Maternal History Of Diabetes Research Articles

Relationship between infant hypothyroidism and maternal thyroid disease

Background: Due to the very high complications of neonatal hypothyroidism in the country, neonatal screening program is performed for timely diagnosis and treatment of neonates. The aim of this study to investigate the relationship between infant hypothyroidism and maternal thyroid disease. Methods: This cross-sectional study was done on 195 neonates with a diagnosis of hypothyroidism. Necessary data were collected by a checklist and then analyzed by statistical methods in statistical package for the social sciences (SPSS) version 21 by statistical methods. Results: Of all mothers, 21.0% had a history of thyroid disease. There was no statistically significant relationship between maternal age and infant thyroid stimulating hormone (TSH). There was no significant relationship between the history of maternal hypothyroidism and maternal hypothyroidism (during experiments) with the amount of TSH in the newborn. There was a direct and significant relationship between maternal TSH level and maternal free T4. But there was no statistically significant relationship between infant TSH level and maternal TSH level and free T4. There was no significant difference in neonatal TSH levels with maternal anti-TPO status. There was no significant relationship between the history of maternal diabetes and the history of maternal hypertension with neonatal TSH. There was no significant difference in neonatal TSH levels by maternal thyroid status. Conclusions: In the present study, no significant relationship was found between the incidence of neonatal hypothyroidism and the presence of thyroid disease in mothers. The existence of different genetic and environmental factors and the significant impact of each of these factors can justify this result.

Abstract 11687: Diagnosis and Management of High-Risk Pulmonary Embolism in a Term Neonate

Case Presentation: A 5 day old, term infant born to a 39-year-old G1P0 with a history of diet-controlled gestational diabetes mellitus presented with hypernatremic dehydration in the setting of poor feeding. On hospital day 2, the infant suffered a bradycardic cardiac arrest requiring 2 minutes of CPR prior to return of spontaneous circulation. An echocardiogram (Figure 1A) revealed moderately depressed right ventricular (RV) function, elevated RV pressure and a large mobile mass extending from the main pulmonary artery (PA) into the left PA with obstruction of flow. D-dimer was markedly elevated at 2740 ng/mL. A subsequent CT angiogram revealed acute pulmonary emboli in the distal left and right branch PAs (Figure 1B). Additional imaging was obtained and showed dural venous sinus, left portal vein and right cephalic vein thromboses. The infant was managed with a heparin infusion and supportive therapy for the RV dysfunction and pulmonary hypertension including mechanical ventilation, inhaled nitric oxide as well as epinephrine and milrinone infusions. Over the course of two weeks, the infant improved clinically with normalization of RV function. Discussion: Neonatal pulmonary arterial thrombosis is an exceedingly rare phenomenon. The majority of cases described in the literature are associated with either an inherited thrombophilia or with underlying congenital heart disease, which were not found to be present in this case. However, this patient presented with severe dehydration and a history of maternal diabetes, both of which are risk factors for neonatal thrombosis. Fortunately, this patient responded to treatment with anticoagulation alone and did not require more invasive therapies, such as surgical thrombectomy or systemic and catheter-directed thrombolysis. Although rare, neonatal pulmonary arterial thrombosis can occur and delays in recognition and treatment may lead to significant RV dysfunction, morbidity, and even death.

Long-term Outcomes Among Young Adults With Type 2 Diabetes Based on Durability of Glycemic Control: Results From the TODAY Cohort Study.

To examine the effect of different patterns of durable glycemic control on the development of comorbidities among youth with type 2 diabetes (T2D) and to assess the impact of fasting glucose (FG) variability on the clinical course of T2D. From the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study, 457 participants (mean age, 14 years) with mean diabetes duration <2 years at entry and a minimum study follow-up of 10 years were included in these analyses. HbA1c, FG concentrations, and β-cell function estimates from oral glucose tolerance tests were measured longitudinally. Prevalence of comorbidities by glycemic control status after 10 years in the TODAY study was assessed. Higher baseline HbA1c concentration, lower β-cell function, and maternal history of diabetes were strongly associated with loss of glycemic control in youth with T2D. Higher cumulative HbA1c concentration over 4 years and greater FG variability over a year within 3 years of diagnosis were related to higher prevalence of dyslipidemia, nephropathy, and retinopathy progression over the subsequent 10 years. A coefficient of variability in FG ≥8.3% predicted future loss of glycemic control and development of comorbidities. Higher baseline HbA1c concentration and FG variability during year 1 accurately predicted youth with T2D who will experience metabolic decompensation and comorbidities. These values may be useful tools for clinicians when considering early intensification of therapy.

