scholarly journals Effect of Carbohydrate-Restricted Dietary Pattern on Insulin Treatment Rate, Lipid Metabolism and Nutritional Status in Pregnant Women with Gestational Diabetes in Beijing, China

Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 359
Author(s):  
Mingxuan Cui ◽  
Xuening Li ◽  
Chen Yang ◽  
Linlin Wang ◽  
Lulu Lu ◽  
...  

Carbohydrates play an important role in blood glucose control in pregnant women with GDM. Carbohydrate-restricted dietary (CRD) pattern for gestational diabetes mellitus (GDM) has been widely used in clinics, but the change in insulin utilization rate beyond CRD intervention in GDM remains unclear. The aim of the present study was to explore the application of insulin in pregnancy with GDM, as well as the influence of CRD pattern on lipid metabolism and nutritional state. A retrospective study of 265 women with GDM who delivered in Peking University People’s Hospital from July 2018 to January 2020 was conducted using a questionnaire survey. Women were divided into a CRD group or a control group according to whether they had received CRD intervention during pregnancy. There was no statistically significant difference in the rate of insulin therapy between the two groups (p > 0.05), the initial gestational week of the CRD group combined with insulin treatment was significantly higher than that of the control group (p < 0.05), and the risk of insulin therapy was positively correlated with fasting plasma glucose (FPG) in early pregnancy (p < 0.05). The incidence of abnormal low-density lipoprotein cholesterol levels in the CRD group was significantly lower than that in the control group (p < 0.05). There were no significant differences in nutritional indexes between the two groups. The results indicate that CRD intervention may be effective in delaying the use of insulin and improving the blood lipids metabolism during GDM pregnancy, while nutritional status may not be significantly affected under CRD intervention, and a high FPG in early pregnancy with GDM may be a risk factor for combined insulin therapy with CRD intervention.

2020 ◽  
Vol 16 (8) ◽  
pp. 895-899 ◽  
Author(s):  
Shahin Safian ◽  
Farzaneh Esna-Ashari ◽  
Shiva Borzouei

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.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Mayu Watanabe ◽  
Akihiro Katayama ◽  
Hidetoshi Kagawa ◽  
Daisuke Ogawa ◽  
Jun Wada

Poor maternal glycemic control increases maternal and fetal risk for adverse outcomes, and strict management of gestational diabetes mellitus (GDM) is recommended to prevent neonatal and maternal complications. However, risk factors for the requirement of antenatal insulin treatment (AIT) are not well-investigated in the pregnant women with GDM. We enrolled 37 pregnant women with GDM and investigated the risk for AIT by comparing the patients with AIT (AIT group;n=10) and without insulin therapy (Diet group;n=27). The 1-h and 2-h plasma glucose levels and the number of abnormal values in 75 g OGTT were significantly higher in AIT group compared with Diet group. By logistic regression analysis, plasma glucose level at 1-h was significant predictor for AIT and the odds ratios were 1.115 (1.004–1.239) using forward selection method and 1.192 (1.006–1.413) using backward elimination method. There were no significant differences in obstetrical outcomes and neonatal complications. 1-h plasma glucose levels in 75 g OGTT are useful parameters in predicting the requirement for AIT in GDM. Both maternal and neonatal complications are comparable in GDM patients with and without insulin therapy.


2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Farideh Akhlaghi ◽  
Seyyed Majid Bagheri ◽  
Omid Rajabi

In this paper, we studied the relation between the micronutrient and gestational diabetes. Therefore, we measured micronutrient concentration including Ni, Al, Cr, Mg, Fe, Zn, Cu, and Se in serum of women with gestational diabetes between 24 and 28 weeks of gestational age (study group) who had inclusion criteria and comparison with micronutrient levels in normal pregnant women with same gestational age (control group). Results showed that there was no significant difference between the serum micronutrient level (Ni, Al, Cr, Mg, Zn, Cu, Se) in study and control groups except serum level of iron which in serum of gestational diabetic women was lower than normal pregnant women and difference was significant.


