Gestational Diabetic Patients Research Articles

EVALUATION OF MEAN PLATELET VOLUME AND 25 HYDROXY VITAMIN D LEVELS IN GESTATIONAL DIABETIC WOMEN

Aim: According to few studies which tried to evaluate mean platelet volume (MPV) and 25 hydroxy vitamin D, have shown conflicting results in gestational diabetic patients. In this study we aimed to compare main platelet volume and 25 hydroxy vitamin D values between gestational diabetic patients and healty individual pregnant womens. Material and method: The patients were selected from 24-28 weeks pregnant people who made gestational diabetes screening and oral glucose tolerance test from obstetric-gynecology, diabetes and endocrinology polyclinics of Okmeydanı Training and Research Hospital. After the searching 52 gestational diabetic patients and 52 healty pregnant women included to the study. We estimated MPV and vitamin D level. In addition, demographic and clinical data of subjects were recorded. Results: Mean platelet volume (MPV) value was found 8,5 ± 1,0 fl and 8,3 ± 1,1 fl. in gestational diabetic and control group respectively. There was no statistically significant differences in MPV value between case and the control group (p>0.05). Mean 25 hydroxy vitamin D value was found 20.5 ± 11.0 ng/ml and 21,1 ± 9,3 ng/ml. gestational diabetic and control group respectively. There was no statistically significant differences in 25 hydroxy (OH) vitamin D value between case and control group. Conclusion: In our study we found no statistically significant differences in MPV and 25-OH vitamin D values between gastational diabetic pregnant group and healty pregnant group.

Are miR-26a and miR-26b microRNAs potent prognostic markers of gestational diabetes?

Gestational diabetes mellitus is a common public health problem, accompanied by complications for the mother and fetus. So, introducing new biomarkers to identify early diabetes is essential. As serum miRNAs are potentially appropriate markers, we investigated miR-26a and miR-26b expression levels in pregnant women with and without gestational diabetes. Demographic and clinical characteristics of 40 gestational diabetic patients and 40 healthy controls were assessed. The expression level of miR-26a and miR-26b microRNAs was measured by real-time PCR. Statistical analysis was done with GraphPad Prism software (version 8.4.3). The findings of this study showed that the expression level of miR-26a and miR-26b increased in women with gestational diabetes compared with healthy pregnant women, but the increase in expression was only significant for miR-26a (p < 0.05). According to the statistical and ROC curves, we suggest miR-26a as a potential biomarker for the early diagnosis of gestational diabetes mellitus.

Imbalance of gut microbiota in gestational diabetes

AimTo investigate the differences in gut microbiota composition among nonpregnant women of reproductive age, healthy pregnant women, and gestational diabetes (GD) patients.MethodsA total of 45 outpatients were enrolled and divided into three groups: nonpregnant women of reproductive age (control group, n = 23), healthy pregnant women (normal group, n = 10), and GD patients (GD group, n = 12). Faecal samples were collected and sequenced using 16S rRNA gene sequencing to analyse the microbial composition.Results(1) Pregnant patients exhibited an increase in the abundance of Streptococcus (Pnormal = 0.01286, PGD = 0.002965) and Blautia (Pnormal = 0.0003924, PGD = 0.000246) but a decrease in the abundance of Roseburia (Pnormal = 0.0361, PGD = 0.007075), Phascolarctobacterium (Pnormal = 0.0003906, PGD = 0.02499) and Lachnoclostridium (Pnormal = 0.0003906, PGD = 0.03866). (2) Compared with healthy pregnant women, GD patients had an excessive increase in Streptococcus abundance and decrease in Roseburia abundance. The increase in Blautia abundance and the decrease in Phascolarctobacterium and Lachnoclostridium abundance in GD patients were less than those in healthy pregnant women. (3) The abundance of Faecalibacterium prausnitzii decreased significantly in GD patients (PGD = 0.02985) but not in healthy pregnant patients (Pnormal = 0.1643).ConclusionsAbnormal increases and decreases in the abundances of gut microbiota components, especially Faecalibacterium prausnitzii, were observed in GD patients.Trial registrationThe cross-sectional research was conducted in accordance with the Declaration of Helsinki, and approved by Sir Run Run Shaw Hospital Clinical Trials and Biomedical Ethics Committee. The study has been registered in the Chinese Clinical Trial Registry (ChiCTR1900026164, 24/09/2019, http://www.chictr.org.cn/showproj.aspx?proj=43,455).