Maternal hypertensive disorder of pregnancy and mortality in offspring from birth to young adulthood: national population based cohort study

ObjectiveTo examine the association of maternal hypertensive disorder of pregnancy (HDP) with overall and cause specific mortality in offspring from birth to young adulthood.DesignNationwide population based cohort study.SettingDanish national health...

1185-P: Low Birth Weight Is Associated with a Nongenetic Higher Incidence Rate of Type 2 Diabetes

Background: Low birth weight, indictive of a poor fetal environment, is a risk factor for type 2 diabetes (T2D) . Most previous studies were based on cross sectional prevalence data and not designed to study the timing of onset of T2D in relation to birth weight (BW) . Furthermore, earlier studies have not adjusted for common genetic variation influencing BW. We aimed to examine associations of BW with age-specific incidence of T2D using BW polygenetic risk scores (BWPRS) to adjust for genetic confounding. Methods: Adults (30-60 years) enrolled in the Inter99 cohort from 1999-20with information on BW from original birth records, and without diabetes at baseline were eligible. Birth records were linked with individual-level data on T2D incidence from the Danish Diabetes Register and key covariates from the Inter99 study. Incidence rates of T2D as a function of age, sex and BW were modelled using Poisson regression and adjusted for adult BMI, socioeconomic status, maternal history of diabetes and BWPRS. Results: Among 4584 participants there were 438 incident cases of T2D during a mean follow-up of 18 years. BW was inversely associated with T2D with a higher incidence in men. T2D incidence increased with age and the rate of increase was higher in persons with lower BW compared with higher BW in a dose-response manner. Conclusion: A lower birth weight is associated with a greater increase in incidence rate of T2D in a non-genetic manner. Disclosure R.Wibaek: Stock/Shareholder; Novo Nordisk A/S. G.S.Andersen: Stock/Shareholder; Novo Nordisk A/S. A.Linneberg: None. N.Grarup: None. T.Hansen: None. C.Brøns: Stock/Shareholder; Novo Nordisk. D.Vistisen: Research Support; Bayer AG, Boehringer Ingelheim International GmbH, Novo Nordisk A/S, Sanofi, Stock/Shareholder; Novo Nordisk A/S. A.A.Vaag: Stock/Shareholder; AstraZeneca. Funding Danish Diabetes Academy, which is funded by the Novo Nordisk Foundation (NNF17SA0031406)

Prevalence of Iron Deficiency in Infants of Diabetic Mothers at the Age of 6 to 12 Months

Background: Iron deficiency (ID) and iron deficiency anemia (IDA) are worldwide problems in infants. The infants of diabetic mothers (IDMs) usually have low iron storage at birth. Therefore, they are at risk for developing ID and IDA during late infancy. Objective: To determine the prevalence of ID and IDA in IDMs aged 6 to 12 months and to identify the risk factors associated with abnormal iron status. Materials and Methods: The present study was a prospective descriptive study conducted in healthy, full-term, IDMs between the ages of 6 to 12 months. Growth and dietary history of IDMs as well as maternal history of diabetes were evaluated. Anemia and iron status were determined by hemoglobin, serum ferritin, and transferrin saturation. Results: Of the 50 IDMs, the prevalence of ID was 46%, and iron depletion was 14%. IDA was found in 11 IDMs. Although the gender, gestational age, birthweight, and the age of complementary food introduction were not found to be associated with abnormal iron status, infants with ID and iron depletion were more likely to be breastfed, or breastfed longer than six months, when compared to iron sufficient infants (p&lt;0.001). No exclusively breastfed infants had iron sufficiency in the study. Conclusion: There was a high prevalence of ID and IDA in IDMs. Therefore, screening for iron status along with anemia is crucial in IDMs at an earlier age. Moreover, iron supplementation starting at four months should be considered in IDMs who were exclusively or mainly breastfed. Keywords: Anemia, Iron deficiency, Iron deficiency anemia, Infants of diabetes mothers

