Gestational Diabetes Control Research Articles

The relationship between low maternal serum vitamin D levels and glycemic control in gestational diabetes assessed by HbA1c levels: an observational cross-sectional study

BackgroundA great association between vitamin D deficiency and type 2 diabetes mellitus has been suggested in literature. During pregnancy, this deficiency is even more critical. It appears that vitamin D insufficiency during pregnancy may be associated with maternal hazards. The aim of this study was to assess the relation between the levels of 25-hydroxy-cholecalciferol (vitamin D), and the glycemic control in pregnant women.MethodsAn observational cross-section study including 160 pregnant women between 20-40 years in age, in their third trimester, divided into two equal groups. First group consisted of 80 women with established diagnosis of gestational diabetes and the second group with proved normal blood glucose levels. We assessed vitamin D in serum, fasting blood glucose, serum insulin and glycosylated hemoglobin (HbA1c) levels and we depicted the insulin sensitivity using the Quantitative insulin sensitivity check index (Quicki). The results were collected and statistically correlated.ResultsThe mean vitamin D levels were 46.61 ± 6.087 and 47.25 ± 10.181in controls and women with gestational diabetes mellitus (GDM) respectively. The fasting insulin levels were significantly higher in the group with GDM with a mean of 18.51 ± 6.44 compared to 8.95 ± 2.52 in the control group.The correlation coefficient (r) between HbA1c levels and Vitamin D level was -0.492 with a P value <0.05. Similar associations were also found with the fasting blood sugar levels (r = - 0.386) and with Quicki values (r = -0.250). Vitamin D levels correlated significantly with the fasting blood glucose, the fasting serum insulin and the HbA1c levels, the P value in all these correlations were <0.05. The P value with Quicki results was 0.064.ConclusionsThere is a statistically significant negative correlation between the glycemic control and vitamin D levels in serum in the whole study population. The effect of adequate vitamin D replacement on glycemic control was not studied in our work correlation. We suggest larger scale studies addressing this issue.

Efficacy of insulin lispro in improving glycemic control in gestational diabetes.

Aim:To assess the safety and efficacy of insulin lispro in improving glycemic control in patients with gestational diabetes.Materials and Methods:A retrospective observational study was conducted at a single center on 201 gestational women with diabetes. Subjects who received insulin lispro performed blood glucose self-monitoring and recorded the readings in the fasting state and 1 h after each meal. At each contact (in person or telephonic contact), the insulin dose was adjusted based on the readings measured. A total of 53 subjects also recorded glucose levels post-partum. Pregnancy and post-delivery glucose level and insulin requirements of these 53 patients were compared.Results:Analysis of glucose levels both fasting and post-prandial glucose levels revealed that after using insulin lispro, the number of episodes of post-prandial hyperglycemia (1 h plasma glucose >120 mg/dL) was minimal and so was the incidence of hypoglycemia. Hypoglycemia was defined as a blood sugar value of. There was neither any congenital abnormality except for a poorly formed pinna in the right ear of one baby nor any post-partum complications of note.Conclusion:Insulin lispro is an effective and safe treatment option in gestational diabetes.

303: Does race affect glycemic control in gestational diabetes?

Black and Hispanic race are known risk factors for developing gestational diabetes (GDM), and research suggests that birth weight varies by maternal race. However, the influence of race on blood sugar (BS) control in GDM is understudied. Our aim is to elucidate this relationship in order to better counsel and more appropriately manage our heterogeneous patient population.

263: Glycemic control in gestational diabetes: it's all a matter of timing

For patients with gestational diabetes (GDM), achieving glycemic control (GC) earlier in pregnancy is presumably associated with improved maternal and neonatal outcome. We sought to determine if the gestational age (GA) at which good GC is achieved affects outcome regardless of the method used to diagnose GDM.

