Degree Of Glucose Intolerance Research Articles

Effect of Educational Programme for recently diagnosed Gestational Diabetic Women on their Knowledge and clinical outcomes

Background: Gestational diabetes is defined as any degree of glucose intolerance with onset or first recognition during pregnancy; and it affects 11% of all pregnancies. Aim of this study is to : Evaluate the effect of educational programme for recently diagnosed Gestational Diabetic Women on their Knowledge and clinical outcome.Research Design: Quasi- experimental research design (One group pre-test, post-test).Subject: purposive sampleof (74) recruited pregnant women from Minia university hospital for maternity and child at antenatal care Department. Tools of data collection:three tools used as; self-administered Questionnaire,knowledge assessment,and clinical outcome assessment.Results:the majority of gestational diabetic women (93.2%, 97.3%) had good knowledge in immediate and Post 3 months respectively as compared in pre-educational program(23.0%) with highly statistically significance differences in which (P=0.000.);and there were highly statistically significance differences between pre and post educational program among gestational diabetes women regarding their clinical outcome random blood glucose and amniotic fluid amount in which (P=0.002, 0.001).Conclusion: study of educational programme is an effective method for improving women knowledge regarding gestational diabetes. Current study revealed that the gestational diabetic women had higher level of knowledge scores as well as improvement of clinical outcomes (random blood glucose and BMI) post-test significantly after education program as compared to their values at pretest.Recommendation: Providing educational program for recently diagnosed gestational diabetic women about proper management of GDM. Applying Counseling tips in gestational diabetic women discharge teaching plan to maintain healthy life style and maximum glycemic control prior to a future conception.

Maternal obesity and degree of glucose intolerance on neonatal hypoglycaemia and birth weight: a retrospective observational cohort study in women with gestational diabetes mellitus.

Gestational diabetes mellitus (GDM) is an increasing problem worldwide. Postnatal hypoglycaemia and excess foetal growth are known important metabolic complications of neonates born to women with diabetes. This retrospective cohort study aims to determine the influence of obesity and glucose intolerance on neonatal hypoglycaemia and birth weight over the 90th percentile (LGA). Data were abstracted from 303 patient medical records from singleton pregnancies diagnosed with GDM. Data were recorded during routine hospital visits. Demographic data were acquired by facilitated questionnaires and anthropometrics measured at the first antenatal appointment. Blood biochemical indices were recorded. Plasma glucose area under the curve (PG-AUC) was calculated from OGTT results as an index of glucose intolerance. OGTT results of 303 pregnant women aged between 33.6years (29.8-37.7) diagnosed with GDM were described. Neonates of mothers with a BMI of over 30kg/m2 were more likely to experience neonatal hypoglycaemia (24 (9.2%) vs. 23 (8.8%), p = 0.016) with odds ratio for neonatal hypoglycaemia significantly higher at 2.105, 95% CI (1.108, 4.00), p = 0.023. ROC analysis showed poor strength of association (0.587 (95% CI, .487 to .687). Neonatal LGA was neither associated with or predicted by PG-AUC nor obesity; however, multiparous women were 2.8 (95% CI (1.14, 6.78), p = 0.024) times more likely to have a baby born LGA.Conclusion: Maternal obesity but not degree of glucose intolerance increased occurrence of neonatal hypoglycaemia. Multiparous women had greater risk of neonates born LGA.What is Known:•Excess foetal growth in utero has long-term metabolic implications which track into adulthood.•Neonatal hypoglycaemia is detrimental to newborns in the acute phase with potential long-term implications on the central nervous system.What is New:•Maternal obesity but not degree of glucose intolerance in a GDM cohort increased occurrence of neonatal hypoglycaemia.•Multiparous women diagnosed had greater risk of neonates born LGA.