MON-080 Unusual Association Between Congenital Hyperinsulinism and Neurofibromatosis Type 1

Background: Neurofibromatosis type 1 (NF1) is an autosomal dominant multisystemic disorder characterized by an increased risk of benign and malignant tumor formation affecting skin, bone and nervous system. In children with NF1, endocrine manifestations include central precocious puberty, growth hormone deficiency and growth hormone hypersecretion, resulting from complications of optic pathway gliomas involving the hypothalamic and sellar region. A few reports of adults with NF1 have been described to have hypoglycemia due to insulinoma. However, hypoglycemia due to hyperinsulinism has not been described in children with NF1. We present a case of NF1 diagnosed during neonatal period associated with congenital hyperinsulinism.Case: Patient was delivered at 36 weeks by C- section with birthweight of 2780 grams which was appropriate for her gestational age. There was no maternal history of diabetes. Pertinent exam findings included microcephaly and multiple café-au-lait spots. She developed hypoglycemia at DOL1 with blood glucose of 26 mg/dl which normalized with IV dextrose at a glucose infusion rate of 6 mg/kg/min. At DOL8, an attempt to wean IV dextrose failed and she developed hypoglycemia with blood glucose of 47 mg/dl. Critical sample showed insulin level 3.3 uU/ml, betahydroxybutyrate 0.08 mg/dl (0.2-2.8), cortisol 18.1 mcg/dL and GH 13.2 ng/mL. A glucagon stimulation test showed an increase in glucose of 30 mg/dl. She was diagnosed with hyperinsulinism and started on Diazoxide (8 mg/kg/day) with improvement of blood glucose with prefeed glucose of > 70 mg/dl. She had normal 8- hour fasting tolerance with all BG > 70 while on Diazoxide. Genetic test for known mutations causing hyperinsulinism was negative. Microarray confirmed a 1.42Mb interstitial deletion at chromosome 17q11.2 which encompasses NF1 gene confirming the diagnosis of NF1. Additionally, she has an Xp22.33 duplication of uncertain clinical significance.Conclusion: Our patient presented with an unusual association between congenital hyperinsulinism and NF1. Further testing needs to be performed to determine whether this association is coincidental or whether congenital hyperinsulinism is a rare manifestation of NF1.

Associations between IL-6 Variations and Congenital Heart Disease Incidence among Chinese Han People.

BackgroundOur research explored if Interleukin-6 (IL-6) variants held substantial connection to congenital heart disease (CHD) susceptibility among Chinese Han children.Material/MethodsA total of 102 CHD children were recruited as the case group while 98 healthy persons were recruited as the control group. We used polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) completed genotyping for IL-6 variants rs1800795 and rs1800796. The Hardy-Weinberg equilibrium (HWE) among controls was tested using χ2 analysis. Genotype and allele frequencies for variants were compared between groups. Odds ratio (OR) accompanied by 95% confidence interval (CI) reflected the potential link of IL-6 variants to CHD occurrence.ResultsA remarkable increased trend of rs1800795 CC genotype and C allele was detected in the CHD patient group (P<0.05). Individuals carrying rs1800795 CC genotype showed higher risk for CHD (OR=3.763, 95% CI=1.162–12.190). In addition, rs1800795 C allele could increase CHD incidence (OR=1.766, 95% CI=1.101–2.832). No significant differences were detected in IL-6 gene rs1800796 polymorphism in both genotype and allele distributions between the case group and the control group (P>0.05). These associations had no significant alteration after the adjustment of age, gender, maternal smoking history, and maternal history of diabetes.ConclusionsIL-6 variant rs1800795 exhibited a close relation to CHD susceptibility among Chinese Han people while the mutant C allele promoted CHD incidence. But rs1800796 variant showed no such influence.

