Anti-hyperglycemic effect of NiO-sodium alginate-polyethylene glycol-crocin nanocomposite via attenuating TLR4/MyD88/NFκB signaling in gestational diabetes triggered rats.

Background: Gestational diabetes mellitus (GDM) is a common condition with risks for mother and baby. Type 2 diabetes mellitus (T2DM) and obesity are occurring with increasing frequency, and the incidence of GDM reflects this trend. Objective: The aim of the study was to determine the relationship between first trimester elevated uric acid levels and subsequent development of gestational diabetes mellitus during pregnancy. Patients and Methods: The study included 78 pregnant women in the first trimester attending the outpatient clinic of Zagazig University Hospitals, Zagazig for antenatal care. In this study, patients were classified according to their serum uric acid level into 3 groups. Results: Women’s GDM in group (I) showed that 3 (11.5%) were normal, 16 (61.5%) their fasting blood sugar levels (FBS) were high in 2nd trimester and 7 (26.9%) their FBS were high in both 2nd and 3rd trimesters while in group (II) 1 (3.8%) were normal, 9 (34.6%) their FBS were high in 2nd trimester and 16 (61.5%) their FBS were high in both 2nd and 3rd trimesters and in group (III) 1 (3.8%) was normal, 5 (19.2%) their FBS were high in 2nd trimester and 20 (76.9%) their FBS were high in both 2nd and 3rd trimesters. There was statistically significant differences between groups where P=0.007. Conclusion: First trimester serum uric acid levels are associated with subsequent development of IGT and GDM. The test has good predictive value for the diagnosis of GDM and it can be used in a risk assessment model.

Background To investigate the association between free fatty acid (FFA) level at mid-pregnancy and large-for-gestational-age (LGA) newborns in women with gestational diabetes mellitus (GDM).Methods We enrolled 710 pregnant women diagnosed with GDM from February 2009 to October 2016. GDM was diagnosed by a ‘two-step’ approach with Carpenter and Coustan criteria. We measured plasma lipid profiles including fasting and 2-hour postprandial FFA (2h-FFA) levels at mid-pregnancy. LGA was defined if birthweights of newborns were above the 90th percentile for their gestational age.Results Mean age of pregnant women in this study was 33.1 years. Mean pre-pregnancy body mass index (BMI) was 22.4 kg/m2. The prevalence of LGA was 8.3% (n=59). Levels of 2h-FFA were higher in women who delivered LGA newborns than in those who delivered non-LGA newborns (416.7 μEq/L vs. 352.5 μEq/L, P=0.006). However, fasting FFA was not significantly different between the two groups. The prevalence of delivering LGA newborns was increased with increasing tertile of 2h-FFA (T1, 4.3%; T2, 9.8%; T3, 10.7%; P for trend <0.05). After adjustment for maternal age, pre-pregnancy BMI, and fasting plasma glucose, the highest tertile of 2h-FFA was 2.38 times (95% confidence interval, 1.11 to 5.13) more likely to have LGA newborns than the lowest tertile. However, there was no significant difference between groups according to fasting FFA tertiles.Conclusion In women with GDM, a high 2h-FFA level (but not fasting FFA) at mid-pregnancy is associated with an increasing risk of delivering LGA newborns.

The prevalence of gestational diabetes mellitus (GDM) has been rapidly increasing in Iceland and 19% of women who gave birth at Landspítali - University hospital in 2018 were diagnosed with GDM. Women who develop GDM in pregnancy have an increased risk of recurrence in future pregnancies, as well as an increased risk for developing type 2 diabetes mellitus later in life. Obesity and a sedentary lifestyle are known risk factors for the development of GDM. Prescribing physical activity has become an available treatment option in all Icelandic primary healthcare centres. The aim of this study was to examine the effect of prescribing postpartum exercise for women with a history of GDM on their physical activity level, quality of life, BMI and biochemical markers typical for metabolic syndrome. Women who delivered from 1st January 2016 to 30th June 2017 and sought prenatal care at healthcare centres within the Primary Health Care of the Capital Area were offered participation in the study. Participants were randomly divided into two groups, with one group being prescribed physical activity for five months while the other group received standard treatment of care. Blood tests (fasting blood sugar, HbA1c, cholesterol and insulin levels), BMI, general activity level and the patient's quality of life were measured at both three and eight months postpartum. 84 women participated, 45 were assigned to the treatment group and 39 to the control group. General activity levels increased significantly in the treatment group, but no significant changes were seen in their blood test values. The treatment suggested an improvement trend in the women's BMI and quality of life, but the results were not significant. Women who breastfed had significantly lower insulin levels than women not breastfeeding. There was a stronger positive correlation between BMI and insulin levels than between fasting blood sugar levels and insulin levels. Prescribing physical activity after delivery for women with a history of GDM significantly increased their general activity level and breastfeeding seems to have a lowering effect on insulin levels.

