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insulin diabetes gestational

Karen Broekhuizen, David Simmons, Roland Devlieger, André van Assche, Goele Jans, Sander Galjaard, Rosa Corcoy, Juan M Adelantado, Fidelma Dunne, Gernot Desoye, Jürgen Harreiter, Alexandra Kautzky-Willer, Peter Damm, Elisabeth R Mathiesen, Dorte M Jensen, Liselotte L Andersen, Annunziata Lapolla, Maria G Dalfra, Alessandra Bertolotto, Ewa Wender-Ozegowska, Agnieszka Zawiejska, David Hill, Frank J Snoek, Judith G M Jelsma, Judith E Bosmans, Mireille N M van Poppel, Johanna M van Dongen
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with perinatal health risks to both mother and offspring, and represents a large economic burden. The DALI study is a multicenter randomized controlled trial, undertaken to add to the knowledge base on the effectiveness of interventions for pregnant women at increased risk for GDM. The purpose of this study was to evaluate the cost-effectiveness of the healthy eating and/or physical activity promotion intervention compared to usual care among pregnant women at increased risk of GDM from a societal perspective...
March 14, 2018: International Journal of Behavioral Nutrition and Physical Activity
Rajesh Kumari, Venus Dalal, Garima Kachhawa, Ipshita Sahoo, Rajesh Khadgawat, Reeta Mahey, Vidushi Kulshrestha, Perumal Vanamail, J B Sharma, Neerja Bhatla, Alka Kriplani
Background: Gestational diabetes mellitus (GDM) is defined as a carbohydrate intolerance first diagnosed in pregnancy and may be associated with adverse maternal and perinatal outcome. Aim: The aim of the study was to determine the maternal and perinatal outcome in GDM during pregnancy. Materials and Methods: It is a retrospective analysis of women diagnosed with GDM who got antenatal care and delivered in our hospital in previous 5 years...
January 2018: Indian Journal of Endocrinology and Metabolism
Annie Dude, Charlotte M Niznik, Emily D Szmuilowicz, Alan M Peaceman, Lynn M Yee
Achieving maternal euglycemia in women with pregestational and gestational diabetes mellitus is critical to decreasing the risk of neonatal hypoglycemia, as maternal blood glucose levels around the time of delivery are directly related to the risk of hypoglycemia in the neonate. Many institutions use continuous insulin and glucose infusions during the intrapartum period, although practices are widely variable. At Northwestern Memorial Hospital, the "Management of the Perinatal Patient with Diabetes" policy and protocol was developed to improve consistency of management while also allowing individualization appropriate for the patient's specific diabetic needs...
March 13, 2018: American Journal of Perinatology
Azadeh Houshmand-Oeregaard, Maren Schrölkamp, Louise Kelstrup, Ninna S Hansen, Line Hjort, Anne Cathrine Baun Thuesen, Christa Broholm, Elisabeth R Mathiesen, Tine D Clausen, Allan Vaag, Peter Damm
Offspring of women with diabetes in pregnancy exhibit skeletal muscle insulin resistance and are at increased risk of developing type 2 diabetes, potentially mediated by epigenetic mechanisms or changes in the expression of small non-coding microRNAs. Members of the miR-15 family can alter the expression or function of important proteins in the insulin signaling pathway, affecting insulin sensitivity and secretion. We hypothesized that exposure to maternal diabetes may cause altered expression of these microRNAs in offspring skeletal muscle, representing a potential underlying mechanism by which exposure to maternal diabetes leads to increased risk of cardiometabolic disease in offspring...