Role of positive glucose challenge test only versus oral glucose tolerance test in pregnancy outcome: a comparative study

Background: Gestational diabetes mellitus is defined as any degree of glucose intolerance which is first recognized during pregnancy and is associated with a number of adverse perinatal outcomes, such as neonatal hypoglycemia, macrosomia with an increased risk of shoulder dystocia and the need for neonatal intensive care. Maternal complications include pre-eclampsia and an increased risk of caesarean delivery. The objective of this study was to compare maternal and perinatal outcomes in pregnant women with positive and negative oral glucose tolerance test following positive glucose challenge test.
 Materials and Methods: This is a prospective observational hospital based study of 120 patients admitted in Nobel Medical College Teaching Hospital, Biratnagar with glucose challenge test positive pregnancy for delivery. Oral glucose tolerance test was performed in all the glucose challenge test positive pregnant and compared with various maternal parameters and newborn’s conditions.
 Results: Among 120 patients included in the study, 28 (30.4%) cases were oral glucose tolerance test. Pregnancy induced hypertension was present in 12 cases. Hyperbilirubinemia was present in 42, hypoglycemia in 32, respiratory distress in 44, birth asphyxia in 15 and macrosomia in 6 cases.
 Conclusions: Pregnancy induced hypertension and hyperbilirubinemia were found to be significantly higher in OGTT positive cases so early detection of GDM screening via is advisable

Circulating microRNAs as modifiable diagnostic biomarkers of gestational and transgenerational metabolic risk: can exercise play a role?

Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance at first recognition during pregnancy (1). It is usually diagnosed at 24–28 gestational weeks, according to the recommendations of international associations and committees (2). Diagnosis is made using a sequential model of universal screening with a 50-g one-hour glucose challenge test (GCT), followed by a diagnostic 100-g three-hour oral glucose tolerance test (OGTT) for women with a positive screening test (3). The overall incidence of GDM is increasing worldwide, affecting approximately 7–15% of all pregnancies (4). It is considered the most frequent metabolic problem during pregnancy, representing about 90% of risky pregnancies (5), although the prevalence of pregnancies complicated by diabetes (gestational or pre-gestational) varies geographically and among different ethnic groups (6). During healthy pregnancy insulin resistance increases due to the secretion of a series of placental hormones antagonists to insulin (cortisol, prolactin, progesterone and lactogen), ultimately causing blood glucose to rise (6). Furthermore, in GDM women insulin production is insufficient to counteract this increasing insulin resistance, due to an increase in β-pancreatic cells apoptotic rate which leads to an abnormal production and secretion of insulin (7). Given that blood glucose easily goes through placenta by facilitated diffusion, it reaches the fetus producing fetal hyperglycemia (8).

SAT-307 NORMAL FETAL KIDNEY VOLUME AND INFANT URINALYSIS IN OFFSPRING OF WOMEN TREATED FOR GESTATIONAL DIABETES

The worldwide prevalence of gestational diabetes mellitus (GDM), defined as any degree of glucose intolerance with onset or first recognition during pregnancy, is increasing, and affects up to 20% of pregnancies. Evidence from animal studies indicate that maternal hyperglycemia can be detrimental to renal development and kidney function in exposed offspring. In humans, renal dysfunction and disease has been reported in adults whose mothers had Type 1 or Type 2 diabetes, suggesting that pre-gestational maternal diabetes influences kidney development and the risk of renal dysfunction in adulthood. Despite its high prevalence, few studies have examined kidney development or renal function in offspring of women with GDM. The aim of this study was to evaluate the impact of treated GDM on fetal kidney size and infant renal physiology. A prospective cohort study was conducted between June 2013 and August 2016 in Melbourne, Australia. Participants were recruited at a large public university teaching hospital and clinical data were collected from women without GDM (n=82) and women diagnosed and treated for GDM (n=76). GDM was diagnosed by routine screening at 26-28 weeks gestation. Women with GDM received specialist support for glucose monitoring, diet and exercise in addition to routine antenatal care. One-third of women with GDM also required insulin therapy. Participants underwent an obstetric ultrasound at 32-34 weeks gestation for fetal biometry and fetal kidney volume measurement. Quantitative urinalyses were performed in infant urine samples at 3 months of age for analysis of protein and electrolytes. Maternal age, weight and body mass index were similar in no-GDM and GDM women. Estimated fetal weight and birth weight were also similar in no-GDM and GDM pregnancies. There were no differences in fetal kidney dimensions, total kidney volume, infant urinary albumin or electrolyte levels. Fetal kidney size did not differ by mode of GDM treatment (i.e. diet and exercise alone, or diet and exercise with insulin therapy). There were no associations between maternal glucose levels at screening and fetal total kidney volume or infant urine albumin in multivariable regression analyses. Findings suggest that a limited period of hyperglycemia prior to diagnosis and treatment of GDM in women attending a large metropolitan public hospital in Australia does not alter fetal kidney volume at 32-34 weeks gestation or urinalysis in 3-month-old infants, a favourable finding considering the increasing number of women diagnosed with GDM.