Assessment of plasma blood sugar level in first degree relatives of known type 2 diabetes patients: a descriptive study from Maharashtra, India

Background: There is steady increase in the prevalence of diabetes mellitus from 0.73% to current 2.4% in rural and 4.0% to 11.6% in urban areas. Familial clustering of diabetes may support a genetic predisposition to diabetes. With increase in the prevalence of diabetes there is increase in number of first degree relative as well, thus an increased risk of developing diabetes, will also increase. To study the plasma glucose levels in First-degree relatives of family member of type 2 diabetic patients was the objective of the present study.Methods: It is a descriptive observational study with 1020 individuals serially coming to our outpatient Department for Pre-employment Medical Health Check Up Annual Health Check Up were selected. These individuals have been enrolled for the study and their family history of diabetes was noted, their sugar levels and their lipid levels were estimated and their body mass index was calculated. The data thus collected and analyzed with excel.Results: 184 (18%) individuals were FDRs, were as 836 (82%) individuals were Non-FDRs. There were 754 (74%) males [131(17%) FDR and 623(83%) Non-FDR], were as 213 (26%) females [53(20%) FDR and 213(80%) Non-FDR], 61(6%) individuals were having Diabetic Mother, 91(9%) individuals had Diabetic Father and 32(3%) were those in whom both the Parents were Diabetic. It was found that maternal history has strong association for getting abnormal BSL levels as compared to a diabetic father as the RR of 9.82 (95% 4.84 to 19.95) in individuals with mother being diabetic, and RR of 1.54(95% 0.68 to 3.87) of father being diabetic.Conclusions: Family history of diabetes, maternal history of diabetes and history of both the parents having diabetes are risk factors for diabetes in FDRs.

Gender-specific siblings and women with maternal history of diabetes are at high risk of developing type2 diabetes-a family study from South India

Risk factors associated with diabetes (DM) are to be well studied, and this study was aimed to investigate the family transmission pattern of type 2 DM in South Indian population. A total of 3093 subjects were selected between June 2017 and May 2018. Details on family history of diabetes, treatment, and age at onset of DM were recorded. The subjects are divided into three groups based on family history risk categories maintained as registries. Group 1 (NPDR) (n = 1414) was with no parent diabetes, group 2 (OPDR) (n = 1216) with one parent diabetes, and group 3 (CPDR) (n = 463) was with both parents diabetes. The history of diabetes in siblings was recorded. Diagnosis of diabetes was confirmed based on the history of treatment and by OGTT. In group 2, genderwise comparison showed higher transmission of diabetes from mothers than fathers. Women had more maternal history of diabetes than paternal history [58.1 vs 41.9%; p < 0.001]. In men, the number of brothers affected by diabetes was higher than sisters (78 vs 29%; p < 0.001) whereas in women, the number of sisters affected was higher than brothers (70.3 vs 45.7%; p < 0.001). In groups 2 and 3, mean age at onset of diabetes in the subjects was one decade earlier than the mean age at onset of diabetes in parents. Gender-specific siblings and women with maternal history of diabetes are at high risk of developing type 2 DM. Men had higher percentage of brothers affected whereas women had higher percentage of sisters affected by diabetes. The mean age at onset of diabetes in subjects was a decade earlier than mean age at onset of diabetes in their parents.

