Diabetic Women Research Articles

Impacts of covid-19 on sleep quality and autonomic function in elderly diabetic women.

to analyze the quality of sleep and cardiac autonomic modulation of elderly diabetic women in the post-covid-19 syndrome. 41 elderly women, aged 60-75years, with a diagnosis of Type 2 Diabetes Mellitus and who had covid-19 were included, divided into three groups: 14 in the Diabetes without covid-19 group (DG), 15 in the Diabetes with covid-19 group (CG), 12 in the Diabetes with covid-19 group who had Pulmonary Compromise (IG). Sleep quality was assessed using the Pittsburgh questionnaire, anamnesis, capillary blood glucose, blood pressure collection, anthropometry, resting electrocardiogram for 10min for heart rate variability (HRV) analysis. Data were analyzed by 1-way ANOVA followed by Tukey-Kramer Multiple Comparisons Test, significance for p≤0.05. there was no significant difference in age, blood glucose, blood pressure, and body composition between the groups. In the analysis of sleep quality, there was significance in the following indices: sleep duration, sleep efficiency, sleep disturbances, and daytime sleepiness. Further, there was a reduction in autonomic indices between CG vs. DG: VarRR (ms2), SDNN (ms), SD1 (ms), TINN (ms), HF-log (ms2), LF-log (ms2); and between IG vs. DG: VarRR (ms2), SDNN (ms), RMSSD (ms), SD1 (ms), SD2 (ms), and HF-log (ms2). it is suggestive that diabetic elderly women who had covid-19, with and without pulmonary impairment, have impaired sleep quality and interference on HRV with decreased parasympathetic autonomic modulation.

Relationship Between Genetic Variant Of OXTR (Rs53576) And MTNR1B (Rs1387153) And Symptoms Of Psychological Stress In Females With Gestational Diabetes Mellitus.

To assess the association of oxytocin receptor (rs53576) and melatonin hormone receptor 1B (rs1387153) gene single nucleotide polymorphisms with psychological symptoms in women with gestational diabetes mellitus. The case-control study was conducted from May 1 to June 1, 2022, at the Department of Physiology, University of Karachi, in collaboration with the Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, and the Department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Centre, Karachi. Fifty gestational diabetic pregnant women and ninety healthy pregnant women were recruited. Sanger sequencing was performed to assess the genotypic frequency and polymorphic variation of all subjects. Perceived stress scale and diabetes-related distress scale were used to assess the stress levels. Data was analysed using SPSS 23. Of the 140 subjects, 90 (64.3%) were controls with mean age 24.96±4.35 years, and 50 (35.7%) were cases with mean age 28.78±5.25 (p<0.05). Mean body weight and mean gestational age were not significantly different between the groups (p>0.05). Melatonin hormone receptor 1B rs1387153 frequency was significantly different between the groups (p<0.05). Among the cases, a significant mean difference for regimen distress scores between AA and GG was observed for oxytocin receptor rs53576 (p=0.04). A significant mean difference in sum of PSS, diabetes-related stress, total diabetes- related stress and emotional distress was noted between CC and TT genotypes for melatonin hormone receptor 1B rs1387153 (p=0.001). MTNR1B rs1387153 genotypes were associated with perceived stress, diabetes-related stress, diabetic distress, and emotional burden, while OXTR rs53576 genotypes were associated with regimen distress in GDM women.

The Impact of Interventional Weight Loss on Bone Marrow Adipose Tissue in People Living with Obesity and Its Connection to Bone Metabolism.

