Diabetes Mellitus Mothers Research Articles

Epidemiology of Gestational Diabetes Mellitus: Newer Evidence to curtail

Gestational diabetes mellitus (GDM) is a state metabolic disorder caused by carbohydrate intolerance during pregnancy for the first time. This disease is very important as it affects the mother and fetus. It is said that GDM disrupts the pregnancy process and causes many diseases, such as recurrent miscarriage, congenital anomalies, preeclampsia, stillbirth, macrosomia, preterm birth, and emergency delivery after pregnancy, pregnancy, and delivery. It also causes long-term complications by inducing type 2 diabetes mellitus in mothers and children. GDM is generally considered a lifestyle disorder, and therefore, its burden varies by race, geographic boundaries, genetics, and reproductive risk. Consequently, it is necessary to investigate the prevalence and risk of GDM to evaluate prevention strategies. Ist Trimester early management of Dysglycemia with Medical Nutrition Treatment (MNT) and Metformin is promising. It might be advocated in the future for curtailing the epidemic of GDM and Type 2 Diabetes. Recently, the TOBOGM study and our ongoing trial with early dysglycemia in 8-10 weeks of gestation resulted in better maternal-fetal outcomes and reduced GDM conversion during pregnancy. This publication is important as the final results of our trial will be published soon

Vitamin D Combined with Exercise During Pregnancy Promotes Neonatal Health in Gestational Diabetes Mellitus Mothers

Vitamin D Combined with Exercise During Pregnancy Promotes Neonatal Health in Gestational Diabetes Mellitus Mothers

Clinical profile and risk factors of symptomatic and asymptomatic hypoglycemia in neonates admitted to NICU in a tertiary care center: A cross-sectional study

Objective: To investigate the clinical profile and risk factors of symptomatic and asymptomatic hypoglycemia in neonates admitted to a neonatal intensive care unit in a tertiary care center. Methods: The prospective observational study was conducted in a tertiary care center in the Specialty Department of Pediatric. 196 Newborn babies with blood glucose levels < 45 mg/dL were examined with a simple random sampling method between December 2019 and November 2021. Maternal and neonatal risk factors and clinical signs were recorded and compared between symptomatic and asymptomatic cases. Results: The proportion of symptomatic hypoglycemia neonates bom to gestational diabetes mellitus mothers was significantly higher (23.4% vs. 8.4%)(P<0.05). Small for gestational age, low birth weight, respiratory distress syndrome, hypothermia, and endocrine disorders were risk factors. The death rate in asymptomatic hypoglycemia neonates was significantly higher (58% vs. 39%) (P<0.05). Conclusions: The study indicates that maternal gestational diabetes mellitus is associated with symptomatic hypoglycemia and asymptomatic hypoglycemia is associated with neonatal mortality. It is important to take vigilance and timely interventions to address associated symptoms, particularly poor feeding, in the management of neonatal hypoglycemia.

Systematic review and bibliometric analysis of the metabolome found in human breast milk from healthy and gestational diabetes mellitus mothers

Systematic review and bibliometric analysis of the metabolome found in human breast milk from healthy and gestational diabetes mellitus mothers

Echocardiographic findings in infants of diabetic mothers and their relation to maternal glycemic control