Glycoregulation During Pregnancy

Abstract Pregnancy is a period marked by profound changes in a woman’s hormonal status and metabolism, including the development of a carbohydrate-intolerant state. Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. The aim of this study was to estimate and analyse the parameters of glycaemic control during pregnancy. We stratified patients into the following three groups according to OGTT results: normal glucose tolerance (NTG), gestational impaired glucose tolerance (GIGT) and GDM. We investigated 92 pregnant women, diagnosed with vital and desired pregnancy up to 12 weeks of gestation, who had signed informed consent forms. Among them, 7 pregnant women had a spontaneous abortion, while 8 pregnant women dropped out, so a total of 77 pregnant women completed the trial. Most of the women examined had no risk factors (48%), while 35% of the women had one risk factor. The current study demonstrates that normal glucose tolerance was shown in 59 (76.6%) participants, while some form of glucose intolerance (GIGT or GDM) was shown in 18 (23.4%) patients. Our findings revealed an increase in glucose intolerance with advancing pregnancy (in the second and third trimester). In conclusion, we demonstrate that the difference in the quality of glycaemic control during pregnancy is manifested in the second and third trimester, until it manifests in the first trimester. These findings underpin the clinical significance of discovering GDM.

Three-Versus Two-Dimensional Sonographic Biometry in the Third Trimester of Pregnancy for Predicting Birth Weight and Macrosomia in Diabetic Pregnancies

Background: diabetes is the most common metabolic disorder affecting pregnancy. Its prevalence seems to be growing in parallel with the epidemics of overweight and obesity. It‘s considered a modern epidemic disease that affects about 8.3% of adults (accounts for 382 million people of the global population) and 46% of cases are estimated to be undiagnosed. Recognizing and treating diabetes or any degree of glucose intolerance in pregnancy results in lowering maternal and fetal complications. Objective: our aim is to test the hypothesis that incorporating 3D fractional thigh volume would be superior to conventional 2D biometry for predicting birth weight and macrosomia in diabetic pregnancies. Patients and Methods: the study was done on 160 pregnant women suffering from pre-gestational or gestational diabetes at El-Hussien and Sayed Galal Hospitals. All women were evaluated by full obstetrical history taking, physical examination, pelvic examination, transabdominal ultrasound, routine laboratory investigations and assessment of the route of delivery. Results: one-fifth of the patients had macrosomia, and four fifths had no macrosomia. There were no statistical significant differences between macrosomia group and no macrosomia group in maternal age, parity, body mass index, obesity, diabetes, gestational age and gestational age at delivery. The mean ± SD was lower for the 2D than the 3D projected estimate. Our study showed that there were statistical high significant regarding birth weight at delivery and difference from 2D/3D (p < 0.001). Conclusion: we suggest that 2D sonography should remain the standard of care for predicting birth weight and macrosomia in diabetic pregnancies

Three-Versus Two-Dimensional Sonographic Biometry in the Third Trimester of Pregnancy for Predicting Birth Weight and Macrosomia in Diabetic Pregnancies

Background: diabetes is the most common metabolic disorder affecting pregnancy. Its prevalence seems to be growing in parallel with the epidemics of overweight and obesity. It‘s considered a modern epidemic disease that affects about 8.3% of adults (accounts for 382 million people of the global population) and 46% of cases are estimated to be undiagnosed. Recognizing and treating diabetes or any degree of glucose intolerance in pregnancy results in lowering maternal and fetal complications. Objective: our aim is to test the hypothesis that incorporating 3D fractional thigh volume would be superior to conventional 2D biometry for predicting birth weight and macrosomia in diabetic pregnancies. Patients and Methods: the study was done on 160 pregnant women suffering from pre-gestational or gestational diabetes at El-Hussien and Sayed Galal Hospitals. All women were evaluated by full obstetrical history taking, physical examination, pelvic examination, transabdominal ultrasound, routine laboratory investigations and assessment of the route of delivery. Results: one-fifth of the patients had macrosomia, and four fifths had no macrosomia. There were no statistical significant differences between macrosomia group and no macrosomia group in maternal age, parity, body mass index, obesity, diabetes, gestational age and gestational age at delivery. The mean ± SD was lower for the 2D than the 3D projected estimate. Our study showed that there were statistical high significant regarding birth weight at delivery and difference from 2D/3D (p < 0.001). Conclusion: we suggest that 2D sonography should remain the standard of care for predicting birth weight and macrosomia in diabetic pregnancies