This review focuses on providing physicians with insights into the complex relationship between bone marrow adipose tissue (BMAT) and bone health, in the context of weight loss through caloric restriction or metabolic and bariatric surgery (MBS), in people living with obesity (PwO). We summarize the complex relationship between BMAT and bone health, provide an overview of noninvasive imaging techniques to quantify human BMAT, and discuss clinical studies measuring BMAT in PwO before and after weight loss. The relationship between BMAT and bone is subject to variations based on factors such as age, sex, menopausal status, skeletal sites, nutritional status, and metabolic conditions. The Bone Marrow Adiposity Society (BMAS) recommends standardizing imaging protocols to increase comparability across studies and sites, they have identified both water-fat imaging (WFI) and spectroscopy (1H-MRS) as accepted standards for in vivo quantification of BMAT. Clinical studies measuring BMAT in PwO are limited and have shown contradictory results. However, BMAT tends to be higher in patients with the highest visceral adiposity, and inverse associations between BMAT and bone mineral density (BMD) have been consistently found in PwO. Furthermore, BMAT levels tend to decrease after caloric restriction-induced weight loss. Although weight loss was associated with overall fat loss, a reduction in BMAT did not always follow the changes in fat volume in other tissues. The effects of MBS on BMAT are not consistent among the studies, which is at least partly related to the differences in the study population, skeletal site, and duration of the follow-up. Overall, gastric bypass appears to decrease BMAT, particularly in patients with diabetes and postmenopausal women, whereas sleeve gastrectomy appears to increase BMAT. More research is necessary to evaluate changes in BMAT and its connection to bone metabolism, either in PwO or in cases of weight loss through caloric restriction or MBS, to better understand the role of BMAT in this context and determine the local or systemic factors involved.

Investigating the risk benefit balance of dairy consumption in the Danish population

Abstract Background Sustainability and health concerns are driving dietary shifts globally, including changes in consumption of dairy products. Dairy provides essential micronutrients e.g., calcium, iodine, and B12 vitamin, and are a source of high-quality protein. They have also been associated with increased risk of diseases. We estimated the health risk-benefit balance of changes in dairy consumption in the Danish population, formulated as three possible consumption scenarios. Methods We applied a risk-benefit assessment approach to compare the health impact of current consumption with the impact of three alternative scenarios (AS) of dairy consumption. We accounted for beneficial and adverse health impacts associated with dairy and micronutrients and estimated disability adjusted life years (DALY) caused or prevented by the theoretical changes in consumption. Data were collected from the Danish food consumption survey, literature and the Global Burden of Disease Study. Results Results showed that a decrease in consumption of dairy in the overall population from current intake to 270 g/day (AS1) would lead to a loss of 4,865 healthy years annually (3,434; 6,344). The health outcomes contributing more were intellectual disability (men) and type 2 diabetes (women). Negative impacts were larger in men than women. Decreasing consumption would also lead to a higher proportion of women below recommended intake of iodine and of children of calcium. In contrast, increasing consumption to 500g/day (AS2) or to estimated optimal consumption for each health outcome (AS3) would lead to a health benefit (3,853 and 11,354 DALYs averted, respectively). We will present results of scenario analyses and discuss impact of assumptions. Conclusions Our estimates emphasize the need to quantify impacts of dietary changes, including health risks and benefits. They will be useful to inform public health policies that consider both sustainability and health impacts of dietary transitions. Key messages • We estimate that the Danish population will loose approximately 5000 healthy life years annually if dairy intake is decreased from the current level. • We argue that our assessment provide quantitative evidence of the trade-offs of shifts in dairy product intake.

B-cell-activating factor (BAFF) and platelet-activating factor (PAF) in pregnancies complicated by maternal obesity and diabetes: a preliminary study

Objective In pregnancies complicated by maternal obesity and diabetes, a disruption in inflammatory mediators occurs, resulting in endothelial microvascular dysfunction, oxidative stress, tissue damage, and maternal and feto-neonatal complications. To outline this proinflammatory status, an innovative approach is represented by the measurement of proinflammatory cytokines. Among these biomarkers, B-cell-activating factor (BAFF) and platelet-activating factor (PAF) play a key role in metabolic regulation, immune response to infections, tissue homeostasis, and “food-related inflammation.” The aim of the present study is to investigate the blood expression of BAFF and PAF in a cohort of pregnant women affected by obesity and diabetes compared with a control group of healthy pregnant women. Methods A prospective longitudinal cohort study has been conducted on pregnant women referred to Fondazione Policlinico Universitario Gemelli IRCCS in Rome. For each pregnant woman, a capillary sample was collected with a swab in three different consecutive evaluations carried out in the three trimesters of pregnancy. Results A total of 77 pregnant women have been enrolled. No significant differences in BAFF and PAF levels were longitudinally observed between groups. Focusing on the exposed group, in the third trimester of pregnancy, both PAF and BAFF levels were lower than the basal time. Among the selected group of patients who developed Gestational Diabetes, only PAF values were longitudinally lower when compared to other groups. The multivariate analysis showed that BAFF levels were positively correlated with thyroid-stimulating hormone levels. No macrosomia, no shoulder dystocia, no major perineal lacerations at birth, and no intrauterine growth restriction were observed in the whole population. Conclusions This study supports the involvement of metabolic and proinflammatory biomarkers in the mechanisms related to pregnancy complications. Improving a good metabolic environment for obese and diabetic pregnant women could break the vicious cycle connecting inflammation, oxidative stress, and metabolic disorders.