Background Diabetes mellitus during pregnancy is a common risk factor for both mothers and infants. Prediction of cardiac problems in infants of diabetic mothers is challenging. Aim The purpose of the study is to determine the type and incidence of congenital heart diseases in infants whose mothers are diabetic in the NICU of Alexandria university maternity hospital, as well as to evaluate functional and morphological changes in the myocardium and its relationship to maternal glycemic control. Patients and methods A case-control study was conducted in the NICU of Alexandria University Hospital. Thirty-five infants of diabetic mothers (IDM) were compared to 37 healthy control infants. All diabetic mothers had their HBA1C levels measured before delivery. Therefore, the infants of diabetic mothers were further divided into 22 infants whose mothers had controlled diabetes (controlled DMM group; controlled diabetes mellitus mothers group) during pregnancy (predelivery HBA1C≤6.5) and 13 infants whose mothers had uncontrolled diabetes during pregnancy (uncontrolled DMM group). All studied infants were scanned for the presence of congenital heart diseases. Right and left ventricular systolic functions were assessed, and septal and left ventricular dimensions were measured using functional echocardiography (FE). Followup scans were done 1–2 months later. This work was registered on clinical trial.gov NCT05050058 Results Incidence of congenital heart diseases is significantly increased in infants of diabetic mothers compared to healthy control group with P value =0.008. Intraventricular septal thickness and left ventricular posterior wall during systole and diastole (IVSs, IVSd, LVPWs, LVPWd and IVSd/ LVPWd ratio) significantly increased in IDM group. Patients whose mothers had uncontrolled diabetes had their IVSd and IVSd/ LVPWd ratio markedly increased over the uncontrolled group. After 45–60 days the septal and posterior wall measures during systole and diastole decreased significantly. Tricuspid regurge (TR) gradient is markedly increased in IDM in the first 24 h after birth, specifically in infants with mothers with poor glycemic control during pregnancy. Conclusion Infants of diabetic mothers were significantly more likely to suffer from ASD, VSD, and complex heart disease. Complex heart diseases were significantly associated with pregestational maternal diabetes. Infants of diabetic mothers with poor glycemic control have affected IVSd and IVSd/LVPWd ratios. Ventricular septal and LVPW measures were markedly improved after 45–60 days of age .Neither the presence of maternal diabetes nor the diabetic control of mothers affected the right and left ventricular functions of their infants.

Comparison of Congenital Heart Disease between Neonates Born to Diabetic and Non-diabetic Mothers

Background: Congenital heart disease (CHD) contributes about one-third of all major congenital anomalies in the world among the neonates, most common in infants of diabetic mothers but incidence is increasing all over the world due to establishing cardiac investigation facilities especially neonatal echocardiogram. Materials & Methods: A hospital-based cross-sectional study was done in two private hospitals in Dhaka from July ’19 to June ’20. A total of 90 neonates were included from nursery and neonatal intensive care units of both hospitals who were requested for echocardiography as suspected CHD. Results: In our study 52% mothers had diabetes mellitus (DM) during this conception and remains were normoglycemic. CHD present in 41.11% non-DM & DM mother’s offspring, there was no significant statistical difference among the groups (p=0.535). Gestational age and maternal coexisting diseases caused little impact on CHD in neonates (p <0.1). Regarding neonatal conditions only respiratory distress was significantly associated with CHD at p<0.05 level. Conclusions: Researcher according to our study diabetes mellitus does not contribute to CHD in neonates. Researcher can focus on other maternal comorbidities and other factors like respiratory distress and cyanosis after birth, which may contribute to CHD in neonates. J Bangladesh Coll Phys Surg 2023; 41: 27-32

Effect of experimental diabetes mellitus of the mother on the morphological characteristics of spermatogenesis of the offspring

AIM: The work aimed to analyze the morphological and functional state of seminiferous epithelium in the offspring of female rats with experimental diabetes mellitus (DM).
 MATERIALS AND METHODS: Studies were conducted on white Wistar laboratory rats (females) with diabetes mellitus induced and their 70-day-old offspring. Diabetes mellitus was reproduced according to the generally accepted method using streptozotocin. The areas of parenchyma and stroma, the number and area of convoluted seminiferous tubules, the total count of spermatogenous cells and their subpopulation composition, and the count of Sertoli cells per one convoluted seminiferous tubule were determined on serial histological specimens of the testes of offspring of the DM mothers. A number of generally accepted indices were determined, including the spermatogenesis index, spermatogenesis relaxation index, and germinative index.
 RESULTS: The offspring of female rats with experimental DM has been established to have a decreased area of the testicular parenchyma and an increase of the area of its stroma, as well as a reduced total count of spermatogenic cells, including primitive sperm cells, primary and secondary spermatocytes, spermatids and, as a result, a decrease in the count of spermatozoa. The results are consistent with a decrease in the spermatogenesis index in the offspring of female rats with experimental DM. A study of the count of Sertoli cells in experimental animals did not reveal significant differences, however, an analysis of the germinative index and the spermatogenesis relaxation index revealed a significant decrease in these parameters in experimental animals compared to the control.
 CONCLUSIONS: Offspring with reduced generative function of the testes is born in female rats with experimental type 1 DM.