March 8, 2018: Human Molecular Genetics
Olga Ulyanova, Abay Baigenzhin, Zhaksylyk Doskaliyev, Temirlan Karibekov, Larissa Kozina, Samat Saparbayev, Rakhat Trimova
OBJECTIVES: Our objective was to determine transforming growth factor β1 levels in patients with type 2 diabetes mellitus after fetal pancreatic stem cell transplant. MATERIALS AND METHODS: We examined 10 patients (age range, 41-65 y) with type 2 diabetes mellitus, which we subsequently divided into 2 groups. Group 1 comprised 5 patients who received fetal pancreatic stem cell transplant (cells were 16-18 wk gestation) performed by intravenous infusion. Group 2 comprised 5 patients (control group) who were on hypoglycemic tablet therapy or insulin therapy...
March 2018: Experimental and Clinical Transplantation
Shuli Yang, Lihui Si, Limei Fan, Wenwen Jian, Huilin Pei, Ruixin Lin
Lycium barbarum L . (LBL) has beneficial effects on gestational diabetes mellitus (GDM) but the related mechanism remains unclear. Polysaccharides of LBL (LBLP) are the main bioactive components of LBL. miR-33, ATP-binding cassette transporter A1 (ABCA1) and sterol regulatory element-binding transcription 1 (SREBF1) affect lipid profiles, which are associated with GDM risk. LBLP may exert protective against GDM by affecting these molecules. Four LBLP fractions: LBLP-I, LBLP-II, LBLP-III, and LBLP-IV were isolated from LBL and further purified by using DEAE-Sephadex column...
2018: Frontiers in Endocrinology
Rachel T McGrath, Sarah J Glastras, Emma S Scott, Samantha L Hocking, Gregory R Fulcher
Metformin is increasingly being used a therapeutic option for the management of gestational diabetes mellitus (GDM). The aim of this study was to compare the maternal characteristics and perinatal outcomes of women with GDM treated with metformin (with or without supplemental insulin) with those receiving other management approaches. A retrospective, case-control study was carried out and 83 women taking metformin were matched 1:1 with women receiving insulin or diet and lifestyle modification alone. Women managed with diet and lifestyle modification had a significantly lower fasting plasma glucose ( p < 0...
March 9, 2018: Journal of Clinical Medicine
Yang Feng, Chen-Dong Jiang, Ai-Min Chang, Ying Shi, Junjun Gao, Linlin Zhu, Zhan Zhang
PURPOSE: The aim of this study was to investigate the correlations and interactions between the polymorphisms of insulin resistance-related genes (ADIPOQ rs2241766), inflammation factors (TNF-α rs1800629, IL-6 rs1800795), obesity-related genes (GNB3 rs5443, ADRB rs1042714), and risk factors for gestational diabetes mellitus (GDM) such as diet structure in the development of GDM. MATERIALS AND METHODS: This research was conducted among women who visited the third-affiliate hospital of Zhengzhou University for pregnancy checkups from 1 June 2014 to 30 December 2014...
March 8, 2018: Journal of Maternal-fetal & Neonatal Medicine
Guanghui Li, Wenyu Huang, Li Zhang, Zhihong Tian, Wei Zheng, Teng Wang, Ting Zhang, Weiyuan Zhang
BACKGROUND: Polycystic ovarian syndrome (PCOS) is a strong risk factor for gestational diabetes (GDM). However, the association between features of PCOS during early pregnancy and the risk of GDM is not clearly characterized. In this prospective cohort study, we seek to identify early-pregnancy risk factors for GDM in PCOS women. METHODS: Between 2011-2013, 248 women with PCOS were followed from their first prenatal visit to delivery. Multiple early-pregnancy metabolic factors were evaluated for their association with the risk of GDM...
March 7, 2018: Diabetes/metabolism Research and Reviews
Anna Gabriela Castro-Martínez, José Sánchez-Corona, Adriana Patricia Vázquez-Vargas, Alejandra Guadalupe García-Zapién, Andres López-Quintero, Héctor Javier Villalpando-Velazco, Silvia Esperanza Flores-Martínez
Gestational diabetes mellitus (GDM) is a metabolically complex disease with major genetic determinants. GDM has been associated with insulin resistance and dysfunction of pancreatic beta cells, so the GDM candidate genes are those that encode proteins modulating the function and secretion of insulin, such as that for calpain 10 (CAPN10). This study aimed to assess whether single nucleotide polymorphism (SNP)-43, SNP-44, SNP-63, and the indel-19 variant, and specific haplotypes of the CAPN10 gene were associated with gestational diabetes mellitus...