Phenotypic characteristics and risk factors in a multi-ethnic cohort of young adults with type 2 diabetes

Background: Early onset of type 2 diabetes (T2DM) is associated with prolonged exposure to hyperglycaemia and increased propensity to chronic complications. The aim of this study was to characterize and compare the phenotypic characteristics and risk factors in a multi-ethnic cohort of young adults with type 2 diabetes (T2DMY).Methods: One hundred young adults (White European [WE], South Asian [SA] and African-Caribbean [AC]) diagnosed with T2DM before the age of 40 years were recruited. Demographics, family history, diabetes related complications, co-morbidities, anthropometry (body mass index [BMI], body composition), physical activity and biochemistry (HbA1c, lipid profile, liver and renal function) and autoantibodies (anti GAD, anti islet cell) were collected for all participants. Data were analysed for the most represented ethnic groups: (WE, N = 36 and SA, N = 53) using SPSS version 23.Results: Mean (± standard deviation) age at diagnosis was 32.5 ± 5.5 years and mean diabetes duration was 7.7 ± 3.8 years. Overweight/obesity was present in 95% of participants, history of maternal diabetes in 68%, deprivation 75%, low physical activity 40%, polycystic ovarian disease 29% (in females), acanthosis nigricans 12% and non-alcoholic fatty liver 11%. There was considerable clustering of risk factors within the cohort with over 75% of all subjects having three or more of the above risk factors and 52% required insulin within 3 years of diagnosis. Two-thirds of the patients had evidence of at least one diabetes related microvascular complication.Conclusion: T2DMY is characterized by a high burden of commonly associated risk factors for both the disease and its long-term complications.

Associations of adiposity and parental diabetes with prediabetes among adolescents in Kuwait: A cross-sectional study.

Prediabetes, a high-risk state for developing diabetes, has become more prevalent among children and adolescents in recent decades. This study sought to estimate the prevalence of prediabetes and assess its association with adiposity among adolescents in Kuwait. Also, to determine whether maternal and paternal history of diabetes associate with offspring prediabetes in a sex-specific manner. A cross-sectional study was conducted by enrolling students (n = 1959; aged 14-19 years) attending high schools across Kuwait. Body mass index-for-age z-scores were estimated using the World Health Organization growth reference. Glycated hemoglobin A1c (HbA1c) was measured in capillary blood using point-of-care testing. Prediabetes was defined according to the diagnostic criteria of the American Diabetes Association (ADA; 5.7 ≤ HbA1c% ≤ 6.4) and the International Expert Committee (IEC; 6.0 ≤ HbA1c% ≤ 6.4). Adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) were estimated using Poisson regression with robust variance estimation. According to the ADA criteria, 33.3% (620/1845) of participants had prediabetes; whereas, 8.5% (157/1845) met the IEC definition for prediabetes. Subjects classified as obese had higher prevalence of prediabetes compared to children in the thinness/normal group (aPR = 1.68, 95% CI: 1.44-1.95). Analysis stratified by offspring sex showed that maternal history of diabetes is associated with prediabetes among male offspring (aPR = 1.29, 95% CI: 1.02-1.63). In contrast, paternal history of diabetes showed an association with prediabetes among female offspring (aPR = 1.22, 95% CI: 1.01-1.48). Prediabetes affects a substantial proportion of adolescents in Kuwait and adiposity and parental diabetes being the main associated factors with prediabetes.

Mitochondrial disease: an uncommon but important cause of diabetes mellitus

SummaryMitochondrial diseases are rare, heterogeneous conditions affecting organs dependent on high aerobic metabolism. Presenting symptoms and signs vary depending on the mutation and mutant protein load. Diabetes mellitus is the most common endocrinopathy, and recognition of these patients is important due to its impact on management and screening of family members. In particular, glycemic management differs in these patients: the use of metformin is avoided because of the risk of lactic acidosis. We describe a patient who presented with gradual weight loss and an acute presentation of hyperglycemia complicated by the superior mesenteric artery syndrome. His maternal history of diabetes and deafness and a personal history of hearing impairment led to the diagnosis of a mitochondrial disorder.Learning points:The constellation of diabetes, multi-organ involvement and maternal inheritance should prompt consideration of a mitochondrial disorder.Mitochondrial encephalomyopathy, lactic acidosis, stroke-like episodes (MELAS) and maternally inherited diabetes and deafness (MIDD) are the most common mitochondrial diabetes disorders caused by a mutation in m.3243A>G in 80% of cases.Metformin should be avoided due to the risk of lactic acidosis.There is more rapid progression to insulin therapy and higher prevalence of diabetic complications compared to type 2 diabetes.Diagnosis of a mitochondrial disorder leads to family screening, education and surveillance for future complications.Superior mesenteric artery syndrome, an uncommon but important cause of intestinal pseudo-obstruction in cases of significant weight loss, has been reported in MELAS patients.

