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Articoli di riviste sul tema "Gestational glucose intolerance"

Autore: Grafiati

Pubblicato: 10 dicembre 2022

Ultima modifica: 28 gennaio 2023

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1

Szlapinski, Sandra K., Anthony A. Botros, Sarah Donegan, Renee T. King, Gabrielle Retta, Brenda J. Strutt e David J. Hill. "Altered pancreas remodeling following glucose intolerance in pregnancy in mice". Journal of Endocrinology 245, n. 2 (maggio 2020): 315–26. http://dx.doi.org/10.1530/joe-20-0012.

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Gestational diabetes mellitus increases the risk of dysglycemia postpartum, in part, due to pancreatic β-cell dysfunction. However, no histological evidence exists comparing endocrine pancreas after healthy and glucose-intolerant pregnancies. This study sought to address this knowledge gap, in addition to exploring the contribution of an inflammatory environment to changes in endocrine pancreas after parturition. We used a previously established mouse model of gestational glucose intolerance induced by dietary low protein insult from conception until weaning. Pancreas and adipose samples were collected at 7, 30 and 90 days postpartum for histomorphometric and cytokine analyses, respectively. Glucose tolerance tests were performed prior to euthanasia and blood was collected via cardiac puncture. Pregnant female mice born to dams fed a low protein diet previously shown to develop glucose intolerance at late gestation relative to controls continued to be glucose intolerant until 1 month postpartum. However, glucose tolerance normalized by 3 months postpartum. Glucose intolerance at 7 days postpartum was associated with lower beta- and alpha-cell fractional areas and higher adipose levels of pro-inflammatory cytokine, interleukin-6. By 3 months postpartum, a compensatory increase in the number of small islets and a higher insulin to glucagon ratio likely enabled euglycemia to be attained in the previously glucose-intolerant mice. The results show that impairments in endocrine pancreas compensation in hyperglycemic pregnancy persist after parturition and contribute to prolonged glucose intolerance. These impairments may increase the susceptibility to development of future type 2 diabetes.

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Sutherland, H. W., D. W. M. Pearson e F. A. Van Assche. "SCREENING FOR GESTATIONAL GLUCOSE INTOLERANCE". Lancet 334, n. 8655 (luglio 1989): 153–54. http://dx.doi.org/10.1016/s0140-6736(89)90202-x.

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Corrado, F., F. Caputo, G. Facciola e A. Mancuso. "Gestational Glucose Intolerance in Multiple Pregnancy". Diabetes Care 26, n. 5 (1 maggio 2003): 1646. http://dx.doi.org/10.2337/diacare.26.5.1646.

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4

Muche, Achenef Asmamaw, Oladapo O. Olayemi e Yigzaw Kebede Gete. "Predictors of postpartum glucose intolerance in women with gestational diabetes mellitus: a prospective cohort study in Ethiopia based on the updated diagnostic criteria". BMJ Open 10, n. 8 (agosto 2020): e036882. http://dx.doi.org/10.1136/bmjopen-2020-036882.

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ObjectivesTo identify the incidence of postpartum glucose intolerance and develop a prediction model based on antenatal characteristics to predict postpartum glucose intolerance.DesignProspective cohort study.SettingGondar town public health facilities in Northwest Ethiopia.ParticipantsWomen who had gestational diabetes mellitus were advised to undergo postpartum oral glucose tolerance test at 6–12 weeks of delivery.Main outcomePostpartum glucose intolerance.Data analysisPredictors of postpartum glucose intolerance were identified using multivariable logistic regression analysis. The discriminative power of the predictor variables for postpartum glucose intolerance and the model accuracy were computed by area under the receiver operating characteristic curve and estimated by area under the curve (AUC) with 95% CI.ResultsA total of 112 (85.5%) women with gestational diabetes mellitus returned and completed the postpartum oral glucose tolerance test. The incidence of postpartum glucose intolerance was 21.4% (95% CI14.3 to 28.4), inclusive of 18.7% pre-diabetes and 2.7% diabetes. Multivariable logistic regression analysis revealed that advanced maternal age, high fasting plasma glucose level at diagnosis, overweight and/or obesity, and antenatal depression were predictors of postpartum glucose intolerance. The AUC of the final reduced model to predict postpartum glucose intolerance was 0.884 (95% CI 0.822 to 0.937). Fasting plasma glucose at diagnosis of gestational diabetes mellitus (AUC=0.736, 95% CI0.616 to 0.845) and overweight and/or obesity (AUC=0.718, 95% CI 0.614 to 0.814) were better predictors of postpartum glucose intolerance. Moreover, the AUC for the combined predictors of fasting plasma glucose at diagnosis and mid-upper arm circumference was 0.822 (95% CI 0.722 to 0.907), which was the best predictor.ConclusionsThe incidence of postpartum glucose intolerance was high among women with gestational diabetes mellitus. Antenatal predictors modestly predicted postpartum glucose intolerance. The findings suggest ongoing glucose screening is indicated for all women with gestational diabetes mellitus.

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Varillas, Dora, e VF Varillas. "Early glucose intolerance postpartum of gestational diabetes associated with overload test with 50 grams of glucose". Problems of Endocrinology 62, n. 5 (22 settembre 2016): 30–31. http://dx.doi.org/10.14341/probl201662530-31.