Diabetic older women without peripheral neuropathy amplify body sway but are capable of improving postural stability during a saccadic gaze task

BackgroundDiabetic older people tend to present deteriorated performance in balance and locomotion activities, even those without peripheral neuropathy. There is evidence that saccadic eye movements are used to reduce body sway in young and older healthy adults, but it has not been shown that diabetic older people preserve this visuomotor adaptation capacity. Research questionAre diabetic older women without peripheral neuropathy capable of improving postural stability during a saccadic gaze task? MethodsSeventeen type 2 diabetic older women (68.2 ± 10.7 years old) and seventeen healthy women, age-matched controls (66.0 ± 8.4 years old) voluntarily participated in the study. All participants were instructed to stand upright, barefoot, as stable as possible, for 30 s. Participants maintained their feet parallel to each other, at standard and narrow bases of support, while either fixating on a stationary target (fixation condition) or performing horizontal saccadic eye movements to follow a target (eccentricity of 11° of visual angle), which continuously disappeared and reappeared immediately on the opposite side (saccade 0.5 Hz and saccade 1.1 Hz conditions). ResultsResults indicated that the diabetic group clearly had deteriorated postural control, as shown by increased values of mean sway amplitude and mean sway velocity. However, diabetic and control groups were similarly capable of using saccadic eye movements to improve their postural stability, reducing their sway velocity compared to a gaze fixation condition. SignificanceDiabetes per se (without peripheral neuropathy) amplifies postural sway of older women as compared to their healthy age-matched controls. However, diabetic older women without peripheral neuropathy are capable of improving postural stability during a saccadic gaze task.

Glycaemic control in comorbid patients: an important element of CVD progression prevention

There is a clear and specific bidirectional relationship between diabetes mellitus and cardiovascular disease. It is known that cardiovascular disease in patients with diabetes occurs 2–5 times more often than in people without diabetes. CVD itself, and it is cardiovascular outcomes, are the main cause of death in patients with diabetes mellitus, both in men and women. In diabetes mellitus, there is a high risk of coronary heart disease, myocardial infarction, arterial hypertension, and acute cerebrovascular accident, and patients with diabetes may experience painless acute myocardial infarction associated with the presence of autonomic cardiac neuropathy. Much more often in diabetes mellitus there are various rhythm disturbances, including paroxysmal forms of atrial fibrillation, which increase the risk of death by 1.8–2 times. Currently, numerous international clinical studies have convincingly demonstrated that improved glycemic control causes a significant reduction in the risk of late macroand microvascular complications of diabetes mellitus. The concept of dysglycemia includes disorders of glycated hemoglobin (HbA1c), fasting glycemia, postprandial glycemia, hypoglycemia, and glycemic variability. Dysglycemia increases the risk of developing type 2 diabetes mellitus and cardiovascular diseases, and their poor prognosis. HbA1c is the “gold standard” for monitoring glycemic control, but this indicator does not provide complete information about daily and intraday changes in glucose levels. Variability (not level) of fasting glucose determines cardiovascular mortality in patients with type 2 diabetes mellitus. Achieving glucose stability may become an additional therapeutic goal for the management of this category of patients with diabetes mellitus, and low glycemic variability is currently assessed as an additional target. Algorithms of specialized medical care for patients with diabetes mellitus recommend that patients with type 2 diabetes mellitus carry out self-monitoring, depending on the type of treatment taken and the degree of carbohydrate metabolism compensation. An important aspect of the technical impact on the adherence of patients to self-control and treatment of diabetes mellitus is the availability of convenient communication between the patient and the doctor, in particular, the possibility of contact remotely via a computer and mobile phone. In conclusion, the possibilities of a new model of the Contour® glucometer line, the Contour® Plus One glucometer, are considered.

