Abnormal Glucose Tolerance Test Research Articles

Abnormal Glucose Tolerance Among Children with Cystic Fibrosis

Abstract Background Cystic fibrosis (CF) is a severe, autosomal recessive disease of high prevalence caused by mutations of the cystic fibrosis transmembrane conductance regulator (CFTR) gene which is located on the long arm of chromosome 7. Objective to screen for glucose tolerance abnormalities among children with cystic fibrosis. Patients and Methods This was a cross-sectional study conducted on 25 cystic fibrosis patients in the age group from 1 – 15 years in the Pediatric pulmonology clinic, from the first of July 2020 to the end of January 2022. The patients were classified according to their glucose tolerance results into CF patients with normal glucose tolerance and CF patients with abnormal glucose tolerance. Results Our analysis also showed that the most important factor associated with abnormal glucose tolerance test was found to be higher age and glycosylated hemoglobin. The previous findings highlight the need for routine screening of CF patients to exclude CFRD or any abnormality in glucose tolerance in these patients. Conclusion The current study demonstrated that abnormal glucose tolerance is not uncommon among the studied CF patients. Our results concluded that abnormal glucose tolerance was significantly associated with older age and higher glycosylated hemoglobin.

Association of Clinical Factors with the Development of GDM in the Hoosier Mom’s Cohort

Introduction: Gestational diabetes mellitus (GDM) develops during pregnancy, raising the risk of adverse perinatal outcomes. The objective of this study was to investigate potential therapeutic targets for prepregnancy and early pregnancy interventions to decrease the impact of GDM on health during and after pregnancy. Methods: The Hoosier Mom’s Cohort was a prospective pregnancy cohort designed to assess for predictors of GDM. Inclusion criteria were gestational age <20 weeks, a singleton pregnancy, and being at least 18 years old. Individuals with a pregestational diabetes diagnosis, HbA1c at screening of ≥6.5, or abnormal 3-hour oral glucose tolerance test before 20 weeks of gestation were excluded. Study visits with survey completion and biospecimen collection occurred, one at enrollment, and one in the early third trimester. All participants were given a Garmin activity tracker to collect objective physical activity and sleep data. Sociodemographic, medical, behavioral, and psychosocial characteristics were obtained, and obstetric outcomes were abstracted after delivery by certified chart abstractors. The primary outcome was development of GDM. Associations between categorical variables and GDM were made with Chi-square testing, and those between continuous variables and GDM were done with t-test. Results: Of 411 participants recruited into the Hoosier Moms Cohort, complete data was available for 391 (95.1%). Participants had a mean age of 30 years, a BMI of 28, and 17% were of Hispanic ethnicity. Study participants self-identified mostly as White (71%) or Black (16%). 66% of participants were nulliparous. Additionally, 54% reported a family history of diabetes, with 4% of patients also reporting a prior history of GDM. A total of 39 participants (10.0%) developed GDM. Participants who developed GDM had significantly higher BMI at study entry (31.6 ±8.5 vs 27.2 ±6.5, p=0.003), lower probability of being nulliparous (15.38% vs 33.61%, p=0.02), higher baseline HbA1c values (5.24 ±0.3 vs 5.07 ±0.3, p<0.001), higher triglycerides levels (156.85 ±62 vs 134.16 ±54.5, p=0.022), and higher blood glucose values (85.90 ±14.4 vs 79.96 ±17.7, p=0.025) at first study visit. Additionally, 28% of participants who developed GDM had a prior history of GDM, compared to 2% of participants who did not (p<0.0001). Those who developed GDM had higher rates of chronic hypertension (12.82% vs 1.96%, p=0.0034) and higher insomnia scores (9.62 ±5.1 vs 7.80 ±4.7, p=0.028). Conclusion/ Implications: Multiple clinical factors were found to be statistically associated with the development of GDM. These characteristics will be utilized in a comprehensive predictive model using machine learning methodologies to guide clinical decisions early in pregnancy.