Serotonin receptor and serotonin transporter expressions in the placental villous tree in gestational diabetes mellitus

BACKGROUND: The serotonergic system during pregnancy plays an important role not only in carbohydrate metabolism, but also in the laying and regulation of the fetoplacental complex, growth and development of the fetus. The study of the expression of placental serotonin 5-HT2A receptor and serotonin transporter (SERT) in gestational diabetes mellitus is foremost for scrutinizing the pathogenesis of perinatal complications, as it may allow for finding new opportunities for their prevention and correction.&#x0D; AIM: The aim of this study was to compare the expression patterns of the serotonin 5-HT2A receptor and SERT in placental tissue in gestational diabetes mellitus and in normal pregnancy.&#x0D; MATERIALS AND METHODS: This comparative cohort study included pregnant women with gestational diabetes mellitus (n = 6) and patients with normal pregnancy (n = 10). The expression of serotonin 5-HT2A receptor (Abcam, USA) and SERT (Bioss Antibodies, USA) was studied in placenta samples from the both study groups by immunohistochemical method. Morphometric analysis was performed using the VideoTest-Morphology 5.2 program (Videotest Ltd., Russia).&#x0D; RESULTS: The relative area of SERT expression in the placenta in gestational diabetes mellitus was higher compared to normal pregnancy (p 0.001). The relative areas of expression of the serotonin 5-HT2A receptor in the placenta did not differ between the study groups (p = 0.5).&#x0D; CONCLUSIONS: Higher SERT expression in the placentas of patients with gestational diabetes mellitus compared to those from women with normal pregnancies may reflect the level of tension of compensatory mechanisms in gestational diabetes mellitus and the effect of insulin therapy on these mechanisms.

The impact of weekly semaglutide, a glucagon-like peptide-1 agonist, on kidney outcomes in adults with type 2 diabetes mellitus.

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder associated with kidney complications. This study aims to investigate the effects of weekly subcutaneous semaglutide, a GLP-1 agonist, on kidney outcomes. This retrospective cohort study was conducted in nephrology and endocrinology clinics at KFAFH from March 2022 to February 2023. The sample size was determined based on hospital records, and randomly selected patients who met the inclusion criteria were included. The inclusion criteria included adults with T2DM who were on weekly subcutaneous semaglutide for 6 months or longer. Patients with type 1 diabetes mellitus, pregnant or gestational diabetes patients, individuals who added other antidiabetic medications during the study period, and participants who refused to be involved were excluded from the study. The study included participants aged between 42 and 85 years, with a mean age of 65.38 years, and the majority (58.7%) were males. There was a significant weight and BMI reduction observed in all patients, with P values <0.001 for both. The average weight reduction was 2.97 kg (SD = 2.34, 95% CI 1.65-3.30), and the average Body (BMI) reduction was 1.16 (SD = 0.91, 95% CI 1.03-1.29). A vast majority of participants (98.5%) reported a weight loss of at least 1 kg, and 13.8% of participants experienced a change in BMI category from higher to lower. No patients reported an increase in the BMI category. There was a significant reduction in glycohemoglobin (HbA1c) measurements from 9.18 pretreatment to 8.13 posttreatment, with an average reduction of 1.05 units (SD = 1.84, 95% CI 0.79-1.31). The majority of participants (70.9%) reported a reduction in HbA1c of at least 0.1 unit. Although there was a slight decrease in estimated glomerular filtration rate (eGFR) values on average (1.35 units), the change was not statistically significant (P = 0.059). More than half of the participants (51.5%) reported an increase in eGFR, 45.4% reported a decrease, and 3.1% reported no change. There was a statistically significant reduction in urinary albumin-to-creatinine ratio (UACR) values from a median of 5.97 pretreatment to a median of 5.60 post-treatment. The median decrease was 0.72 units, with one-third (33.3%) reporting an increase and two-thirds (66.7%) reporting a decrease in values. The correlation analysis revealed no significant association between the total quantity of semaglutide taken and the magnitude of changes. Our study on the impact of weekly semaglutide in adults with T2DM reveals positive effects on kidney outcomes, including weight loss, glycemic control and improved urine albumin creatine ratio, and a reduced risk of nephropathy. These findings highlight the potential of semaglutide as a safe and effective treatment option for improving renal health in individuals with T2DM.