February 28, 2018: Cellular and Molecular Biology
Oded Langer
Controversies persist over the most efficacious pharmacologic treatment for gestational diabetes mellitus. For purposes of accuracy in this article, the individual American College of Obstetricians and Gynecologists Practice Bulletin and American Diabetes Association Standards of Medical Care positions on each issue are quoted and then deliberated with evidence of counter claims presented in point/counterpoint. This is a review of all the relevant evidence for the most holistic picture possible. The main issues are (1) which diabetic drugs cross the placenta, (2) the quality of evidence and data source validity, (3) the rationale for the designation of glucose control as the primary outcome in gestational diabetes mellitus, and (4) which drugs (metformin, glyburide, or insulin) are most effective in improving secondary outcomes...
February 28, 2018: American Journal of Obstetrics and Gynecology
Lucia Cea-Soriano, Luis A García-Rodríguez, Kimberly G Brodovicz, Elvira Masso Gonzalez, Dorothee B Bartels, Sonia Hernández-Díaz
AIMS: To evaluate the association between use of non-insulin antidiabetics in early pregnancy and the risk of miscarriages, stillbirths and major structural malformations. MATERIALS AND METHODS: A cohort of 1,511 pregnancies in women with pre-gestational diabetes linked to livebirths was identified using electronic medical records from The Health Improvement Network (THIN) for the period 1995 to 2012. Information on prescriptions, foetal outcomes, and potential confounders was ascertained from both codes and free text in THIN database...
March 2, 2018: Diabetes, Obesity & Metabolism
Xiao-Song Yuan, Ming Zhang, Hui-Yan Wang, Jian Jiang, Bin Yu
By biochemical and epidemiological similarity with type 2 diabetes mellitus (T2DM), gestational diabetes mellitus (GDM) has some overlap between prediction markers and risk factors of T2DM. The present study aimed to establish that secreted frizzled-related protein 4 (SFRP4) and ficolin-3 levels, which have been linked to insulin resistance and the development of T2DM, are elevated in GDM women. A longitudinal prospective cohort study of 86 GDM and 273 normal glucose tolerant (NGT) pregnant women was performed...
February 27, 2018: Endocrine Journal
Wanyi Zhang, Rina Su, Li Lin, Huixia Yang
INTRODUCTION: Fetal macrosomia has confirmed be related to multiple labor complications and metabolism syndromes later in life. However, the mechanism of fetal macrosomia in normal glucose tolerance (NGT) and gestational diabetes mellitus (GDM) pregnant women is still obscure. This study aimed to investigate the mechanism of Rho guanine nucleotide exchange factor 11 (ARHGEF11) and the insulin signaling pathway in placenta affecting fetal overgrowth in NGT and GDM pregnant women. METHODS: Eighty-nine pregnant women with paired antepartum BMI were recruited and divided into four groups: NGT with normal birth weight (NGT-N, n = 30) or macrosomia (NGT-M, n = 22) and GDM with normal birth weight (GDM-N, n = 22) or macrosomia (GDM-M, n = 15)...
March 2018: Placenta
Eran Weiner, Elad Barber, Ohad Feldstein, Letizia Schreiber, Ann Dekalo, Yossi Mizrachi, Jacob Bar, Michal Kovo
OBJECTIVE: We aimed to compare placental histopathological lesions and neonatal outcome in singleton vs. twin pregnancies complicated by gestational diabetes mellitus (GDM). METHODS: Maternal characteristics, neonatal outcomes, and placental histopathology reports of pregnancies complicated by GDM, between 1/2008-10/2016, were reviewed. Results were compared between singletons (singleton group) and dichorionic-diamniotic twins (twin group). Placental lesions were classified as placental weight abnormalities, maternal and fetal vascular malperfusion lesions (MVM, FVM), inflammatory lesions, and lesions associated with chronic villitis...
