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https://www.readbyqxmd.com/read/27921426/-gestational-diabetes-mellitus
#1
Hana Krejčí
The present generation of women of childbearing age more frequently suffer from overweight, obesity, initial as well as fully established metabolic syndrome, which together with postponing motherhood until the third decade in life plays an important role in the increasing incidence of gestational diabetes (GDM) that currently affects about 1/5 of pregnant women. However the causal link between diabetes during pregnancy and metabolic diseases in the whole population is mutual. By way of epigenetic changes, maternal diabetes unfavourably programmes metabolism of the offspring, who tend to transfer the disorder to the next generations...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27917777/the-identification-and-treatment-of-women-with-hyperglycaemia-in-pregnancy-an-analysis-of-individual-participant-data-systematic-reviews-meta-analyses-and-an-economic-evaluation
#2
Diane Farrar, Mark Simmonds, Susan Griffin, Ana Duarte, Debbie A Lawlor, Mark Sculpher, Lesley Fairley, Su Golder, Derek Tuffnell, Martin Bland, Fidelma Dunne, Donald Whitelaw, John Wright, Trevor A Sheldon
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with a higher risk of important adverse outcomes. Practice varies and the best strategy for identifying and treating GDM is unclear. AIM: To estimate the clinical effectiveness and cost-effectiveness of strategies for identifying and treating women with GDM. METHODS: We analysed individual participant data (IPD) from birth cohorts and conducted systematic reviews to estimate the association of maternal glucose levels with adverse perinatal outcomes; GDM prevalence; maternal characteristics/risk factors for GDM; and the effectiveness and costs of treatments...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27904553/comparison-of-the-effects-of-metformin-flutamide-plus-oral-contraceptives-and-simvastatin-on-the-metabolic-consequences-of-polycystic-ovary-syndrome
#3
Ferdous Mehrabian, Hatav Ghasemi-Tehrani, Mahboobe Mohamadkhani, Maryam Moeinoddini, Pooya Karimzadeh
BACKGROUND: Polycystic ovary syndrome (PCOS) is one of the common endocrine disorders in women of reproductive ages. It is associated with a range of disorders, such as dyslipidemia, hypertension, insulin resistance (IR), compensatory hyperinsulinemia, gestational, and type 2 diabetes, and increased risk of cardiovascular morbidity. There are different treatments available for PCOS. The purpose of this study was to determine and compare the effects of metformin, flutamide plus oral contraceptives (OCs), and simvastatin on the metabolic consequences of PCOS...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27824743/managing-recurring-obstetric-cholestasis-with-metformin
#4
Abdullatif Elfituri, Amanda Ali, Hassan Shehata
BACKGROUND: Obstetric cholestasis is a pregnancy-related disorder associated with an adverse pregnancy outcome. It is characterized by generalized pruritus, elevated bile acids, and abnormal liver enzymes. Recent publications show that obstetric cholestasis is associated with, and likely to potentiate, the risk of developing gestational diabetes mellitus. CASE: This case describes an unusual pattern of the disease, in which obstetric cholestasis occurred in five consecutive pregnancies with a different course of the disease in the fifth pregnancy...
December 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27823607/metformin-from-research-to-clinical-practice
#5
REVIEW
Meng H Tan, Hussain Alquraini, Kara Mizokami-Stout, Mark MacEachern
Metformin is the recommended first-line oral glucose-lowering drug initiated to control hyperglycemia in type 2 diabetes mellitus. It acts in the liver, small intestines, and skeletal muscles with its major effect on decreasing hepatic gluconeogenesis. It is safe, inexpensive, and weight neutral and can be associated with weight loss. It can reduce microvascular complication risk and its use is associated with a lower cardiovascular mortality compared with sulfonylurea therapy. It is also used to delay the onset of type 2 diabetes mellitus, in treating gestational diabetes, and in women with polycystic ovary syndrome...