2016 ◽  
Vol 62 (5) ◽  
pp. 31-32 ◽  
Author(s):  
Polina Popova ◽  
Aleksandra Tkachuk ◽  
Aleksandra Dronova ◽  
Yana Bolotko ◽  
Elena Grineva

Background and aims. Placental hormones and proteins are important regulators of insulin resistance during pregnancy. However, the data concerning the assosiation between placental lactogen (PL) and placental growth factor (PLGF) level in early pregnancy and further development of gestational diabetes mellitus (GDM) are limited and incostintent. The aim of this study was to compare the level of these two placental proteins and homeostasis model assessment of insulin resistance (HOMA-IR) in early pregnancy among women diagnosed with and without GDM months later.Materials and methods. A nested case-control study was conducted in a prospective cohort of pregnant women. Among them, 78 incident GDM cases were identified and 95 women who were not diagnosed with GDM were randomly selected as a control group. Blood was sampled for measurements of PL, PLGF, fasting plasma glucose and insulin at 8-14 weeks of pregnancy. All the women underwent oral glucose tolerance test (OGTT) at 24-32 weeks. GDM was diagnosed according to the International Association of Diabetes In Pregnancy Study Groups (IADPSG) recommendations (fasting glucose ≥5.1 mmol / l and / or 1 hour ≥10.0 mmol / l and / or 2 hours ≥8.5 mmol / L). The maternal and neonatal anthropometric parameters were also measured. Statistical analysis included Student's t-test, logistic regression and Pearson's correlation.Results. There was no difference between GDM and control groups in the mean levels of PL (0,70 +/- 0,53 vs 0,81 +/- 0,58 mg/L, р =0,215 ) and PLGF (60,7 +/- 169.6 vs 46,6+105,6 pg/ml, р=0,503). Women with GDM were older (30.2 +/- 3.9 vs 28.4 +/- 4.7 years, p = 0.008), had higher first trimester body mass index (BMI) (25.2 +/- 5.2 vs 23.1 +/- 4.6 kg/m2, р = 0.006), higher levels of insulin (10.3 +/- 5.5 vs 7.9 +/- 3.9 mU/L, p = 0,007) and HOMA-IR ( 2.17 +/- 1.1 vs 1.7 +/- 0.9, p = 0,007) compared to the control group. Women with GDM also had a higher level of fasting plasma glucose (4.8 + 0.6 and 4.6 + 0,5 mmol/L, p = 0.063), although the difference did not reach statistical significance. HOMA-IR was positively associated with the development of GDM (OR: 1.62, 95% CI: 1.12 - 2.34, P = 0.01) and the association retained under a multivariable analysis controlling for age and BMI (OR: 1.59, 95% CI: 1.04 - 2.45, P = 0.033). Maternal PL and PLGF were not related to the results of OGTT, HOMA-IR or neonatal anthropometry. A positive correlation between PL level and gestational age at the time of blood sampling was observed (r = 0.657, p <0.001).Conclusion. Serum concentrations of PL and PLGF in pregnant women at 8-14 weeks’ gestation were not associated with HOMA-IR and later development of GDM. Higher HOMA-IR score in early pregnancy is significantly associated with an elevated risk for GDM.


2020 ◽  
Vol 9 (8) ◽  
pp. 2587
Author(s):  
Tomasz Gęca ◽  
Maciej Kwiatek ◽  
Arkadiusz Krzyżanowski ◽  
Anna Kwaśniewska

Background: Gestational diabetes mellitus (GDM) is the most common metabolic disorder in pregnant women, defined as any degree of glucose intolerance with onset or first detected during pregnancy. Explanation of its pathogenesis is extremely important due to the possibility of preventing serious maternal and fetal complications. The aim of the study was to evaluate the concentrations of two molecules: C1q/tumor necrosis factor-related protein-3 (CTRP-3) and pigment epithelium-derived factor (PEDF) which may possibly participate in GDM development. To our knowledge, this is the first study in pregnant women with GDM evaluating CTRP-3 level. Methods: Serum CTRP-3 and PEDF concentration and clinical characteristics were detected in 172 pregnant women. These women were divided into two groups: normal glucose tolerance group (NGT, n = 54) and gestational diabetes mellitus group (GDM, n = 118). This second group was further divided into two subgroups depending on the treatment used: GDM 1—diet only (n = 75) and GDM 2—insulin treatment (n = 43). Results: Our study did not reveal any statistically significant difference between the concentration of PEDF in the control and GDM group. In our study there was a significantly higher concentration of CTRP-3 evaluated in the peripheral blood serum in patients with gestational diabetes (GDM) compared to those in the control group (8.84 vs. 4.79 ng/mL). Significantly higher values of CTRP-3 were observed in both the diet-treated subgroup and the group with insulin therapy when compared to control group (8.40 and 10.96, respectively vs. 4.79 ng/mL). Conclusion: PEDF concentration does not change in GDM, whereas an increased level of CTRP-3 may point to the key role of this adipokine in the development of GDM.