Oral Glucose Tolerance Test as a Risk Marker for Developing Post-Transplant Diabetes Mellitus

IntroductionThe incidence of post-transplant diabetes mellitus (PTDM) can reach 30% during the first 6 months after kidney transplantation (KT), increasing the risk of graft failure and mortality. There is no well-established biomarker for predicting PTDM occurrence. This study evaluated the association between the abnormal 2-hour oral glucose tolerance test (OGTT) and the PTDM incidence. MethodsA retrospective single-center study, including adult kidney transplant recipients from deceased donors, was performed between March 2021 and June 2022. Exclusion criteria: age <18 years; pretransplant diabetes mellitus (DM); death with a functioning graft; loss of follow-up and/or graft failure before 6 months post-transplant. The results of pretransplant OGTT, fasting (FPG), and afternoon plasma glucose levels at hospitalization and FPG in the first, second, and third months post-transplant were evaluated. For analysis, patients were grouped according to the PTDM diagnosis: PTDM and non-PTDM. ResultsFrom 164 KT performed in the period, 50 (30%) were included, most male (n = 34, 68%), with a mean age of 48.3 ± 12.5 years. Nine patients (18%) developed PTDM, 44% between 3 and 6 months. General characteristics and immunosuppressive therapy were similar between the groups. The mean FPG in the pretransplant OGTT was significantly higher in the PTDM group compared with the non-PTDM group (85.7 ± 7.9 vs 79.1 ± 8.2, P = .03). The number of patients classified as impaired glucose tolerance (IGT) on the pre-transplant OGTT was significantly higher in the PTDM group. ConclusionIGT in the pretransplant OGTT was associated with PTDM cases in kidney transplant recipients without a previous diagnosis of DM.

Dietary Intake and Oral Glucose Tolerance Test Results in Women with Gestational Diabetes

Background/Objective: Diet is a risk factor for gestational diabetes mellitus (GDM). There are few studies on women’s diet and glucose tolerance test (GTT) results during pregnancy. The objective of this study was to evaluate the relationship between one’s previous diet and the number of abnormal values on the diagnostic GTT in women with GDM. We hypothesized that there would be an inverse relation between antioxidant micronutrient consumption and the number of abnormal GTT values. Methods: This cross-sectional study included 60 women diagnosed with GDM (2-h, 75 g-GTT), divided in two groups as follows: 1 abnormal glucose value and 2–3 abnormal values. Shortly after the diagnosis, participants answered a validated food frequency questionnaire to assess their food consumption in the last 6 months. The Mann–Whitney test was used to compare the dietary intake of the participants in the two groups. Results: The participant characteristics were similar. The median intake of total calories, carbohydrates, lipids, and proteins did not differ significantly between groups. Participants with 1 abnormal GTT value had significantly higher intakes of fiber (11.9 vs. 11.0 g/day p = 0.049), vitamin D (40.6 vs. 40.4 mcg/day p = 0.049), and vitamin C (180.0 vs. 151.0 mg/day p = 0.008) than those with 2–3 abnormal values. Conclusions: Our results suggest a possible association between the consumption of fiber and antioxidant micronutrients and the number of abnormal GTT values.

Glucose levels measured with continuous glucose monitoring in uncomplicated pregnancies

IntroductionTo characterize glucose levels during uncomplicated pregnancies, defined as pregnancy with a hemoglobin A1c <5.7% (<39 mmol/mol) in early pregnancy, and without a large-for-gestational-age birth, hypertensive disorders of pregnancy, or...

Trajectory of gestational weight gain in patients with gestational diabetes mellitus

Introduction: Weight gain in pregnancy is a significant modifiable factor that impacts immediate and future health of the mother and her fetus Hence, worldwide guidelines are developed about weight gain in pregnancy. In a recent study patients with abnormal glucose tolerance test and diagnosed with gestational diabetes had less deviation from expected gestational weight gain. Purpose: The aim of our study is to look at the trajectory of gestational weight gain for women diagnosed with gestational diabetes followed at the King Faisal Specialist Hospital and Research Centre (KFSH&amp;RC) Methods: Our study population included 215 pregnant women with singleton pregnancy diagnosed with diabetes mellitus who attended the obstetrics outpatient clinic and family health clinics from first antenatal visit until delivery. Results: From among the 215 women in the study cohort, the total number of weight gain was 143. The number of patients who lost weight was 48, and the number of patients who remained stable were 24. Overall, the amount of weight gain for women in this study was comparable to the expected. Conclusion: In our study we found the patients diagnosed with gestational diabetes mellitus have a wide range of changes in their weight gain trajectory from previously expected parameters in the healthy population, which might be explained by other factors like adherence to diet, exercise and medications designed control the metabolism.