Isolated polyhydramnios in the third trimester or polyhydramnios secondary to late-onset gestational diabetes: is it worth distinguishing?

The aim of this study was to compare pregnancy outcomes of patients with polyhydramnios due to late-onset gestational diabetes mellitus and patients with isolated polyhydramnios. Of the women who fully participated in prenatal examinations at Etlik Lady Zübeyde Hospital between January 1, 2018, and December 31, 2019, women with polyhydramnios of nonfetal-placental origin manifesting in the third trimester were retrospectively reviewed. Women with normal 75-g oral glucose tolerance test results between 24 and 28 weeks gestation who met the inclusion criteria were enrolled in the study and divided into two groups based on the results of rescreening with the 75-g oral glucose tolerance test for polyhydramnios in the third trimester: women with isolated polyhydramnios (group 1) and women with late-onset polyhydramnios due to gestational diabetes mellitus (group 2). There were a total of 295 participants, of whom 35 (11.8%) were diagnosed with polyhydramnios due to late-onset gestational diabetes mellitus. There were no differences in the main outcomes. Birthweight and gestational age at birth were identified as independent risk factors for predicting composite maternal outcome {[odds ratio (OR)=1.273, 95% confidence interval (CI) 1.063-1.524, p=0.009]} and composite neonatal outcome (OR=0.606, CI 0.494-0.744, p<0.001), respectively. Polyhydramnios in late pregnancy without evidence of pregnancy-related causes leading to polyhydramnios may be a sign of late-onset gestational diabetes mellitus in women with a normal prior oral glucose tolerance test. As pregnancy outcomes and management were indifferent, it does not seem necessary or useful to diagnose whether or not late-onset gestational diabetes mellitus is present.

Awareness About Diabetes And Its Complications Among Patients With Diabetes Mellitus

Objective: Awareness of diabetes and its potential complications is crucial for effective management and prevention of long-term health risks. This study aimed to assess the level of awareness and understanding of diabetes and its complications among patients diagnosed with type 2 diabetes mellitus. Methods: A cross-sectional study included 200 patients with type 2 diabetes mellitus as per the American Diabetes Association (ADA) criteria. Type 1 diabetes and gestational diabetes patients were excluded from the study. The duration of the study was 8 months. The patient’s awareness regarding diabetes and its complications was assessed as per the prefixed questionnaire. Analysis of the data was carried out with SPSS version 28. The Chi-square test was used to investigate the association of awareness of diabetes mellitus with various independent variables variable as age and duration of diabetes. The level of statistical significance was p &lt;0.05. Results: Among the participants, 80 (40%) were male and 120 (60%) were female. A significant portion of patients 73 (36.5%) were never informed about diabetes or its complications. 69 (34%) of patients were never educated about the symptoms of hypoglycemia. 142 (71%) of the patients had a glucometer and 88 (44%) participants had poor follow-up and never checked HbA1C. Moreover, Patients with longer diabetes duration were more likely to visit ophthalmologists at regular intervals (P value 0.023). 111 (56%) never checked their urine for proteinuria and 172 (86%) were aware that diabetes can affect their kidneys. Foot care and awareness of diabetic foot complications were lacking among patients. 48 (24%) examined their feet daily, 66 (33%) never examined their feet, and 73 (36%) were never told about foot care by their doctors. The statistically significant impact of age on patients' knowledge regarding blood sugar levels (P=0.009) and foot care (P=0.013) Conclusion: There is a significant lack of awareness among individuals with diabetes, highlighting the urgent need for educational initiatives. Both the public and private healthcare sectors should take the responsibility of providing awareness programs. Keywords: Type 2 diabetes mellitus, awareness, complications.