Methylation of HIF3A promoter CpG islands contributes to insulin resistance in gestational diabetes mellitus.

BackgroundGestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance during pregnancy, and will lead to high risk of diabetes even after pregnancy. Hypoxia‐inducible factor (HIF) family proteins are transcriptional factors that are highly correlated with methylation, which might be involved in the regulation of GDM.MethodsBaseline clinical characteristics of the GDM patients and healthy women were analyzed. Omental tissue from GDM patients and control groups were collected and detected for the expression levels of HIF1A, HIF2A, and HIF3A. The CpG islands of HIF3A promoter were predicted by “methprimer” software, and the methylation level of CpG islands was detected by bisulfite sequencing PCR.Results HIF3A was downregulated in the omental tissue from GDM patients, whereas HIF1A and HIF2A were not affected. Furthermore, HIF3A expression was positively correlated with levels of estrogen receptor α (ESR1) and solute carrier family 2 member 4 (SLC2A4). Moreover, CpG islands of HIF3A promoter were highly methylated in GDM patients. In addition, methylation level of CpG islands could be upregulated by Estradiol (E2) treatment, since high dose of E2 reduced HIF3A mRNA expression in 3T3‐L1 adipocytes.ConclusionOur findings demonstrate that the expression level of HIF3A, but not HIF1A or HIF2A, is downregulated in GDM patients. The methylation status of HIF3A promoter region is highly correlated with GDM, which could be a novel therapeutic target for GDM treatment.

The Effect of Oat Bran Supplement on Fasting Blood Sugar and Glycosylated Hemoglobin in Patients with Gestational Diabetes Mellitus: Single-blind Randomized Clinical Trial

Background: Gestational diabetes mellitus (GDM) is known as a degree of glucose intolerance that occurs for the first time during pregnancy. There is paucity of evidence regarding the effect of oat bran on GDM. Oat as a source of β-glucan can be effective in reducing the blood sugar levels. This study aimed to investigate the effect of oat bran on fasting blood sugar (FBS) and glycosylated hemoglobin (HbA1c) in patients with GDM. Method: This single-blind clinical trial was conducted on 90 pregnant women with GDM. The experimental group (EG) consumed 30 g of oat bran daily with 100 g of low-fat yogurt before lunch and dinner for 4 weeks. The control group (CG) consumed only low-fat yogurt and both groups received nutrition counseling. The present study investigated the FBS, HbA1c, and weight gain at the beginning and after four weeks of intervention. Results: Out of 90 patients, 80 completed the study. FBS decreased in the EG (P = 0.04, -2.75 ± 8.22), whereas, it increased in the CG (P = 0.003, 4.37 ± 8.72). No significant difference was observed between the two groups in terms of HbA1c levels. Weight gain was controlled more efficiently in the EG than the CG (P = 0.001). Conclusion: The use of oat bran for four weeks decreased the FBS,; whereas, it did not affect HbA1c levels. Weight gain was controlled better in the EG than the CG.