Prevalence and Associated Factors of Prediabetes in Postpartum Gestational Diabetes Mellitus Mothers in the East Coast of Malaysia

Introduction: Majority of gestational diabetes mellitus (GDM) mothers resume normal glycaemic state after delivery. However, this hyperglycaemic condition may persist in some women. Postpartum GDM mothers have a higher risk of progression to diabetes and prediabetes than those with normal pregnancy. This study was aimed to determine the prevalence of prediabetes among postpartum GDM mothers and its associated factors during six weeks of postpartum glucose testing. Materials and method: A cross-sectional secondary data review was conducted from January 2021 until May 2021 among postpartum mothers with history of GDM who performed postpartum glucose testing in all government health clinics in Besut, Terengganu from January 2018 until December 2019. A descriptive and multiple logistic regression analysis were performed using IBM SPSS Statistics version 26 software. Result: A total of 429 cases were included. Prevalence of diabetes and prediabetes was 2.3% (95% CI 1.6%, 3.0%) and 13.8% (95% CI 12.1%, 15.5%), respectively. There was significant associations found between previous history of GDM (Adj. OR 3.28; 95% CI 1.83, 5.87; p < 0.001) and insulin usage (Adj. OR 2.75; 95% CI 1.51, 4.99; p= 0.001) with development of prediabetes at postpartum period. Conclusion: The prevalence of diabetes and prediabetes among postpartum GDM mothers in Besut district was as high as other studies in Malaysia and globally. Women with a previous history of GDM and insulin usage should be focused on prevention strategies as they were at higher risk of developing prediabetes in the postpartum period.

Change of cortisol level in umbilical cord blood of neonates delivered by gestational diabetes mellitus mothers and its influence on offspring health

Change of cortisol level in umbilical cord blood of neonates delivered by gestational diabetes mellitus mothers and its influence on offspring health

An Analytical Study of Short-Term Morbidities in Large for Gestational Age Infants- A Single Centre Experience from South India

Introduction: Globally, Large for Gestational Age (LGA) infants constitute a significant proportion of live births, with Gestational Diabetes Mellitus (GDM) being a primary contributor. Infants born to GDM mothers are more prone for morbidity and mortality and if born large, the incidence of morbidities could increase. The clinico-demographical profile of LGA infants has not been well analysed, especially in Lower Middle Income Countries (LMIC) like India, where gestational diabetes is very common. Aim: To analyse the incidence, demographic profile and short-term neonatal outcomes of LGA births, stratified for GDM. Materials and Methods: This was an analytical retrospective cohort study conducted in a tertiary care hospital in South India. Medical records of LGA infants ≥35 weeks born between December 2018 and May 2020 were reviewed (in December 2020 and January 2021), after Institutional Human Ethics committee approval (No:296/IHEC/JAN 2021). The LGA infants were grouped as GDM induced large infants born to gestational and pregestational diabetes mellitus mothers (LIDM) and large infants born to non-gestational diabetes mellitus mothers (LnIDM). Case records with incomplete data were excluded. Demographic profile of the two groups at birth and their clinical morbidities during hospitalisation were recorded. The primary outcome was requirement of respiratory support in the two groups. The categorical outcomes were compared using Chi-square test/Fisher's exact test, while numerical variables were compared using Mann-Whitney U test. Odds ratio and their 95% Confidence Intervals (CI) were obtained as appropriate. Multivariate logistic regression, controlling for potential confounders, was done to derive the adjusted odds ratio. The p-value <0.05 was taken as significant. All analysis was performed using Statistical Package for the Social Sciences (SPSS) software version 22.0. Results: Out of 2653 live births, 268 were LGA infants ≥35 weeks (9.72%). LIDM were 126 (48.8%) and LnIDM were 132 (51.2%). Ten case records were excluded due to incomplete data hence, 258 infants were included in the final analysis. The median (Interquartile range) birth weight was significantly higher in the LIDM’s {3.92(3.86, 4.08) kg} compared to LnIDM’s {3.89(3.75, 3.96) kg}. The primary outcome of need for respiratory support was not significantly different between the two groups (aOR 1.62; 95% CI 0.92 -2.83; p-value=0.08). Multivariate logistic regression, controlling for confounders, showed higher neonatal intensive care admission rates (aOR 2.15; 95% CI 1.17-4, p=0.01), neonatal hyperbilirubinemia (aOR 1.70; 95% CI: 1.01-2.84, p=0.04) and Persistent Pulmonary Hypertension (PPHN) (aOR 4.43; 95% CI: 1.41-13.82, p=0.004) in the LIDM infants. Conclusion: GDM contributes significantly to LGA births in India, and is associated with higher NICU admissions, neonatal hyperbilirubinemia and PPHN, compared to non-GDM causes.