Complications and Risk Factors of Neonatal Macrosomia: A Case-Control Study

Background: Macrosomia is defined as the birth weight of greater than or equal to 4,000 grams, which is considered to be a public health issue threatening mothers and neonates. Studies indicate that the prevalence rate of macrosomia is on the rise in developing countries. The present study aimed to evaluate the influential factors in the occurrence of neonatal macrosomia. Methods: This case-control study was conducted at Al-Zahra Hospital in Tabriz, located in the north-west of Iran, during March 2013-February 2014. Sample population included all the live-born neonates and their mothers. The case group consisted of the neonates with the birth weight of ≥4,000 grams (n=404), and the control group included 404 newborns weighing 2,500-3,999 grams. Data were collected using a maternal and neonatal information form (maternal age, neonatal gender, mode of delivery, maternal height, and maternal history of diabetes). Data were extracted from the medical files of the samples and recorded in the form. Data analysis was performed in SPSS version 20 using descriptive and inferential statistics (independent t-test and 2χ) at the significance level of α=0.05. Results: In total, 8,012 neonates were born during the study, 404 of whom has macrosomia (5.04%). Mean maternal age in the case and control groups was 29.6±6.1 and 27.9±8.3 years, respectively (P<0.001). Significant differences were observed in the gender (male) (odds ration [OR]=2.2 [95% CI: 1.33-3.04]; P<0.001), mode of delivery (OR=0.51 [95% CI: 0.37-0.69]; P<0.001), maternal history of diabetes (OR=4.5 [95% CI: 2.3-8.73]; P<0.001), and number of deliveries (birth rank) (OR=1.6 [95% CI: 1.19-2.39]; P<0.001) between the case and control groups. Conclusion: According to the results, there were significant associations between macrosomia at birth and maternal age, maternal history of diabetes, and birth rank. Therefore, proper planning and educational interventions are recommended for the control of the influential factors in the occurrence of macrosomia.

Family history of diabetes is associated with enhanced adipose lipolysis: Evidence for the implication of epigenetic factors

AimsType 2 diabetes is associated with insulin resistance, adipose hypertrophy and increased lipolysis. The heritability of these traits has been determined by associating them with a family history of diabetes. MethodsAbdominal subcutaneous fat biopsies were obtained from 581 subjects in a cross-sectional study. Fat cells were isolated, and the difference between measured and expected fat-cell volume was used to determine adipose morphology (degree of hypertrophy or hyperplasia). Spontaneous lipolytic activity was determined in explants of adipose tissue by measuring glycerol release. Insulin-stimulated lipogenesis was assessed by measuring the incorporation of radiolabelled glucose into fat-cell lipids. Information on parental history of diabetes was gathered by a questionnaire. ResultsAdipose morphology correlated positively with lipolysis (P<0.0001) and inversely with insulin-stimulated lipogenesis (P<0.008). Also, 24% of probands had a family history of diabetes, which was associated with higher body mass index (BMI) scores, and more insulin resistance (HOMAIR) and adipose hypertrophy. Lipolytic activity was increased, and insulin-stimulated lipogenesis decreased, in probands with a parental history of diabetes. The results for HOMAIR, lipolysis and adipose morphology remained significant after adjusting for proband BMI. A maternal history of diabetes was associated with increased adipose lipolytic activity in probands. ConclusionA family history of diabetes is independent of proband BMI, but associated with adipocyte hypertrophy and enhanced lipolysis, which suggests that these factors are genetically linked to diabetes. Moreover, the influence on lipolysis was only observed in probands with a maternal history of diabetes, thereby supporting an epigenetic impact.

Prevalence of gestational diabetes mellitus and associated risk factors in pregnant Chinese women: a cross-sectional study in Huangdao, Qingdao, China.