Association between abnormal oral glucose tolerance test patterns in the second trimester and large for gestational age newborns

Objective: To investigate the impact of abnormal patterns of 75 g oral glucose tolerance test (OGTT) in the second trimester on the risk of large for gestational age (LGA) newborn deliveries. Methods: General clinical data and OGTT results of 66 290 pregnant women who received regular prenatal care and delivered in Guangdong Maternal and Child Health Hospital from December 24, 2016 to July 26, 2022 were collected. According to the results of OGTT, the pregnant women were divided into 8 groups: normal blood glucose group (normal fasting blood glucose, 1-hour and 2-hour after oral glucose, 54 518 cases), gestational diabetes mellitus (GDM) 0 group (only abnormal fasting blood glucose, 1 430 cases), GDM 1 group (only abnormal blood glucose at 1-hour after oral glucose, 2 150 cases), GDM 2 group (only abnormal blood glucose at 2-hour after oral glucose, 3 736 cases), GDM 0+1 group (both fasting blood glucose and 1-hour after oral glucose were abnormal, 371 cases), GDM 0+2 group (both fasting blood glucose and 2-hour after oral glucose were abnormal, 280 cases), GDM 1+2 group (abnormal blood glucose at 1-hour and 2-hour after oral glucose, 2 981 cases) and GDM 0+1+2 group (abnormal fasting blood glucose, 1-hour and 2-hour after oral glucose, 824 cases). Multivariate logistic regression was used to analyze the effects of different abnormal OGTT patterns on LGA. In addition, the blood glucose measurements at the three time points of OGTT were combined and used as continuous variables in the receiver operating characteristic (ROC) curve to evaluate the predictive value of each blood glucose measurement mode for LGA and the area under the curve (AUC) was compared. Results: (1) Multivariate logistic regression analysis showed that the risks of LGA were significantly increased in GDM 0 group (OR=1.76, 95%CI: 1.50-2.08; P<0.001), GDM 0+1 group (OR=2.29, 95%CI: 1.72-3.04; P<0.001), and GDM 0+1+2 group (OR=1.98, 95%CI: 1.61-2.43; P<0.001). (2) ROC curve analysis showed that fasting blood glucose, 1-hour after oral glucose, 2-hour after oral glucose, fasting+1-hour after oral glucose, fasting+2-hour after oral glucose, 1-hour+2-hour after oral glucose, and fasting+1-hour+2-hour after oral glucose had certain predictive value for LGA (all P<0.001). The AUC of fasting blood glucose measurement was higher than that of 2-hour blood glucose measurement in predicting LGA, and the difference was statistically significant (P<0.05). There was no significant difference in the AUC between fasting blood glucose and other blood glucose measurement modes for predicting LGA (all P>0.05). Conclusions: In the abnormal OGTT patterns, pregnant women with abnormal fasting blood glucose, abnormal fasting+1-hour after oral glucose, and abnormal fasting+1-hour+2-hour after oral glucose have an increased risk of LGA. Fasting blood glucose measurement is of great significance for the prediction of LGA, and could be used as an optimal indicator to evaluate the risk of LGA in clinical practice.

Are maternal serum subfatin levels altered in women with one abnormal glucose tolerance test value?

Subfatin, a newly discovered adipokine, plays a pivotal role in the regulation of glucose metabolism. The relationship between gestational diabetes mellitus and maternal dyslipidemia is well-documented. This study aims to assess serum subfatin levels and the triglyceride/high-density lipoprotein cholesterol ratio in women with one abnormal glucose tolerance test value and those with gestational diabetes mellitus. In this case-control study, 105 pregnant women were categorized into three groups: women with normal 3-h oral glucose tolerance test results (n=35), women with one abnormal 3-h oral glucose tolerance test result (n=35), and women diagnosed with gestational diabetes mellitus (n=35). Serum subfatin levels were measured using human enzyme-linked immunosorbent assay kits. Serum subfatin levels were significantly lower in the gestational diabetes mellitus group (0.94±0.15 ng/mL) compared to the normal oral glucose tolerance test group (1.48±0.55 ng/mL) and the group with one abnormal oral glucose tolerance test result (1.50±0.59 ng/mL). The triglyceride/high-density lipoprotein cholesterol ratio was also lower in the healthy control group than in the gestational diabetes mellitus and one abnormal oral glucose tolerance test result groups. Serum subfatin levels in women with one abnormal abnormal glucose tolerance test value are compared to those in the control group, while the triglyceride/high-density lipoprotein cholesterol ratio is significantly altered in women with one abnormal abnormal glucose tolerance test value when compared to the control group.