December 2016: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/27819164/current-trends-in-the-diagnosis-and-management-of-gestational-diabetes-mellitus-in-the-united-states
#6
Brianne E Bimson, Barak M Rosenn, Sara A Morris, Elizabeth B Sasso, Rachelle A Schwartz, Lois E Brustman
OBJECTIVE: To assess current practice patterns among members of the Society for Maternal-Fetal Medicine (SMFM) with respect to the diagnosis and management of gestational diabetes mellitus (GDM). METHODS: A 38 question survey on GDM diagnosis and management was distributed to SMFM members. RESULTS: 2330 SMFM members were surveyed with a 40% response rate. Overall, 90.6% of respondents recommend a 2-step (versus a 1-step) diagnostic test. Cutoff values for the 1-h-50 g glucose challenge test vary from 130-140 mg/dL, but the majority (83%) adopts Carpenter Coustan criteria for the 3-h-100 g oral glucose tolerance test...
November 24, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27817155/liver-triacylglycerol-content-and-gestational-diabetes-effects-of-moderate-energy-restriction
#7
Kenneth Hodson, Chiara Dalla Man, Fiona E Smith, Alison Barnes, Catherine McParlin, Claudio Cobelli, Stephen C Robson, Vera Araújo-Soares, Roy Taylor
AIMS/HYPOTHESIS: Women with a history of gestational diabetes mellitus (GDM) have raised liver triacylglycerol. Restriction of energy intake in type 2 diabetes can normalise glucose control and liver triacylglycerol concentration but it is not known whether similar benefits could be achieved in GDM. The aim of this work was to examine liver triacylglycerol accumulation in women with GDM and the effect of modest energy restriction. METHODS: Sixteen women with GDM followed a 4 week diet (5 MJ [1200 kcal]/day)...
November 5, 2016: Diabetologia
https://www.readbyqxmd.com/read/27806559/investigation-the-effects-of-metformin-versus-insulin-on-neonatal-and-maternal-outcomes-in-women-with-gestational-diabetes-mellitus-a-randomized-clinical-trail
#8
Mahin Najafian, Mojgan Barati, Sara Masihi, Ailin Fardipor
The aim of this study was to evaluate the effectiveness of metformin versus insulin in the glycemic control and to investigate the maternal and neonatal outcomes in in women with gestational diabetes mellitus. Pregnant women with gestational diabetes were randomized to either receive metformin (n=70) or insulin (n=70). Inclusion criteria were singleton pregnancy, following healthy diet and performing exercise for at least one week without satisfactory blood glucose level, no risk factor contributing to lactic acidosis, and no anatomic and/or chromosome anomalies...
September 28, 2016: Global Journal of Health Science
https://www.readbyqxmd.com/read/27752931/pharmacological-management-of-gestational-diabetes-mellitus
#9
REVIEW
Riki Bergel, Eran Hadar, Yoel Toledano, Moshe Hod
Gestational diabetes mellitus (GDM) is one of the most common morbidities complicating pregnancy, with short- and long-term consequences to the mothers, fetuses, and newborns. Management and treatment are aimed to achieve best possible glycemic control, while avoiding hypoglycemia and ensuring maternal and fetal safety. It involves behavioral modifications, nutrition and medications, if needed; concurrent with maternal and fetal surveillance for possible adverse outcomes. This review aims to elaborate on the pharmacological options for GDM therapy...
November 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27687080/annals-express-natural-selection-the-evolution-of-diagnostic-criteria-for-gestational-diabetes
#10
Claire L Meek
Gestational diabetes (GDM) is a common pregnancy disorder which is generally managed with diet, exercise, metformin or insulin treatment and which usually resolves after delivery of the infant. Identifying and treating GDM improves maternal and fetal outcomes, and allows for health promotion to reduce the mother's risk of type 2 diabetes in later life. However, there remains considerable controversy about the optimal method of identification and diagnosis of women with GDM. The NICE-2015 diagnostic criteria (75g oral glucose tolerance test (OGTT) 0 hr ⩾5...