Platelet-to-lymphocyte ratio and serum hsCRP levels in third trimester and adverse pregnancy outcomes in women with gestational diabetes mellitus

Gestational diabetes mellitus (GDM) is a major complication of pregnancy. GDM is associated with a higher risk of adverse pregnancy outcomes (APO). The purpose of this study was to assess the association between third-trimester platelet to lymphocyte ratio (PLR) and high-sensitivity C-reactive protein (hsCRP) concentration and the risk of APO in GDM pregnant women. This study selected 406 non-elderly gestational diabetes patients diagnosed in the Renmin Hospital of Wuhan University from May 2021 to February 2023 as the research objects. According to the presence or absence of APO, they were divided into an APO group (n = 171) and a non-APO group (n = 235). Logistic regression model to evaluate the correlation between PLR and hsCRP and APO in women with GDM; Restricted cubic spline analyses was used to explore nonlinear correlations between PLR or hsCRP and the risk of APO; ROC curve analysis of the diagnostic performance of PLR and hsCRP for APO in women with GDM. APO occurred in 171 of the 406 included participants. Compared with the non-APO group, patients in the APO group had higher PLR and hsCRP levels. The incidence of APO was positively associated with PLR and the hsCRP level in each logistic regression model (P < 0.05). After adjusting for all the risk factors included in this study, restricted cubic spline analyses found that the PLR and the hsCRP level were positively associated with the risk of APO. The levels of PLR and hsCRP in the third trimester are related to the occurrence of APO in women with GDM, and high levels of PLR and hsCRP may indicate the occurrence of APO.

Exploring Motivations Regarding Dietary Intake Intentions in Gestational Diabetes Mellitus: Development and Validation of a Questionnaire.

The maintenance of stable blood glucose levels in gestational diabetes patients depends on their ability to make scientific decisions. Decision-making ability is influenced by factors such as preferences, knowledge acquisition, and risk perceptions. At present, problems such as irrational dietary structure, difficulties in decision-making, and poor adherence still exist in clinical practice. The key to guiding gestational diabetes patients in developing their scientific decision-making abilities lies in identifying the weak key points that affect their decision-making abilities. There is a lack of validated tools to assess these patients' perceptions of dietary intake. In this study, we aimed to develop and validate the Dietary Intake Perceived Motivation Questionnaire for Patients with Gestational Diabetes Mellitus with the purpose of accurately identifying the obstacles encountered by gestational diabetes mellitus patients in the development of their scientific decision-making abilities. In this study, 304 individuals with gestational diabetes were recruited from a public hospital in Wuxi, China. The questionnaire was developed in 3 stages, consisting of questionnaire development, a pilot study, and a formal test, and the validity and reliability of the questionnaire were tested and confirmed. The content validity index and exploratory factor analysis were completed by expert correspondence to indicate the validity of the content and structure. In addition, Cronbach's α was used to evaluate the internal consistency of each item of the questionnaire, and Spearman-Brown analysis was used to analyze the split-half reliability. In addition to the questionnaire, the study participants were asked to complete a general information questionnaire that included items on various demographic factors such as age, week of gestation, and mode of conception. The questionnaire was validated through principal component analysis, resulting in a 31-item questionnaire named the Dietary Intake Perceived Motivation Questionnaire for Patients with Gestational Diabetes Mellitus. This questionnaire explained 86.267% of the variance and demonstrated good internal consistency (Cronbach's α= 0.929). Our study determined that the questionnaire serves as a valuable tool in evaluating the motivation behind dietary intake in gestational diabetes patients.

Flash glucose monitoring system in gestational diabetes: a study of accuracy and usability.