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Introduction. The glucose intolerance later gestational diabetes is a very important indicator that helps establish the prognosis of diabetes in pregnant women who have had gestational diabetes (1). In this study we followed for one year to all gestational diabetes who were treated at the Hospital of Fuerteventura in endocrinology consultation,Canary Island, Spain. The aim was to study what factors might be related to glucose intolerance in the immediate postpartum.Materials and methods. All pregnant women served with the diagnosis of gestational diabetes during April 2012 to May 2013, diagnosed according to the criteria of the ADA (2), were subjected to routine procedure of specialized gynecology and endocrinology unit, first: test loading test with 50 grams of glucose, and if blood glucose was greater whom 140 mgdl,SOG was performed with 100 grams glucose three hours. All these patients were followed up with a minimum of a monthly review by both gynecology and endocrinology as was given a standard diet and as controls if necessary insulin treatment. In addition glycemia in the first quarter, glycated hemoglobin in the second and third quarter was measured, if there was family history of diabetes, as well as history of previous gestational diabetes, presence of other diseases, hypertension in pregnancy, if they had done treatment with diet or insulin. Finally, it determines if the birth was eutocic or dystocia. All the analyzes were performed in the Hospital Fuerteventura laboratory by standard autoanalyzer. SPSS v.24 program for frequency valuations and statistical analyzes. Was measured frequencies, all dependent and independent variables and logistic regression analysis, ANOVA and linear correlation with statistical significance of ≤0.05 was performed.Results. Of the 60 diabetic gestational included in the study, 49 completed the assessment of oral glucose tolerance test at 0 and 120 minutes, 81'7%, of these 57.1% were normal, 41.8% had glucose intolerance which were 26.5% impaired fasting glucose and 14’3 were intolerant, 2.5 were diabetic. In these patients: 57.6 percent had a normal vaginal delivery and 39.0% were dystocia. When we analyze all the variables according to the diagnosis of glucose intolerance, just correlated test 50 grams of glucose, ANOVA (p <0.033) with degrees of impaired glucose tolerance and there was a correlation positive linear between higher blood glucose value post 50 grams of glucose and glucose intolerance in the immediate postpartum. When we analyze dystocia, there was no correlation with any of the studied variables.Discussion. Interestingly in this study it is among correlation values loading test with 50g glucose and the presence of glucose intolerance and diabetes immediately after birth of gestational diabetes. It is known that after 50 grams of glucose greater than 200 glucose has an almost certain chance of having gestational diabetes (2) and according to some centers especially in the United States is not necessary to make a confirmatory SOG (2), however, their relationship to the immediate postpartum, it has not been seen in another study that we know until now and therefore part of their predictive value for gestational diabetes, could already give us an indication of glycemic alteration itself will happen in the immediate postpartum (3). Compared with other studies, the prevalence of glucose intolerance is similar to other high-risk populations, such as the Indian population (4), which gives the Canarian population at high risk of developing diabetes in the future. This study shows that the overload test with 50 grams of glucose is not only indicative of a very high suspicion of gestational diabetes, but can also help establish the prognosis of a future change in glucose metabolism in gestational diabetes.

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Bajaj, Harpreet S., Chang Ye, Anthony J. Hanley, Mathew Sermer, Bernard Zinman e Ravi Retnakaran. "Biomarkers of vascular injury and endothelial dysfunction after recent glucose intolerance in pregnancy". Diabetes and Vascular Disease Research 15, n. 5 (5 giugno 2018): 449–57. http://dx.doi.org/10.1177/1479164118779924.

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Objective: Women with gestational diabetes mellitus and milder gestational impaired glucose intolerance have elevated future risks of type 2 diabetes and cardiovascular disease. However, it is unclear whether they show postpartum evidence of vascular injury/dysfunction, an early event in the natural history of cardiovascular disease. Methods: In total, 337 women underwent a glucose challenge test and oral glucose tolerance test in pregnancy, yielding four gestational glucose tolerance groups: gestational diabetes mellitus, gestational impaired glucose intolerance, abnormal glucose challenge test with normal glucose tolerance on the oral glucose tolerance test and normal glucose challenge test with normal glucose tolerance. At 3 years postpartum, they underwent repeat oral glucose tolerance test (on which 69 women had pre-diabetes/diabetes) and measurement of the following serum markers of vascular injury/dysfunction: thrombomodulin, E-selectin, P-selectin, intercellular adhesion molecule-3 and vascular cell adhesion molecule-1. Results: At 3 years postpartum, mean adjusted vascular cell adhesion molecule-1 was the only vascular marker that differed across the previous gestational glucose tolerance groups. On multiple linear regression analysis, each strata of gestational dysglycaemia was an independent predictor of lower vascular cell adhesion molecule-1 at 3 years postpartum (gestational diabetes mellitus: p = 0.005; gestational impaired glucose intolerance: p = 0.003; abnormal glucose challenge test normal glucose tolerance: p = 0.0008), as was current pre-diabetes/diabetes ( p = 0.01). Conclusion: Dysregulation of vascular cell adhesion molecule-1 may be an early event in the natural history of cardiovascular disease in women with recent glucose intolerance in pregnancy.

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Mladenovic, Violeta, Milica Dimitrijevic-Stojanovic, Djuro Macut e Aleksandar Djukic. "Glycoregulation During Pregnancy". Serbian Journal of Experimental and Clinical Research 20, n. 2 (1 giugno 2019): 9–16. http://dx.doi.org/10.1515/sjecr-2017-0009.

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Abstract Pregnancy is a period marked by profound changes in a woman’s hormonal status and metabolism, including the development of a carbohydrate-intolerant state. Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. The aim of this study was to estimate and analyse the parameters of glycaemic control during pregnancy. We stratified patients into the following three groups according to OGTT results: normal glucose tolerance (NTG), gestational impaired glucose tolerance (GIGT) and GDM. We investigated 92 pregnant women, diagnosed with vital and desired pregnancy up to 12 weeks of gestation, who had signed informed consent forms. Among them, 7 pregnant women had a spontaneous abortion, while 8 pregnant women dropped out, so a total of 77 pregnant women completed the trial. Most of the women examined had no risk factors (48%), while 35% of the women had one risk factor. The current study demonstrates that normal glucose tolerance was shown in 59 (76.6%) participants, while some form of glucose intolerance (GIGT or GDM) was shown in 18 (23.4%) patients. Our findings revealed an increase in glucose intolerance with advancing pregnancy (in the second and third trimester). In conclusion, we demonstrate that the difference in the quality of glycaemic control during pregnancy is manifested in the second and third trimester, until it manifests in the first trimester. These findings underpin the clinical significance of discovering GDM.