Introduction: Diabetes in pregnancy, including gestational and pre-gestational diabetes, presents significant risks to both maternal and fetal health. Understanding the impact of these conditions on pregnancy outcomes is crucial for developing effective management strategies.Methods: This observational comparative study involved 300 pregnant women at Rangpur Medical College Hospital, divided into three groups: pre-gestational diabetic (Group A), gestational diabetic (Group B), and non-diabetic control (Group C). Data on socio-demographic characteristics, obstetric profiles, mode of delivery, maternal complications, and fetal outcomes were collected and analyzed.Result: The study meticulously analyzed socio-demographic characteristics, revealing no significant differences across the groups. In obstetric profiles, Group A (Pre-Gestational Diabetic) had a notably lower mean gestational age at delivery (36.06 ± 2.71 weeks) compared to Group B (Gestational Diabetic) and Group C (Control), with mean ages of 37.34± 1.12 and 38.46±1.13 weeks, respectively. Maternal complications were significantly higher in Group A at 47%, compared to 25% in Group B and 12% in Group C. Fetal outcomes showed marked variations: Group A had 95% stable births, 5% stillbirths, and 60% of neonates with Apgar scores ≤7 at 5 minutes. In contrast, Group B had 96% stable births, 4% stillbirths, and 27% of neonates with Apgar scores ≤7, while Group C reported 100% stable births and 11% with Apgar scores ≤7. Birth weight distribution indicated 24% of neonates in Group A weighed &lt;2 kg, compared to 5% in Group B and 4% in Group C. NICU admissions were highest in Group A (44%), followed by Group B (29%) and Group C (11%). Perinatal complications like birth asphyxia (38% in Group A, 16% in Group B, 6% in Group C), hypoglycemia (22% in Group A, 10% in Group B, 4% in Group C), and hyperbilirubinemia (16% in Group A, 12% in Group B, 0% in Group C) were also significantly higher in diabetic groups.Conclusion: The presence of gestational or pre-gestational diabetes in mothers significantly impacts fetal outcomes and increases the risk of maternal complications. This study highlights the need for specialized care and vigilant monitoring in pregnancies complicated by diabetes to improve health outcomes for mothers and babies.

Gestational diabetes mellitus (GDM) is the serious complication of pregnancy induced via dysfunction in glucose metabolism during the pregnancy. Crocetin already proved antidiabetic effect in streptozotocin (STZ)-induced diabetes mellitus in rats. In this protocol, we have investigated the potential effect of crocetin against STZ-induced GDM in rats. Wistar rats were used for the current protocol; STZ was used for the induction for DM and finally caused the GDM. Body weight and serum advanced glycation end products level were estimated at regular time intervals. We also estimated the fetus weight and placental weight. Biochemical, antioxidant, pro-inflammatory cytokines, inflammatory mediators, and apoptosis parameters were estimated. mRNA expression of NOX2, RAGE, MCP-1, VCAM-1, EGFR, and p65 were also estimated. Crocetin treatment significantly (p<.001) reduced the fetus weight and increased the placental weight and index. Crocetin significantly (p<.001) reduced the blood glucose level and increased the body weight. Crocetin significantly (p<.001) boosted the level of antioxidant enzymes and includes superoxide dismutase, glutathione peroxidase, glutathione, and catalase. Crocetin significantly (p<.001) altered the level of lipid parameters and pro-inflammatory cytokines. Crocetin significantly (p<.001) reduced the level of intercellular adhesion molecule 1, cyclooxygenase-2, and nuclear factor kappa B and increased the level of visfatin against GDM rats. Crocetin significantly (p<.001) altered the level of mRNA expression. Based on the result, we can say that crocetin is a protective drug against the GDM in pregnant rats via antioxidant, inflammatory, and apoptosis parameters. PRACTICAL APPLICATIONS: As we all know, gestational diabetes mellitus (GDM) cases rise all over the world. The current investigation showed the protective effect of crocetin on GDM in experimental rats. The current finding exhibited the protective effect of crocetin against STZ-induced GDM via suppression of inflammatory, oxidative, and apoptosis parameters. The result suggests the antioxidant and anti-inflammatory effect of crocetin. Crocetin can be used as a preventive medication in the treatment of gestational diabetes mellitus, according to the latest findings.