Betaine for the prevention and treatment of insulin resistance and fatty liver in a high-fat dietary model of insulin resistance in C57BL mice.

The aim was to investigate mechanisms by which betaine improves hepatic insulin signaling in a dietary mouse model of insulin resistance and fatty liver. C57BL 6J mice were fed a standard diet (SF), a standard diet with betaine (SFB), a nutritionally complete high fat (HF) diet, or a high fat diet with betaine (HFB) for 14 weeks. In a separate experiment, mice were fed high fat diet for 18 weeks, half of whom received betaine for the final 4 weeks. Activation of insulin signaling in the liver was assessed by western blot. Insulin signaling was also assessed in insulin resistant primary human hepatocytes treated with betaine. As compared with SF, mice receiving HF diet were heavier, had more hepatic steatosis, and abnormal glucose tolerance test (GTT). Betaine content in liver and serum was 50% lower in HF than in SF; betaine supplementation restored serum and liver betaine content. Betaine treatment of HF reduced whole body insulin resistance as measured by GTT. Betaine treatment of HF increased tyrosine phosphorylation of insulin receptor substrate-1 and phosphorylation (activation) of Akt, and increased hepatic glycogen content. In vitro, betaine reversed insulin resistance in primary human hepatocytes by increasing insulin-stimulated tyrosine phosphorylation of IRS1 and of Akt. Betaine supplementation reduced whole body insulin resistance and increased activation of insulin signaling pathways in the liver in a mouse model of insulin resistance and fatty liver created by feeding a nutritionally complete high fat diet for 14 weeks. Betaine also reduced liver injury as assessed by ALT and by liver histology. In vitro, betaine reversed insulin resistance by increasing insulin-stimulated tyrosine phosphorylation of IRS1 and activation of downstream proteins in the insulin signaling cascade in insulin resistant primary human hepatocytes.

Prevalance of impaired glucose tolerance and its association with adverse perinatal outcomes in non-gestational diabetes pregnancies

Objective: Gestational diabetes mellitus (GDM) is characterized by glucose intolerance with onset during pregnancy and is one of the most common metabolic disorders complicating pregnancy. The aim of this study was to evaluate the risk of maternal and neonatal outcomes in non-gestational diabetes pregnancies with abnormal glucose challenge test (GCT) and abnormal glucose tolerance test (GTT) results.&#x0D; &#x0D; Methods: In this retrospective cohort study of 2982 singleton pregnancies, all patients underwent a non-fasting 50 g GCT at 24 to 28 weeks of gestation. A GCT cutoff of ≥ 140 mg/dl was selected. Women with an elevated GCT underwent prompt diagnostic testing with a 3-hour GTT. Subjects were divided into four groups according to GCT and GTT results.&#x0D; &#x0D; Results: There was an impaired glucose tolerance in 19.2 % of patients and 14.7 % of them had mild glucose intolerance and 4.5 % of them had moderate glucose intolerance. As expected, there was statistically significant difference in fetal macrosomia, neonatal hypoglicemia, PE, primary CS, and preterm birth between secreening negative and GDM patients (p &lt; 0.0001). We also observed statistically significant difference in neonatal hypoglicemia (p = 0.0001) and PE (p = 0.0277) between screning negative and mild glucose intolerance group. Moreover, there was a significant difference in fetal macrosomia (p=0.0480) between mild glucose intolerance and moderate glucose intolerance groups.&#x0D; &#x0D; Conclusion: Compared with screening negative group, mild and moderate glucose intolerance are associated with increased adverse maternal and neonatal outcomes even in the absence of GDM.

Future diabetes risk can be predicted by the number of abnormal oral glucose tolerance test values during pregnancy.