Nursing management of gestational diabetes mellitus in Ghana: Perspectives of nurse-midwives and women

BackgroundGestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance that is observed in the beginning of, or first acknowledged during pregnancy. The prevalence of GDM is estimated to be approximately 15% globally and is expected to increase due to growing numbers of overweight and obesity in women in their reproductive age. The nursing management of GDM in terms of lifestyle modifications (exercise, diet and nutrition) and the taking of diabetes medication, if required, and adherence thereto is crucial to prevent maternal and neonatal-perinatal complications. This qualitative study therefore aimed to explore and describe the experiences of women regarding the nursing management they received after being diagnosed with GDM; and the perceptions of nurse-midwives on their nursing management of GDM in Ghana. SettingThis study was conducted in the military health institutions in Ghana, which includes one hospital and nine satellite clinics referred to as Medical Reception Stations providing antenatal and postnatal care to both military as well as civilian patients. Research on GDM in Ghana is extremely limited. DesignWe used a descriptive phenomenological approach to conduct 15 unstructured individual interviews with women that have been diagnosed with GDM (n = 7) and nurse-midwives (n = 8) providing nursing management of GDM during a six months period (December 2014 to May 2015). Audio-recorded data was transcribed, coded and analyzed using an adapted version of Tesch's eight steps for coding. ParticipantsSeven (n = 7) women between 28 and 45 years of age, with 1 to 3 offspring each, participated. Most women (n = 5) did not have a family history of diabetes. The eight (n = 8) nurse-midwives that participated were between 32 and 50 years old with between 2 and 12 years of experience. FindingsParticipants in this study reported similar issues that could assist in better management of GDM. The majority of participants indicated the need for education on GDM, but both women and nurse-midwives acknowledged that this education is hugely lacking. Participants generally felt that emotional support for women is critical and it was included in the nursing management of GDM. Both groups of participants acknowledged that involving women and their significant others in the nursing management of GDM is important. Cultural and socio-economic issues, such as cultural beliefs that clashed with diabetic diets, lack of financial and social grants and limited nurse-midwifery staff were mentioned by both groups to affect the nursing management of GDM. Key conclusionsThe results demonstrate that, despite the reported challenges experienced by nurse-midwives and women, it was evident that the aim of nurse-midwives was to manage GDM as optimally as possible for women diagnosed with GDM, while considering the constraints established in the results. The challenges identified, specifically in terms of lack of education and cultural and socio-economic issues that affect the quality of and adherence to the nursing management of GDM, need to be addressed in order to optimize care for women diagnosed with GDM in Ghana. Implications for practiceBased on our findings, recommendations are provided that can assist nurse-midwives and other health practitioners to provide comprehensive nursing management to women that have been diagnosed with GDM.

Logistic Regression Model as Classifier for Early Detection of Gestational Diabetes Mellitus

Gestational diabetes mellitus (GDM) is any degree of glucose intolerance during pregnancy. In view of maternal morbidity and mortality as well as fetal complications, early diagnosis is an utmost necessity one in the present scenario. In a developing country like India, early detection and prevention will be more cost effective. Oral glucose tolerance test (OGTT) is the crucial method for diagnosing GDM done usually between 24th and 28th week of pregnancy. The proposed work focuses on early detection of GDM without a visit to the hospital for women who are pregnant for the second time onwards (multigravida patients). In recent years, prediction models using multivariate logistic regression analysis have been developed in many areas of healthcare research. With an accuracy of 82.45%, the classifier has proved to be an efficient model for diagnosis of GDM without the conventional method of blood test by providing newly designed parameters as inputs to the model.

Logistic regression model as classifier for early detection of gestational diabetes mellitus

Gestational diabetes mellitus (GDM) is any degree of glucose intolerance during pregnancy. In view of maternal morbidity and mortality as well as fetal complications, early diagnosis is an utmost necessity one in the present scenario. In a developing country like India, early detection and prevention will be more cost effective. Oral glucose tolerance test (OGTT) is the crucial method for diagnosing GDM done usually between 24th and 28th week of pregnancy. The proposed work focuses on early detection of GDM without a visit to the hospital for women who are pregnant for the second time onwards (multigravida patients). In recent years, prediction models using multivariate logistic regression analysis have been developed in many areas of healthcare research. With an accuracy of 82.45%, the classifier has proved to be an efficient model for diagnosis of GDM without the conventional method of blood test by providing newly designed parameters as inputs to the model.

