scholarly journals TIMER: A Clinical Study of Energy Restriction in Women with Gestational Diabetes Mellitus

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2457
Author(s):  
Efrosini Tsirou ◽  
Maria G. Grammatikopoulou ◽  
Meletios P. Nigdelis ◽  
Eleftheria Taousani ◽  
Dimitra Savvaki ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Gestational Diabetes ◽  
Gestational Age ◽  
Low Energy ◽  
Composite Score ◽  
Insulin Use ◽  
Infant Birth ◽  
Type Of Delivery ◽  
Low Energy Diet

Medical nutrition therapy is an integral part of gestational diabetes mellitus (GDM) management; however, the prescription of optimal energy intake is often a difficult task due to the limited available evidence. The present pilot, feasibility, parallel, open-label and non-randomized study aimed to evaluate the effect of a very low energy diet (VLED, 1600 kcal/day), or a low energy diet (LED, 1800 kcal/day), with or without personalized exercise sessions, among women with GDM in singleton pregnancies. A total of 43 women were allocated to one of four interventions at GDM diagnosis: (1) VLED (n = 15), (2) VLED + exercise (n = 4), (3) LED (n = 16) or (4) LED + exercise (n = 8). Primary outcomes were gestational weight gain (GWG), infant birth weight, complications at delivery and a composite outcomes score. Secondary outcomes included type of delivery, prematurity, small- for-gestational-age (SGA) or large-for-gestational-age (LGA) infants, macrosomia, Apgar score, insulin use, depression, respiratory quotient (RQ), resting metabolic rate (RMR) and middle-upper arm circumference (MUAC). GWG differed between intervention groups (LED median: 12.0 kg; VLED: 5.9 kg). No differences were noted in the type of delivery, infant birth weight, composite score, prevalence of prematurity, depression, RQ, Apgar score, MUAC, or insulin use among the four groups. Regarding components of the composite score, most infants (88.4%) were appropriate-for-gestational age (AGA) and born at a gestational age of 37–42 weeks (95.3%). With respect to the mothers, 9.3% experienced complications at delivery, with the majority being allocated at the VLED + exercise arm (p < 0.03). The composite score was low (range 0–2.5) for all mother-infant pairs, indicating a “risk-free” pregnancy outcome. The results indicate that adherence to a LED or VLED induces similar maternal, infant and obstetrics outcomes.

Antibiotic Use in Pregnancy, Abnormal Fetal Growth, and Development of Gestational Diabetes Mellitus

2018 ◽  
Vol 36 (03) ◽  
pp. 243-251 ◽  
Author(s):  
Janet Catov ◽  
Tiffany Deihl ◽  
Maisa Feghali ◽  
Christina Scifres ◽  
John Mission
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Gestational Age ◽  
Academic Medical Center ◽  
Antibiotic Use ◽  
Large For Gestational Age ◽  
The Impact ◽  
In Pregnancy

Objective Antibiotics are commonly used in pregnancy. Prior studies have indicated that antibiotic use in pregnancy may affect birth weight, whereas data in nonpregnant individuals suggest that antibiotic exposure may increase diabetes risk. We evaluated the impact of antibiotic prescriptions during pregnancy on the prevalence of small for gestational age (SGA) and large for gestational age (LGA) birth weight and gestational diabetes mellitus (GDM). Study Design This retrospective cohort study of 12,551 women who delivered at a large academic medical center between 2012 and 2014 assessed the number and type of antibiotic prescriptions prior to GDM testing using the electronic medical record. SGA and LGA birth weight and GDM rates were compared among women who were or were not prescribed antibiotics. Results Overall, 3,991 (31.8%) of 12,551 patients received at least one antibiotic prescription. After covariate adjustment, no differences existed in risk of SGA (adjusted odds ratio [aOR]: 1; 95% confidence interval [CI]: 0.88–1.15; p = 0.94), LGA (aOR: 1; 95% CI: 0.86–1.17; p = 0.97), or GDM (aOR: 0.90; 95% CI: 0.72–1.13; p = 0.36) between women who were or were not prescribed antibiotics. Conclusion Antibiotic use does not affect the risk of SGA or LGA birth weight or GDM in pregnant women. These results provide reassurance regarding the use of antibiotics when clinically indicated in pregnancy.

scholarly journals A study of the prevalence of gestational diabetes mellitus and its maternal and fetal outcomes in a tertiary care hospital

2017 ◽  
Vol 6 (9) ◽  
pp. 4011 ◽  
Author(s):  
Manisha R. Gandhewar ◽  
Binti R. Bhatiyani ◽  
Priyanka Singh ◽  
Pradip R. Gaikwad
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Tertiary Care ◽  
Significant Risk ◽  
Care Hospital ◽  
Family History Of Diabetes ◽  
Significant Difference ◽  
History Of