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BEN-ZIV, RINAT GABBAY, e MOSHE HOD. "GESTATIONAL DIABETES MELLITUS". Fetal and Maternal Medicine Review 19, n. 3 (agosto 2008): 245–69. http://dx.doi.org/10.1017/s0965539508002234.

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Gestational diabetes (GDM) is defined as “carbohydrate intolerance of variable severity with onset or first recognition during pregnancy.” The definition is applicable regardless of whether insulin is used for treatment or the condition persists after pregnancy. It does not exclude the possibility that unrecognized glucose intolerance may have antedated the pregnancy”. GDM complicates 3–15% of all pregnancies and is a major cause of perinatal morbidity and mortality, as well as maternal long term morbidity. Of all types of diabetes, gestational diabetes (GDM) accounts for approximately 90–95% of all cases of diabetes in pregnancy.

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Champion, Macie L., Ashley N. Battarbee, Joseph R. Biggio, Brian M. Casey e Lorie M. Harper. "Postpartum glucose intolerance following early gestational diabetes mellitus". American Journal of Obstetrics & Gynecology MFM 4, n. 3 (maggio 2022): 100609. http://dx.doi.org/10.1016/j.ajogmf.2022.100609.

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Petry, Clive J. "Nutrition for Gestational Diabetes—Progress and Potential". Nutrients 12, n. 9 (3 settembre 2020): 2685. http://dx.doi.org/10.3390/nu12092685.

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Phan, Thi To Nhu, e Trung Vinh Hoang. "Investigation of the progress in the women with gestational diabetes mellitus postpartum". Vietnam Journal of Diabetes and Endocrinology, n. 40 (28 gennaio 2021): 45–51. http://dx.doi.org/10.47122/vjde.2020.40.8.

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Aims: Our aim was to evaluate the uptake of postpartum screening, the prevalence and the risk factors for glucose intolerance in women with a recent history of gestational diabetes mellitus (GDM). Methods: All women with a history of GDM are advised to undergo a 75g oral glucose tolerance test (OGTT) around 6 - 12 weeks postpartum. Indices of insulin sensitivity (the Matsuda index and the reciprocal of the homeostasis model assessment of insulin resistance, HOMA-IR) and an index of beta-cell function, the Insulin Secretion-Sensitivity Index-2 (ISSI-2) were calculated based on the OGTT postpartum. Multivariable logistic regression was used to some factors. Results: Of all women (135) who received an OGTT postpartum, 42.2% (57) had glucose intolerance (11.8% impaired fasting glucose, 24.4% impaired glucose tolerance and 6.0% both impaired fasting and impaired glucose tolerance) and 1.5% (2) had overt diabetes. Compared to women with a normal OGTT postpartum, women with glucose intolerance and diabetes were older (32.5 ± 4.3 vs. 30.8 ± 4.8 years, p = 0.049), were more often obese (34.5% vs. 17.3%, p = 0.023). In the multivariable logistic regression, an EM background [OR = 2.76 (1.15 - 6.62), p = 0.023] and the HbA1c level at the time of the OGTT in pregnancy [OR = 4.78 (1.19 - 19.20), p = 0.028] remained significant predictors for glucose intolerance postpartum. Women with glucose intolerance and diabetes postpartum had a similar insulin sensitivity [Matsuda index 0.656 (0.386 - 1.224) vs. 0.778 (0.532 - 1.067), p = 0.709; HOMA-IR 0.004 (0.002 - 0.009) vs. 0.064 (0.003 - 0.007), p = 0.384] but a lower beta-cell function compared to women with a normal OGTT postpartum, remaining significant after adjustment for confounders [ISSI-2 1.6 (1.2 - 2.1) vs. 1.9 (1.7 - 2.4), p = 0.002]. Conclusions: Glucose intolerance is very frequent in early postpartum in women with GDM these women have an impaired beta-cell function. Nearly one third of women did not attend the scheduled OGTT postpartum and these women have an adverse risk profile. More efforts are needed to engage and stimulate women with GDM to attend the postpartum OGTT.

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Bachaspati, Dash. "Screening of Gestational Diabetes and its correlation with Maternal and Prenatal Morbidity". International Journal Of Medical Science And Clinical Invention 5, n. 3 (23 marzo 2018): 3694–97. http://dx.doi.org/10.18535/ijmsci/v5i3.24.

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Introduction: Gestational Diabetes Mellitus (GDM) has public health importance far beyond its immediate effect on the mother and child. Pregnancy is a diabetogenic state and GDM is a major driver of the Type 2 diabetes epidemic. About 1% - 3% of all pregnant women will show glucose intolerance. GDM is the most common metabolic complication that affects pregnant women. The frequency of GDM and its associated maternal, prenatal and long term morbidity emphasizes the importance of screening method. Aim: To study the role of 50 gm glucose challenge test for screening of gestational diabetes Method: Two hundred and fifty antenatal patients between 24-28 weeks of gestation were screened for gestational diabetes by 50 gm oral glucose challenge test. Comparison was made among normal patients and patients diagnosed with gestational diabetes regarding risk factors, clinical examination, routine and special investigations and pregnancy outcome Results: Out of 250 patients 150 had no risk factors while 100 had one or more risk factors. 10 patients (4%) were diagnosed as having gestational diabetes. 8 patients were detected at 24-28 weeks and 2 were detected from the risk factor group at 32-34 weeks. Conclusion: Universal screening of all pregnant patients during 24-28 weeks with glucose challenge test is simple, convenient, cheap and easy to organize instrument to identify women with GDM. In India we recommend universal screening of all pregnant women, as they have 11 fold increased risk of developing glucose intolerance during pregnancy compared to Caucasian women.

