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insulin in pregnancy

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https://www.readbyqxmd.com/read/29150756/impact-of-risk-factors-for-gestational-diabetes-gdm-on-pregnancy-outcomes-in-women-with-gdm
#1
T Filardi, F Tavaglione, M Di Stasio, V Fazio, A Lenzi, S Morano
PURPOSE: In this study, we evaluated the impact of risk factors for gestational diabetes on clinical/biochemical parameters and maternal/fetal outcomes. METHODS: One hundred eighty-three (n 183) women (age 33.8 ± 5.5 years, 59% Caucasians, 41% non-Caucasians) with gestational diabetes were included in the study. Anamnestic information, anthropometric and laboratory parameters, and maternal and fetal outcomes at delivery were collected. RESULTS: Insulin therapy prevalence was higher in Asians vs Caucasians (p = 0...
November 17, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/29144833/low-dietary-fiber-intake-increases-collinsella-abundance-in-the-gut-microbiota-of-overweight-and-obese-pregnant-women
#2
Luisa F Gomez-Arango, Helen L Barrett, Shelley A Wilkinson, Leonie K Callaway, H David McIntyre, Mark Morrison, Marloes Dekker Nitert
The gut microbiota contributes to the regulation of glucose metabolism in pregnancy. Abundance of the genus Collinsella is positively correlated with circulating insulin; however, it is unclear what determines Collinsella abundance. This study aims to validate the correlation between Collinsella and insulin and to elucidate if macronutrient intake alters Collinsella abundance and gut microbiota composition. Gut microbiota profiles were assessed by 16S rRNA sequencing in 57 overweight and 73 obese pregnant women from the SPRING (Study of PRobiotics IN Gestational diabetes) trial at 16 weeks gestation and correlated with metabolic hormone levels and macronutrient intake...
November 16, 2017: Gut Microbes
https://www.readbyqxmd.com/read/29142651/prevention-of-insulin-resistance-by-dietary-intervention-among-pregnant-mothers-a-randomized-controlled-trial
#3
Masoomeh Goodarzi-Khoigani, Seyed Saeed Mazloomy Mahmoodabad, Mohammad Hossein Baghiani Moghadam, Azadeh Nadjarzadeh, Farahnaz Mardanian, Hossein Fallahzadeh, Azam Dadkhah-Tirani
Background: Chronic insulin resistance (IR) is a basic part of the pathophysiology of gestational diabetes mellitus. Nutrition significantly impacts IR and weight loss reduces insulin levels, whereas weight gain increases the concentrations. Therefore, we surveyed the effect of nutrition intervention on IR in pregnant women and whether this effect is irrespective of weight gaining in accordance with Institute of Medicine limits. Methods: This prospective, randomized clinical trial was carried out among 150 primiparous pregnant mothers in fifteen health centers, five hospitals, and 15 private obstetrical offices in Isfahan...
2017: International Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29142561/feto-maternal-outcomes-and-glycemic-control-in-metformin-versus-insulin-treated-gestational-diabetics
#4
Rabia Arshad, Samia Khanam, Fuad Shaikh, Nasim Karim
Objective: To evaluate and compare feto-maternal outcomes and glycemic control in metformin versus insulin treated gestational diabetics. Methods: The study was conducted in 2010- 2012 as a part of M. Phil at Civil hospital, Lyari General Hospital and Mamji Hospital in Karachi. After written informed consent, 71 GDM diagnosed females with WHO criteria were enrolled. They were divided into two groups. Group-A, 32 females were given oral metformin 500 mg TDS while Group-B, 39 females were given insulin 0...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29125636/very-tight-versus-tight-control-which-should-be-the-criteria-for-pharmacologic-therapy-dose-adjustment-in-diabetes-in-pregnancy-evidence-from-randomized-controlled-trials
#5
Claudia Caissutti, Gabriele Saccone, Andrea Ciardulli, Vincenzo Berghella
INTRODUCTION: There is inconclusive evidence from randomized controlled trials (RCTs) to support any specific criteria for pharmacologic therapy dose adjustment in diabetes in pregnancy. Our objective was to analyze the criteria for dose adjustment of pharmacologic treatment for diabetes mellitus (DM) in pregnancy. MATERIAL AND METHODS: Data sources: MEDLINE, OVID and Cochrane Library were searched from their inception to September 2017. Selection criteria included all trials of DM in pregnancy managed by oral hypoglycemic agents or insulin reporting criteria for pharmacologic therapy dose adjustment...