Gestational diabetes mellitus increased the risk of adverse neonatal outcomes: A prospective cohort study in Northwest Ethiopia

BackgroundGestational diabetes mellitus is a rising global public health problem that can have short- and long-term sequelae for both mother and offspring. However, there are limited evidences on the effect of gestational diabetes mellitus on adverse neonatal outcomes using the updated international diagnostic criteria on adverse effects on neonatal outcomes. Therefore, this study was aimed to examine the effects of gestational diabetes mellitus on the risk of adverse neonatal outcomes in Ethiopia. MethodsA prospective cohort study was conducted among pregnant women recruited from antenatal clinics and followed through pregnancy to delivery. Gestational diabetes mellitus was diagnosed using a two-hour 75g oral glucose tolerance test strategy with recent criteria. Multivariable log-binomial model was used to identify the effects of gestational diabetes mellitus on the risk of adverse neonatal outcomes which includes macrosomia, low birth weight, large for gestational age, small for gestational age, preterm birth, low Apgar score at the first minute, low Apgar score at fifth minute, and composite adverse neonatal outcome. ResultsAmong pregnant women (n=1027) included in the follow up data on neonatal outcomes were available for 684 (118 newborns of mothers with gestational diabetes mellitus and 566 newborns of women without gestational diabetes mellitus). There was a statistical baseline difference between the two groups by maternal age, dietary diversity status, level of physical activity, and antenatal depression. The incidence of composite adverse neonatal outcome was significantly higher (P<0.001) among newborns from mothers with gestational diabetes mellitus (51.7%) than among newborns from mothers without gestational diabetes mellitus (25.8%). Significantly higher risk of developing adverse neonatal outcomes among newborns from gestational diabetes mellitus mothers was observed for composite adverse neonatal outcome (Adjust Relative Risk (ARR)=1.72; 95% CI: 1.35, 2.19), macrosomia (ARR= 3.81; 95% CI: 1.95, 7.45), large for gestational age (ARR= 2.38; 95% CI: 1.41, 4.03), preterm birth (ARR= 2.03; 95% CI: 1.17, 3.53), low Apgar score at the first minute (ARR= 1.71; 95% CI: 1.02, 2.86), and fifth minute (ARR= 2.14; 95% CI: 1.05, 4.36). However, no significant differences in the risk of low birth weight and small for gestational age by gestational diabetes mellitus status. ConclusionsGestational diabetes mellitus increases the risk of adverse neonatal outcomes particularly macrosomia, large for gestational age, preterm birth, and poor Apgar score. Hence, the role of preventing gestational diabetes mellitus is quite crucial to improve neonatal outcomes.

Characterizing the Effects of Diabetes and Obesity on Insulin and Leptin Levels amongst Pregnant Women.

In this study, we assess the impact of obesity and diabetes on maternal brain and periphery, as well as fetal exposure to insulin and leptin, and two hormones that play an important role in regulating energy homeostasis. Fasting maternal plasma, fetal cord vein and artery plasma, and maternal cerebrospinal fluid (CSF) were collected in 37 women (12 lean, nondiabetic [prepregnancy body mass index (BMI): 22.9 ± 1.7 kg/m2]; 12 overweight/obese nondiabetic [BMI: 37.8 ± 7.3 kg/m2]; 13 gestational/type 2 diabetes mellitus [BMI: 29.8 ± 7.3 kg/m2]) with uncomplicated singleton pregnancies undergoing elective Cesarean delivery. HbA1C, insulin, glucose, and leptin levels were measured. Compared with lean mothers, mothers with obesity and diabetes mellitus (DM) had significantly lower CSF-to-plasma ratios of insulin. Moreover, mothers with obesity and DM had significantly lower cord arterial and cord venous to maternal plasma ratios of insulin, but not leptin, compared with lean mothers. There were no differences in CSF and cord blood insulin and leptin levels between obese and DM mothers. Compared with lean individuals, mothers with obesity and DM have relative deficiencies in insulin exposure. The patterns observed in mothers with obesity and diabetes were similar highlighting the importance of the maternal metabolic environment in obesity and suggesting obese patients warrant further clinical focus.