Free fatty acid (FFA) is correlated with fetal growth during pregnancy and with neonatal fat mass in women with gestational diabetes mellitus (GDM). However, there are few studies between FFA level and postpartum glucose metabolism in women with GDM. The aim of this study was to evaluate the association between FFA level at mid-pregnancy and postpartum glucose intolerance in women with GDM. We enrolled 769 pregnant women diagnosed with GDM from February 2009 to October 2016. FFA levels (fasting and postprandial 2-h) were measured during 24-32 gestational weeks and 75-g OGTT was performed at 6-12 weeks after delivery. High FFA was defined by more than the median level of FFA at mid-pregnancy. Postpartum glucose intolerance was defined as fasting plasma glucose (FPG) ≥ 100 mg/dL or 2-h plasma glucose (2-h PG) ≥ 140 mg/dL. Mean age was 33.1 years and mean pre-pregnancy BMI was 22.4 kg/m2. The prevalence of postpartum glucose intolerance was 48.0% (n = 369). Although postprandial 2-h FFA level and FFA difference (between fasting and postprandial 2-h FFA) were not significantly different between two groups, women with postpartum glucose intolerance had higher fasting FFA level at mid-pregnancy than those with normal glucose tolerance (733.7 μEq/L vs. 700.6 μEq/L, P = 0.049). Compared to women with low fasting FFA, women with high fasting FFA had higher postpartum glucose intolerance (51.8% vs. 44.1%, P = 0.033). After adjustment for maternal age, pre-pregnancy BMI, parity, family history of diabetes, FPG, and lipid measures (total cholesterol, triglyceride, HDL-cholesterol), women with high fasting FFA were 1.47 times (95% CI 1.07-2.01) more likely to have postpartum glucose intolerance than those with low fasting FFA. In women with GDM, high fasting FFA level at mid-pregnancy is associated with elevated risk of postpartum glucose intolerance. Disclosure K. Kim: None. S. Kim: None. Y. Cho: None. S. Park: None.

Introduction: Diabetes in pregnancy, including gestational and pre-gestational diabetes, presents significant risks to both maternal and fetal health. Understanding the impact of these conditions on pregnancy outcomes is crucial for developing effective management strategies.&#x0D; Methods: This observational comparative study involved 300 pregnant women at Rangpur Medical College Hospital, divided into three groups: pre-gestational diabetic (Group A), gestational diabetic (Group B), and non-diabetic control (Group C). Data on socio-demographic characteristics, obstetric profiles, mode of delivery, maternal complications, and fetal outcomes were collected and analyzed.&#x0D; Result: The study meticulously analyzed socio-demographic characteristics, revealing no significant differences across the groups. In obstetric profiles, Group A (Pre-Gestational Diabetic) had a notably lower mean gestational age at delivery (36.06 ± 2.71 weeks) compared to Group B (Gestational Diabetic) and Group C (Control), with mean ages of 37.34± 1.12 and 38.46±1.13 weeks, respectively. Maternal complications were significantly higher in Group A at 47%, compared to 25% in Group B and 12% in Group C. Fetal outcomes showed marked variations: Group A had 95% stable births, 5% stillbirths, and 60% of neonates with Apgar scores ≤7 at 5 minutes. In contrast, Group B had 96% stable births, 4% stillbirths, and 27% of neonates with Apgar scores ≤7, while Group C reported 100% stable births and 11% with Apgar scores ≤7. Birth weight distribution indicated 24% of neonates in Group A weighed &lt;2 kg, compared to 5% in Group B and 4% in Group C. NICU admissions were highest in Group A (44%), followed by Group B (29%) and Group C (11%). Perinatal complications like birth asphyxia (38% in Group A, 16% in Group B, 6% in Group C), hypoglycemia (22% in Group A, 10% in Group B, 4% in Group C), and hyperbilirubinemia (16% in Group A, 12% in Group B, 0% in Group C) were also significantly higher in diabetic groups.&#x0D; Conclusion: The presence of gestational or pre-gestational diabetes in mothers significantly impacts fetal outcomes and increases the risk of maternal complications. This study highlights the need for specialized care and vigilant monitoring in pregnancies complicated by diabetes to improve health outcomes for mothers and babies.&#x0D;

Background: Gestational diabetes mellitus (GDM) represents the most frequent endocrine disorder of pregnancy. Prevalence of GDM is increasing worldwide. Hence, impact of GDM on maternal and fetal health is a major concern and important from research point of view. Aim and Objectives: The aim of this study is to investigate risk factors associated with GDM and potential maternal complications of GDM. Materials and Methods: A total of 900 antenatal women of gestational age >24 weeks were screened for GDM using 50 g glucose challenge test followed by oral glucose tolerance test. Based on the American diabetes association criteria, 30 women were diagnosed with GDM cases and followed till their deliveries. Data regarding risk factors associated with GDM and percentage distribution of maternal complications associated with risk factors were recorded. Results: Complications of pre-eclampsia and polyhydramnios were found in 20% and 10% cases, respectively. Conclusion: High maternal age, increased parity, previous GDM history, and a family history of DM are the predisposing risk factors for the development of GDM. Information about the risks of GDM could potentially help to incorporate early intervention measures and prevent maternal morbidities.