To quantify the future risk of type 2 diabetes (T2D) in women with gestational diabetes (GD) based on baseline metabolic characteristics and the number of abnormal values during a 3-hour 100-g oral glucose tolerance test (OGTT). We conducted a population-based retrospective cohort study of 10 023 pregnant women who underwent testing for GD in a large health maintenance organization in Israel using a 100-g OGTT. Glucose values were obtained at four time points, 0, 60, 120 and 180 minutes. We identified 9939 women who met the study criteria. Median follow-up was 3.25 (interquartile range 1.5-5.1; maximum 10.1) years. Using women without GD as reference, women with GD were at an increased risk of future T2D (hazard ratio [HR] 5.33 [95% confidence interval {CI} 3.86-7.34]). This risk increased with a greater number of abnormal OGTT values, with the highest risk seen in women with four abnormal values (HR 16.67 [95% CI 7.94-35.01]). In a multivariate model, a higher number of abnormal values, Arab ethnicity, higher body mass index, triglycerides and prepregnancy glucose were significantly associated with increased risk. Future T2D risk was also affected by the type of OGTT abnormality; an abnormal fasting value had the greatest risk, whereas an abnormal 3-hour value had the lowest risk (HR 3.61 [95% CI 2.42-5.38] vs. 1.50 [95% CI 0.93-2.43], respectively). GD isa heterogenous disease, with varying degrees of glucose intolerance and subsequent T2D risk. Targeting interventions to womenat the highest risk may help to improve postpartum adherence and effective long-term follow-up strategies.

SERUM C REACTIVE PROTEIN AS AN INFLAMMATORY MARKER IN GESTATIONAL DIABETES MELLITUS

Background: Gestational diabetes mellitus is the most prevalent metabolic disorder of pregnancy. A number of factors are implicated in its causation. Inflammation may play a role in development of diabetes. This study aimed to look for an association between serum C reactive protein and gestational diabetes mellitus. Methods: This cross-sectional analytical study was carried out at Physiology Department, Army Medical College in collaboration with Pak Emirates Military Hospital from July 2019 to March 2020. Thirty healthy pregnant females and 30 gestational diabetes mellitus patients with 24–32 weeks of gestation were selected. The diagnosis of gestational diabetes was made on the basis of abnormal glucose tolerance test according to International Association for Diabetes and Pregnancy Study Group (IADPSG) criteria. Blood samples were evaluated for serum CRP. Data were analyzed on SPSS-22. Data were expressed as mean and standard deviation. Comparison of data was performed using independent samples t-test. Pearson correlation coefficient was determined to find association between numerical variables. Results were considered significant at p?0.05. Results: Mean Serum C reactive protein level was significantly higher in gestational diabetes group compared with healthy control group and had significant positive correlation with plasma glucose levels as well as glycosylated haemoglobin. Conclusion: High CRP levels in GDM had positive correlation with blood sugar levels. Early diagnosis of inflammation with raised CRP level may be helpful in identifying the subjects at risk. Pak J Physiol 2023;19(3):3–6

Trying Modified Approaches to the Management of Pregnancy Induced Diabetes Mellitus (GDM) a Prospective Study

Background: To investigate maternal and foetal outcomes in patients with gestational diabetes mellitus diagnosed according to the criteria of the International Association of Diabetes and Pregnancy Study Groups (IADPSG), but who were evaluated using a twenty-four hour seven-value sugar profile prior to the implementation of management. This study sought to examine maternal and fetal outcomes in patients with gestational diabetes mellitus. Place of Study: Sialkot Medical College Sialkot Duration of Study: JUNE 2021 TO JUNE2022 Methods: This prospective observational study was undertaken at the Sialkot Medical College Hospital over the course of one year. The hospital served as the study's location. Prior to starting any medication between 24 and 28 weeks of pregnancy, women diagnosed with GDM based on IADPSG criteria were needed to undertake a seven-value sugar profile within twenty-four hours. This criterion applied to women diagnosed with gestational diabetes between 24 and 28 weeks of pregnancy. The remaining patients were treated with medical nutrition therapy (MNT), which may or may not have been supplemented with medication depending on what was necessary to maintain their normal blood sugar levels. Documentation and analysis of maternal and fetal outcomes were conducted to assess whether or not the groups displayed differentiating characteristics. Results: GDM was diagnosed in 198 out of a total of 1867 pregnant women, representing a 9.1% prevalence rate. In 81 patients, or 40.90% of the total, the 7-point blood glucose profile (ITT) was normal, and these individuals required no medical intervention other than watchful observation. Other patients received treatment; 89 (44.9% of patients) required only MNT control, while 19 (9.59%) received supplementary medication in the form of metformin and 9 (4.5%) required insulin. It was determined that there were no statistically significant differences between the treated and untreated groups in terms of maternal–fetal outcomes. Upon comparing treated and untreated groups, this was the result that was reached. Conclusions: After an abnormal Oral Glucose Tolerance Test, the technique of evaluating patients with a seven-value, twenty-four-hour sugar profile limited the capacity of nearly one-third of women to get medication and treatment for GDM without compromising maternal–fetal outcomes. This was the case despite the absence of a link between an aberrant OGT and a diminished capacity to receive therapy and treatment for GDM. Keywords: GDM IADPSG Maternal fetal outcomes

