Beverage Intake and the Risk of Gestational Diabetes Mellitus: The SECOST

The contribution and impact of beverage intake to total nutrient and energy intake may be substantial. Given the link between lifestyle, diet, and the risk of pregnancy complications, this study investigated the association between the quantity and types of beverages with gestational diabetes mellitus (GDM) risk. The study included 452 women from the Seremban Cohort Study (SECOST). The mean energy by beverage intake was 273 ± 23.83 kcal/day (pre-pregnancy), 349 ± 69.46 kcal/day (first trimester) and 361 ± 64.24 kcal/day (second trimester). Women significantly increased intake of maternal milks and malted drinks, but significantly reduced the intake of carbonated drinks and other drinks from before until the second trimester of pregnancy. For chocolate drinks, carbonated drinks, and soy milk, women increased intake from pre-conception to the first trimester, but reduced their intake from the first to the second trimester. While higher intake of cultured-milk drinks was associated with an increased risk of GDM, higher fruit juice intake was associated with a lower risk of GDM. However, these associations were only observed for intake prior to pregnancy and during the first trimester. Further research is needed to corroborate these findings and investigate the contributions of different beverages to overall diet quality as well as adverse health outcomes during pregnancy.

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Plasma retinol-binding protein 4 in the first and second trimester and risk of gestational diabetes mellitus in Chinese women: a nested case-control study

Nutrition & Metabolism ◽

10.1186/s12986-019-0425-9 ◽

2020 ◽

Vol 17 (1) ◽

Cited By ~ 1

Author(s):

Chuyao Jin ◽

Lizi Lin ◽

Na Han ◽

Zhiling Zhao ◽

Zheng Liu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Binding Protein ◽

First Trimester ◽

Retinol Binding Protein ◽

Second Trimester ◽

Retinol Binding Protein 4 ◽

Plasma Retinol

Abstract Background To assess the association between plasma retinol-binding protein 4 (RBP4) levels both in the first trimester and second trimester and risk of gestational diabetes mellitus (GDM). Methods Plasma RBP4 levels and insulin were measured among 135 GDM cases and 135 controls nested within the Peking University Birth Cohort in Tongzhou. Multivariable linear regression analysis was conducted to assess the influence of RBP4 levels on insulin resistance. Conditional logistic regression models were used to compute the odds ratio (OR) and 95% confidence interval (CI) between RBP4 levels and risk of GDM. Results The GDM cases had significantly higher levels of RBP4 in the first trimester than controls (medians: 18.0 μg/L vs 14.4 μg/L; P < 0.05). Plasma RBP4 concentrations in the first and second trimester were associated with fasting insulin, homeostasis model assessment for insulin resistance (HOMA-IR), and the quantitative insulin sensitivity check index (QUICKI) in the second trimester (all P < 0.001). With adjustment for diet, physical activity, and other risk factors for GDM, the risk of GDM increased with every 1-log μg/L increment of RBP4 levels, and the OR (95% CI) was 3.12 (1.08–9.04) for RBP4 in the first trimester and 3.38 (1.03–11.08) for RBP4 in the second trimester. Conclusions Plasma RBP4 levels both in the first trimester and second trimester were dose-dependently associated with increased risk of GDM.

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Early prediction of gestational diabetes mellitus in the Chinese population via advanced machine learning

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa899 ◽

2020 ◽

Author(s):

Yan-Ting Wu ◽

Chen-Jie Zhang ◽

Ben Willem Mol ◽

Andrew Kawai ◽

Cheng Li ◽

...

Keyword(s):

Diabetes Mellitus ◽

Machine Learning ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Chinese Population ◽

Feature Selection Method ◽

Area Under The Curve ◽

First Trimester ◽

Record System ◽

Increased Risk

Abstract Context Accurate methods for early gestational diabetes mellitus (GDM) (during the first trimester of pregnancy) prediction in Chinese and other populations are lacking. Objectives Establishing effective models to predict early GDM. Setting Pregnancy data for 73 variables during the first trimester were extracted from the electronic medical record system. Main measures Based on a machine learning (ML) driven feature selection method, 17 variables were selected for early GDM prediction. In order to facilitate clinical application, 7 variables were selected from the 17-variable panel. Advanced ML approaches were then employed using the 7-variable dataset and the 73-variable dataset to build models predicting early GDM for different situations respectively. Results 16,819 and 14,992 cases were included in the training and testing sets, respectively. Using 73 variables, the deep neural network model achieved high discriminative power, with area under the curve (AUC) values of 0.80. The 7-variable logistic regression (LR) model also achieved effective discriminate power (AUC = 0.77). Low BMI (≤ 17) was related to an increased risk of GDM, compared to a BMI in the range of 17 to 18 (minimum risk interval) (11.8% vs 8.7%, P = 0.0935). TT3 and TT4 were superior to FT3 and FT4 in predicting GDM. Lipoprotein (a) was demonstrated a promising predictive value (AUC = 0.66). Conclusions We employed ML models that achieved high accuracy in predicting GDM in early pregnancy. A clinically cost-effective 7-variable LR model was simultaneously developed. The relationship of GDM with thyroxine and BMI was investigated in the Chinese population.