November 10, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29122892/subclinical-first-trimester-renal-abnormalities-are-associated-with-preeclampsia-in-normoalbuminuric-women-with-type-1-diabetes
#6
Clare B Kelly, Michelle B Hookham, Jeremy Y Yu, Alicia J Jenkins, Alison J Nankervis, Kristian F Hanssen, Satish K Garg, James A Scardo, Samar M Hammad, M Kathryn Menard, Christopher E Aston, Timothy J Lyons
OBJECTIVE: This study was conducted to determine the utility of tubular (urinary/plasma neutrophil gelatinase-associated lipocalin [NGAL] and urinary kidney injury molecule 1 [KIM-1]) and glomerular (estimated glomerular filtration rate [eGFR]) biomarkers in predicting preeclampsia (PE) in pregnant women with type 1 diabetes mellitus (T1DM) who were free of microalbuminuria and hypertension at the first trimester. RESEARCH DESIGN AND METHODS: This was a prospective study of T1DM pregnancy...
November 9, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29111856/vascular-derived-connective-tissue-growth-factor-ctgf-is-critical-for-pregnancy-induced-%C3%AE-cell-hyperplasia-in-adult-mice
#7
Raymond C Pasek, Jennifer C Dunn, Joseph M Elsakr, Mounika Aramandla, Anveetha R Matta, Maureen Gannon
During pregnancy, maternal β cells undergo compensatory changes including hypertrophy, hyperplasia, and increased glucose-stimulated insulin secretion (GSIS). Failure of these adaptations to occur can result in gestational diabetes mellitus. The secreted protein, Connective tissue growth factor (Ctgf), is critical for normal β cell development and promotes regeneration after partial β cell ablation. During embryogenesis, Ctgf is expressed in pancreatic ducts, vasculature, and β cells. In the adult pancreas, Ctgf is expressed only in the vasculature...
November 7, 2017: Islets
https://www.readbyqxmd.com/read/29110650/group-based-developmental-bmi-trajectories-polycystic-ovary-syndrome-and-gestational-diabetes-a-community-based-longitudinal-study
#8
Nadira Sultana Kakoly, Arul Earnest, Lisa J Moran, Helena J Teede, Anju E Joham
BACKGROUND: Obesity is common in young women, increasing insulin resistance (IR) and worsening pregnancy complications, including gestational diabetes (GDM). Women with polycystic ovary syndrome (PCOS) are commonly obese, which aggravates the severity of PCOS clinical expression. Relationships between these common insulin-resistant conditions, however, remain unclear. METHODS: We conducted a secondary analysis of the Australian Longitudinal Study on Women's Health (ALSWH) database, including data from 8009 women aged 18-36 years across six surveys...
November 6, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29109760/influence-of-serum-hmw-adiponectin-level-in-patients-with-pregnancy-induced-hypertension-syndrome-on-the-occurrence-of-eclampsia-in-secondary-pregnancy
#9
Qian Xu, Dongmei Fan, Fahong Li, Zhanhong Zhang
In the present study, we studied the influence of serum high-molecular weight adiponectin (HMWA) levels in patients with pregnancy-induced hypertension (PIH) on the occurrence of eclampsia in secondary pregnancy and its related mechanisms. In total, 130 patients who were diagnosed with PIH for the first time were selected for this study; the median interval of the secondary pregnancy was 28.5 months. The serum HMWA and leptin levels both times were detected, and the insulin resistance indexes (HOMA-IR) were calculated...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29108634/maternal-growth-restriction-and-stress-exposure-in-rats-differentially-alters-expression-of-components-of-the-placental-glucocorticoid-barrier-and-nutrient-transporters
#10
Jessica F Briffa, Sogand S Hosseini, Melanie Tran, Karen M Moritz, James S M Cuffe, Mary E Wlodek
The placenta plays a major role in the development of fetal growth restriction, which affects 10% of pregnancies and contributes to chronic adult disease risk. We have reported that female rats born small develop cardiometabolic dysfunction only during pregnancy. The physiological tests performed during pregnancy induced a maternal stress response as indicated by increased maternal corticosterone concentrations. This stress effected placental growth compared to females who were unhandled during pregnancy. Maternal stress and growth restriction independently program F2 offspring metabolic dysfunction...