Local Preserving Class Separation Framework to Identify Gestational Diabetes Mellitus Mother Using Ultrasound Fetal Cardiac Image

In the presence of gestational diabetes mellitus (GDM), the fetus is exposed to a hyperinsulinemia environment. This environment can cause a wide range of metabolic and fetal cardiac structural alterations. Fetal myocardial hypertrophy predominantly affecting the interventricular septum possesses a morphology of disarray similar to hypertrophic cardiomyopathy, and may be present in some GDM neonates after birth. Myocardial thickness may increase in GDM fetuses independent of glycemic control status and fetal weight. Fetal echocardiography performed on fetuses with GDM helps in assessing cardiac structure and function, and to diagnose myocardial hypertrophy. There are few studies in the literature which have established evidence for morphologic variation associated with cardiac hypertrophy among fetuses of GDM mothers. In this study, fetal ultrasound images of normal, pregestational diabetes mellitus (preGDM) and GDM mothers were used to develop a computer aided diagnostic (CAD) tool. We proposed a new method called local preserving class separation (LPCS) framework to preserve the geometrical configuration of normal and preGDM/GDM subjects. The generated shearlet based texture features under LPCS framework showed promising results compared with deep learning algorithms. The proposed method achieved a maximum accuracy of 98.15% using a support vector machine (SVM) classifier. Hence, this paradigm can be helpful to physicians in detecting fetal myocardial hypertrophy in preGDM/GDM mothers.

Serum concentration of angiogenic (CXCL1, CXCL12) and angiostasis (CXCL9, CXCL10) CXC chemokines are differentially altered in normal and gestational diabetes mellitus associated pregnancies.

The present study was aimed and designed to determine the serum levels of CXCL1 and CXCL12 as angiogenesis along with CXCL9 and CXCL10 as angiostasis, chemokines in, Gestational diabetes mellitus mothers (GDMM) and normal pregnancy mothers (NPM) and neonates who delivered by them. We have recruited 63 pregnant GDMM and 63 normal pregnant mothers at the third trimester of pregnancy to this cross-sectional study. Cord blood specimens were obtained from neonates who were delivered from GDMM and NPM. The serum and cord blood levels of chemokines were measured by ELISA in studied groups. Data were analyzed by chi-square and student's t test between two groups. The P-values less than 0.05 were considered significant. Our results revealed that the serum levels of CXCL1, CXCL9 and CXCL12 were increased in GDMM, while no alteration was found in the serum levels of CXCL10 when compared to NPM. We have observed that in neonates the serum levels of angiogeneic chemokines followed an inverse fashion when compared to angiostasis chemokines. Interestingly, CXCL1 and CXCL12 were both increased in neonates who were delivered by GDMM, while, CXCL9 and CXCL10 were decreased in neonates delivered by GDMM.

Gestational diabetes mellitus in mothers and long term cardiovascular disease in both parents: Results of over a decade follow-up of the Iranian population

Background and aimsWe aimed at evaluating whether the presence of gestational diabetes mellitus (GDM) in mothers is associated with increased risk of incident cardiovascular disease (CVD) in both mothers and fathers. MethodsIn this population-based study, 4308 Iranian women, aged 18–64 years, with at least 1 live-birth delivery, and free of CVD at baseline, were followed. Corresponding spouses were identified in 2547 cases. The association between history of GDM and incident CVD was assessed using multivariate Cox's proportional hazard in 3 models: model 1, unadjusted; model 2, adjusted for age, body mass index, smoking (for men), maternal parity, miscarriage, physical activity, hypertension and hypercholesterolemia, and model 3, further adjusted for diabetes mellitus. ResultsAfter a median follow-up of 14.1 years, 314 mothers and 424 fathers experienced CVD. Women with history of GDM had an adjusted hazard ratio (HR), 95% CI of 1.85 (1.38–2.48) and 1.29 (0.96–1.75) for CVD in models 1 and 2, respectively. Furthermore, an independent association with CVD was observed in fathers with an adjusted HR of 1.35 (1.02–1.79) in the confounder adjusted model and even after further controlling for diabetes [1.36 (1.03–1.80)]. Moreover, all traditional risk factors, excluding BMI, showed an independent risk for CVD in both genders. ConclusionsWomen with prior GDM showed an increased risk of CVD that was not independent of important CVD risk factors. However, among men, spousal history of GDM was an independent risk factor for incident CVD, even after considering important traditional risk factors, including diabetes.