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Benhalima, Katrien, Paul Van Crombrugge, Carolien Moyson, Johan Verhaeghe, Sofie Vandeginste, Hilde Verlaenen, Chris Vercammen et al. "Prediction of Glucose Intolerance in Early Postpartum in Women with Gestational Diabetes Mellitus Based on the 2013 WHO Criteria". Journal of Clinical Medicine 8, n. 3 (19 marzo 2019): 383. http://dx.doi.org/10.3390/jcm8030383.

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Predictors for glucose intolerance postpartum were evaluated in women with gestational diabetes mellitus (GDM) based on the 2013 World Health Organization (WHO) criteria. 1841 women were tested for GDM in a prospective cohort study. A postpartum 75g oral glucose tolerance test (OGTT) was performed in women with GDM at 14 ± 4.1 weeks. Of all 231 mothers with GDM, 83.1% (192) had a postpartum OGTT of which 18.2% (35) had glucose intolerance. Women with glucose intolerance were more often of Asian origin [15.1% vs. 3.7%, OR 4.64 (1.26–17.12)], had more often a recurrent history of GDM [41.7% vs. 26.7%, OR 3.68 (1.37–9.87)], higher fasting glycaemia (FPG) [5.1 (4.5–5.3) vs. 4.6 (4.3–5.1) mmol/L, OR 1.05 (1.01–1.09)], higher HbA1c [33 (31–36) vs. 32 (30–33) mmol/mol, OR 4.89 (1.61–14.82)], and higher triglycerides [2.2 (1.9–2.8) vs. 2.0 (1.6–2.5) mmol/L, OR 1.00 (1.00–1.01)]. Sensitivity of glucose challenge test (GCT) ≥7.2 mmol/l for glucose intolerance postpartum was 80% (63.1%–91.6%). The area under the curve to predict glucose intolerance was 0.76 (0.65–0.87) for FPG, 0.54 (0.43–0.65) for HbA1c and 0.75 (0.64–0.86) for both combined. In conclusion, nearly one-fifth of women with GDM have glucose intolerance postpartum. A GCT ≥7.2 mmol/L identifies a high risk population for glucose intolerance postpartum.

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Blesson, Chellakkan S., Amy K. Schutt, Vidyadharan A. Vipin, Daren T. Tanchico, Pretty R. Mathew, Meena Balakrishnan, Ancizar Betancourt e Chandra Yallampalli. "In utero low-protein-diet-programmed type 2 diabetes in adult offspring is mediated by sex hormones in rats†". Biology of Reproduction 103, n. 5 (7 agosto 2020): 1110–20. http://dx.doi.org/10.1093/biolre/ioaa133.

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Abstract Sex steroids regulate insulin sensitivity and glucose metabolism. We had characterized a lean type 2 diabetes (T2D) rat model using gestational low-protein (LP) diet programming. Our objective was to identify if endocrine dysfunction leading to decreased sex hormone levels will precede the development of T2D and if steroid replacement will prevent the onset of the disease. Pregnant rats were fed control or isocaloric LP diet from gestational day 4 until delivery. Normal diet was given to all mothers after delivery and to pups after weaning. LP offspring developed glucose intolerance and insulin resistance at 4 months. We measured sex steroid hormone profiles and expression of key genes involved in steroidogenesis in testis and ovary. Furthermore, one-month old rats were implanted with 90-day slow release T and E2 pellets for males and females, respectively. Glucose tolerance test (GTT) and euglycemic hyperinsulinemic clamp was performed at 4 months. LP-programmed T2D males had low T levels and females had low E2 levels due to dysregulated gene expression during steroidogenesis in gonads. GTT and euglycemic hyperinsulinemic clamp showed that LP males and females were glucose intolerant and insulin resistant; however, steroid supplementation prevented the onset of glucose intolerance and insulin resistance. Rats that developed T2D by LP programming have compromised gonadal steroidogenesis leading to low T and E2 in males and females, respectively. Sex steroid supplementation prevented the onset of glucose intolerance and insulin resistance indicating low sex steroid levels could cause compromised glucose metabolism ultimately leading to T2D.

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Sharma, Nirmala, e Durga BC. "Screening of Diabetes in Pregnancy at Nepalgunj Medical College Teaching Hospital Kohalpur". Journal of Nepalgunj Medical College 18, n. 2 (9 agosto 2021): 63–67. http://dx.doi.org/10.3126/jngmc.v18i2.38911.

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Introduction: Gestational Diabetes Mellitus (GDM) is defined as glucose intolerance of variable severity or hyperglycemia occuring for the first time during pregnancy but the glucose intolerance reverting back to normal after the puerperium. According to American Diabetic Association, approximately 7% of all pregnancy are complicated by Gestational Diabetes Mellitus, resulting in more than two lakhs cases annually and the prevalence may range from 1-14% of all pregnancies. Gestational Diabetes Mellitus usually develop in the second trimester and carries grave prognosis both for mother and fetus. So screening of diabetes is necessary for early detection of diabetes and prevention of further progression. Aims: Screening of impaired glucose tolerance and gestational diabetes mellitus by glucose challenge test (GCT) and oral glucose tolerance test (OGTT) at 24-28 weeks of pregnancy. Methods: This study was conducted in Nepalgunj Medical College Teaching Hospital over one year period taking 98 pregnant women who came to ANC (Antenatal Check up) out patient department. Screening for diabetes was done giving 50 gm of oral glucose (glucose challenge test) to the pregnant women at 24-28 weeks of gestational age. Results: The incidence of Impaired glucose tolerance and gestational diabetes in this study population was 4.1% and 1% respectively. Conclusion: Screening of Diabetes mellitus in Second trimester of pregnancy is important investigation to be done to prevent the mother and the fetus from many upcoming complications of diabetes.

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K.C., Kamana, Hua Zhang e Anju Vaidya. "Increased Incidence in False Positive Diagnosis of Gestational Diabetes Mellitus with 75gm Oral Glucose Tolerance Test: A Clinical Study in Chinese Women". Journal of Nepal Health Research Council 17, n. 01 (28 aprile 2019): 103–8. http://dx.doi.org/10.33314/jnhrc.v17i01.1588.