This study explored the prevalence of gestational diabetes mellitus (GDM) in Chinese pregnant women and identified risk factors for GDM after the implementation of the universal two-child policy. On the basis of income and population, we randomly selected three hospitals through stratified and cluster sampling. From January 1 to July 31, 2016, 4959 women who had been registered within 12 weeks of gestation received a 75-g 2-h oral glucose tolerance test (OGTT) at 24-28 gestational weeks. International Association of Diabetes and Pregnancy Study Group criteria were used for the diagnosis of GDM. The OGTT was positive in 1080 (21.8%; 1080/4959) women, who were then diagnosed as having GDM on the basis of their results. GDM was positively associated with the following factors: advanced maternal age (p<0.001; adjusted odds ratio [OR]=4.88; 95% confidence interval [CI]=2.38-10.0, pre-pregnancy body mass index overweight (OR=2.44, 95% CI=1.78-3.34)/obesity (OR=10.9, 95% CI=6-19.6; p<0.001), paternal history of diabetes (p=0.003; OR=2.54, 95% CI=1.38-4.67), and maternal history of diabetes (p<0.001; OR=3.6, 95% CI=2.16-5.98). Qingdao has an exceptionally high estimated prevalence of GDM. Widely recognized risk factors for GDM were advanced age, pre-pregnancy overweight/obesity, and a family history of diabetes in first-degree relatives. More options to prevent and manage GDM must be explored.

Prevalence and risk of diabetes based on family history in the Shanghai High-Risk Diabetic Screen (SHiDS) study.

To evaluate the prevalence and risk of diabetes based on family history in high-risk subjects and also to evaluate insulin sensitivity and insulin secretion in these subjects. Data were analysed from 9756 participants in the Shanghai High-Risk Diabetic Screen (SHiDS) Project. Family history of diabetes was classified according to parental and sibling diabetes status. The prevalence and odds ratios were calculated for each grouping after adjusting for other risk factors. Insulin resistance and sensitivity were evaluated using oral glucose tolerance test-derived indices that were validated by hyperinsulinaemic-euglycaemic and hyperglycaemic clamps. A total of 30.4% of the subjects had a family history of diabetes in a first-degree relative. The proportions of subjects with a father, mother or sibling with diabetes were 7.5, 11.9 and 5.5%, respectively. The prevalence rates of diabetes in subjects with sibling history, maternal history or paternal history of diabetes were 39.3, 38.3 and 36.4%, respectively. Sibling history was a strong risk factor for diabetes (odds ratio 1.53, 95% CI 1.27-1.84; P < 0.05). Insulin secretion was significantly lower in those with a maternal or sibling history of diabetes; however, insulin sensitivity was not significantly different among subjects with a family history of diabetes. Sibling history of diabetes was more strongly associated with diabetes risk than parental history among high-risk subjects. Subjects with a sibling or maternal history of diabetes had significantly lower insulin secretion. Sibling history is an important and independent risk factor for diabetes even among multi-risk populations. Those with a sibling history of diabetes warrant intensive care and follow-up screening.

Severe atrophy of the cerebellum on magnetic resonance imaging in a Chinese patient with maternally inherited diabetes and deafness with the A3243G mitochondrial DNA mutation

Maternally inherited diabetes and deafness (MIDD) is a rare form of diabetes with a maternal transmission and sensorineural hearing loss. Neuroradiological abnormality manifestations have been relatively rarely reported in MIDD patients. In this report, we will describe the clinical features, genetic alterations, and neuroradiological alterations in a Chinese patient with MIDD. We conducted a series of clinical examinations in the patient, including beta cell function, cognitive function tests, and magnetic resonance imaging (MRI) of the brain. The A3243G mitochondrial DNA (mtDNA) mutation in blood cells was assessed by direct sequencing analysis, and the proportions of mutant mtDNA was also analyzed. The patient exhibited the clinical features of early onset of diabetes with progressive insulin secretory defect, sensorineural hearing loss, and maternal history of diabetes and deafness. He had slightly impaired cognitive function. A brain MRI revealed severe atrophy of the cerebellum. Analysis of mtDNA revealed the A3243G mutation, with the proportion of mutant mtDNA of 15 % in leukocytes. This case extends the phenotype of the tRNALeu [UUR] A3243G mtDNA mutation.