Importance of vitamin D supplementation in pregnancy-review

Pregnancy is a state that leads to several deficiency and increased demand of essential nutrients for the growing foetus. In one such case it is seen that vitamin D deficiency can lead to severe outcome in the new-born as well as the mother. Vitamin D travels to the foetus by passive transfer and the foetus is entirely dependent on maternal stores. Therefore it becomes all the more essential to know your vitamin D level during antenatal period to prevent adverse outcomes. Vitamin D supplementation helps in preventing the outcomes like rickets, low birth weight, bone and dental deformity in foetus, decreased immunity and impaired lung function in children, whereas also helping in decreased incidence of primary caesarean sections, preeclampsia, gestational diabetes mellitus in mother. The recommended dose has been described up to 2000IU/day as a supplementation and not therapeutic dose, which is found to be safe and effective.

THE Drug utilization pattern of gestational diabetes mellitus in pregnant women and complication of gestational diabetes mellitus in mother and newborn in a secondary care hospital: A retrospective study

The present study was a retrospective study, carried out by total of 100 cases in the Obstetric And Gynaecology department of a secondary care hospital, Tiruppur, Tamil Nadu. There were 100 pregnant women who had gestational diabetes. Increasing gravida (secondary gravida G2 -44% ) shows more prevalence of GDM than primi (34%).Body Mass Index , family history of diabetes and previous history of GDM shows more significance in occurring GDM. Among 100 population, 45% patients receiving insulin with medical nutritional therapy (MNT) ,30% patients receiving medical nutritional therapy (MNT) alone , 11% patients receiving medical nutritional therapy (MNT) with metformin, 3% patients receiving medical nutritional therapy (MNT) with Oral Hypoglycaemic Agents (OHA) and insulin , 3% patients receiving insulin alone and 8% patients didn’t receiving any therapy. Overall 96% of women with GDM had one or more complications and 4% had no complication. From this , 35.89% patients shows caesarean delivery with recurrent GDM, followed by 10.25% patients shows caesarean delivery with polyhydramnios, 15.38% patients shows caesarean delivery with Pregnancy Induced Hypertension (PIH).Overall 74% of new-borns had one or more complications and 27% had no complication. 24.32% patients shows macrosomia with neonatal hypoglycaemia, 16.21% patients shows macrosomia with preterm birth, 13.52% patients shows macrosomia with hyperbilirubinemia. Our study concludes that the complications arise from GDM to both mother and new-borns can be resolved and minimised by proper diagnosis and appropriate treatment during the pregnancy.&#x0D; Keywords: Gestational Diabetes Mellitus, Drug Utilization Pattern, Complications, Oral Glucose Tolerence Test

Fetal sex and risk of developing gestational diabetes mellitus and type 2 diabetes mellitus in mother

Fetal sex and risk of developing gestational diabetes mellitus and type 2 diabetes mellitus in mother

Nutrient intake and perceived psychosocial stress of gestational diabetes mellitus mothers

Nutrient intake and perceived psychosocial stress of gestational diabetes mellitus mothers

Macrosomic Newborn and Glucose Level in Lean Pregnant Diabetes Mellitus Patients at Dr. Soetomo General Hospital Surabaya

Background : Gestational diabetes mellitus, defined as glucose intolerance in variable degree with onset during pregnancy, is a risk factor for the development of fetal macrosomia, a newborn with the birthweight of more than 4000g. The objective of this study was to explore an association between glucose level in lean pregnant diabetes mellitus patients, resulting in babies and the incidence of macrosomia in Dr Soetomo General Hospital in Surabaya. Methods : This was a retroprospective analytic study with a cross sectional design by using medical records at Dr. Soetomo General Hospital Surabaya, collected from January 2016 to December 2017. The correlation between fasting glucose level, 2-hour postprandial glucose and glucose level at the time of birth and weight of newborn was assessed. Results : Controlled and uncontrolled fasting glucose level, 2-hour postprandial glucose level and glucose level at the time of birth of mother were not significantly associated with macrosomia newborns. Macrosomia newborn were born with gestational diabetes mellitus mothers compare with pregestational mellitus mothers. Conclusions : There is no association between macrosomia with glucose level of lean gestational and pregestational diabetes mellitus, however, therapeutic approach such as physical exercise should be implemented to reduce effects of uncontrolled glucose level.