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Background: Currently, most of the countries across the globe follow the International Association of the Diabetes and Pregnancy Study Groups criteria in the diagnosis of gestational diabetes mellitus, which is based on the analysis of Hyperglycemia and Adverse Pregnancy Outcome study. The International Association of the Diabetes and Pregnancy Study Groups criterion comes with its benefits and doubts. Although it has been adopted worldwide, diagnosis of gestational diabetes mellitus with single test and only one positive value has always been debated and is often criticized. This study aimed to assess if the participant with lesser degree of glucose intolerance increases the incidence of false positive diagnosis of gestational diabetes mellitus with 75gm Oral Glucose Tolerance Test based on International Association of the Diabetes and Pregnancy Study Groups criteria.Methods: This prospective, interventional study was conducted in outpatient department of a tertiary hospital of China over a period of 12 months. 48 patients who were diagnosed with gestational diabetes mellitus in 24-31 weeks of pregnancy by 75mg Oral Glucose Tolerance Test were selected via conventional sampling technique based on lesser degree (less severe, not in need of immediate medical attention) of glucose intolerance. These patients underwent second Oral Glucose Tolerance Test within 2-3 weeks of first test. Patients with normal 2nd Oral Glucose Tolerance Test were observed closely throughout their gestational period and compared with the control group.Results: The mean values of data of control and case group were compared and 37.5% of the patients failed to reproduce the same result with the second test and all of them having normal maternal and fetal outcome without any treatment of gestational diabetes mellitus (t-test, p=0.05).Conclusions: With International Association of the Diabetes and Pregnancy Study criteria, more patients with lesser degree of glucose intolerance have been falsely diagnosed and treated as gestational diabetes mellitus.Keywords: Gestational diabetes mellitus; international association of the diabetes and pregnancy study groups; Oral glucose tolerance test .

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Chowdhury, Salma, Tanvirul Hasan, Mir Moyeedul Islam, Susmita Nargis e ABM Moniruddin. "Gestational Diabetes Mellitus". KYAMC Journal 9, n. 2 (10 settembre 2018): 81–86. http://dx.doi.org/10.3329/kyamcj.v9i2.38154.

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Diabetes mellitus during pregnancy (i.e., Gestational Diabetes Mellitus or GDM) has definite impact on maternal & fetal health. A woman is diagnosed with gestational diabetes specially when glucose intolerance continues beyond 24-28 weeks of gestation GDM needs to be specially considered, because it may often remain undiagnosed leading to abortion, miscarriage, fetal obesity, intra-uterine growth retardation (IUGR), intrauterine death (IUD) of fetus in addition to maternal morbidities & mortalities. Here we have reviewed in brief about the causes, pathophysiology, complications, risks, diagnosis, management, prevention etc. of GDM.KYAMC Journal Vol. 9, No.-2, July 2018, Page 81-86

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Nouhjah, Sedigheh, Hajieh Shahbazian, Nahid Shahbazian, Alireza Jahanshahi, Shayesteh Jahanfar e Bahman Cheraghian. "Incidence and Contributing Factors of Persistent Hyperglycemia at 6–12 Weeks Postpartum in Iranian Women with Gestational Diabetes: Results from LAGA Cohort Study". Journal of Diabetes Research 2017 (2017): 1–9. http://dx.doi.org/10.1155/2017/9786436.

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Background. A history of gestational diabetes is an important predictor of many metabolic disturbances later in life.Method. Life after gestational diabetes Ahvaz Study (LAGAs) is an ongoing population-based cohort study. Up to February 2016, 176 women with gestational diabetes underwent a 75 g oral glucose tolerance test (OGTT) at 6–12 weeks postpartum in Ahvaz (southwestern of Iran). Gestational diabetes was diagnosed according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria and the American Diabetes Association (ADA) criteria applied for diagnosis of postpartum prediabetes and diabetes. Univariate and multivariate regression analysis were done.Results. Overall incidence of early postpartum glucose intolerance was 22.2% (95% CI, 16.3–29.0), 17.6% prediabetes (95% CI, 12.3–24.1) and 4.5% diabetes (95% CI, 2.0–8.8%). Independent risk factors for glucose intolerance were FPG ≥ 100 at the time of OGTT (OR 3.86; 95% CI; 1.60–9.32), earlier diagnosis of GDM (OR 0.92; 95% CI; 0.88–0.97), systolic blood pressure (OR 1.02; 95% CI; 1.002–1.04), and insulin or metformin therapy (OR 3.14; 95% CI; 1.20–8.21).Conclusion. Results determined a relatively high rate of glucose intolerance at 6–12 weeks after GDM pregnancy. Early postpartum screening of type 2 diabetes is needed particularly in women at high risk of type 2 diabetes.

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Harris, M. I. "Gestational Diabetes May Represent Discovery of Preexisting Glucose Intolerance". Diabetes Care 11, n. 5 (1 maggio 1988): 402–11. http://dx.doi.org/10.2337/diacare.11.5.402.

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Benhalima, Katrien, Liesbeth Leuridan, Peggy Calewaert, Roland Devlieger, Johan Verhaeghe e Chantal Mathieu. "Glucose Intolerance after a Recent History of Gestational Diabetes". International Journal of Endocrinology 2014 (2014): 1–9. http://dx.doi.org/10.1155/2014/727652.