November 2017: Placenta
https://www.readbyqxmd.com/read/29108631/mesenchymal-stromal-cells-isolated-from-gestationally-diabetic-human-placenta-exhibit-insulin-resistance-decreased-clonogenicity-and-angiogenesis
#11
Suja Ann Mathew, Ramesh Bhonde
Pregnancy is known to be a diabetogenic state. With sedentary lifestyle and wrong dietary choices, gestational diabetes mellitus is on the rise. This raises a concern as placenta is becoming an acceptable choice, as a source of Mesenchymal Stromal Cells (MSCs). In our current study we questioned whether there exists a difference between MSCs isolated from normal and diabetic (Gd-P-MSCs) placenta, as the health of the cells used in therapy is of prime importance. We isolated and verified the Gd-P-MSCs based on their surface markers and differentiation potential...
November 2017: Placenta
https://www.readbyqxmd.com/read/29106783/gestational-diabetes-is-diet-and-insulin-the-only-solution
#12
(no author information available yet)
Gestational diabetes (GDM) is a relatively common complication of pregnancy. Maternal hyperglycemia causes many serious side effects for mothers, fetuses and newborns. In 90% of women diagnosed with GDM, a dietary treatment results in satisfactory levels of blood glucose. The remaining 10% require insulin therapy to achieve the recommended glycemic levels. The majority of recent studies show the efficiency of metformin in gestational diabetes and prove that it is not a cause for any harmful side effects to the embryo and/or fetus...
October 6, 2017: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/29104874/akt-mtor-role-in-human-foetoplacental-vascular-insulin-resistance-in-diseases-of-pregnancy
#13
REVIEW
Roberto Villalobos-Labra, Luis Silva, Mario Subiabre, Joaquín Araos, Rocío Salsoso, Bárbara Fuenzalida, Tamara Sáez, Fernando Toledo, Marcelo González, Claudia Quezada, Fabián Pardo, Delia I Chiarello, Andrea Leiva, Luis Sobrevia
Insulin resistance is characteristic of pregnancies where the mother shows metabolic alterations, such as preeclampsia (PE) and gestational diabetes mellitus (GDM), or abnormal maternal conditions such as pregestational maternal obesity (PGMO). Insulin signalling includes activation of insulin receptor substrates 1 and 2 (IRS1/2) as well as Src homology 2 domain-containing transforming protein 1, leading to activation of 44 and 42 kDa mitogen-activated protein kinases and protein kinase B/Akt (Akt) signalling cascades in the human foetoplacental vasculature...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/29103210/insulin-for-the-treatment-of-women-with-gestational-diabetes
#14
REVIEW
Julie Brown, Luke Grzeskowiak, Kathryn Williamson, Michelle R Downie, Caroline A Crowther
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with short- and long-term complications for the mother and her infant. Women who are unable to maintain their blood glucose concentration within pre-specified treatment targets with diet and lifestyle interventions will require anti-diabetic pharmacological therapies. This review explores the safety and effectiveness of insulin compared with oral anti-diabetic pharmacological therapies, non-pharmacological interventions and insulin regimens...
November 5, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29100822/-which-ovarian-stimulation-to-which-women-the-polycystic-ovary-syndrome-pcos
#15
P Merviel, S Bouée, M Ménard, M-T Le Martelot, S Roche, C Lelièvre, J-J Chabaud, C Jacq, H Drapier, D Beauvillard
Polycystic ovarian syndrome (PCOS) is a frequent pathology in the young woman, linking infertility to a metabolic disease. Initial support will include a plan (in the case of overweight or obesity) to lose at least 5 to 10% of the weight. Subsequently, clomiphene citrate is the first treatment for ovulation induction with pregnancy rates of 40 to 80% after 6 cycles. If there is resistance to clomiphene citrate, the choice will be between the ovarian drilling (50-60% of pregnancy in the year following, including the half spontaneous) or ovarian stimulation with gonadotropins...