Structural Equation Modeling in Explaining the Effect of Brain Behavioral System on the Psychological Vulnerability of Female Patients with Diabetes: The Mediating Role of Positive and Negative Emotions

Background and Aim: Chronic diseases are the leading cause of death and general disability in 202, accounting for two-thirds of all diseases; therefore, the present research aimed to model structural equations in explaining the effect of the brain-behavioral system on diabetic women's psychological vulnerability with the mediating role of positive and negative emotions. Materials and Methods: This descriptive study was conducted using structural equation modeling. The statistical population of the study included all women with diabetes in the specialized diabetes clinic of Karaj in the first half of 2011. Among this population, 380 cases were selected via purposive sampling and participated in the study. Data were collected using Carver and White's behavioral brain systems questionnaire, mental health questionnaire (SCL-25), and Watson et al.'s (1988) positive and negative emotions questionnaire. Data were analyzed in SPSS (version 23) and Amos (version 18) software packages using Pearson's correlation coefficient and structural equation modeling. Results The results pointed out that the indirect path coefficient between the behavioral inhibition system and psychological vulnerability (P=0.001; β=0.188) was positive, and the indirect path coefficient between the behavioral activation system and psychological vulnerability (0.01&gt;P; β=0.147) was negative and significant. Nonetheless, the coefficient of the indirect path between the behavioral inhibition system and psychological vulnerability through positive affect (P=0.003; β=0.066) was positive, and the indirect coefficient between the behavioral activation system and psychological vulnerability through positive affect (0.001 P=0.070, β=0.070) was negative and significant. However, the coefficient of the indirect path between the behavioral inhibition system and psychological vulnerability through negative emotion (P=0.001; β=0.126) was positive, and the indirect coefficient between the behavioral activation system and psychological vulnerability through negative emotion (0.007 P=0.081, β=0.081) was negative and significant. Conclusion: As evidenced by the obtained results, it can be concluded that among female patients with diabetes, positive and negative emotions positively medicated the effect of the behavioral inhibition system on psychological vulnerability and negatively mediated the effect of the behavioral activation system on psychological vulnerability.

Influence of diabetes mellitus on the pathological profile of aortic stenosis: a sex-based approach

BackgroundDiabetes mellitus (DM) accelerates the progression of aortic stenosis (AS), but how their underlying molecular mechanisms interact is not clear. Moreover, whether DM contributes to clinically relevant sex-differences in AS is unknown. In this work we aim to characterize the sex-specific profile of major pathological mechanisms fundamental to aortic valve (AV) degeneration in AS patients with or without concomitant DM.Methods283 patients with severe AS undergoing surgical valve replacement (27.6% DM, 59.4% men) were recruited. Expression of pathological markers related to AS were thoroughly assessed in AVs and valve interstitial cells (VICs) according to sex and presence of DM. Complementary in vitro experiments in VICs in the presence of high-glucose levels (25 mM) for 24, 48 and 72 h were performed.ResultsOxidative stress and metabolic dysfunction markers were increased in AVs from diabetic AS patients compared to non-diabetic patients in both sexes. However, disbalanced oxidative stress and enhanced inflammation were more predominant in AVs from male AS diabetic patients. Osteogenic markers were exclusively increased in the AVs of diabetic women. Basal characterization of VICs confirmed that oxidative stress, inflammation, calcification, and metabolic alteration profiles were increased in diabetic VICs with sex-specific differences. VICs cultured in hyperglycemic-like conditions triggered inflammatory responses in men, whereas in women rapid and higher production of pro-osteogenic molecules.ConclusionsDM produces sex-specific pathological phenotypes in AV of AS patients. Importantly, women with diabetes are more prone to develop AV calcification. DM should be considered as a risk factor in AS especially in women.

Breastfeeding Efficacy and Longevity in Scotland – Time to Think Outside the Box?

The World Health Organization (WHO) and Baby Friendly Initiative (BFI) recommend that infants are exclusively breastfed until six months of age. While there is a high initiation rate for breastfeeding at hospital discharge, the drop-off rate continues to increase. There have been many studies conducted into reasons behind the decreased longevity and exclusivity of breastfeeding and there is evidence from the literature that there needs to be more intervention antenatally to have a positive influence on infant feeding. Innovative thinking is required in how this can be facilitated and one intervention that requires further research is antenatal hand expressing. Antenatal hand expression of colostrum has been researched in pregnant diabetic women but there is a lack of evidence for non-diabetic pregnant women and the potential role it may have in influencing longevity and exclusivity of breastfeeding.