ELEVATED ANION GAP AS A MARKER OF SEVERE SARS-COV-2 INFECTION IN PREGNANT PATIENTS WITHOUT DIABETES: A CASE SERIES

ELEVATED ANION GAP AS A MARKER OF SEVERE SARS-COV-2 INFECTION IN PREGNANT PATIENTS WITHOUT DIABETES: A CASE SERIES

Thirty-Minute Post-load Glucose Could Be a Useful Screening Measure for Abnormal Oral Glucose Tolerance Test Response in Adolescents with Obesity

BackgroundWith the growing obesity epidemic, subjecting every child with obesity to a 2-hour oral glucose tolerance test (OGTT) is impractical. Instead, 30-minute plasma glucose (PG), which reflects the acute phase of insulin secretion, might be a useful measure in the initial assessment of such individuals. Our study aimed to evaluate the optimal cutoff of 30-minute PG in predicting abnormal OGTT response and to compare the predictive value of this cutoff with that of the previously reported values from a combination of non-fasting parameters.MethodsFor this study, 332 overweight or obese pediatric individuals who had undergone the OGTT under the Department of Pediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong, from 2012 to 2018 were included. The optimal cutoff of 30-minute PG for prediction of abnormal OGTT response was determined using a receiver operating characteristics curve, and the positive predictive value (PPV) was evaluated.ResultsThere were 180 males (54.2%) and the mean age of the included individuals was 15.4±2.3 years. A 30-minute PG ≥9.2 mmol/L predicts abnormal OGTT response with the best combination of sensitivity and specificity. The PPV for abnormal OGTT response at this cutoff was 45%. Addition of this 30-minute PG cutoff to non-fasting parameters, including glycated hemoglobin, abnormal alanine transaminase, and family history of diabetes, resulted in an improved PPV of 70% for abnormal OGTT response.ConclusionAddition of 30-minute PG to non-fasting parameters improved the clinical utility in identifying high-risk individuals for abnormal OGTT response.

Prevalence of Gestational Diabetes Mellitus among Pregnant Women Undergoing Oral Glucose Tolerance Test (OGTT) at Chitwan Medical College and Teaching Hospital

INTRODUCTION: Gestational Diabetes Mellitus (GDM) is defined as glucose intolerance of variable severity in which spontaneous hyperglycemia develops during pregnancy. GDM is affecting approximately 14% of pregnancies worldwide, representing approximately 18 million births annually. GDM increases the risk of adverse maternal and perinatal outcome and also increases risk of future diabetes to the mother and their child. MATERIALS AND METHODS: The cross-sectional study was carried out over 8 months in 149 pregnant subjects of gestation period between 24 and 28 at Chitwan Medical College Teaching Hospital (CMCTH). All pregnant women were considered for 50gm Glucose Tolerance Test (GCT). Those pregnant subjects with GCT ≥ 140mg% only undergo 100 gm Oral Glucose Tolerance Test (OGTT) &amp; plasma glucose were estimated at the interval of 0,1,2 and 3 hours respectively. The GDM was diagnosed after performing OGTT based on Carpenter-Coustan Criteria. RESULTS: In our study from 149 study population, the frequency of normal &amp; abnormal GCT in pregnant women was 111(74.50%) &amp; 38(25.50%) respectively. Out of 149 subjects only 38 pregnant women have abnormal GCT in which only 23 have done OGTT test. Among 23 subjects the presence of GDM was found in 9 subjects with 39.10% whereas GDM was not found in 14 subjects with 60.9%. The prevalence of GDM among 149 populations was found to be 9 which is 6.04%. CONCLUSIONS: The prevalence of GDM among 149 populations was found to be 6.04%. The real burden, risk factors, and potential preventative interventions of gestational diabetes mellitus must also be measured in large observational studies for finding the correlation to assess the severity of the disease.