Background: The aim of this study was to study the prevalence of gestational diabetes mellitus (GDM) using Diabetes in Pregnancy Study group India (DIPSI) criteria to diagnose patients with GDM and to study the maternal and neonatal outcomes.Methods: 500 patients attending the antenatal clinic between January 2013 to September 2014 with singleton pregnancies between 24 and 28 weeks of gestation were evaluated by administering 75g glucose in a nonfasting state and diagnosing GDM if the 2-hour plasma glucose was more than 140 mg/ dl. Women with multiple pregnancies, pre-existing diabetes mellitus, cardiac or renal disease were excluded from the study.Results: 31 women were diagnosed with GDM (prevalence 6.2%). The prevalence of risk factors such as age more than 25, obesity, family history of Diabetes Mellitus, history of GDM or birth weight more than 4.5kg in previous pregnancy and history of perinatal loss were associated with a statistically significant risk of developing GDM. Though the incidence of Gestational hypertension, polyhydramnios and postpartum haemorrhage was higher in the GDM group, it did not reach statistical significance. More women in the GDM group were delivered by LSCS. There was no significant difference in the incidence of SGA or preterm delivery in the groups. The mean birth weight in GDM group was higher than in the non GDM group.Conclusions: Early detection helps in preventing both maternal and fetal complications. This method of screening is convenient to women as it does not require them to be fasting.

scholarly journals Neonatal Morbidity Pattern among Infants Born to Diabetic Mothers at Jamhouria Hospital, Benghazi- Libya

2021 ◽  
pp. 38-55
Author(s):  
Munera Awad Radwan ◽  
Najia Abdelati El Mansori ◽  
Mufeda Ali Elfergani ◽  
Faiaz Ragab Halies ◽  
Mohanad Abdulhadi Lawgali
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Glycemic Control ◽  
Gestational Diabetes ◽  
Congenital Anomalies ◽  
Maternal Diabetes ◽  
Birth Trauma ◽  
Metabolic Disturbance ◽  
Cardiac Lesion ◽  
Diabetic Mothers

Introduction: Diabetes has long been associated with maternal and perinatal morbidity and mortality. The infant of a diabetic mother have higher risks for serious problems during pregnancy and at birth. Problems during pregnancy may include increased risks of abortions and stillbirths. Abnormal fetal metabolism during pregnancy complicated by maternal diabetes mellitus results in multiple neonatal sequallae, including abnormalities of growth, glucose and calcium metabolism, hematologic status, cardio- respiratory function, bilirubin metabolism, and congenital anomalies. The causes of the fetal and neonatal sequallae of maternal diabetes are Multifactorial. However, many of the perinatal complications can be traced to the effect of maternal glycemic control on the fetus & can be prevented by appropriate periconceptional & prenatal care. Objective:  to describe the morbidity pattern among infants of diabetic mothers (IDMs) either gestational or preconception diabetes mellitus. Methods:  A cross sectional study was conducted in Jamhouria hospital/ neonatal ward & enrolled 120 consecutive infants born to diabetics mother either gestational or preconception diabetes mellitus over one year period. Results: 120 babies were diagnosed as IDMs and were admitted to Neonatal intensive care unit, male, female, 74(60.8%) were gestational diabetes, and 46 (38.3%) with preconception diabetes, full term comprise 98 cases (81.6%) while premature were 22 cases (18.3%). For birth weight 20 case [16.7%} were low birth weight, macrosomia represent 16 case (13.3%). Most common congenital anomalies was cardiac lesion 36 cases, for GDM 18 case =24.3% were PCDM 18 case around 40.0%. Central nervous system 11 case (9.1%) all of them dilated ventricular system& only 2 of them need surgical intervention with shunt. Gastrointestinal anomalies 4 cases {3.4%} 2 of them ectopic anus & 2 short bowel syndrome. Most common metabolic disturbance was Hypocalcemia 17 case (14.1%), followed by hypoglycemia 11 case (9.1%), followed with hyper bilirubinemia 3 cases (2.5%) Followed by Respiratory distress syndrome 26 case (21.6%), 17 case hyaline membrane disease (14.1%) ,transient tachypnea of neo born 9 cases (7.5%) , Birth trauma  3 cases Erb,s palsy one of them  birth asphyxia. Conclusion: Most common type of diabetes in pregnancy is gestational diabetes, and most common congenital anomalies is the cardiac lesion & the most common metabolic disturbance is the hypocalcemia. Macrosomia associated with large birth weight as well as birth trauma. Large for gestational age and hypoglycemia associated mainly with poor maternal glycemic control.

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.

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