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First Trimester Metabolites Predict Gestational Diabetes Mellitus Diagnosis: A Case: Control Study (FS03-04-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz046.fs03-04-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Manuel Ramos ◽

Anna Lamb ◽

Noemi Alarcon ◽

Adilene Quintana-Diaz ◽

Rob Fanter ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Dietary Intervention ◽

Intervention Group ◽

First Trimester ◽

Case Control ◽

Plasma Metabolites ◽

Blood Draw ◽

Increased Risk

Abstract Objectives Gestational Diabetes Mellitus (GDM) has an overall prevalence estimated as high as 13% of overweight/obese (OW/OB) pregnant women. Since the occurrence of GDM can have a combination of adverse perinatal outcomes and long-term increased risk of health issues in the future for both the mother and child, it is important that the mechanisms involved in this disease are better understood so that better prevention strategies can be devised. We sought to identify early and late pregnancy metabolites that discriminated women who developed vs. did not develop GDM to provide insight into its etiology and help improve treatments. Methods Participants were 26 OW/OB women enrolled in the Healthy Beginnings Trial and completed blood draws at 13 weeks, 26 weeks, and 35 weeks gestation. Participants from the control and dietary intervention group who developed GDM (N = 12) were matched on age and study entry BMI with those who did not develop GDM (N = 14). Plasma samples were analyzed by ultra-high-performance liquid chromatography-hybrid triple‐quadrupole linear ion trap mass spectrometry (UPLC-QTRAP) using two targeted metabolomics assays for primary metabolomics and aminomics. Results A total of 142 metabolites were identified. Most metabolite differences were observed during the first trimester blood draw, prior to GDM diagnosis. At first trimester, metabolites related to energy metabolism that were altered included lower levels of alpha-ketoglutarate and glycerol-3-phosphate, as well as the medium-chain acylcarnitines’ lauroyl-carnitine, dodecenoyl-carnitine, and octanoyl-carnitine (P < 0.05). Interestingly, the neurotransmitters serotonin and glutamate were elevated in subjects who later developed GDM (P < 0.01). In regards to the observed elevated creatine, the lower concentrations of methionine and glycine may suggest utilization of these amino acids for its production (P < 0.03). Lastly, the gut microbiota-derived indole-3-propionate was higher in GDM cases (P < 0.05). In the third trimester of the GDM group, only levels of 4-pyridoxate (vitamin B-6) were lowered (P < 0.05). Conclusions Metabolic changes associated with the numerous plasma metabolites that were different between GDM case-control subjects during first trimester may predict the development of this condition. Funding Sources NIH, ARI.

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Air pollution and gestational diabetes mellitus: evidence from cohort studies

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2019-000937 ◽

2020 ◽

Vol 8 (1) ◽

pp. e000937 ◽

Cited By ~ 2

Author(s):

Xingyao Tang ◽

Jian-Bo Zhou ◽

Fuqiang Luo ◽

Yipeng Han ◽

Yoriko Heianza ◽

...

Keyword(s):

Diabetes Mellitus ◽

Particulate Matter ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Air Pollutants ◽