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Aim. Our aim was to evaluate the uptake of our current screening strategy postpartum and the risk factors for glucose intolerance in women with a recent history of gestational diabetes (GDM).Methods. Retrospective analysis of files of women with a recent history of GDM diagnosed with the Carpenter and Coustan criteria from 01-01-2010 till 31-12-2013. Multivariable logistic regression was used to adjust for confounders.Results. Of all 231 women with a recent history of GDM, 21.4% (46) did not attend the scheduled postpartum OGTT. Of the women tested, 39.1% (66) had glucose intolerance and 5.3% (9) had diabetes. These women were more often overweight (39.7% versus 25.3%,P= 0.009), were more often treated with basal-bolus insulin injections (52.0% versus 17.4%,P= 0.032), and had a lower beta-cell function and lower insulin sensitivity, remaining significant after adjustment for age, BMI, and ethnicity (insulin secretion sensitivity index-2 (ISSI-2) in pregnancy 1.5 ± 0.5 versus 1.7 ± 0.4,P= 0.029; ISSI-2 postpartum 1.5 (1.2–1.9) versus 2.2 (1.8–2.6),P= 0.020; Matsuda index postpartum 3.8 (2.6–6.2) versus 6.0 (4.3–8.8),P= 0.021).Conclusion. Glucose intolerance is frequent in early postpartum and these women have a lower beta-cell function and lower insulin sensitivity. One fifth of women did not attend the scheduled OGTT postpartum.

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Yang, X., BH H. Hsu-Hage, L. Dong, H. Zhang, C. Zhang e Y. Zhang. "Postpartum glucose intolerance in Chinese women with gestational diabetes". Diabetic Medicine 20, n. 8 (agosto 2003): 687–89. http://dx.doi.org/10.1046/j.1464-5491.2003.09282.x.

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22

Miyakoshi, Kei, Mamoru Tanaka, Tadashi Matsumoto, Yoshihisa Hattori, Kazunori Ueno, Takahide Teranishi, Kazuhiro Minegishi, Hitoshi Ishimoto, Akira Shimada e Yasunori Yoshimura. "Hypertensive disorders in Japanese women with gestational glucose intolerance". Diabetes Research and Clinical Practice 64, n. 3 (giugno 2004): 201–5. http://dx.doi.org/10.1016/j.diabres.2003.11.002.

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23

Selen, Daryl J., P. Kaitlyn Edelson, Kathryn Corelli, Kaitlyn James, Marie-France Hivert, Ravi Thadhani, Jeffrey Ecker e Camille Elise Powe. "Insulin Resistant Gestational Glucose Intolerance Is Associated With Adverse Perinatal Outcomes". Journal of the Endocrine Society 5, Supplement_1 (1 maggio 2021): A434. http://dx.doi.org/10.1210/jendso/bvab048.885.

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Abstract (sommario):

Abstract Background: Women with gestational diabetes mellitus (GDM) and gestational glucose intolerance (GGI, abnormal initial GDM screening test) and their infants have an increased risk of adverse perinatal outcomes including large for gestational age birth weight (LGA), pregnancy-related hypertension, neonatal intensive care unit (NICU) admission, and cesarean delivery. We expanded a prior analysis defining physiologic subtypes of GGI categorized by insulin resistance, insulin deficiency, or mixed pathophysiology. We aimed to determine if GGI subtypes are at differential risk for adverse outcomes. Methods: We applied homeostasis model assessment (HOMA2) to fasting glucose and insulin levels at 16–20 weeks’ gestation to assess insulin resistance and deficiency, defined using the 50th percentile in 220 women with a normal glucose loading test (GLT) at 24–30 weeks’ gestation. We defined GGI as GLT 1-hr glucose ≥140 mg/dL (n=245) and normal glucose tolerance (NGT) as GLT 1-hr glucose <140 mg/dL (n=1538). We classified women with GGI into subtypes according to the presence of insulin resistance and/or deficiency. We compared odds of adverse outcomes in each subtype to odds in women with NGT using logistic regression with adjustment for age, race/ethnicity, marital status, and 1st trimester BMI, plus infant sex in LGA models. Results: Of women with GGI, 49.0% had the insulin resistant subtype (IR, n=120), 30.6% had the insulin deficient subtype (ID, n=75), 15.9% had mixed pathophysiology (MP, n=39), and 4.5% had no evidence of IR or ID (n=11). GLT results and GDM diagnosis were similar among GGI subtypes. We found increased odds of LGA (primary outcome) in women with IR compared to women with NGT (OR 1.97 [1.17–3.32], p=0.01) in an unadjusted model; this was attenuated in an adjusted model with BMI (adjusted OR 1.43 [0.82–2.49], p=0.21). There was a trend toward increased odds of LGA in women with ID (adjusted OR 1.87 [0.92–3.80], p=0.09) and no increased odds in women with MP (adjusted OR 1.33 [0.50–3.57], p=0.57) compared to NGT. The odds of pregnancy-related hypertension in the IR subtype were increased (adjusted OR 1.68 [1.02–2.77], p=0.04) compared to women with NGT; women with ID (adjusted OR 0.91 [0.44–1.88], p=0.79) or MP (adjusted OR 1.13 [0.48–2.67], p=0.78) did not have increased odds. Neither infants of women with IR nor ID had increased odds of NICU admission overall, yet among women with BMI <25, infants of those with IR had increased odds of NICU admission compared to those of women with NGT (adjusted OR 3.37 [1.04–10.96], p=0.02); odds of NICU admission were not increased in infants of women with ID and BMI <25 (adjusted OR 0.50 [0.07–3.83], p=0.50). There was no difference in cesarean delivery across subtypes. Conclusion: Insulin resistant GGI is a high-risk subtype for adverse perinatal outcomes. Using HOMA2 to delineate subtypes may provide opportunities for a personalized approach to GGI/GDM.

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Rajput, Disha Andhiwal, e Jaya Kundan Gedam. "The application of 50g oral glucose challenge test in screening for gestational diabetes mellitus in patients attending antenatal care OPD". International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, n. 5 (27 aprile 2017): 1952. http://dx.doi.org/10.18203/2320-1770.ijrcog20171955.

