on the association of birth with gestational diabetes mellitus (GDM) is lacking. The present study explores the association between birth seasonality and GDM in East China.MethodsThis retrospective cohort study was conducted at the International Peace Maternal and child health hospital between 2014 and 2019. A total of 79, 292 pregnant women were included in the study after excluding participants with previous GDM, stillbirth, polycystic ovary syndrome, and lack of GDM laboratory records. The multivariate logistic regression model was employed to estimate the odds ratio and 95% confidence interval. After log transformation of blood glucose level, the percentage change and 95% confidence interval were estimated by a multivariate linear model.ResultsThe risk of GDM among pregnant women born in spring, autumn, and winter was not significantly different compared to that among participants born in summer. Pregnant women born in autumn had significantly higher 1-hour postprandial blood glucose (PBG-1h) and 2-hour postprandial blood glucose (PBG-2h) levels than pregnant women born in summer. Compared to pregnant women born in August, the PBG-1h level of pregnant women born in October, November, and December increased significantly, whereas the PBG-2h levels of pregnant women born in November and December increased significantly.ConclusionPregnant women born in autumn exhibit higher postprandial blood glucose levels during pregnancy than in those born in summer. The findings provide evidence that exposure to seasonal changes in early life may influence blood glucose metabolism during pregnancy.

scholarly journals Glycaemic profile in the second and third trimesters of normal pregnancy compared to non-pregnant adult females

2019 ◽  
Vol 13 (1) ◽  
pp. 30-36 ◽  
Author(s):  
Aruna Nigam ◽  
Neha Varun ◽  
Sumedha Sharma ◽  
YP Munjal ◽  
Anupam Prakash
Keyword(s):  
Blood Glucose ◽  
Pregnant Women ◽  
Normal Pregnancy ◽  
Postprandial Blood Glucose ◽  
Second Trimester ◽  
Third Trimester ◽  
Glycaemic Variability ◽  
The Third ◽  
Data Points ◽  
Mean Blood Glucose

Aim To assess the glycaemic profile and glycaemic variation in the second and third trimesters of normal pregnancies. Methodology Healthy pregnant women aged 19–35 years between 24 and 36 weeks of gestation were recruited for ambulatory glucose profile monitoring. A total of 18 women in the second trimester, 15 women in the third trimester and 9 healthy non-pregnant women were recruited providing, respectively, 205 days (19,680 data points), 147 days (14,112 data points) and 100 days (9,600 data points) for analysis. Results Mean blood glucose level was 20.2% lower in the second trimester and 10.6% lower in the third trimester than non-pregnant women (p < 0.001). In pregnancy, it took 15 to 20 minutes more to reach peak postprandial blood glucose levels compared to non-pregnant women (p = 0.003). Glycaemic variability was more in the third trimester (p < 0.001). Conclusion There is tight blood sugar control along with lower mean blood glucose in healthy pregnant women compared to non-pregnant women. Despite this tight glycaemic control, glycaemic variability is higher during pregnancy.

A Prospective Study of the Clinical and Demographic Profile of Type 2 Diabetes Mellitus Patients Receiving Antidiabetic Drug Combinations

2020 ◽  
Vol 16 (5) ◽  
pp. 503-508
Author(s):  
Akash Gadgade ◽  
Ashok S. Kudgi ◽  
Ashwin Kamath ◽  
Priyanka Kamath ◽  
Prabha Adhikari ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Blood Glucose ◽  
Dose Escalation ◽  
Tertiary Care ◽  
Postprandial Blood Glucose ◽  
Antidiabetic Treatment