September 28, 2016: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/27619399/effect-of-metformin-treatment-during-pregnancy-on-women-with-pcos-a-systematic-review-and-meta-analysis
#11
Xingrong Tan, Shengbing Li, Ying Chang, Chao Fang, Hua Liu, Xingping Zhang, Yi Wang
PURPOSE: Some previous studies have found that continued metformin use is beneficial in the management of polycystic ovary syndrome (PCOS) in pregnant women. A systemic review and meta-analysis were needed to more fully assess the effects of metformin on pregnant PCOS patients. METHODS: The literature was fully searched using MEDLINE, EMBASE, SCOPUS, and COCHRANE for continued metformin use during pregnancy in women with PCOS. A systematic review and meta-analysis were performed to evaluate the comprehensive effects of continued metformin treatment on pregnancy-related outcomes in these women...
2016: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
https://www.readbyqxmd.com/read/27603343/effects-of-metformin-on-pregnancy-outcomes-in-women-with-polycystic-ovary-syndrome-a-meta-analysis
#12
Xian-Ling Zeng, Ya-Fei Zhang, Quan Tian, Yan Xue, Rui-Fang An
AIM: The aim of the study is to evaluate the effects of metformin on pregnancy outcomes in women with polycystic ovary syndrome (PCOS). METHODS: We searched electronic databases and bibliographies of relevant papers to identify studies comparing the pregnancy outcomes in the metformin group with those in the placebo or blank control group. Then, we did this meta-analysis based on the PRISMA guidelines. The primary outcomes included early pregnancy loss (EPL), preterm delivery, term delivery, and gestational diabetes mellitus (GDM)...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27597988/could-metformin-manage-gestational-diabetes-mellitus-instead-of-insulin
#13
Hend S Saleh, Walid A Abdelsalam, Hala E Mowafy, Azza A Abd ElHameid
Gestational diabetes mellitus (GDM) complicates a significant number of pregnancies. Blood glucose control improves perinatal outcomes. Medical nutrition therapy is the foundation in management. Aim of This Study. To evaluate efficacy of metformin in comparison to insulin for managing GDM. Methods. In prospective randomized comparative study, 150 antenatal women whose pregnancies had been complicated by GDM and did not respond to diet alone were recruited from antenatal clinics at Obstetrics Department in Zagazig University Hospitals from November 2012 to December 2014...
2016: International Journal of Reproductive Medicine
https://www.readbyqxmd.com/read/27549367/metformin-a-potentially-effective-drug-for-gestational-diabetes-mellitus-a-systematic-review-and-meta-analysis
#14
Ye Feng, Huixia Yang
Metformin has been gradually used in the management of gestational diabetes mellitus (GDM). In order to prove the safety and efficacy of metformin used in pregnancy, we searched several databases for the reports of randomized trials comparing insulin and metformin used in GDM and conducted a meta-analysis. Data showed the rates of neonatal large for gestational age, cesarean section, neonatal respiratory distress and preterm birth were similar in both groups. Maternal glycated hemoglobin-% at gestational week 36-37 was significantly lower in metformin group, indicating good glycemic control of metformin...
September 9, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27531282/the-use-of-dextrose-insulin-infusions-during-labour-and-delivery-in-women-with-gestational-diabetes-mellitus-is-there-any-point
#15
Maritza T Farrant, Kathryn Williamson, Malcolm Battin, William M Hague, Janet A Rowan
We compared, in 733 women with gestational diabetes mellitus treated with metformin and/or insulin, rates of neonatal hypoglycaemia in those who had received a dextrose/insulin infusion during labour and prior to delivery (n = 132) with those who did not (n = 601). Women who had infusions were more likely to have been treated with insulin (87.1% vs 70.4%, P < 0.01) and have higher mean capillary glucose values (measured four times daily) in the two weeks prior to delivery (P < 0.01). They had lower mean (SD) glucose values in the 12 h prior to delivery (5...