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Background: To screen patients at average risk for Gestational Diabetes using 50g Glucose Challenge test, to ascertain the prevalence of Gestational diabetes through further diagnostic testing and to prevent and manage complications. Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable severity with onset or first recognition during pregnancy. Women with GDM are at risk for maternal and foetal complications, so it is important to screen all the pregnant woman.Methods: This study was conducted in 198 patients between 24 and 28 weeks of gestation, attending the Antenatal clinic. 50g oral glucose is administered irrespective of time of the last meal and plasma glucose is measured one hour later. Patients with plasma glucose levels more than 140 mg/dl were subjected to a 100g oral glucose tolerance test, patients with two or more abnormal reading were labelled as GDM and managed accordingly.Results: Prevalence of GDM in our study was 9.59%. Maternal complications like gestational hypertension, vaginal infections and foetal complications were much higher in GDM patients as compare to non GDM group.Conclusions: GDM is a disease which adversely affects both mother as well as foetus. It is concluded that 50 gm glucose challenge test at 24-28 weeks of gestation with a cut-off value of 140 mg/dl is a reliable screening test for GDM. This test offers the best combination of ease and economy of use and reproducibility in screening for gestational diabetes mellitus in average risk patients.

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Brewster, Shireen, John Floras, Bernard Zinman e Ravi Retnakaran. "Endothelial Function in Women with and without a History of Glucose Intolerance in Pregnancy". Journal of Diabetes Research 2013 (2013): 1–9. http://dx.doi.org/10.1155/2013/382670.

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Background/Aims. Gestational diabetes mellitus (GDM) and milder gestational impaired glucose tolerance (GIGT) identify women who are at risk of developing cardiovascular disease. Endothelial dysfunction, as indicated by impaired flow-mediated dilatation (FMD) on brachial artery ultrasound, is an early marker of vascular disease. Thus, we sought to evaluate endothelial function in women with and without recent glucose intolerance in pregnancy.Methods. One-hundred and seventeen women underwent oral glucose tolerance testing (OGTT) in pregnancy, enabling stratification into those with normal gestational glucose tolerance (n=59) and those with GDM or GIGT (n=58). 6 years postpartum, they underwent a repeat of OGTT and brachial artery FMD studies, enabling assessment of FMD and 4 secondary vascular measures: FMD after 60 seconds (FMD60), baseline arterial diameter, peak shear rate, and reactive hyperemia.Results. There were no differences between the normal gestational glucose tolerance and GDM/GIGT groups in FMD (mean 8.5 versus 9.3%,P=0.61), FMD60(4.1 versus 5.1%,P=0.33), baseline diameter (3.4 versus 3.4 mm,P=0.66), peak shear rate (262.6 versus 274.8 s−1,P=0.32), and reactive hyperemia (576.6 versus 496.7%,P=0.07). After covariate adjustment, there were still no differences between the groups.Conclusion. Despite their long-term cardiovascular risk, women with glucose intolerance in pregnancy do not display endothelial dysfunction 6 years postpartum.

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Plows, J. F., J. M. Ramos Nieves, F. Budin, K. Mace, C. M. Reynolds, M. H. Vickers, I. Silva-Zolezzi, P. N. Baker e J. L. Stanley. "The effects of myo-inositol and probiotic supplementation in a high-fat-fed preclinical model of glucose intolerance in pregnancy". British Journal of Nutrition 123, n. 5 (27 novembre 2019): 516–28. http://dx.doi.org/10.1017/s0007114519003039.

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AbstractGlucose intolerance during pregnancy – a major driver of gestational diabetes mellitus (GDM) – has significant short- and long-term health consequences for both the mother and child. As GDM prevalence continues to escalate, there is growing need for preventative strategies. There is limited but suggestive evidence that myo-inositol (MI) and probiotics (PB) could improve glucose tolerance during pregnancy. The present study tested the hypothesis that MI and/or PB supplementation would reduce the risk of glucose intolerance during pregnancy. Female C57BL/6 mice were randomised to receive either no treatment, MI, PB (Lactobacillus rhamnosus and Bifidobacterium lactis) or both (MIPB) for 5 weeks. They were then provided with a high-fat diet for 1 week before mating commenced and throughout mating/gestation, while remaining on their respective treatments. An oral glucose tolerance test occurred at gestational day (GD) 16·5 and tissue collection at GD 18·5. Neither MI nor PB, separately or combined, improved glucose tolerance. However, MI and PB both independently increased adipose tissue expression of Ir, Irs1, Akt2 and Pck1, and PB also increased Pparγ. MI was associated with reduced gestational weight gain, whilst PB was associated with increased maternal fasting glucose, total cholesterol and pancreas weight. These results suggest that MI and PB may improve insulin intracellular signalling in adipose tissue but this did not translate to meaningful differences in glucose tolerance. The absence of fasting hyperglycaemia or insulin resistance suggests this is a very mild model of GDM, which may have affected our ability to assess the impact of these nutrients.

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Suhonen, Lauri, e Kari Teramo. "Hypertension and pre-eclampsia in women with gestational glucose intolerance". Acta Obstetricia et Gynecologica Scandinavica 72, n. 4 (gennaio 1993): 269–72. http://dx.doi.org/10.3109/00016349309068036.

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Ales, KathyL, e DianaL Santini. "SHOULD ALL PREGNANT WOMEN BE SCREENED FOR GESTATIONAL GLUCOSE INTOLERANCE?" Lancet 333, n. 8648 (maggio 1989): 1187–91. http://dx.doi.org/10.1016/s0140-6736(89)92763-3.

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29

Forsbach, G., C. Cantú-Diaz, J. Vázquez-Lara, M. A. Villanueva-Cuellar, C. Alvarez y Garcı́a e E. Rodrı́guez-Ramı́rez. "Gestational diabetes mellitus and glucose intolerance in a Mexican population". International Journal of Gynecology & Obstetrics 59, n. 3 (dicembre 1997): 229–32. http://dx.doi.org/10.1016/s0020-7292(97)00221-x.

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30

Ding, G., F. Wang, H. Huang, J. Sheng, Q. Luo e P. Lv. "Intergenerational transmission of glucose intolerance associated with gestational diabetes mellitus". Fertility and Sterility 92, n. 3 (settembre 2009): S199. http://dx.doi.org/10.1016/j.fertnstert.2009.07.1438.