Shoulder dystocia related fetal neurological injuries: the role of diabetic control

Abstract The study explores the roles of routine prenatal diabetic screening and control in the occurrence of neurological birth injuries associated with shoulder dystocia. The investigation involved retrospective review of 226 medical records that contained information about the antenatal events in cases that resulted in permanent neonatal injuries following arrest of the shoulders at delivery. Close attention was paid to diabetic screening and management of mothers with evidence of glucose intolerance. Analysis of the records revealed that one-third of all women, including those with predisposing factors, received no diabetic screening during pregnancy. The majority of confirmed diabetic patients were not treated adequately. Among babies of diabetic women, birth weights exceeding 4500 g were about 30-fold more frequent than among those with normal glucose tolerance. The data suggest that universal screening and rigid diabetic control, including mothers with borderline glucose tolerance, are effective measures for the prevention of excessive fetal growth and intrapartum complications deriving from it. If ignored, impaired maternal glucose tolerance may become a major predisposing factor for neurological birth injuries. It appears therefore that with routine screening for diabetic predisposition and effective control of gestational diabetes the risk of fetal damage can be reduced substantially.

Management of gestational diabetes from the patient's perspective – a comparison of Swedish and Middle‐Eastern born women

To explore patients' evaluation of a specialized diabetes clinic for management of women with gestational diabetes born in Sweden and the Middle East and its contribution to a decreased level of stress and improved coping capability to promote health in patients receiving care. No studies comparing patients' perceptions of healthcare in women of different origin with gestational diabetes have been found. A perceived clinical problem in specialized diabetes care is of lower activity level in self-care in foreign- than Swedish-born women and the question is whether the healthcare organization is optimal in meeting different individuals' needs. Explorative study. Semi-structured individual interviews by external evaluators. Consecutive sample. Females with gestational diabetes, 13 born in Sweden and 14 born in the Middle East. The healthcare model was perceived as functioning well. Swedish women were problem focused and information seeking. Frustration and stress were increased due to perceived delay in information concerning gestational diabetes, limited access to telephone service and lack of confidence in staff because they lacked the expected competence. Control of gestational diabetes and pregnancy by different persons led to perceived lack of holistic care. Women from the Middle East felt cared, had been given the necessary information and claimed to follow advice. Adequate information reduced respondents' anxiety and increased their control over the situation. The clinic needs to be further improved by adapting programmes to persons to become problem focused by giving adequate information immediately. Cultural differences in coping strategies and attitudes to gestational diabetes need to be considered. Training of staff working with gestational diabetes patients is urgently needed.

Hypoglycemia in Infants of Diabetic Mothers: Experience in a Rural Hospital

The purpose of this study was to identify which factors contribute to neonatal hypoglycemia in infants of diabetic mothers. A chart review of infants of diabetic mothers was undertaken noting the timing of blood glucose levels, symptoms of hypoglycemia, and interventions provided. The impact of maternal and gestational factors was assessed using marginal mixed models and Poisson regression. Of the 66 infants who had blood glucose determinations, none developed symptomatic hypoglycemia and none required intravenous glucose. The first 90 minutes of life had the lowest mean blood glucose level (mean, 3.01 mmol/L [54.24 mg/dL]) and nearly all of the blood glucose levels < 1.7 mmol/L (30 mg/dL). The risk of a blood glucose level < 1.7 mmol/L decreased with maternal age. With presumably tighter control of gestational diabetes, the risk of symptomatic hypoglycemia appears diminished. If glucose monitoring of asymptomatic newborns is to be performed, it need only be done in the first 2 hours of life.

Verified self-monitored blood glucose data versus glycosylated hemoglobin and glycosylated serum protein as a means of redicting short- and long-term metabolic control in gestational diabetes

Glycosylated hemoglobin and glycosylated serum protein have been suggested as tools for evaluation of long- and short-term glycemic control, respectively. Twenty-six patients with gestational diabetes were prospectively studied to determine the relationship of glycosylated hemoglobin and glycosylated serum protein to metabolic control. To verify the accuracy of blood glucose data, a memory-based reflectance meter was used for subjects with gestational diabetes who tested 6.5 +/- 1 times per day. Our analysis revealed that despite a statistically positive correlation between glycosylated hemoglobin, glycosylated serum protein, and verified data, their use as a clinical tool is limited because of their poor predictability.