FRI628 Subnormal Fructosamine Levels In Non Diabetic Pregnant Women

Abstract Disclosure: U.M. Kabadi: None. S. Exley: None. Introduction: American College of Obstetrics and Gynecology (ACOG) and American Diabetes Association (ADA) recommend 2 step testing for diagnosis of Gestational Diabetes (GDM). The process is cumbersome and inconvenient. HbA1c levels are adopted as a screening test in nonpregnant adults but not during pregnancy. Alternatively, serum Fructosamine is not tested for diagnosis of DM in any population. We are in the process of examining utility of serum Fructosamine as a screening test for diagnosis of GDM. However, no data is available regarding Fructosamine concentrations in nondiabetic pregnant women. Therefore, we determined serum Fructosamine levels in pregnant women at 24 to 28 weeks at the time of 1 hour or 3 hour OGTT. Subjects and Methods: Random glucose (mg/dl), Fructosamine ( mcM/l) and HbA1c (%) were determined at 24-30 weeks in 200 pregnant women, age 24-40 years in whom the diagnosis of GDM was eliminated by either normal 1 hour OGTT or by normal 3 hour OGTT in presence of abnormal 1 hour OGTT according to criteria established by ACOG and ADA. 21 age matched nonpregnant women participated as controls. Normal reference ranges for all determinations were established by the local laboratory (Glucose, 60-139; Fructosamine, 200-285; HbA1c, 4.4-5.6). Statistical comparisons between 2 groups were conducted using Student’s ‘t’ test. Results: Fructosamine levels (182 ± 4) were significantly lower (p&amp;lt; 0.01) in non diabetic pregnant women when compared with age matched non pregnant women ( 224 ± 5). Cutoff Fructosamine between groups was 182. Glucose (96 ±7) and HbA1c (5.1 ± 0.2) were not significantly different amongst groups. Conclusion: In non diabetic pregnant women, Serum Fructosamine concentrations are subnormal whereas random glucose and HbA1c levels remain within normal range noted in age matched non pregnant women. Further studies are underway to assess the utility of serum Fructosamine as a screening test in diagnosis of GDM. Presentation: Friday, June 16, 2023

Reference range for glycated haemoglobin in full term non diabetic pregnant women: a multicentric cross sectional study.

There are no large studies to define the normal value of glycated haemoglobin (HbA1c) measured in full term pregnant women measured at the time of delivery. The study was conducted at three government hospitals in South India. Clinical data, maternal blood sample and foetal cord blood sample were collected from women admitted for safe confinement. Mean (± SD) of HbA1c in participants with no known diabetes (gestational or pregestational) or any complications (maternal or fetal) is described, 2.5th-97.5th centile reference range was derived. From 3 centres, 2004 women participated in the study. Data from 1039 participants who had no history of diabetes or any maternal or fetal complication were used to determine the reference range for HbA1c at term pregnancy. The mean HbA1c in subjects devoid of diabetes and its known complications was 5.0 (± 0.39) %. The reference range for normal HbA1c at term in these women was found to be 4.3-5.9%. Maternal HbA1c at term pregnancy in non-diabetic pregnant women is associated with pre-pregnancy BMI, maternal age and 2-h plasma glucose level of 2nd trimester oral glucose tolerance test (OGTT). The mean HbA1c at term pregnancy in non-diabetic women admitted for safe confinement is 5.00 (± 0.39) %. An HbA1c of 5.9% or more at term should be considered abnormal and women with such a value may be kept at a close surveillance for development of diabetes.

Fast Walk Exercise on Blood Pressure Changes in Women With Diabetes Mellitus

Diabetes Mellitus (DM) is a metabolic disorder of chronic hyperglycemia, often accompanied by the onset of metabolic syndrome, namely hypertension which can trigger and exacerbate cardiovascular complications so it is necessary to implement 4 pillars of management namely education, medical nutrition therapy, physical exercise and medical therapy Nonpharmacological interventions are proven to be the best for prevention and hypertension treatment such as Aerobics (Fast Walking) which can be done for 90–150 minutes/week. The type of research used is quantitative research using the Quasi Experimental Pretest-Posttest Control Group Design. The sample size is 40 people.Brisk walking has an influence on changes in blood pressure in diabetic women so it is hoped that light sports activities will be increased as one of the therapies in non-pharmacological treatment of diabetes mellitus patients.

