Gestational Diabetes Mellitus In Mothers Research Articles

Gestational Exercise Antagonises the Impact of Maternal High-Fat High-Sucrose Diet on Liver Mitochondrial Alterations and Quality Control Signalling in Male Offspring.

Maternal high-caloric nutrition and related gestational diabetes mellitus (GDM) are relevant modulators of the intrauterine environment, increasing the risk of liver metabolic alterations in mothers and offspring. In contrast, as a non-pharmacological approach against metabolic disorders, exercise is highly recommended in GDM treatment. We analysed whether gestational exercise (GE) protects mothers from diet-induced GDM metabolic consequences and mitigates liver mitochondrial deleterious alterations in their 6-week-old male offspring. Female Sprague Dawley rats were fed with control or high-fat high-sucrose (HFHS) diet and kept sedentary or submitted to GE. Male offspring were sedentary and fed with control diet. Sedentary HFHS mothers and their offspring showed impaired hepatic mitochondrial biogenesis and morphological evidence of mitochondrial remodelling. In contrast, GE-related beneficial effects were demonstrated by upregulation of mitochondrial biogenesis signalling markers and mitochondrial fusion proteins and downregulation of mitochondrial fission protein. Alterations in miR-34a, miR-130b, and miR-494, associated with epigenetic regulation of mitochondrial biogenesis, suggested that GE is a more critical modulator of intergenerational changes in miRs expression than the maternal diet. Our data showed that GE positively modulated the altered hepatic mitochondrial biogenesis and dynamics markers and quality control signalling associated with maternal HFHS-diet-related GDM in mothers and offspring.

Review of the Screening Guidelines for Gestational Diabetes Mellitus: How to Choose Wisely.

Currently, there is no international unanimity regarding the timings, the optimal cut-off points, and standardized methods of screening or diagnosis of gestational diabetes mellitus (GDM). The screening guidelines and recommendations for GDM evolved over time; concise information has been presented here in the review. We searched electronic databases for various guidelines for screening of GDM in PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), Embase, Cochrane, Google Scholar, Scopus, Guidelines International Network (GIN library), National Guidelines Clearinghouse (NGC); Web sites of relevant organizations; and trial registries. The mesh headings derived after reviewing the articles and were used to further search the articles are: ("Screening Guidelines GDM" or "Screening Criteria for GDM") and ("Glucose Intolerance in Pregnancy" or "Gestational Diabetes Mellitus"). The articles published from 1960 till December 2022 were included. Key outcomes included the prevalence of GDM is 14.6% according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria and 13.4% according to Diabetes in Pregnancy Study Group India (DIPSI) criteria, making the DIPSI criterion a cost-effective method for low-resource settings. The IADPSG) criterion diagnoses and treats GDM earlier, thus reducing the complications associated with GDM in the mother and newborn. The IADPSG criteria at a cut-off of ≥140 mg/dL have a sensitivity of 81% and specificity of 93%, whereas the World Health Organization (2013) criteria at the same cut-off has a lower sensitivity of 59% and specificity of 81%. The risk factors of having GDM are family history, history during past pregnancy, medical history, multiple current pregnancies, and raised hemoglobin A1c. The screening guidelines have been developed by different organizations and institutions over the years. The guidelines with the threshold values for screening and their standardization for detecting GDM in Indian mothers are yet to be established.

Trends in Gestational Diabetes at First Live Birth by Race and Ethnicity in the US, 2011-2019

(JAMA. 2021;326:660–669) Gestational diabetes mellitus (GDM) is a common condition during pregnancy associated with adverse maternal and child outcomes, including increased risk for future diabetes postpregnancy and cardiovascular disease. For infants, maternal GDM is shown to be associated with macrosomia and increased adiposity, and increased risk for cardiometabolic disease into the full lifespan. Differentiated rates of GDM in the United States has been estimated for major ethnic groups but is undefined for disaggregated subgroups within these larger populations. Large-scale data were mined to quantify annual rates of GDM in mothers at first live birth stratified across race and ethnicity subgroups in the United States. This analysis informs equitable approaches for management and prevention of gestational diabetes at the clinical and population levels.

Evaluation of MicroRNA-16 and MicroRNA-221 in Serum and Placenta in Gestational Diabetes Mellitus: Correlation with Macrosomia

Gestational diabetes mellitus (GDM) is associated with short and long term complications for pregnant women and their coming offspring. MicroRNAs are small noncoding RNA molecules that regulate gene expression. This study aimed to investigate the expression of microRNA-16 and 221 in maternal serum and their mirror expression in the placenta in GDM and their correlation with severity of GDM and Macrosomia. Subjects and methods: This study was conducted on twenty pregnant women with GDM and other twenty healthy pregnant women who served as a control group. GDM group was further subdivided into severe and mild subgroups according to the levels of fasting and postprandial 2 hours glucose levels. MicroRNA-16 and microRNA-221 were estimated by quantitative real time polymerase chain reaction (qRT-PCR). Results revealed that microRNA-16 levels in serum and placental tissue were significantly higher in the GDM group than the control group, with high significant increase in severe GDM than in mild GDM subgroup. Significant decreases in the levels of microRNA-221 were detected in both serum and placenta in GDM group versus the control group. In GDM group, there was a direct high significant correlation of microRNA-16 in serum and placenta with fetal macrosomia, but there was no correlation of microRNA-221 in serum with fetal macrosomia. Conclusions: The significant increase of microRNA-16 in the severe GDM group than in the mild GDM group could conclude that microRNA-16 may be the noncoding RNA at the molecular level that affected the severity of GDM in mothers and the macrosomia of their off-springs.