Evidence Base ◽

Second Trimester ◽

Increased Risk ◽

Particulate Matter 2.5

Exposure to different air pollutants has been linked to type 2 diabetes mellitus, but the evidence for the association between air pollutants and gestational diabetes mellitus (GDM) has not been systematically evaluated. We systematically retrieved relevant studies from PubMed, Embase, and the Web of Science, and performed stratified analyses and regression analyses. Thirteen studies were analyzed, comprising 1 547 154 individuals from nine retrospective studies, three prospective studies, and one case–control study. Increased exposure to particulate matter ≤2.5 µm in diameter (PM2.5) was not associated with the increased risk of GDM (adjusted OR 1.03, 95% CI 0.99 to 1.06). However, subgroup analysis showed positive correlation of PM2.5 exposure in the second trimester with an increased risk of GDM (combined OR 1.07, 95% CI 1.00 to 1.13). Among pollutants other than PM2.5, significant association between GDM and nitrogen dioxide (NO2) (OR 1.05, 95% CI 1.01 to 1.10), nitrogen oxide (NOx) (OR 1.03, 95% CI 1.01 to 1.05), and sulfur dioxide (SO2) (OR 1.09, 95% CI 1.03 to 1.15) was noted. There was no significant association between exposure to black carbon or ozone or carbon monoxide or particulate matter ≤10 µm in diameter and GDM. Thus, systematic review of existing evidence demonstrated association of exposure to NO2, NOx, and SO2, and the second trimester exposure of PM2.5 with the increased risk of GDM. Caution may be exercised while deriving conclusions from existing evidence base because of the limited number and the observational nature of studies.

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Cost effectiveness of different screening strategies for gestational diabetes mellitus screening: study protocol of a randomized community non-inferiority trial

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-019-0493-z ◽

2019 ◽

Vol 11 (1) ◽

Author(s):

Fahimeh Ramezani Tehrani ◽

Keyword(s):

Diabetes Mellitus ◽

Health Care ◽

Cost Effectiveness ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Standard Care ◽

First Trimester ◽

Trial Registration ◽

Second Trimester

Abstract Background There is lack of ideal and comprehensive economic evaluations of various GDM strategies. The aim of this study is to the compare efficacy and cost-effectiveness of five different methods of screening for gestational diabetes mellitus (GDM). Methods This study is a randomized community non-inferiority trial among 30,000 pregnant women in five different geographic regions of Iran, who were randomly assigned to one of the five GDM screening methods. All first trimester pregnant women, seeking prenatal care in governmental health care systems, who met our eligibility criteria were enrolled. The criteria suggested by the International-Association-of-Diabetes-in-Pregnancy-Study-Group, the most intensive approach, were used as reference. We used the non-inferiority approach to compare less intensive strategies to the reference one. Along with routine prenatal standard care, all participants were scheduled to have two phases of GDM screening in first and second-trimester of pregnancy, based on five different pre-specified protocols. The screening protocol included fasting plasma glucose in the first trimester and either a one step or a two-step screening method in the second trimester of pregnancy. Pregnant women were classified in three groups based on the results: diagnosed with preexisting pre-gestational overt diabetes; gestational diabetes and non-GDM women. Each group received packages for standard-care and all participants were followed till delivery; pregnancy outcomes, quality of life and cost of health care were recorded in detail using specific standardized questionnaires. Primary outcomes were defined as % birth-weight > 90th percentile and primary cesarean section. In addition, we assessed the direct health care direct and indirect costs. Results This study will enable us to compare the cost effectiveness of different GDM screening protocols and intervention intensity (low versus high). Conclusion Results which if needed, will also enable policy makers to optimize the national GMD strategy as a resource for enhancing GDM guidelines. Trial registration Name of the registry: Iranian Registry of Clinical Trials. Trial registration number: IRCT138707081281N1. Date of registration: 2017-02-15. URL of trial registry record: https://www.irct.ir/trial/518

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Characteristics of the gut microbiome in women with gestational diabetes mellitus: A systematic review

PLoS ONE ◽

10.1371/journal.pone.0262618 ◽

2022 ◽

Vol 17 (1) ◽

pp. e0262618

Author(s):

Louise Søndergaard Rold ◽

Caspar Bundgaard-Nielsen ◽

Julie Niemann Holm-Jacobsen ◽

Per Glud Ovesen ◽

Peter Leutscher ◽

...

Keyword(s):