Effect of flax seeds on lipids: Insulin and ghrelin in type 2 diabetic women with metabolic syndrome

Introduction: Metabolic syndrome and diabetes are emerging diseases nowadays. so adjuvant therapy which is without harmful side effects has become the subject of various researches. Its beneficial effect has been proven however its place in the diet of obese subject remains to be dicovered. The subject of our work is to study the effects of flax seeds on lipids. insulin and ghrelin in women with type 2 diabetes with metabolic syndrome. Method: We followed a population of 50 women with type 2 diabetes with metabolic syndrome who consumed 30g / d of flaxseed for 8 weeks. Then we compared the anthropometric and biochemical parameters at T0. T4 and T8 weeks. for the hormonal parameters we measured only between T0 and T8 because it is an expensive dosage. Results: Improvement of the various parameters followed after consumption of flax seeds in our study group. This improvement is significantly better after 8 weeks. For glycemia. CT. TG. HDL-C. IMC. TT. PAS. PAD. insulinemia. ghrelinemia and resistinemia (p between 0.00 and 0.01 for all these parameters studied). Discussion: Because of their high fibers and in SDG content. the flax seeds improve the anthropometric parameters. probably they favor a better glycemic profile by their richness in omega 3. The flax seen its contents rich in ALA shows an effectiveness to reduce the figures of the plasma lipids as well as the improvement of hormonal parameters. Conclusion: In the end. this study. combined with the literature. allowed us to better understand the importance of the seeds of this plant in the diet of obese subjects with metabolic syndrome. Enriching your diet with these seeds would therefore be an effective means in the fight against obesity and metabolic syndrome.

Impact of serum level concentrations of IgG and IgM on abortion in women who had both risk factors diabetes and hypertension.

Abortion is a significant global public health concern affecting millions of women each year. Factors such as maternal diabetes and hypertension have been recognized as major contributors to increased abortion risk. Immunoglobulins, specifically IgG and IgM, play crucial roles in pregnancy outcomes and have been studied extensively. This study aimed to assess the levels of Toxoplasma IgG and IgM in aborted women with and without diabetes or hypertension. This cross-sectional study examined 64 women who experienced Toxoplasma gondii-induced abortions at Erbil Maternity Teaching Hospital between January 2021 and May 2021. Their medical history, including diabetes and hypertension status, was collected through interviews. Blood samples were analyzed using VIDAS technology to measure serum IgG and IgM levels. The mean IgG and IgM antibody levels were compared between groups of women based on the number of abortions, diabetes status, and hypertension status. In women with a history of abortion, IgM antibody levels differed significantly among the five groups (P ≤ 0.01). While the average serum toxoplasma IgG concentration varied between diabetic and non-diabetic women, these differences were not significant (P>0.05). Conversely, there were highly significant differences in the concentration of serum toxoplasma IgM (P<0.01). Comparing women with and without hypertension, no significant differences were found in the mean concentrations of serum toxoplasma IgG and IgM (P > 0.05). The IgM antibody had a significant impact on the number of performed abortions, and these effects were also observed in abortion in women with diabetes.

Factors Associated with Cesarean Operations of Gestational Diabetic Mellitus and Diabetes Complications

Objective: To identify risk factors of cesarean delivery in pregnant women with diabetes mellitus and complications caused by gestational diabetes. Materials and Methods: A retrospective cohort study was conducted at the Department of Obstetrics and Gynecology, Phatthalung Hospital. The participants consisted of pregnant women who labored at Phatthalung Hospital between 2017 and 2021. The inclusion criteria comprised women who labored from 28 to 42 weeks and had complete medical records. Patients having previous cesarean sections, cesarean section on maternal demand, and twin pregnancy were excluded. The study group was diabetic mellitus pregnant women, while non-diabetic pregnant women was generated by random numbers at ratio of 1:1 as control group. The data collected were demographic data, age, body mass index (BMI), number of gestations, parity, abortion, type of diabetic mellitus, underlying disease, route of delivery, indications for cesarean delivery, and maternal and neonatal outcomes. Results: Two thousand twelve pregnant women consisted of 1,006 pregnancies with diabetes and 1,006 non-diabetic pregnancies. Pregnant women with diabetes significantly increased the risk of cesarean section 1.42 time (95% CI 1.19 to 1.70, p&lt;0.001). The greatest indication for cesarean section of both groups was cephalopelvic disproportion, but failure for induction of labor and macrosomia were found in the study group more than in the control group. Logistic regression analysis, adjusted for age group, number of gestations, and BMI, showed that pregnancy-induced hypertension and newborn weight of 4,000 g or more were risk factors for cesarean section among diabetic pregnancies. The maternal complications of the study group were preeclampsia, indicated preterm labor, and premature rupture of membranes. The common fetal complications were macrosomia and birth asphyxia. Conclusion: Risk factors of cesarean section among pregnant women with diabetes included preeclampsia and newborn weight of 4,000 g or more. Gestational diabetes increased significantly the maternal and fetal complications. Keywords: Gestational diabetic mellitus; Cesarean section; Complications