Prevalence of Gestational Diabetes, Risk Factors and its Outcome in a Tertiary Hospital

Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. GDM increases the risk of adverse maternal and perinatal outcome and increases risk of diabetes in mother and child in the future. Prevalence of GDM is increasing all over the world. This is hospital based cross sectional study done in Department of Obstetrics and Gynecology, Nepal Medical College and Teaching Hospital to find out the prevalence of GDM and to trace maternal and fetal risk factors and adverse outcome. In this study, 600 pregnant women were enrolled during 2016-17. Among them 27 (4.5%) were found to have GDM. Among GDM, four (14.4%) were ≥ 35 years old and six (22.2%) had BMI of ≥ 25 kg/m2. Caesarean section was more common mode of delivery in women with GDM than without (51.9% vs 22.2%). Increased prevalence shown in this study necessitates universal screening of GDM.

Association Between Serum Adipsin Levels and Insulin Resistance in Subjects With Various Degrees of Glucose Intolerance.

ContextThe association between adipsin and glucose metabolism in human subjects remains unclear.ObjectiveWe investigated the associations between adipsin and insulin resistance/β-cell function in subjects with various degrees of glucose intolerance.DesignFasting blood samples were collected for measurements of fasting plasma glucose (FPG), insulin, and adipsin. An oral glucose tolerance test was conducted in subjects with no history of diabetes.SettingThis study was conducted at a medical center.PatientsWe enrolled 240 subjects with no history of diabetes and 80 patients with known type 2 diabetes (T2D) on diet control or metformin monotherapy.Main Outcome Measure β-cell function and insulin resistance were assessed using the homeostasis model assessment (HOMA-β and HOMA-IR, respectively).ResultsLevels of serum adipsin were higher in subjects with normal glucose tolerance (4.0 ± 1.1 µg/mL) or prediabetes (4.0 ± 1.5 µg/mL) compared with subjects with newly diagnosed diabetes (3.8 ± 1.1 µg/mL) or with known T2D on diet control (3.4 ± 1.0 µg/mL) or metformin monotherapy (3.0 ± 1.0 µg/mL, P < 0.001). There was no significant association between adipsin and HOMA-β. In contrast, there was an independent negative association between adipsin and HOMA-IR (β coefficient −0.414, 95% CI −0.720 to −0.109, P = 0.008). The association was more prominent in subjects with a body mass index (BMI) ≥25 kg/m2 or an FPG ≥100 mg/dL (P interaction < 0.001 and 0.014, respectively).ConclusionsSerum adipsin levels were negatively associated with insulin resistance, especially in subjects with a BMI ≥25 kg/m2 or an FPG ≥100 mg/dL.

Comparative Analysis of Gestational Diabetes using Data Mining Techniques

Data mining is process of extracting hidden knowledge from large volumes of raw data. Data mining is used to discover knowledge out of data and presenting it in a form that is easily understand to humans Disease Prediction plays an important role in data mining. Medical data mining has great potential for exploring the hidden patterns in the data sets of the medical domain. Data Mining is used intensively in the field of medicine to predict Gestational diabetics which is affected the pregnant women. Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. This paper analyzes the Gestational diabetics predictions using different classification algorithms. Medicinal data mining has high potential for exploring the unknown patterns in the data sets of medical domain. These patterns can be used for medical analysis in raw medical data using decision table, Multi-layer perceptron and Naives Bayes algorithm and number of experiment has been conducted in WEKA tool to compare the performance of predictive data mining technique on the same dataset and the outcome reveals that Naives Bayes algorithm outperforms than other predictive methods such as Decision table, Multi-layer perceptron.

Anti-islet Cell Antibodies in a Sample of Egyptian Females with Gestational Diabetes and its Relation to Development of Type 1 Diabetes Mellitus.

Gestational diabetes mellitus is any degree of glucose intolerance with first diagnosis during pregnancy; it affects 3-10% of pregnancies. The presence of diabetes-related autoantibodies has shown to be able to predict the development of type 1 diabetes before hyperglycemia arises. To recognize the prevalence of islet cell antibodies among a sample of Egyptian females with gestational diabetes and its possible relation to development of Type 1 diabetes within one year postpartum. Our cross sectional study was conducted on 150 Egyptian pregnant females with gestational diabetes aged 19-39 years diagnosed by 75-g 2-hour oral glucose tolerance test. All females were subjected to full history, thorough clinical examination and laboratory measurement of anti-islet cell antibodies. Those females with positive antibodies were followed up six months and one year after delivery for their fasting insulin, fasting blood glucose and two hours post prandial glucose levels. The prevalence of pregnant females with gestational diabetes having positive anti islet cell antibodies was (44%), the prevalence of females diagnosed to have diabetes mellitus was (37.88%) six months and (51.52%) one year postpartum. The high prevalence of ICAs among pregnant Egyptian females with GDM and the risk of developing type 1diabetes later in life makes screening for ICA among women with GDM important to recognize those at risk of developing type 1 diabetes later in life.

