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insulin in pregnancy

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
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
Lucio Barile, Elisabetta Cervio, Vincenzo Lionetti, Giuseppina Milano, Alessandra Ciullo, Vanessa Biemmi, Sara Bolis, Claudia Altomare, Marco Matteucci, Dario Disilvestre, Tudor Emanuel Fertig, Tiziano Torre, Stefanos Demertzis, Pierluigi Mauri, Tiziano Moccetti, Giuseppe Vassalli
Aims: Cell therapy trials using cardiac-resident progenitor cells (CPCs) and bone marrow-derived mesenchymal stem/progenitor cells (BMCs) in patients after myocardial infarction have provided encouraging results. Exosomes, nanosized extracellular vesicles of endosomal origin, figure prominently in the bioactivities of these cells. However, a head-to-head comparison of exosomes from the two cell types has not been performed yet. Methods and Results: CPCs and BMCs were derived from cardiac atrial appendage specimens and sternal bone marrow, respectively, from patients (n=20; age, 69...
March 5, 2018: Cardiovascular Research
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
Bahendeka Silver, Kaushik Ramaiya, Swai Babu Andrew, Otieno Fredrick, Sarita Bajaj, Sanjay Kalra, Bavuma M Charlotte, Karigire Claudine, Anthony Makhoba
A diagnosis of diabetes or hyperglycemia should be confirmed prior to ordering, dispensing, or administering insulin (A). Insulin is the primary treatment in all patients with type 1 diabetes mellitus (T1DM) (A). Typically, patients with T1DM will require initiation with multiple daily injections at the time of diagnosis. This is usually short-acting insulin or rapid-acting insulin analogue given 0 to 15 min before meals together with one or more daily separate injections of intermediate or long-acting insulin...
March 5, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Jane L Tarry-Adkins, Catherine E Aiken, Thomas J Ashmore, Susan E Ozanne
Developmental programming phenotypes can be recapitulated in subsequent generations not directly exposed to the initial suboptimal intrauterine environment. A maternal low-protein diet during pregnancy and postnatal catch-up growth ('recuperated') alters insulin signaling and inflammation in rat offspring (F1-generation). We aimed to establish if this phenotype is also present in F2-generation females. Insulin-receptor-substrate-1 protein expression was decreased in para-ovarian adipose tissue at 3 months in offspring exposed to a grand-maternal low-protein diet (F2-recuperated), vs...
March 5, 2018: Scientific Reports
James Beattie, Hasanain Al-Khafaji, Pernille R Noer, Hanaa Esa Alkharobi, Aishah Alhodhodi, Josephine Meade, Reem El-Gendy, Claus Oxvig
The insulin-like growth factor (IGF) axis is required for the differentiation, development, and maintenance of bone tissue. Accordingly, dysregulation of this axis is associated with various skeletal pathologies including growth abnormalities and compromised bone structure. It is becoming increasingly apparent that the action of the IGF axis must be viewed holistically taking into account not just the actions of the growth factors and receptors, but also the influence of soluble high affinity IGF binding proteins (IGFBPs)...
2018: Frontiers in Endocrinology
Chellakkan S Blesson, Amy Schutt, Pretty R Mathew, Daren Tanchico, Meena Balakrishnan, Uma Yallampalli, Chandra Yallampalli
OBJECTIVES: Gestational low-protein (LP) programming causes glucose intolerance (GI) and insulin resistance (IR) in adult offspring. Folate supplementation has been shown to rescue the offspring from various programming effects. The aim of this study was to investigate whether folate supplementation during pregnancy reverses LP-induced GI and IR. METHODS: Pregnant rats were fed control (20% protein), isocaloric low-protein (LP, 6%) or LP with 5 mg/kg folate (LPF) diets from gestational day 4 to delivery...
November 13, 2017: Nutrition
Lan Liu, Wenjuan Jia, Ruike Liu, Jie Shen
BACKGROUND: Studies reported that fulminant type 1 diabetes (fT1DM) can occurred during pregnancy or within 2 weeks after delivery, and was defined as pregnancy-associated fulminant type 1 diabetes (PF). In PF patients, plasma glucose (PG) levels have an abrupt rise while glycated hemoglobin (HbA1C ) levels are not markedly elevated, resulting in a sharply increased PG/HbA1C ratio. METHODS: We studied 30 PF patients, 21 non-pregnant fulminant type 1 diabetes (NPF) patients, and 26 female patients of child-bearing age (13-49 years) with diabetic ketoacidosis (DKA), all from China...