Studies of flash glucose monitoring systems (FGMSs) in pregnancy are insufficient, especially in gestational diabetes (GD). Our aim was to evaluate Freestyle Libre's usability and accuracy (compared to self-monitoring of blood glucose [SMBG]) for GD patients in real-life conditions. This is a prospective study with pregnant women diagnosed with GD (n = 24 for the usability analysis; n = 19 for the accuracy analysis). The study duration was up to 28 days (lifetime of two sensors). Participants executed a minimum of four daily FGMS readings obtained immediately after capillary SMBG. Analytical accuracy was assessed with mean absolute relative difference (MARD) and mean absolute difference (MAD); clinical accuracy was assessed with Surveillance Error Grid (SEG). Usability was evaluated with a user acceptability questionnaire. The mean pregestational BMI was 25.21 ± 5.15 kg/m2 (mean ± SD), the mean gestational age was 30.31 ± 2.02 weeks, and the mean glucose values were 76.63 ± 7.49 mg/dL. A total of 1339 SMBG-FGMS pairs of values were obtained. Analytical accuracy was good with an overall MARD of 14.07% and an in-target MARD of 13.79%. The number of SMBG-FMGS pairs for above-target values was low (122 of 1339) with an associated MARD of 17.95%. Clinical accuracy of the FGMS was demonstrated, with 94.4% of values in the no-risk or slight, lower risk zones of the SEG. FGMS accuracy was unaffected by pregestational BMI or gestational age. The user acceptability questionnaire showed high levels of satisfaction, with 95.8-100% preferring FGMS to SMBG. No unexpected or severe adverse effects occurred. FGMS showed good performance in GD regarding accuracy and usability. Larger studies are needed to corroborate our results, verify the analytical accuracy of above-target values as this glucose range might lead to initiation or adjustment of pharmacological therapy, and ultimately establish definitive recommendations regarding prescription of FGMS for GD patients.

Effect of Case Management for Patients with Gestational Diabetes

Objective: To explore the effect of allocating case managers for gestational diabetes patients. Methods: 200 patients with gestational diabetes mellitus from December 2021 to December 2022 were included in this study, and the collection period. They were divided into groups according to the interventions received. Each patient in the observation group was managed by a case manager, while the control group were managed with conventional methods without the supervision of a case manager. There were 100 cases in each group, and the curative effects of the two groups were compared. Results: The fasting blood glucose and 2-hour postprandial blood glucose in the observation group were significantly lower than those of the control group (P &lt; 0.05). The re-admission rate of patients due to poor blood sugar control in the observation group was lower than that in the control group (P &lt; 0.05). The pregnancy outcome of the observation group was better than that of the control group (P &lt; 0.05). Conclusion: Case management of gestational diabetes can not only control the blood glucose of pregnant women, but also improve pregnancy outcomes.

Differences in Ultrasonographic Predictors of Fetal and Maternal Morbidity and Mortality Between Gestational and Pregestational Diabetics [ID: 1376398

INTRODUCTION: We sought to estimate the association between polyhydramnios and/or large for gestational age (LGA) and perinatal outcomes in pregestational (PreDM) compared to gestational diabetic (GDM) patients. METHODS: This was a secondary analysis of an observational study at a large academic center between 2014 and 2021, excluding congenital anomalies. Using modified Poisson regression, we measured the relationship between polyhydramnios (mild or moderate/severe) and/or LGA, and risk of stillbirth, neonatal intensive care unit (NICU) admission, cesarean delivery, and postpartum hemorrhage. We adjusted for potential confounders and stratified by diabetes group (PreDM versus GDM). We also created a model including interaction terms between diabetes type and presence of 1) polyhydramnios or 2) LGA, to test for interactions on outcomes. RESULTS: Among 2,533 pregnancies, 2,298 (91%) had GDM and 235 (9%) had PreDM. Four hundred seventy-two (18.6%) had LGA and 41 (1.6%) had moderate/severe polyhydramnios, and both were more common in PreDM versus GDM (34% versus 17%, P&lt;.001, and 3.8% versus 1.4%, P&lt;.05, respectively). LGA was associated with a significantly increased risk for cesarean section and NICU admission in both groups; however, moderate/severe polyhydramnios was associated with higher risk of stillbirth in PreDM (RR 14.7 [95% CI 1.3–163], P&lt;.05), but not GDM. In those with moderate/severe polyhydramnios, PreDM had a significantly greater risk of stillbirth compared to GDM (P&lt;.05). There was no statistically significant interaction between diabetes type, LGA, and risk of stillbirth. CONCLUSION: Moderate/severe polyhydramnios portends a higher risk of stillbirth in PreDM versus GDM. The presence of moderate/severe polyhydramnios should be considered in determining antenatal surveillance and delivery timing in patients with PreDM.