Diabetes Mellitus ◽

Systematic Review ◽

Gestational Diabetes ◽

Gut Microbiota ◽

Gestational Diabetes Mellitus ◽

First Trimester ◽

Multiple Time ◽

Increased Risk ◽

Multiple Time Points ◽

Gut Microbiota Dysbiosis

Background The incidence of women developing gestational diabetes mellitus (GDM) is increasing, which is associated with an increased risk of type 2 diabetes mellitus (T2DM) for both mother and child. Gut microbiota dysbiosis may contribute to the pathogenesis of both GDM and the accompanying risk of T2DM. Thus, a better understanding of the microbial communities associated with GDM could offer a potential target for intervention and treatment in the future. Therefore, we performed a systematic review to investigate if the GDM women have a distinct gut microbiota composition compared to non-GDM women. Methods We identified 21 studies in a systematic literature search of Embase and PubMed up to February 24, 2021. Data on demographics, methodology and identified microbial metrics were extracted. The quality of each study was assessed according to the Newcastle-Ottawa Scale. Results Sixteen of the studies did find a GDM-associated gut microbiota, although no consistency could be seen. Only Collinsella and Blautia showed a tendency to be increased in GDM women, whereas the remaining genera were significantly different in opposing directions. Conclusion Although most of the studies found an association between GDM and gut microbiota dysbiosis, no overall GDM-specific gut microbiota could be identified. All studies in the second trimester found a difference between GDM and non-GDM women, indicating that dysbiosis is present at the time of diagnosis. Nevertheless, it is still unclear when the dysbiosis develops, as no consensus could be seen between the studies investigating the gut microbiota in the first trimester of pregnancy. However, studies varied widely concerning methodology and study design, which might explain the highly heterogeneous gut microbiota compositions between studies. Therefore, future studies need to include multiple time points and consider possible confounding factors such as ethnicity, pre-pregnancy body mass index, and GDM treatment.

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The association of first trimester high blood pressure and risk of gestational diabetes mellitus

Arterial’naya Gipertenziya (Arterial Hypertension) ◽

10.18705/1607-419x-2012-18-1-67-72 ◽

2012 ◽

Vol 18 (1) ◽

pp. 67-72

Author(s):

P. V. Popova ◽

A. S. Gerasimov ◽

E. N. Kravchuk ◽

E. S. Shelepova ◽

E. M. Ryazantseva ◽

...

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Fold Increase ◽

First Trimester ◽

Elevated Blood Pressure ◽

Elevated Blood ◽

Increased Risk ◽

First Trimester Of Pregnancy

Objective. To determine the relationship between blood pressure measured during the first trimester of pregnancy and the risk of the development of gestational diabetes mellitus. Design and methods. A total of 209 pregnant women were screened for gestational diabetes mellitus between weeks 24 and 28 of gestation, as defined by WHO criteria. Blood pressure, weight and waist circumference data were obtained by review of the medical records. Results. An elevated blood pressure at first trimester of pregnancy was associated with a six-fold increase in the risk of the development of gestational diabetes mellitus (OR = 5.8, 95 % CI 1.9-17.5, p = 0.001) compared with non-hypertensive women. Arterial hypertension (including controlled forms) in the first trimester of pregnancy was followed by a three-fold (OR = 3.04, 95 % CI 1.5-6.3) increase in the risk of gestational diabetes mellitus compared with non-hypertensive women (p = 0.005). Conclusion. Obtained data indicate that women with elevated blood pressure in the first trimester of pregnancy have an increased risk of the development of gestational diabetes mellitus.

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Higher mean amplitude of glycaemic excursion in the second trimester of pregnancy is associated with the subsequent development of gestational diabetes mellitus: an observational study

10.22541/au.163843479.99686909/v1 ◽

2021 ◽

Author(s):

Phaik Ling Quah ◽

Kok Hian Tan ◽

Nurul Razali ◽

Nurul Sakinah Razali

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Gestational Diabetes ◽

Observational Study ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Subsequent Development ◽

Mean Amplitude ◽

First Trimester ◽

Second Trimester

Objective: To examine glycaemic variability (GV) and glycaemic control (GC) parameters in early pregnancy with subsequent development of gestational diabetes mellitus (GDM). Design: Longitudinal observational study. Setting: Pregnant women from KK Women and Children’s Hospital in Singapore Participants: 51 study participants in the first trimester (9-13 weeks’ gestational), and 44 participants (18-23 weeks’ gestation) in the second trimester of pregnancy. Methods: Independent t-tests were used to examine the differences in the parameters between participants who developed GDM and those who did not. Main outcome measure: GDM was determined at 24-30 weeks’ gestation using oral glucose tolerance test (OGTT). GV parameters examined were, mean amplitude of glycaemic excursion (MAGE), standard deviation of blood glucose (SDBG) and mean of daily continuous 24 h blood glucose (MBG) and coefficient of variation (CV). GC parameters measured were, J-Index and % time spent in glucose target ranges. Results: In the second trimester of pregnancy, mean amplitude of glycaemic excursions (MAGE) was significantly higher in participants who subsequently developed GDM, compared to those who did not (mean (SD): 3.18(0.68) vs 2.60(0.53), p=0.02). Other study parameters measured in the second trimester of pregnancy were not significantly different between groups. There were no significant associations between all the GV and GC parameters determined from the CGM in the first trimester with subsequent development of GDM (p>0.05). Conclusion: MAGE is an important GV parameter associated to the development of subsequent GDM in pregnant women. The findings highlight the potential value of CGM in gestational glycaemic profiling.