Author(s):  
Riham M. Enab ◽  
Amal A. El Sokary ◽  
Heba A. Mourad ◽  
Amal E. Mahfouz

Background: Vitamin D3 is synthesized in skin and sequentially metabolized in liver and kidney in humans. It is well known for its function in maintaining calcium and phosphorus homeostasis and promoting bone mineralization. The primary objective of this study was to evaluate vitamin D3 level in pregnant women who were suffering from gestational diabetes mellitus and comparing it with the control groups. Materials and Methods: This case control study was conducted on 100 pregnant women who were attending the inpatient and outpatient clinics of Obstetrics department, Tanta University Hospital, who were divided into two equal groups.Group A (control group): Fifty apparently healthy pregnant women at 24th-28th weeks of gestation. Group B (study group): Fifty pregnant women had gestational diabetes. Results: There is significant increase between the two studied groups according to HbA1c, also there is decrease between the two groups as regards VIT D. Mean HbA1c % was statistically significant higher in the study group versus control group. There was statistical significant difference noted between mean serum level of vitamin D among the two studied groups. A statistically significant negative correlation was observed between serum 25 OH vitamin D and HbA1c among our cases (r=- 0.745) (p ≤ 0.001). Mean serum vitamin D was significantly lower in cases with complications than those with normal outcome. Conclusion: Vitamin D deficiency may have a positive relationship with gestational diabetes mellitus.


2020 ◽  
Vol 28 (2) ◽  
pp. 89-94
Author(s):  
Aşkın Evren Güler ◽  
Zeliha Çiğdem Demirel Güler ◽  
Asil Budak ◽  
Buket Koparal ◽  
Özge Şehirli Kıncı

Objective The aim of this study was to investigate the anxiety levels of pregnant women with gestational diabetes mellitus (GDM) followed by different treatment methods. Methods Our study was carried out with 141 cases whose pregnancy follow ups were made in Gynecology and Obstetrics Clinic. Cases which had GDM screening with 75-g oral glucose tolerance test (OGTT) were divided into 3 groups. Group 1 (control group) consisted of 50 cases with 75-g OGTT results in normal range, Group 2 consisted of 50 cases which had significant 75-g OGTT results and followed up by diet (A1), and Group 3 consisted of 41 cases which were diagnosed with GDM as a result of 75-g OGTT and received diet as well as medical therapy (A2). Beck anxiety inventory (BAI) was administered to the patients in Group 1 in 24th week, and to patients in Groups 2 and 3 in the 24th and 32nd weeks. Results In the first evaluation of the patients, BAI scores of the control group were statistically found to be significantly lower than the patients with GDM (p=0.001). There was no significant difference in BAI scores among patients diagnosed with GDM, and high anxiety scores were found in both groups. There was a significant decrease in anxiety levels in the Groups 2 and 3 after the treatment (p<0.01). In the Group 2, the BAI scores were observed to decrease from 51.76±4.47 to 45.62±3.65, and from 51.73±5.27 to 41.48±3.29 in the Group 3 (p<0.001). Conclusion In addition to the metabolic disorders brought by the disease itself, GDM can cause various problems by increasing the levels of anxiety in patients. With an effective treatment for glycemic control, anxiety levels of patients can be reduced.