Influence of gestational diabetes mellitus on outcomes of preinduced labour with dinoprostone vaginal insert.

The aim of this study was to evaluate the effectiveness of labour preinduction using a dinoprostone vaginal insert in patients with gestational diabetes mellitus versus patients undergoing labour induction for other causes. The second aim of the study was to compare perinatal outcomes in both groups. The study has a retrospective character, conducted in 2019-2021 in a tertiary reference hospital. The following endpoints were assumed for the analysis: natural childbirth, birth occurring within 12 hours of dinoprostone administration and neonatal outcomes. Furthermore, indications of a Caesarean section were analysed. The percentage of natural childbirths was similar in both groups. Furthermore, in both groups, over 80% of patients gave birth within less than 12 hours following dinoprostone administration. Neonatal outcomes (body weight, Apgar score) did not differ statistically. Analysing indications for a Caesarean section, failure in the progress of labour was an indication in 39.5% of cases in the control group, 29.4% of cases in gestational diabetes mellitus (GDM), and 50% of cases in diabetes mellitus (DM). The risk of foetal asphyxia was an indication in 55.8% of cases in the control group, 35.3% of cases in GDM and 50% of cases in DM. Ineffective labour induction - no induction of the contractile function was an indication for a C-section in 4.7% of cases in the control group and 35.3% of cases in GDM; no cases were noted in DM (p = 0.024). The study demonstrated that patients undergoing labour induction due to GDM using a dinoprostone vaginal insert did not differ in terms of labour duration, oxytocin administration compared to patients undergoing labour induction for other causes. Furthermore, the same rate of Caesarean sections was found in the study group; however, these groups differ in terms of indications, including risk of foetal asphyxia (35.3% vs 55.8%), failure in the progress of labour (29.4% vs 39.5%), and no active labour (1.8% vs 1.5%). The neonatal Apgar score at 1.5 and 10 minutes after birth was similar in both groups.

EFFECTS OF DEPRESSION, ANXIETY, OR LOW SELF-ESTEEM UPON GLYCEMIC VARIABILITY, IN DIABETIC PREGNANT VERSUS NON-PREGNANT PATIENTS.

We analyzed the correlation between glycemic variability and psychological problems such as depression, anxiety disorder, and low self-esteem in pregnant and non-pregnant (excluding gestational diabetes) patients with diabetes. Besides its originality, this study might contribute to better / earlier diagnosis of these psychological conditions, with a special interest in pregnant diabetic women. Better management and cost reduction of care could be a consequence. We compared diabetic pregnant and non-pregnant women from the perspective of the glycemic variability (for a period of 15 days prior inclusion in the study) and their results on the standardized questionnaires: Beck depression inventory, Hamilton anxiety scale - HRSA, Rosenberg self-esteem test. A statistically significant correlation was identified in both groups between the glycemic oscillation and depression, anxiety, and low self-esteem. Diabetic pregnant women had a higher statistical significance for the correlation between the glycemic oscillation and depression, as well as between the glycemic oscillation and anxiety than non-pregnant diabetic patients. The present data justify further research. Our results could be developed into a preliminary intervention protocol, using the daily glycemic values measurements, collected by patients.