Risk factors for gestational diabetes mellitus in pregnant women with chronic HBV infection and its influence on maternal and fetal outcomes

Objective To investigate the factors for gestational diabetes mellitus (GDM) in pregnant women with chronic hepatitis B virus (HBV) infection, their pregnancy outcome, and related influence on neonates. Methods A retrospective analysis was performed for 317 pregnant women with chronic HBV infection who were treated, gave birth, and were followed up in Beijing YouAn Hospital, Capital Medical University, from January to December 2017, and according to the presence or absence of GDM, they were divided into chronic HBV+GDM group and chronic HBV control group. Related data were recorded, including HBV serology, liver function, HBV DNA quantification, pregnancy comorbidities, mode of delivery, and the condition of neonates at birth. The t-test or t′-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups; a binary logistic regression analysis was used to investigate the risk factors for GDM in mothers with chronic HBV infection. Results Among the 317 mothers, 64 (20.19%) had chronic HBV infection and GDM, and there were 253 mothers (79.81%) in the control group. Compared with the control group, the chronic HBV+GDM group had significantly higher age (Z=-2.652, P Conclusion HBV DNA quantification and old age are risk factors for GDM in mothers with chronic HBV infection, and GDM in pregnant women with chronic HBV infection may increase the incidence rate of premature rupture of membranes, fetal intrauterine distress, and premature delivery.

The use of antipsychotic agents during pregnancy and the risk of gestational diabetes mellitus: a systematic review and meta-analysis.

Previous studies have found contradicting results with regard to the use of antipsychotics during pregnancy and the risk of gestational diabetes mellitus (GDM). We aimed to evaluate the association between antipsychotic use in pregnancy and GDM. A systematic literature search was conducted in PubMed, EMBASE, PsycINFO and Cochrane Library databases up to March 2019, for data from observational studies assessing the association between gestational antipsychotic use and GDM. Non-English studies, animal studies, case reports, conference abstracts, book chapters, reviews and summaries were excluded. The primary outcome was GDM. Estimates were pooled using a random effect model, with the I2 statistic used to estimate heterogeneity of results. Our study protocol was registered with PROSPERO number: CRD42018095014. In total 10 cohort studies met the inclusion criteria in our systematic review with 6642 exposed and 1 860 290 unexposed pregnancies. Six studies were included in the meta-analysis with a pooled adjusted relative risk of 1.24 overall [95% confidence interval (CI) 1.09-1.42]. The I2 result suggested low heterogeneity between studies (I2 = 6.7%, p = 0.373). We found that the use of antipsychotic medications during pregnancy is associated with an increased risk of GDM in mothers. However, the evidence is still insufficient, especially for specific drug classes. We recommend more studies to investigate this association for specific drug classes, dosages and comorbidities to help clinicians to manage the risk of GDM if initiation or continuation of antipsychotic prescriptions during pregnancy is needed.

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.
 Keywords: Gestational Diabetes Mellitus, Drug Utilization Pattern, Complications, Oral Glucose Tolerence Test

Prevention of Type 2 diabetes after gestational diabetes directed at the family context: a narrative review from the Danish Diabetes Academy symposium

In this review, we aim to summarize knowledge about gestational diabetes mellitus (GDM) after delivery; with special focus on the potential of preventing Type 2 diabetes in a family context. The review expands on the key messages from a symposium held in Copenhagen in May 2017 and highlights avenues for future research. A narrative review of the symposium presentations and related literature is given. GDM is associated with increased short- and long-term adverse outcomes including Type 2 diabetes for both mother and offspring. Interestingly, GDM in mothers also predicts diabetes in the fathers. Thus, although GDM is diagnosed in pregnant women, the implications seem to affect the whole family. Structured lifestyle intervention can prevent or delay the onset of Type 2 diabetes. In this review, we show how numerous challenges are present in the target group, when such interventions are sought and implemented in real-world settings. Although interlinked and interacting, barriers to maintaining a healthy lifestyle post-partum can be grouped into those pertaining to diabetes beliefs, the family context and the healthcare system. Health literacy level and perceptions of health and disease risk may modify these barriers. There is a need to identify effective approaches to health promotion and health service delivery for women with prior GDM and their families. Future efforts may benefit from involving the target group in the development and execution of such initiatives as one way of ensuring that approaches are tailored to the needs of individual women and their families.

First Trimester 50 g Glucose Challenge Test (GCT) Predicts Gestational Diabetes Mellitus at 24–28 Weeks of Pregnancy

Increase in weight of pregnant women, and resulting higher pregestational insulin resistance, augmented the rate of gestational diabetes mellitus (GDM). Accordingly, GDM screening should be performed as early as possible to reduce the short- and long-term complications of GDM in mothers and fetus. An additional strategy would be to predict GDM in those screened negative to establish primary preventive care and to avoid development of GDM.