Background: The specific treatment recommendations for type 2 diabetes mellitus (T2DM) differ based on a particular guideline. The goal of pharmacotherapy is to achieve the target HbA1c and fasting and postprandial blood glucose levels to avoid disease complications. Objective: To evaluate the profile of T2DM patients on different antidiabetic treatment regimens and the factors leading to dose escalation in these patients. Methods: A prospective descriptive study was conducted at Kasturba Medical College Hospital, Mangalore, a tertiary care teaching hospital, over a period of one year. The study population comprised of patients with T2DM for ≥5 years. The demographic and clinical data were collected during the baseline and follow-up visits. Results: Of the 119 patients studied, 59.7% were males; 32.8% were ≥65 years of age. A significant decrease in the fasting blood glucose (FBG) on follow-up was seen (p = 0.028) in patients on sulfonylurea and metformin combination. A significant decrease in the glycated haemoglobin (HbA1c) was seen in patients on sulfonylurea with metformin and pioglitazone (p = 0.011); sulfonylurea with metformin, pioglitazone, and sitagliptin (p = 0.026); and metformin with insulin (p = 0.001). Patients who received dose escalation had a longer duration of the disease (p = 0.042), higher FBG (p = 0.039) and HbA1c (p = 0.05). Conclusion: A combination of metformin with sulfonylurea was the preferred first-line treatment; insulin was added when HbA1c was >9. Patients who received dose escalation had a longer duration of the disease and higher FBG and HbA1c.

scholarly journals Association of WISP1/CCN4 with Risk of Overweight and Gestational Diabetes Mellitus in Chinese Pregnant Women

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Lei Liu ◽  
Jiajin Hu ◽  
Liu Yang ◽  
Ningning Wang ◽  
Yang Liu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Fasting Blood Glucose ◽  
Adverse Outcomes ◽  
Obese Women ◽  
Complement C1q

Background. Obese women with gestational diabetes mellitus (GDM) have a higher risk of adverse outcomes than women with obesity or GDM alone. Our study is aimed at investigating the discriminatory power of circulatory Wnt1-inducible signaling pathway protein-1 (WISP1), a novel adipocytokine, on the copresence of prepregnancy overweight/obesity and GDM and at clarifying the relationship between the WISP1 level and clinical cardiometabolic parameters. Methods. A total of 313 participants were screened from a multicenter prospective prebirth cohort: Born in Shenyang Cohort Study (BISCS). Subjects were examined with a 2×2 factorial design for body mass index BMI≥24 and GDM. Between 24 and 28 weeks of pregnancy, follow-up individuals underwent an OGTT and blood sampling for cardiometabolic characterization. Results. We observed that the WISP1 levels were elevated in prepregnancy overweight/obesity patients with GDM, compared with nonoverweight subjects with normal blood glucose (3.45±0.89 vs. 2.91±0.75 ng/mL). Multilogistic regression analyses after adjustments for potential confounding factors revealed that WISP1 was a strong and independent risk factor for prepregnancy overweight/obesity with GDM (all ORs>1). In addition, the results of the ROC analysis indicated that WISP1 exhibited the capability to identify individuals with prepregnancy overweight/obesity and GDM (all AUC>0.5). Finally, univariate and multivariate linear regression showed that WISP1 level was positively and independently correlated with fasting blood glucose, systolic blood pressure, and aspartate aminotransferase and was negatively correlated with HDL-C and complement C1q. Conclusions. WISP1 may be critical for the prediction, diagnosis, and therapeutic strategies against obesity and GDM in pregnant women.

scholarly journals Mobile-Based Lifestyle Intervention in Women with Glucose Intolerance after Gestational Diabetes Mellitus (MELINDA), A Multicenter Randomized Controlled Trial: Methodology and Design

2020 ◽  
Vol 9 (8) ◽  
pp. 2635
Author(s):  
Caro Minschart ◽  
Toon Maes ◽  
Christophe De Block ◽  
Inge Van Pottelbergh ◽  
Nele Myngheer ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Randomized Controlled Trial ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Lifestyle Intervention ◽  
Glucose Intolerance ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Multicenter Randomized Controlled Trial