Real-time continuous glucose monitoring: a review

Continuous glucose monitoring (CGM) is preferably recommended for diabetic patients with Type 1, Gestational, and Type 2 diabetes via multiple insulin injections. There is an increasing awareness about its use, even among patients without Diabetes. This review aims to assess the indications, benefits, and future perspectives of CGM. We searched PubMed, MEDLINE, and the first 100 articles in Google Scholar, for articles published in English and assessed the indications, benefits, and recent updates on CGM. The search criteria were limited to articles published from 2013 to November 2022. The keywords such as CGM, indications, benefits, and updates were used. CGM is recommended for use among both types of Diabetes through continuous insulin injections. In addition, CGM is beneficial to patients with gestational diabetes mellitus and patients that experience frequent hypoglycemic attacks. Although CGM is imperative for diabetic patients, the cost is a major limiting factor. There is an increasing awareness about the use of CGM among patients without Diabetes to avoid Diabetes, improve life quality, and enhance mental and physical health. The effects of CGM on HbA1c might be conflicting. However, it improved time in the range, microvascular complications, and fetus and mother complications.

The sFlt-1/PlGF Ratio in Patients Affected by Gestational Diabetes and SARS-CoV-2 Infection.

Low values of the ratio of plasmatic soluble blocking factor FMS-like tyrosine Kinase 1 and placental growth factor (sFlt-1/PlGF) are required for an adequate placental angiogenesis and function. It has been shown that patients affected by gestational diabetes (GD) and patients with pneumonia from SARS-CoV-2 are characterized by an increased sFlt-1/PlGF ratio. The aim of the present study was to evaluate the sFlt-1-PlGF ratio in pregnancies complicated by COVID-19 and GD. We compared the plasmatic sFlt-1/PlGF ratio among the following groups of pregnant women: COVID-19, GD patients; COVID-19, non-GD patients; non-COVID-19, GD patients; and non-COVID-19, non-GD controls. We enrolled 62 women in the present study, who were divided as follows: 14 COVID-19, GD patients; 12 COVID-19, non-GD patients; 11 non-COVID-19, GD patients; and 25 non-COVID-19, non-GD controls. The COVID-19, GD patients presented a higher pre-pregnancy BMI, a higher prevalence of hypertensive disorders of pregnancy as a co-morbidity, and an increased need for medication for their diabetes. Neonatal data were similar between the groups. The controls showed a significantly lower sFlt-1/PlGF ratio compared to pregnancies complicated by GD and SARS-CoV-2 infection. The sFlt-1/PlGF ratio was higher in patients affected by both GD and SARS-CoV-2 infection; these subjects were characterized by a greater incidence of obesity and hypertensive disorders of pregnancy.

Maternal and Placental DNA Methylation Changes Associated with the Pathogenesis of Gestational Diabetes Mellitus.

Gestational diabetes mellitus (GDM) is an important metabolic complication of pregnancy, which affects the future health of both the mother and the newborn. The pathogenesis of GDM is not completely clear, but what is clear is that with the development and growth of the placenta, GDM onset and blood glucose is difficult to control, while gestational diabetes patients' blood glucose drops and reaches normal after placenta delivery. This may be associated with placental secretion of insulin-like growth factor, adipokines, tumor necrosis factor-α, cytokines and insulin resistance. Therefore, endocrine secretion of placenta plays a key role in the pathogenesis of GDM. The influence of DNA methylation of these molecules and pathway-related genes on gene expression is also closely related to the pathogenesis of GDM. Here, this review attempts to clarify the pathogenesis of GDM and the related maternal and placental DNA methylation changes and how they affect metabolic pathways.

Disrupted placental vitamin D metabolism and calcium signaling in gestational diabetes and pre-eclampsia patients.

Gestational diabetes (GDM) and pre-eclampsia (PE) represents the unrecognized risk factors for reduced bone content in neonates. The present study is planned to explore the components of vitamin D metabolism and calcium transport in placenta of GDM and PE cases and its effect on the neonatal bone mass determination using bone densitometry system. We have collected serum and placenta tissues from GDM (n = 20), PE (n = 20), and healthy pregnancies (n = 20). In the present study, we found mRNA expression of oxidative stress markers, vitamin D metabolic components and calcium channels, calcium channel binding proteins, plasma membrane calcium ATPase, ATP synthase and Ca2+ release genes; Ryanodine receptors genes were assessed by quantitative real-time PCR (qRT-PCR) in placental tissue of GDM, PE, and healthy pregnancies. We observed high level of oxidative stress in both GDM and PE placenta compared to normal pregnancies. CYP2R1 and VDR mRNA expression was significantly downregulated and upregulation of CYP27B1 and CYP24A1 in GDM and PE compared with healthy cases. Similarly, calcium transporters were downregulated in GDM and PE placental tissues. In addition, CYP24A1, VDR, CaBP28K, TRPV5 and PMCA3 mRNA expression were correlated with BMC of neonates. Oxidative stress is probably relevant to disrupted vitamin D homeostasis and calcium transport in the placenta of GDM and PE cases. The altered regulatory mechanism of CYP24A1 and VDR could indicates more pronounced serum 25(OH)D reduction. Additionally, reduced BMC in the neonates of these cases might be as consequences of modified CYP24A1, VDR, CaBP28K, TRPV5 and PMCA3 mRNA expression.