October 31, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29098391/fetal-sex-influences-maternal-fasting-plasma-glucose-levels-and-basal-%C3%AE-cell-function-in-pregnant-women-with-normal-glucose-tolerance
#16
Xinqian Geng, Lulu Geng, Yinan Zhang, Huijuan Lu, Yixie Shen, Ruihua Chen, Pingyan Fang, Minfang Tao, Congrong Wang, Weiping Jia
AIMS: Fetal sex has recently emerged as a new factor that is related to maternal glucose homeostasis during pregnancy. The present study aimed to investigate the effect of fetal sex on maternal glucose metabolism in women with normal glucose tolerance (NGT) during pregnancy in the Chinese population. METHODS: A total of 877 pregnant women with NGT were recruited at 24-28 weeks of gestation and underwent a 75-g oral glucose tolerance test (OGTT). Pregnant women were divided into two groups according to fetal sex...
November 2, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/29097511/precision-medicine-in-obesity-and-type-2-diabetes-the-relevance-of-early-life-exposures
#17
REVIEW
Angela C Estampador, Paul W Franks
BACKGROUND: Type 2 diabetes is highly prevalent and devastating. Obesity is a diabetogenic factor, driving insulin resistance and a compensatory demand for increased insulin secretion from the pancreatic β cells; a failure to address this demand results in diabetes. Accordingly, primary and secondary prevention of obesity are at the core of diabetes prevention programs. The development of obesity and decline in β-cell function often span many years or decades before diabetes is clinically manifest...
November 2, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/29077742/dna-methylation-and-gene-expression-of-txnip-in-adult-offspring-of-women-with-diabetes-in-pregnancy
#18
Azadeh Houshmand-Oeregaard, Line Hjort, Louise Kelstrup, Ninna S Hansen, Christa Broholm, Linn Gillberg, Tine D Clausen, Elisabeth R Mathiesen, Peter Damm, Allan Vaag
BACKGROUND: Fetal exposure to maternal diabetes increases the risk of type 2 diabetes (T2DM), possibly mediated by epigenetic mechanisms. Low blood TXNIP DNA methylation has been associated with elevated glucose levels and risk of T2DM, and increased skeletal muscle TXNIP gene expression was reported in subjects with impaired glucose metabolism or T2DM. Subcutaneous adipose tissue (SAT) and skeletal muscle play a key role in the control of whole body glucose metabolism and insulin action...
2017: PloS One
https://www.readbyqxmd.com/read/29070511/metformin-in-gestational-diabetes-mellitus-predictors-of-poor-response
#19
Inês Gante, Luís Melo, Jorge Dores, Luísa Ruas, Maria do Céu Almeida
OBJECTIVE: Metformin can be regarded as a first-line treatment in Gestational Diabetes Mellitus (GDM) due to its safety and effectiveness. However, a proportion of women do not achieve adequate glycemic control with metformin alone. We aim to identify predictors of this poor response to metformin. DESIGN AND METHODS: Retrospective multicentre cohort study of women with GDM who started metformin as first-line treatment. The assessed cohort was divided into a metformin group and metformin plus insulin group...
October 25, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29063044/exercise-and-its-role-in-gestational-diabetes-mellitus
#20
REVIEW
Chen Wang, Kym Janese Guelfi, Hui-Xia Yang
Gestational diabetes mellitus (GDM) refers to diabetes diagnosed in the second or third trimester of pregnancy that is not clearly either type 1 or type 2 diabetes. GDM is a common medical complication in pregnancy that has been rapidly increasing worldwide. GDM is associated with both short- and long-term health issues for both mothers and offspring. Consistent with type 2 diabetes, peripheral insulin resistance contributes to the hyperglycemia associated with GDM. Accordingly, it is important to identify strategies to reduce the insulin resistance associated with GDM...
December 2016: Chronic Dis Transl Med
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