Influence of Race/Ethnicity and Sex on Coronary Stent Outcomes in Diabetic Patients.

How diabetes mellitus (DM), race/ethnicity, and sex impact ischemic events following coronary artery stent procedures is unknown. Using the PLATINUM Diversity and PROMUS Element Plus Post-Approval Pooled Study (N = 4184), we examined the impact of race/ethnicity, sex, and DM on coronary stent outcomes. Primary outcome was 1-year major adverse cardiac events (MACE) (MACE composite: death, myocardial infarction [MI], and target vessel revascularization). The study sample included 1437 diabetic patients (501 White men, 470 White women, 246 minority men, 220 minority women) and 2641 patients without medically treated DM (561 minority, 1090 women). Mean age (years) ranged from 61 in minority men to 65 in White women. Diabetic patients had a higher prevalence of atherosclerotic risk factors and comorbidities. Diabetic minority women (DMW; 70% Black, 27% Hispanic) had similar atherosclerotic risk factors to other diabetics, but experienced higher 1-year MACE (14.4% vs 7.5%, P <.01) and MI (4.3% vs 1.6%, P <.01) rates compared with patients without medically treated DM. No other diabetic cohort (White men, White women, minority men) showed an increased risk of MACE vs patients without medically treated DM. The incremental risk of MACE in DMW was associated with insulin use and persisted after risk adjustment (adjusted odds ratio 1.6 vs patients without medically treated DM; 95% CI, 1.0-2.5). Independent predictors of 1-year MACE included insulin use, hyperlipidemia, renal disease, and prior MI. DMW face the highest risk of ischemic events following coronary stenting, driven, in part, by insulin use. Aggressive secondary prevention and strict glycemic control are imperative in this cohort, and further research is warranted to elucidate the biologic mechanisms underpinning these observations. NCT02240810 (http://clinicaltrials.gov/).

Oral Carbohydrate Administration was Suitable for Cesarean Section–A Systematic Review and Meta-Analysis of Randomized Trials

The use of carbohydrate (CHO) drinks prior to elective cesarean section has gained momentum, but its effect on maternal and neonatal outcomes remains controversial. The aim of this meta-analysis was to assess the effect of an oral CHO load prior to cesarean delivery on insulin sensitivity, insulin resistance, maternal glycemia, neonatal glycemia, and breastfeeding. As of May 21, 2023, we searched through five databases for English-language experimental studies on pre-cesarean oral CHO. A total of 3,940 citations were received, of which seven were selected. The concentrations of CHO used in these studies ranged from 5.9% to 14.2%, and the amounts used were 300-400 ml. We found that pre-cesarean CHO loading reduced maternal insulin resistance and increased maternal glucose levels. CHO loading activates the insulin pathway of critical en-zymes to some extent, increasing glucose utilization by peripheral tissues and ultimately reducing postop-erative insulin resistance. Of course, this is also beneficial in improving maternal blood sugar. We did not find that CHO increased maternal insulin sensitivity or neonatal blood glucose levels. Future prospective randomized controlled trials can use nutritional load to increase colostrum production after Caesarean sec-tion to enhance the confidence of these mothers in breastfeeding. In addition, our preoperative beverage could be more individualized to accommodate diabetic women.

Is there any difference between metabolomic profiles of mothers who progress to gestational diabetes versus healthy women during pregnancy?

Is there any difference between metabolomic profiles of mothers who progress to gestational diabetes versus healthy women during pregnancy?

Process Evaluations of Interventions for the Prevention of Type 2 Diabetes in Women with Gestational Diabetes Mellitus: A Systematic Review (Preprint)

Process Evaluations of Interventions for the Prevention of Type 2 Diabetes in Women with Gestational Diabetes Mellitus: A Systematic Review (Preprint)