March 2, 2018: Endocrine
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
Pedro-Antonio Regidor, Adolf Eduard Schindler, Bernd Lesoine, Rene Druckman
Introduction The use of 2 × 2000 mg myo-inositol +2 × 200 μg folic acid per day is a safe and promising tool in the effective improvement of symptoms and infertility for patients with polycystic ovary syndrome (PCOS). In addition, PCOS is one of the pathological factors involved in the failure of in vitro fertilization (IVF). Typically, PCOS patients suffer of poor quality oocytes. Patients and methods In an open, prospective, non-blinded, non-comparative observational study, 3602 infertile women used myo-inositol and folic acid between 2 and 3 months in a dosage of 2 × 2000 mg myo-inositol +2 × 200 μg folic acid per day...
March 2, 2018: Hormone Molecular Biology and Clinical Investigation
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
Sarah Gonzalez-Nahm, Michelle Mendez, Whitney Robinson, Susan K Murphy, Cathrine Hoyo, Vijaya Hogan, Diane Rowley
Diet is dictated by the surrounding environment, as food access and availability may change depending on where one lives. Maternal diet during pregnancy is an important part of the in utero environment, and may affect the epigenome. Studies looking at overall diet pattern in relation to DNA methylation have been lacking. The Mediterranean diet is known for its health benefits, including decreased inflammation, weight loss, and management of chronic diseases. This study assesses the association between maternal adherence to a Mediterranean diet pattern during pregnancy and infant DNA methylation at birth...
May 2017: Environmental Epigenetics
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
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
Timothy P Sheets, Ki-Eun Park, Chi-Hun Park, Steven M Swift, Anne Powell, David M Donovan, Bhanu P Telugu
The domestic pig is an attractive model for biomedical research because of similarities in anatomy and physiology to humans. However, key gaps remain in our understanding of the role of developmental genes in pig, limiting its full potential. In this publication, the role of NEUROGENIN 3 (NGN3), a transcription factor involved in endocrine pancreas development has been investigated by CRISPR/Cas9 gene ablation. Precomplexed Cas9 ribonucleoproteins targeting NGN3 were injected into in vivo derived porcine embryos, and transferred into surrogate females...
February 26, 2018: Scientific Reports
Hee Young Cho, Yeonkyung Cho, Yun-Jeong Shin, Jieun Park, Sunghan Shim, Yongwook Jung, Sungshin Shim, Donghyun Cha
The prediction and monitoring of fetal growth restriction (FGR) fetuses has become with the use of ultrasound. However, these tools lack the fundamental evidence for the growth of fetus with FGR excluding pathogenic factors.Amniotic fluid samples were obtained from pregnant women for fetal karyotyping and genetic diagnosis at 16 to 19 weeks of gestation. For this study, 15 FGR and 9 control samples were selected, and cell-free fetal RNA was isolated from each supernatant of the amniotic fluid for microarray analysis...
January 2018: Medicine (Baltimore)
Hao Wang, Ewa Wender-Ozegowska, Ester Garne, Margery Morgan, Maria Loane, Joan K Morris, Marian K Bakker, Miriam Gatt, Hermien de Walle, Susan Jordan, Anna Materna-Kiryluk, Vera Nelen, Guy Thys, Awi Wiesel, Helen Dolk, Lolkje T W de Jong-van den Berg
OBJECTIVES: To evaluate the risk of major congenital anomaly associated with first-trimester exposure to insulin analogues compared with human insulin in offspring of women with pregestational diabetes. DESIGN AND SETTING: A population-based cohort of women with pregestational diabetes (n=1661) who delivered between 1996 and 2012 was established retrospectively from seven European regions covered bythe European Surveillance of Congenital Anomalies (EUROCAT) congenital anomaly registries...
February 24, 2018: BMJ Open
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