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Vitamin D status and association with gestational diabetes mellitus in a pregnant cohort in Iceland

Food & Nutrition Research ◽

10.29219/fnr.v65.5574 ◽

2021 ◽

Author(s):

Kristin S. Magnusdottir ◽

Ellen A. Tryggvadottir ◽

Ola K. Magnusdottir ◽

Laufey Hrolfsdottir ◽

Thorhallur I. Halldorsson ◽

...

Keyword(s):

Diabetes Mellitus ◽

Vitamin D ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

First Trimester ◽

Vitamin D Status ◽

Increased Risk ◽

Vitamin D Levels ◽

25Ohd Concentration

Background: Vitamin D deficiency has been associated with an increased risk of gestational diabetes mellitus (GDM), one of the most common pregnancy complications. The vitamin D status has never previously been studied in pregnant women in Iceland. Objective: The aim of this research study was to evaluate the vitamin D status of an Icelandic cohort of pregnant women and the association between the vitamin D status and the GDM incidence. Design: Subjects included pregnant women (n = 938) who attended their first ultrasound appointment, during gestational weeks 11–14, between October 2017 and March 2018. The use of supplements containing vitamin D over the previous 3 months, height, pre-pregnancy weight, and social status were assessed using a questionnaire, and blood samples were drawn for analyzing the serum 25‑hydroxyvitamin D (25OHD) concentration. Information regarding the incidence of GDM later in pregnancy was collected from medical records. Results: The mean ± standard deviation of the serum 25OHD (S-25OHD) concentration in this cohort was 63±24 nmol/L. The proportion of women with an S-25OHD concentration of ≥ 50 nmol/L (which is considered adequate) was 70%, whereas 25% had concentrations between 30 and 49.9 nmol/L (insufficient) and 5% had concentrations < 30 nmol/L (deficient). The majority of women (n = 766, 82%) used supplements containing vitamin D on a daily basis. A gradual decrease in the proportion of women diagnosed with GDM was reported with increasing S-25OHD concentrations, going from 17.8% in the group with S-25OHD concentrations < 30 nmol/L to 12.8% in the group with S-25OHD concentrations ≥75 nmol/L; however, the association was not significant (P for trend = 0.11). Conclusion: Approximately one-third of this cohort had S-25OHD concentrations below adequate levels (< 50 nmol/L) during the first trimester of pregnancy, which may suggest that necessary action must be taken to increase their vitamin D levels. No clear association was observed between the vitamin D status and GDM in this study.

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First Trimester Potential Biochemical Predictive Tests for Gestational Diabetes Mellitus: A Systematic Review

Iranian journal of diabetes and obesity ◽

10.18502/ijdo.v13i4.8002 ◽

2021 ◽

Author(s):

Soodabeh Darvish ◽

Farzaneh Rashidi Fakari ◽

Simin Haghdoost

Keyword(s):

Diabetes Mellitus ◽

Systematic Review ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

First Trimester ◽

Predictive Tests ◽

Increased Risk ◽

Metabolic Complication ◽

Hs Crp ◽

Maternal Bmi

Objective: Gestational diabetes mellitus (GDM) is the most common metabolic complication during pregnancy. So, a large number of studies have evaluated the usefulness of different screening tests. The aim of this study was focused on the potential of only first-trimester screening used in the prediction of GDM. Materials and Methods: In this systematic review, we searched PubMed, EMBASE, and Scopus (between 2010 and 2020) and also searched the reference lists of the relevant articles manually. After performing a thorough evaluation of the 242 potentially eligible papers, only 60 papers were selected in terms of the inclusion criteria. Search key terms were combining ‘Gestational diabetes’ or ‘GD’ “gestational diabetes mellitus” or” GDM” or pregnancy-induced diabetes’ with at least one of the following terms: “screening test”, “first-trimester”, “prediction”, “marker predictor”, “serum marker”. Results: A total of 161954 pregnant women were evaluated in these reviewed studies. Moreover, many tests were assessed in the first trimester of pregnancy to predict GDM. This review showed that hs-CRP, FPG, TG, and LDL-C along with maternal BMI in the first trimester were related to the increased risk of developing GDM. Other tests were used in only one or two studies. Conclusion: This review showed that hs-CRP, FPG, TG, and LDL-C along with maternal BMI in the first trimester were linked to an increased risk of developing GDM. It is recommended that further well-designed studies by considering the cost-effective advantages of these predictive tests, should be performed.

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