ASSOCIATION BETWEEN IRON STATUS AND GESTATIONAL DIABETES MELLITUS

Background: Early identification of risk factors for gestational diabetes may result in its prevention and better management. In this study, we aimed to compare serum iron, total iron binding capacity and transferring saturation in pregnant women with and without gestational diabetes. Methods: A comparative cross sectional analytical study was conducted at Army Medical College and Centre for Research in Experimental and Analytical Medicine (CREAM) in association with Pak Emirates Military Hospital. Thirty healthy pregnant women and thirty patients of gestational diabetes mellitus matched for age, gestational age and body mass index (BMI) were recruited for the study. The diagnosis of gestational diabetes was made on the basis of abnormal glucose tolerance test at twenty four weeks of gestation. Serum iron and total iron binding capacity of all subjects were measured using colorimetric assay and transferrin saturation was calculated. Analysis of data was carried using SPSS-22. Mean values were calculated for all variables and compared by two sample t-test. Pearson correlation was determined to find association between different quantitative variables in two groups and p?0.05 was considered significant. Results: Serum iron was significantly higher (p=0.007), TIBC significantly lower (p=0.004) and transferrin saturation significantly higher (p&lt;0.001) in gestational diabetes group as compared to control group. Conclusion: Markers of iron status including serum iron and transferrin saturation were higher in patients of gestational diabetes and may pose a risk of developing gestational diabetes mellitus. Pak J Physiol 2022;18(2):47–50

Clinical implications of the 100-g oral glucose tolerance test in the third trimester.

The clinical implications of gestational diabetes mellitus (GDM) diagnosed in the third trimester are not well established and controversy continues regarding the performance of diagnostic tests beyond 28-week gestation. This study aimed to evaluate the incidence of abnormal third trimester oral glucose tolerance test (OGTT) results in women at high risk and to compare the obstetric and neonatal outcomes with those of women with normal OGTT results. The study included 372 women who completed late (>29weeks) 100-g OGTT due to suspected fetal macrosomia, polyhydramnios or a personal risk factor for GDM, diagnosed according to the Carpenter & Coustan criteria. Women withonly one abnormal OGTT value were diagnosed with GDM by abnormal glucose follow-up and analyzed separately. Obstetric and neonatal outcomes were compared between the GDM and the non-GDM groups. GDM was diagnosed in 85/372 (22%) women, including 35 (59.3%) women with one abnormal OGTT value who were later diagnosed with GDM. Of 200 women who had a normal 1-h 50-g glucose challenge test at 24-28weeks, late GDM was diagnosed in 33 (16.5%). Seventy-six (89.5%) of those with GDM were treated by dietary therapy and 9 (10.5%) by pharmacological therapy. Among women with GDM, large-for-gestational-age fetuses, labor induction and elective cesarean section were more prevalent than for those without GDM. Significant differences were not found between the groups in macrosomia and neonatal outcomes. The performance of OGTT in women with risk factors during the third trimester should be considered following further prospective trials.

Gas Chromatography–Mass Spectroscopy-Based Metabolomics Analysis Reveals Potential Biochemical Markers for Diagnosis of Gestational Diabetes Mellitus