August 17, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/27435163/metformin-in-women-with-type-2-diabetes-in-pregnancy-mity-a-multi-center-randomized-controlled-trial
#16
Denice S Feig, Kellie Murphy, Elizabeth Asztalos, George Tomlinson, Johanna Sanchez, Bernard Zinman, Arne Ohlsson, Edmond A Ryan, I George Fantus, Anthony B Armson, Lorraine L Lipscombe, Jon F R Barrett
BACKGROUND: The incidence of type 2 diabetes in pregnancy is rising and rates of serious adverse maternal and fetal outcomes remain high. Metformin is a biguanide that is used as first-line treatment for non-pregnant patients with type 2 diabetes. We hypothesize that metformin use in pregnancy, as an adjunct to insulin, will decrease adverse outcomes by reducing maternal hyperglycemia, maternal insulin doses, maternal weight gain and gestational hypertension/pre-eclampsia. In addition, since metformin crosses the placenta, metformin treatment of the fetus may have a direct beneficial effect on neonatal outcomes...
2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27371343/neonatal-outcomes-according-to-different-therapies-for-gestational-diabetes-mellitus
#17
Amanda L da Silva, Augusto R do Amaral, Daniela S de Oliveira, Lisiane Martins, Mariana R E Silva, Jean Carl Silva
OBJECTIVES: To compare different neonatal outcomes according to the different types of treatments used in the management of gestational diabetes mellitus (GDM). METHODS: This was a retrospective cohort study. The study population comprised pregnant women with GDM treated at a public maternity hospital from July 2010 to August 2014. The study included women aged at least 18 years, with a singleton pregnancy, who met the criteria for GDM. Blood glucose levels, fetal abdominal circumference, body mass index and gestational age were considered for treatment decision-making...
June 28, 2016: Jornal de Pediatria
https://www.readbyqxmd.com/read/27366715/comparison-of-maternal-and-fetal-outcomes-among-asian-indian-pregnant-women-with-or-without-gestational-diabetes-mellitus-a-situational-analysis-study-wings-3
#18
Manni Mohanraj Mahalakshmi, Balaji Bhavadharini, Kumar Maheswari, Gunasekaran Kalaiyarasi, Ranjit Mohan Anjana, Unnikrishnan Ranjit, Viswanathan Mohan, Kurian Joseph, Kurian Rekha, Sivagnanam Nallaperumal, Belma Malanda, Arivudainambi Kayal, Anne Belton, Ram Uma
AIM: To compare the existing maternal and fetal outcomes in Asian Indian women with or without gestational diabetes mellitus (GDM) before the development of the Women in India with GDM Strategy (WINGS) GDM model of care (MOC). MATERIALS AND METHODS: Records of pregnant women were extracted retrospectively from three maternity centers in Chennai. GDM was diagnosed using the International Association for Pregnancy Study Groups criteria or the Carpenter and Coustan criteria...
July 2016: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27339886/gestational-diabetes-mellitus-does-an-effective-prevention-strategy-exist
#19
REVIEW
Rochan Agha-Jaffar, Nick Oliver, Desmond Johnston, Stephen Robinson
The overall incidence of gestational diabetes mellitus (GDM) is increasing worldwide. Preventing pathological hyperglycaemia during pregnancy could have several benefits: a reduction in the immediate adverse outcomes during pregnancy, a reduced risk of long-term sequelae and a decrease in the economic burden to healthcare systems. In this Review we examine the evidence supporting lifestyle modification strategies in women with and without risk factors for GDM, and the efficacy of dietary supplementation and pharmacological approaches to prevent this disease...
September 2016: Nature Reviews. Endocrinology
https://www.readbyqxmd.com/read/27332919/metformin-versus-placebo-in-obese-pregnant-women-without-diabetes
#20
LETTER
Mustafa Sahin, Demet Corapcioglu
No abstract text is available yet for this article.
June 23, 2016: New England Journal of Medicine
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