The aims of the ‘Mobile-based lifestyle intervention in women with glucose intolerance after gestational diabetes mellitus (GDM)’ study (MELINDA) are: (1) to evaluate the prevalence and risk factors of glucose intolerance after a recent history of GDM; and (2) to evaluate the efficacy and feasibility of a telephone- and mobile-based lifestyle intervention in women with glucose intolerance after GDM. This is a Belgian multicenter randomized controlled trial (RCT) in seven hospitals with the aim of recruiting 236 women. Women in the intervention group will receive a blended program, based on one face-to-face education session and further follow-up through a mobile application and monthly telephone advice. Women in the control group will receive follow-up as in normal routine with referral to primary care. Participants will receive an oral glucose tolerance test (OGTT) one year after baseline. Primary endpoint is the frequency of weight goal achievement (≥5% weight loss if pre-pregnancy BMI ≥ 25 Kg/m2 or return to pre-gravid weight if BMI < 25 Kg/m2). At each visit blood samples are collected, anthropometric measurements are obtained, and self-administered questionnaires are completed. Recruitment began in May 2019.

scholarly journals Comparison of Different Anthropometric Indices to Predict Prediabetes in North China, Beijing: a 7-year Prospective Study

2020 ◽  
Author(s):  
Yulin Gu ◽  
Changming Zhao ◽  
Ping An ◽  
Kang Chen ◽  
Yijun Li ◽  
...  
Keyword(s):  
Blood Glucose ◽  
General Population ◽  
Fast Blood Glucose ◽  
Postprandial Blood Glucose ◽  
Anthropometric Measures ◽  
Logistic Analysis ◽  
Chinese Study ◽  
Significant Difference ◽  
Diagnosed Diabetes

Abstract Background Obesity is an increasing problem worldwide and is one of the underlying risk factors for prediabetes. Although WHtR, BMI, WC and WHR were found to be associated with dysglycemia, in view of significant differences in basic characteristics, glycemic metabolism, and ethnicity, it is of practical value to investigate which indicators are the most useful measures to predict the incidence of prediabetes in Chinese population. The aim of this study was to compare the value of different anthropometric measures of obesity in the detection of prediabetes in a cohort study in China and to identify the best cut-off point of predicting prediabetes in this population. Methods The present study was a part of the ongoing Risk Evaluation of cAncers in Chinese diabetic Individuals: an IONgitudinal (REACTION) study. After 7 years of follow-up, a total of 2568 individuals in Beijing were analyzed. Waist-to-height ratio (WHtR), body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) were measured at baseline and during follow-up. These four values were divided into tertiles. Fast blood glucose and postprandial blood glucose were tested. The association of these four anthropometric values with blood glucose were tested using multiple logistic analysis. Results A total of 2568 normoglycemic participants (810 males and 1758 females) were recruited, with an average age of 62.68 ± 6.97 years. After 7 years of follow-up, 52 subjects had developed newly diagnosed diabetes, and 423 individuals had developed prediabetes. Among those with prediabetes, 278 had IGT, 105 had IFG, and 40 had IGT + IFG. The incidences of prediabetes and diabetes were calculated to be 115.3 per 1000 person-years and 14.2 per 1000 person-years, respectively. Multivariable regression analysis revealed that there was no significant difference in the WHtR, BMI, WC, WHR among those with diabetes and nondiabets. In the general population and the group of females with prediabetes, we found that WHtR was the best value to predict prediabetes, and with an increase in the WHtR, the possibility of prediabetes increased by 90% or 102%, respectively. In the group of males, WHR was the most associated with prediabetes, and people in Tertile 2 was 2.62 times more likely to suffer from prediabetes than those in Tertile 1. For females, the optimal cut-off points of WHtR, BMI, WC and WHR were 0.48, 23.5 kg/m2, 75.6 cm and 0.84, respectively. For males, the optimal cut-off points of the WHtR, BMI, WC and WHR were 0.50, 25.5 kg/m2, 88.9 cm and 0.93, respectively. Conclusion In a Chinese study population, WHtR was the best predictor of the development of prediabetes in the general population and in females 7 years in advance, while WHR could predict the development of prediabetes in males. Early identification of prediabetes can better prevent diabetes.

Sign in / Sign up

Export Citation Format

Share Document