Coping With Diabetes During the COVID-19 Lockdown in Saudi Arabia: Lessons Learned in the Post-pandemic Era.

Uncontrolled diabetes has appeared as one of the major risk factors for morbidity and mortality in diabetic patients with coronavirus disease 2019 (COVID-19). Alterations in dietary habits, physical inactivity, and inability to take advice from the physician are some of the contributing factors. This study aimed to assess the impact of the COVID-19 lockdown in Saudi Arabia on medication accessibility, medication adherence, lifestyle, and quality of life of diabetes patients. A cross-sectional observational study was conducted among diabetic patients using a self-reported questionnaire developed on an online platform (SurveyMonkey®). The survey was distributed through social media platforms (WhatsApp, Telegram). For those who were digitally illiterate, responses were collected by family members. The targeted population was type 1, type 2 and gestational diabetes patients. The analysis of the data was done using IBM SPSS Statistics, version 26. Four hundred forty-nine participants completed the survey. Most of the participants had type 2 diabetes (n=359; 79.8%) and were well educated (83.2%) with a high school degree and above. Complications from COVID-19 infection were reported in 12% (n=54) patients. During quarantine, 78.8% (n=354) of participants measured their blood glucose regularly. Results showed that during quarantine, 68.3% (n=311) participants skipped their scheduled follow-up whereas only 5.1% (n=23) of them took their medication inappropriately. This study reported good levels of self-monitoring of blood glucose levels, whereas patients' accessibility to seek healthcare services seemed to be interrupted. Further efforts are needed in the post-pandemic era to empower patients' self-care behaviors and utilize telehealth models to facilitate timely access to medical care.

Prevalence and antimicrobial susceptibility pattern of uropathogenic organisms among diabetic patients attending State Specialist Hospital, Maiduguri Nigeria.

Urinary tract infection (UTI) is the colonization of the urinary tract by pathogenic microorganisms. There is paucity of data on the development of multidrug resistant uropathogenic strains associated with Diabetes Mellitus (DM). In this cross-sectional study we investigated a total of three hundred and thirty (330) known diabetes mellitus (DM) patients, comprising of 06 (1.8%) Type I DM, 296 (89.7%) Type II DM and 28 (8.5%) Gestational Diabetes patients aged 21 to 80 years. The subjects consisted of 150 males (45.5%) and 180 (54.5%) females. Urine culture was carried out on CLED, MacConkey and blood agar and Kirby Bauer disc diffusion for antimicrobial susceptibility testing was carried out to determine the susceptibility of the isolated organisms to commonly used antimicrobials in the study area. The study revealed that one hundred and twenty-two (37%) yielded significant bacterial growth. The percentage distribution of the organisms isolated are as follows; Staphylococci (10.6%), Klebsiella spp. (13.2%), Coliforms spp. (13.9%), Staphylococcus aureus (24.6%) and Escherichia coli has the highest occurrence of (37.7%). Gram negative bacteria isolated were highly susceptible to Ciprofloxacin (10 μg), tarivid (10 μg) and streptomycin (30 μg); and moderately- to poorly sensitive to the other antibiotics used in the study. In conclusion female diabetics were at a higher risk for UTIs that than males (p=0.000) and low educational level/social class was also a risk factor (p=0.04) when compared to subjects of higher educational level/ social class.