Gestational diabetes mellitus (GDM) is currently the most common complication of pregnancy, and the prevalence of undiagnosed hyperglycemia and overt diabetes in young women is increasing. In this regard, the present study aimed to investigate the effect of training intervention based on the health belief model of self-care behaviors in women with gestational diabetes. The present study was an interventional study, which was conducted on 160 women with gestational diabetes (80 in the interventional group and 80 in the control group), who were under treatment in healthcare centers in the city of Fasa in Fars Province, Iran, in 2022-2023. The method was simple random sampling. The collecting data tools were demographic characteristics questionnaire (age, education, occupation, monthly income of the family, gestational age (in the week), and rank of pregnancy, a knowledge assessment questionnaire, a questionnaire based on the health belief model (perceived sensitivity, perceived severity, perceived advantages, and disadvantages, self-efficiency), and the self-care behaviors questionnaire. The questionnaires were completed before the intervention and 6 weeks after the intervention. The women in the intervention group received six sessions of 50-55 min. Fasting blood sugar level and blood sugar level 2 h after the meal, A1C hemoglobin, and the need for taking insulin and the required dosage were recorded. The data were analyzed using SPSS 24, Kolmogorov-Smirnov tests (for normal distribution of data), independent t-test, paired t-test, chi-2 test, and descriptive statistics (P < 0.05). The mean age of the participants in the intervention group and control group was 32.45 ± 4.82 and 33.16 ± 4.69, respectively. The results showed that the mean scores of all structures of the health belief model in the intervention group were significantly different from those obtained after the intervention in this group (p < 0.001). Also, the comparison of averages of blood sugar levels after the intervention in the two groups indicated that fasting blood sugar level, A1C hemoglobin, and blood sugar levels measured 2 h after the meal significantly decreased in the intervention group (p < 0.001). The need to increase the dosage of insulin in the intervention group was lower than in the control group. according to the results, the health belief model was effective in improving clinical results of self-care behaviors in women with gestational diabetes. HBM played an important role in understanding what care and support the women need. Therefore, the incidence of various diseases can be prevented and mothers with GDM can experience such vulnerability less than before. It can also be used as a model to design, implement, and monitor health programs for women with gestational diabetes.

The significance of gestational diabetes mellitus (GDM) results from its short-term detrimental effects on the fetus and its long-term prediction of NIDDM in the mother. We compared several variables associated with insulin resistance between GDM and non-GDM pregnant women to show the similarities between GDM and NIDDM (and thus insulin resistance). On the basis of a 3-h oral glucose tolerance test (OGTT), 52 GDM patients and 127 non-GDM patients were recruited from pregnant, non-diabetic women who had a nonfasting 1-h-50-g glucose screening test > or = 7.2 mmol/l (130 mg/dl) performed between 16 and 33 weeks of gestation (a total of 518 of 3,041 women drawn from six community health care prenatal clinics were screened positive). During the OGTT, several potential markers of insulin resistance were measured at fasting and 2-h time points, in addition to the standard glucose measurements. The relationship of these variables with the diagnosis of GDM was studied. GDM patients, compared with non-GDM patients, had 1) higher prepregnancy weight (P = 0.011), prepregnancy BMI (P = 0.006), C-peptide at fasting (P = 0.002) and at 2 h (P < 0.001), insulin at fasting (P = 0.001) and at 2 h (P < 0.001), triglycerides at fasting (P = 0.005) and at 2 h (P = 0.003), free fatty acids at fasting (P = 0.017), beta-hydroxybutyrate at fasting (P = 0.007); and 2) lower HDL cholesterol at fasting (P = 0.029). These variables were all predictive of GDM (P < 0.036) individually. Using stepwise logistic regression with all of these variables available, fasting (P = 0.019) and 2-h (P < 0.001) insulin levels, fasting free fatty acids (P = 0.031), and fasting beta-hydroxybutyrate (P = 0.036) were statistically significant as jointly predictive of GDM. Comparisons between GDM patients and non-GDM patients matched by BMI confirmed that the metabolic abnormalities persisted when difference in BMI was taken into account. Concomitant blood pressure measurements in women with GDM did not differ significantly from those without GDM. Our results show that many of the known metabolic components of the syndrome of insulin resistance (syndrome X) are predictive of GDM. These results are in keeping with the argument that GDM is one phase of the syndrome of insulin resistance. We suggest that GDM be looked upon as a component of the syndrome of insulin resistance that provides an excellent model for the study and prevention of NIDDM in a relatively young age-group.