2020 ◽  
Vol 14 (2) ◽  
pp. 145
Author(s):  
Devi Pratiktowati ◽  
Dewi Marhaeni Diah Herawati ◽  
Ginna Megawati ◽  
Deni Kurniadi Sunjaya

A high prevalence chronic energy deficiency (CED) in pregnant women exist in Indonesia, which approximately 16.2%. The government had made various efforts to eliminate CED in pregnant women. Therefore, our study aimed to analyze the efficacy of eel cookies on improving nutritional status of pregnant women with CED risk. An experiment with a pre-post design of 36 pregnant women with risk of CED in Ciletuh, Sukabumi was carried out for 30 days. Pregnant women in intervention group were given eel cookies, while control group were given cookies without eel. At the beginning and end of the study, MUAC were measured and food intake was assessed through a 24 hour recall. The research data was analysed using t-test, Mann-Whitney test and chi square. Significant difference in body weight between intervention and control groups was not found (p > 0.05). The mean bodyweight in intervention group after intervention (48.5) was higher than in control group (48.3). The Mean bodyweight and MUAC in the two groups before and after intervention also did not show a significant difference  (p> 0.05). The risk of CED in pregnant women who received eel cookies were lower compared to the control group. Consumption of eel cookies can reduce CED risk in pregnant women by 35%, while cookies without eel only reduce the risk by 29.4%. Eel cookies had higher efficacy compared to cookies without eel on reducing CED risk in pregnant women.


2021 ◽  
Author(s):  
Sedighe Esmaeilzadeh ◽  
Reza Ghadimi ◽  
Sepideh Mashayekhamiri ◽  
Mouloud Agajani Delavar ◽  
Zahra Basirat

Abstract Purpose: This study is striving to test the hypothesis that a low dosage of myo-inositol supplementation may decrease the likelihood of gestational diabetes in overweight, pregnant women. Methods: A randomized, double-blind, controlled trial was performed on 60 eligible overweight, pregnant women at 12-14 weeks of gestation at two Iranian obstetric clinics. The participants were divided into two groups based on blocked randomization. The myo-inositol group, receiving 2000 mg plus 200 μg folic acid daily and the control group, receiving 400 μg of folic acid daily from 14 - 24 gestational weeks. The occurrence of gestational diabetes was determined based on 75-g 2-hour oral glucose tolerance test (OGTT) at 24–28 gestational weeks, which was the primary outcome of the study. The secondary outcomes were: the evaluation of insulin therapy, insulin resistance, and lipid profile, gestational weight gain, as well as fetal and maternal outcomes. Results: The incidence of gestational diabetes in myo-inositol group was noticeably minimized compared with that of the control group (RR 0.29, 95% CI 0.09-0.94, p= 0.037). There were no differences between the two groups in terms of fasting blood sugar, fasting insulin, HOMA-IR, insulin therapy, and triglyceride. There was no report of severe adverse drug reactions, either.Conclusions: The absolute risk reduction and the ‘‘Number-Needed-to-Treat’’ for gestational diabetes were 26.8% (95% CI, 5.6–48) and 3.7 (95% CI, 2.1–18.0), respectively. Hence, it can be concluded that approximately one out of every four overweight pregnant women receiving myo-inositol benefitted from its daily intake.


2012 ◽  
Vol 140 (9-10) ◽  
pp. 583-588
Author(s):  
Violeta Mladenovic ◽  
Aleksandar Djukic ◽  
Mirjana Varjacic ◽  
Djuro Macut

Introduction. Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. The diagnosis of GDM is made by performing the oral glucose tolerance test (OGTT) in women with risk factors, usually during 24th to 28th week of gestation. The most common used insulin therapy regime is a conventional intensive insulin therapy with four daily doses. Objective. The aim of our study was to determine the changes in parameters of glycoregulation in GDM patients with different approach to the introduction of insulin therapy. Methods. Study group consisted of 50 pregnant women divided into two groups depending on the parameters of glycoregulation (glycemic profile and HbA1). Group 1 consisted of pregnant women initially treated with diet only and then, according to glycemic profile and HbA1 profile, in the next few weeks with insulin therapy. Group 2 were pregnant women who were treated with insulin therapy immediately after GDM diagnosis. Results. There was a statistically significant difference in mean glycemia values in the 60th and 120th minute between the two groups (p=0.001). There was a difference in mean value of fasting blood and postprandial glucose between the two groups; it was higher in Group 2. There was a statistically significant difference between the two groups in HbA1c value at the beginning (5.1?0.4% vs. 5.42?0.43%, p=0.005) and at the end of therapy (4.87?0.29% vs. 5.1?0.39 %, p=0.018). Conclusion. Satisfactory glycoregulation was achieved in both studied groups.


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