Evaluation of the diabetes in pregnancy study group of India criteria and Carpenter-Coustan criteria in the diagnosis of gestational diabetes mellitus.

Objective:Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance that is diagnosed for the first time during pregnancy. This prospective study was undertaken to validate the single-step non-fasting 75 gm Diabetes in Pregnancy Study Group of India (DIPSI) criteria of GDM in Indian patients in comparison with the two-step fasting 100 gm glucose challenge through the Carpenter Coustan criteria (CCC).Materials and Methods:Two hundred patients underwent comparative testing using the DIPSI criteria and CCC. Plasma venous blood glucose levels were estimated using the hexokinase method; values ≥140 mg/dL at 2 hours were considered positive according to the DIPSI criteria. Any two values from ≥95 mg/dL for fasting, ≥180 mg/dL at 1 hour, ≥155 mg/dL at 2 hours, and ≥140 mg/dL at 3 hours were considered positive with the CCC.Results:The mean age and body mass index were 24.26±3.75 years and 20.7±3.07 kg/m2. The sensitivity, specificity, and positive and negative predictive values of the DIPSI guidelines were found as 100%, 97.14%, 83.87%, and 100%, respectively. The positive and negative likelihood ratios were 35.8 and zero. Diagnostic accuracy was found as 97.56%.Conclusion:DIPSI having high sensitivity, specificity, negative predictive value and diagnostic accuracy. DIPSI offers simplicity, feasibility, convenience, and repeatability while economizing universal screening and diagnosis of GDM on a mass-scale. The DIPSI procedure has the potential to be applied to the entire obstetric population, in the implementation of public health programs to diagnose GDM in the community, thus reaching the needs of the developing world.

Do probiotics effectively ameliorate glycemic control during gestational diabetes? A systematic review.

Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. The aim of this work was to systematically review all studies in which probiotic supplements were used during pregnancy and analyse the effects on GDM. The data were collected using the medical subheading (MeSH) terms: ("diabetes, gestational"[MeSH Terms] OR ("diabetes"[All Fields] AND "gestational"[All Fields]) OR "gestational diabetes"[All Fields] OR ("gestational"[All Fields] AND "diabetes"[All Fields])) AND ("probiotics"[MeSH Terms] OR "probiotics"[All Fields]). The search included original articles written in English/Portuguese and published between 2012 and 2017. Of the 31 articles identified, seven met the inclusion criteria and were included in this review. In these studies, the sample size ranged from 60 to 373 women with GDM, which was between 24 and 40weeks of pregnancy (second and third trimesters). Results demonstrated that probiotics used during pregnancy in women with GDM may improve glycaemic control and reduce VDL cholesterol, triglycerides, and inflammatory markers. The present systematic review highlights the importance of probiotics for glycemic control and decrease of inflammatory markers in GDM. Further long-term studies should be conducted to elucidate this interaction.

The role of new adipokines in gestational diabetes mellitus pathogenesis.

Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition dur-ing pregnancy. Explanation of the GDM pathogenesis is important due to preventing gestational complications. During pregnancy there are significant changes in maternal metabolism. Many of these changes are influenced by different adi-pokines produced in the placenta and adipose tissue. The exact role of adipokines in the pathogenesis of GDM remains still unknown. Several adipokines have been analysed throughout gestation and their levels have been suggested as biomarkers of maternal-perinatal outcomes. Some of them have been postulated as significant in the pathogenesis of pregnancy complications like GDM. This report aims to review some of the recent topics of adipokine research that may be of particular importance in patho-physiology and diagnosis of gestational diabetes mellitus. Because of manuscript length limitations, after thorough literature review and in view of the recent evidence, we focus on the one of the most well-known adipokine: adiponectin, and not so well-studied: nesfatin-1, chemerin, ghrelin, and CTRP 1.