Don't sugar coat it: The independent and synergistic impacts of obesity and gestational diabetes on placental parameters.

Gestational diabetes (GD) is a metabolic disorder characterized by glucose intolerance during pregnancy, significantly impacting maternal and fetal health. Its global prevalence is approximately 14%, with risk factors including obesity, family history of diabetes, advanced maternal age, and ethnicity, which are linked to cellular and molecular disruptions in glucose regulation and insulin resistance. GD is associated with short- and long-term complications for both the mother and the newborn. For mothers, GD increases the risk of developing type 2 diabetes, cardiovascular diseases, and metabolic syndrome. In the offspring, exposure to GD in utero predisposes them to obesity, glucose intolerance, and metabolic disorders later in life. This review aims to elucidate the complex cellular and molecular mechanisms underlying GD to inform the development of effective therapeutic strategies. A systematic review was conducted using medical subject headings (MeSH) terms related to GD's cellular and molecular pathophysiology. Inclusion criteria encompassed original studies, systematic reviews, and meta-analyses focusing on GD's impact on maternal and fetal health, adhering to PRISMA guidelines. Data extraction captured study characteristics, maternal and fetal outcomes, key findings, and conclusions. GD disrupts insulin signaling pathways, leading to impaired glucose uptake and insulin resistance. Mitochondrial dysfunction reduces ATP production and increases reactive oxygen species, exacerbating oxidative stress. Hormonal influences, chronic inflammation, and dysregulation of the mammalian target of rapamycin (mTOR) pathway further impair insulin signaling. Gut microbiota alterations, gene expression, and epigenetic modifications play significant roles in GD. Ferroptosis and placental dysfunction primarily contribute to intrauterine growth restriction. Conversely, fetal macrosomia arises from maternal hyperglycemia and subsequent fetal hyperinsulinemia, resulting in excessive fetal growth. The chronic inflammatory state and oxidative stress associated with GD exacerbate these complications, creating a hostile intrauterine environment. GD's complex pathophysiology involves multiple disruptions in insulin signaling, mitochondrial function, inflammation, and oxidative stress. Effective management requires early detection, preventive strategies, and international collaboration to standardize care and improve outcomes for mothers and babies.

Background: The placenta is a pivotal medium for physiological exchanges between the maternal and fetal circulations. However, diabetic insults early in gestation can influence the placental barrier, potentially impacting fetal development and outcomes. This study sought to understand the histological changes in the placentae of gestational diabetes mellitus (GDM) cases, highlighting the significance of these alterations on fetal health. Aims and Objectives: The primary aim of this research was to elucidate the histological changes present in the placentae of women diagnosed with GDM. Furthermore, the study sought to determine the implications of these changes on the standard placental anatomy and its associated functionalities, thereby assessing potential impacts on fetal development and outcomes. Materials and Methods: A case–control study was conducted at MES Medical College, Perinthalmanna, Kerala, from October 2014 to December 2018. Inclusion criteria considered pregnant women aged 19–38 years diagnosed with GDM, among other factors. Exclusion criteria weeded out pre-diagnosed diabetes cases, unclear glycemic statuses, and a range of pregnancy complications. Placentae samples underwent meticulous histological and histochemical analyses, focusing on key histological features, including syncytiotrophoblastic knots, vasculosyncytial membranes, and chorangiosis. Results: Significant histological variations were observed in GDM cases compared to controls. Notably, there was an increased formation of syncytial knots and reduced vasculosyncytial membranes in GDM placentae. In addition, chorangiosis was more prevalent, suggesting potential chronic prenatal hypoxia. Marked thickening of the syncytiotrophoblast basement membrane, villous edema, and fibrinoid necrosis were other pertinent findings in GDM cases, each with statistical significance (P &lt; 0.001). Conclusion: The findings underscore the profound histological changes in the placenta associated with GDM, emphasizing the need for comprehensive maternal care and monitoring. These alterations can compromise fetoplacental transport and may have long-term implications on fetal health, highlighting the critical role of timely GDM diagnosis and intervention.

Dysregulation of cytokine expression in tubulointerstitial nephritis associated with murine malaria

Anti-inflammatory effects of phenolic acids punicalagin and curcumin in human placenta and adipose tissue