Due to many adverse effects of gestational diabetes mellitus (GDM) on the mother and fetus, its diagnosis is crucial. The presence of GDM can be confirmed by an abnormal fasting plasma glucose level (aFPG) and/or oral glucose tolerance test (OGTT) performed mostly between 24 and 28 gestational week. Both aFPG and abnormal glucose tolerance (aGT) are used to diagnose GDM. In comparison to measurement of FPG, OGTT is time-consuming, usually inconvenient for the patient, and very often needs to be repeated. Therefore, it is necessary to seek tests that will be helpful and convenient to diagnose GDM. For this reason, we investigated the differences in fasting serum metabolites between GDM women with abnGM and normal FPG (aGT-GDM group), with aFPG and normal glucose metabolism (aFPG-GDM group) as well as pregnant women with normal glucose tolerance (NGT) being a control group. Serum metabolites were measured by an untargeted approach using gas chromatography–mass spectrometry (GC–MS). In the discovery phase, fasting serum samples collected from 79 pregnant women (aFPG-GDM, n = 24; aGT-GDM, n = 26; NGT, n = 29) between 24 and 28 weeks of gestation (gwk) were fingerprinted. A set of metabolites (α–hydroxybutyric acid (α–HB), β–hydroxybutyric acid (β–HB), and several fatty acids) significant in aGT-GDM vs NGT but not significant in aFPG-GDM vs NGT comparison in the discovery phase was selected for validation. These metabolites were quantified by a targeted GC–MS method in a validation cohort consisted of 163 pregnant women (aFPG-GDM, n = 51; aGT-GDM, n = 44; and NGT, n = 68). Targeted analyses were also performed on the serum collected from 92 healthy women in the first trimester (8–14 gwk) who were NGT at this time, but in the second trimester (24–28 gwk) they were diagnosed with GDM. It was found that α–HB, β–HB, and several fatty acids were associated with aGT-GDM. A combination of α–HB, β–HB, and myristic acid was found highly specific and sensitive for the diagnosis of GDM manifested by aGT-GDM (AUC = 0.828) or to select women at a risk of aGT-GDM in the first trimester (AUC = 0.791). Our findings provide new potential markers of GDM and may have implications for its early diagnosis.

Glycyrrhiza glabra alcoholic root extract ameliorates hyperglycemia, hyperlipidemia, and glycation-induced free iron-mediated oxidative reactions.

Hyperglycemia-associated oxidative stress leads to various pathophysiological complications in diabetes mellitus. Here, the effects of Glycyrrhiza glabra (G. glabra) root extract of streptozotocin (STZ)-induced diabetic changes and the associated free iron-mediated oxidative reactions were investigated. The animals were divided into five group, Group 1: Control (NC received buffer); Group 2: STZ-induced (DC); Group 3: Control treated withG. glabraroot extract (NT, 60mg/Kg b.w daily for 1month); Group 4: Diabetic treated withthe extract(60mg/Kg b.w daily for 1month); Group 5: Diabetic treated with glibenclamide (DTG, 8.6mg/Kg b.w for 1month). STZ (i) induced hyperglycemia, abnormal intraperitoneal glucose tolerance test (IPGTT), increased HbA1c and decreased plasma insulin levels (ii) hyperlipidemia (iii) lowered antioxidant enzyme activities (iv) diminished RBC membrane fluidity (v) enhanced hemoglobin glycation-induced iron release and associated free radical reactions. Treatment with the extract resulted in significant reversal of hyperglycemia (DC: 205.0±7.0mg/dl vs. DT: 87.5±4.5mg/dl, p<.05); HbA1c (DC: 11.5±2.0 vs. DT: 7.5±0.8 vs. DT: 7.5 ± 0.8, p<.05); insulin (DC: 0.3±0.06 vs. DT: 1.25±0.15 μgm/L, p<.05); free iron (DC: 150.4±7.07 vs. DT: 98.8±7.7 μgm/gm of Hb, p<.05); TBARS (DC + H2 O2 : 24.62±11.30 vs. DC + H2 O2 : 9.82±2.56 mmoles/h, p<.05); carbonyl (DC: 40.40±1.57 vs. DT: 25.50±1.12 mmoles/g of Hb, p<.05) levels and β-cell count/pancreatic islet (DC: 85±15 vs. DT: 125±20, p < .05). Thus, G. glabra extract is quite effective against hyperglycemia and the associated free iron-mediated oxidative stress. PRACTICAL APPLICATIONS: Chronic use of oral hypoglycemic synthetic drugs may produce side effects and drug resistance. Recently, various plant extracts are being researched to explore their antihyperglycemic potential. Here, the effects of this alcoholic powdered root extract on STZ-induced diabetic changes and associated oxidative stress, including hemoglobin-induced free iron-mediated oxidative reactions were examined. The STZ-induced diabetic changes and hemoglobin-glycation-induced free iron-mediated oxidative reactions were alleviated in the Wistar rats after 1-month of treatment with the extract. We have also reported previously that glycyrrhizin, a bioactive constituent of Glycyrrhiza glabra root inhibits peroxidase, esterase activities of hemoglobin and hemoglobin-mediated oxidative damage without affecting oxygen-binding capacity of the protein. This preclinical work further substantiates the potential therapeutic use of the G. glabra whole root extract in the treatment of diabetes mellitus.