March 2018: Placenta
Michela Meregaglia, Livia Dainelli, Helen Banks, Chiara Benedetto, Patrick Detzel, Giovanni Fattore
BACKGROUND: The incidence of Gestational Diabetes Mellitus (GDM) is rising in all developed countries. This study aimed at assessing the short-term economic burden of GDM from the Italian healthcare system perspective. METHODS: A model was built over the last pregnancy trimester (i.e., from the 28th gestational week until childbirth included). The National Hospital Discharge Database (2014) was accessed to estimate delivery outcome probabilities and inpatient costs in GDM and normal pregnancies (i...
February 23, 2018: BMC Pregnancy and Childbirth
Eleanor M Scott, Rudy W Bilous, Alexandra Kautzky-Willer
BACKGROUND: Accuracy of the FreeStyle Libre™ Flash Glucose Monitoring System has not been evaluated in pregnant women with diabetes. The aim of this study was to determine accuracy (compared to self-monitoring of blood glucose [SMBG]), clinical safety, and acceptability of the FreeStyle Libre System when used at home by this population. MATERIALS AND METHODS: Seventy-four participants, with type 1 (T1D, n = 24), type 2 (T2D, n = 11), or gestational (n = 39) diabetes, were enrolled across 13 sites (9 in United Kingdom, 4 in Austria)...
February 22, 2018: Diabetes Technology & Therapeutics
Dilek Dilli, Nazan Neslihan Doğan, Mehmet Şah İpek, Yunus Çavuş, Serdar Ceylaner, Haldun Doğan, Arzu Dursun, Tuncay Küçüközkan, Ayşegül Zenciroğlu
BACKGROUND: To evaluate the effects of maternal fish oil supplementation in women with gestational diabetes mellitus (GDM) on birthweight and DNA methylation at insulin like growth factor-1 (IGF-1) gene in their offspring. METHODS: Randomized controlled trial. A total of 120 women with GDM were randomized to one of the two groups between 24 and 28 weeks of the pregnancy: Group 1 (n = 52) received fish oil liquid softgel (Ocean plus®) and Group 2 (Placebo) (n = 68) sunflower oil liquid softgel...
February 2018: Clinical Nutrition ESPEN
Hexing Wang, Jiaqi Yang, Hongyi Du, Linji Xu, Shuping Liu, Jianping Yi, Xu Qian, Yue Chen, Qingwu Jiang, Gengsheng He
BACKGROUND: Exposure to perfluoroalkyl substances (PFASs) can affect glucose homeostasis and has been suggested as a potential risk of diabetes mellitus, but data are limited for pregnant women. OBJECTIVES: We aimed to explore the associations of exposure to PFASs with glucose homeostasis and gestational diabetes mellitus (GDM) in Chinese pregnant women. METHODS: The current study was conducted in Hebei Province of Northern China between 2013 and 2014 and 560 pregnant women were recruited in their early term of pregnancy and two representative serum PFASs, perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS), were measured...
February 16, 2018: Environment International
Naricha Chirakalwasan, Somvang Amnakkittikul, Ekasitt Wanitcharoenkul, Suranut Charoensri, Sunee Saetung, Suwannee Chanprasertyothin, La-Or Chailurkit, Panyu Panburana, Sommart Bumrungphuet, Ammarin Takkinstian, Sirimon Reutrakul
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is associated with gestational diabetes mellitus (GDM). This study assessed the effects of continuous positive airway pressure (CPAP) in obese pregnant females with GDM and OSA. METHODS: A randomized controlled trial was conducted (April 2014 - June 2016). Obese females at 24 to 34 weeks gestation and with diet-controlled GDM were screened for OSA. Those with OSA were randomly assigned to receive 2 weeks nightly CPAP or be part of a waitlist control group...
February 13, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
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