Transient Tachypnea of Newborn in Neonatal Care Unit of Children Welfare Hospital Medical City /Baghdad

Background: Transient tachypnea (TTN) is a common disorder of the newborn. It is characterized by the early onset of tachypnea sometimes with retractions or expiratory grunting and occasionally cyanosis that isrelieved by minimal oxygen supplementation (&lt;40%).Objectives: To identify the risk factors and describe the clinical characteristics, treatment and outcome ofinfants with TTN.Patients and methods: This study was carried out on 100 newborn babies with birth weight of 2500 to 4000 gm and gestational ages range from (completed 37 -42 wks), who were admitted to the neonatal care unitof Children Welfare Teaching Hospital, Medical city, Baghdad, from 1st of September 2013 to the 31st ofJanuary 2014, and diagnosed as having TTN.Results: Males represented 68% and females were 32%, with a male to female ratio of 2.1:1. Fifty-threepercent aged 38 weeks, compared to 38% aged &lt; 38 weeks and 9% &gt; 38 weeks, indicating that therewas a significant inverse correlation between the incidence of TTN and the gestational age. There was ahighly significant inverse correlation between the neonate’s weight and the frequency of TTN. Cesareansection done in 80% compared to 20% delivered with spontaneous vaginal delivery (SVD) and neonateswho were delivered by elective section were more likely to have TTN than those delivered with SVD oremergency section. The history of maternal diabetes in (17%), a statistically significant association wasfound between TTN and the maternal Diabetes Mellitus but not with other maternal diseases. Tachypneaand chest retraction were the most frequent clinical manifestations, 93% and 72% respectively. Chest X-rayrevealed that 71% had increased pulmonary vascular markings, over aeration in 22%. Out of the 100 cases,95% were discharged after they improved without complications, 5% complicated with Pneumothorax. Nodeath in the studied group.Conclusions: There was a significant association between TTN and maternal diabetes, mode of deliveryespecially elective CS, lower gestational age (38 weeks and less), and lower body weight. The most frequentclinical manifestations of TTN are Tachypnea and chest retraction. Increased pulmonary vascular markingsand over- aeration are the most frequent radiological manifestations. TTN is a self-limited disease in mostof the cases.

Prevalence and risk factors of superior segmental optic hypoplasia in a Korean population: the Korea National Health and Nutrition Examination Survey.

BackgroundThis study investigated the prevalence and risk factors for superior segmental optic hypoplasia (SSOH) in a Korean population based on the data from the nationwide Korea National Health and Nutrition Examination Survey (KNHANES).MethodsWe performed a retrospective review of the KNHANES dataset covering January 2012 to December 2012. The study population comprised 5,612 subjects (≥19 years of age) who had participated in a medical interview covering demographic and systemic information, been issued a questionnaire regarding associated SSOH risk factors including gender, age, systemic disease, and family history, and had undergone an ophthalmologic examination. Two masked readers evaluated fundus photography, paying special attention to the presence of SSOH. Associations of risk factors (identified in the medical interview portion) with SSOH prevalence were investigated using multivariate logistic regression analysis.ResultsSSOH was detected in 16 eyes of 14 subjects, or 0.24% of the 5,612 subjects. All 16 eyes showed a corresponding visual-field defect. In multivariate logistic regression analyses, maternal history of diabetes (Odds ratio (OR), 7.666; 95% Confidence interval (CI), 2.601 ~ 22.593, p < 0.001) and paternal history of ischemic heart disease (IHD) (OR, 11.105; CI, 3.361 ~ 36.686, p < 0.001) were associated with increased risk of SSOH.ConclusionsThis study provides the first representative population-based data on SSOH prevalence in Korea. Additionally, multivariate analyses revealed that a history of maternal diabetes and paternal IHD was the most important factor influencing the prevalence of SSOH.