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31

Jang, Eun-Hee, e Hyuk-Sang Kwon. "β-Cell dysfunction and insulin resistance in gestational glucose intolerance". Korean Journal of Internal Medicine 28, n. 3 (2013): 294. http://dx.doi.org/10.3904/kjim.2013.28.3.294.

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32

Edelson, P. Kaitlyn, Kaitlyn E. James, Aaron Leong, Juliana Arenas, Melody Cayford, Michael J. Callahan, Sarah N. Bernstein et al. "Longitudinal Changes in the Relationship Between Hemoglobin A1c and Glucose Tolerance Across Pregnancy and Postpartum". Journal of Clinical Endocrinology & Metabolism 105, n. 5 (3 febbraio 2020): e1999-e2007. http://dx.doi.org/10.1210/clinem/dgaa053.

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Abstract (sommario):

Abstract Objective To characterize the relationship between hemoglobin A1c (HbA1c) levels and glucose tolerance across pregnancy and postpartum. Design and Participants In a longitudinal study of pregnant women with gestational diabetes risk factors (N = 102), we performed oral glucose tolerance testing (OGTT) and HbA1c measurements at 10–15 weeks of gestation, 24–30 weeks of gestation (N = 73), and 6–24 weeks postpartum (N = 42). Complete blood counts were obtained from clinical records. We calculated HbA1c-estimated average glucose levels and compared them with mean OGTT glucose levels (average of fasting, 1- and 2-hour glucose levels). Linear mixed effects models were used to test for longitudinal changes in measurements. Results Mean OGTT glucose increased between 10–15 and 24–30 weeks of gestation (β = 8.1 mg/dL, P = .001), while HbA1c decreased during the same time period (β = –0.13%, P < .001). At 10–15 weeks of gestation and postpartum the discrepancy between mean OGTT glucose and HbA1c-estimated average glucose was minimal (mean [standard deviation]: 1.2 [20.5] mg/dL and 0.16 [18.1] mg/dL). At 24–30 weeks of gestation, the discrepancy widened (13.2 [17.9] mg/dL, β = 12.7 mg/dL, P < .001, compared to 10–15 weeks of gestation, with mean OGTT glucose being higher than HbA1c-estimated average glucose). Lower hemoglobin at 24–30 weeks of gestation was associated with a greater discrepancy (β = 6.4 mg/dL per 1 g/dL lower hemoglobin, P = .03 in an age- and gestational age-adjusted linear regression model). Conclusions HbA1c accurately reflects glycemia in the 1st trimester, but underestimates glucose intolerance in the late 2nd trimester. Lower hemoglobin level is associated with greater underestimation. Accounting for gestational age and maternal hemoglobin may improve the clinical interpretation of HbA1c levels during pregnancy.

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Singh, Sumi. "Diagnosis of High-risk Gestational Diabetes". Nepal Journal of Health Sciences 1, n. 1 (30 luglio 2021): 57–59. http://dx.doi.org/10.3126/njhs.v1i1.38734.

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Gestational diabetes mellitus (GDM) can be defined as any degree of glucose intolerance with onset or first recognition during pregnancy. Screening for GDM is done usually at 24-28 weeks of gestation. In this case a 27-year-old primigravida who was diagnosed as GDM after a one step approach at 22 weeks of pregnancy. Institution of management early by the help of one step diagnosis was associated with successful outcome. The case highlights the importance of diagnosing GDM early especially in developing countries where resources are limited.

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Akinci, Baris, Aygul Celtik, Serkan Yener, Sinan Genc, Sunay Tunali, Faize Yuksel, Mehmet Ali Ozcan, Mustafa Secil e Sena Yesil. "Plasma Thrombin-Activatable Fibrinolysis Inhibitor Levels Are not Associated With Glucose Intolerance and Subclinical Atherosclerosis in Women With Previous Gestational Diabetes". Clinical and Applied Thrombosis/Hemostasis 17, n. 6 (14 marzo 2011): E224—E230. http://dx.doi.org/10.1177/1076029610397753.

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We aimed to determine plasma thrombin-activatable fibrinolysis inhibitor (TAFI) antigen levels in women with previous gestational diabetes mellitus (GDM) and to evaluate the possible association of plasma TAFI with glucose intolerance and markers of subclinical atherosclerosis. This cross-sectional study was performed in 111 women with previous GDM and 60 controls. Glucose intolerance was evaluated. Homeostasis model assessment score was calculated. Circulating lipids, interleukin-6, matrix metalloproteinase-1, fibrinogen, plasminogen activator inhibitor-1, and TAFI antigen levels were assayed. Carotid intima media thickness (IMT) was measured. Women with previous GDM had increased levels of atherosclerosis markers and carotid IMT. On the other hand, plasma TAFI antigen levels were similar ( P = .395). Thrombin-activatable fibrinolysis inhibitor was not associated with the indices of insulin resistance, glucose intolerance, markers of atherosclerosis, and carotid IMT. Our data demonstrated that plasma TAFI was not altered in women with previous GDM. TAFI was not associated with glucose intolerance and subclinical atherosclerosis.

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35

Mahmood, Dr Faisal. "Most Appropriate Gestational Age for OGTT amongst High-Risk Pregnant Patients? Need for RCT". SAS Journal of Medicine 8, n. 9 (24 settembre 2022): 644–50. http://dx.doi.org/10.36347/sasjm.2022.v08i09.012.

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Abstract (sommario):

High risk for gestational diabetes mellitus includes mothers with certain ethnicities, increasing maternal age, mothers with history of high or low birth weights, rising parity, previous macrosomic baby, stillborn baby, a family history or first degree relative with gestational diabetes (GDM) and type 2 diabetes mellitus, history of glucose intolerance or GDM, polycystic ovarian syndrome and maternal obesity. Timely screening, hence intervention can prevent complications of GDM to fetus and mother. Studies investigating, when during pregnancy should this high-risk group be screened, have established that 24-28 weeks OGTT have missed a few early onset GDM cases and booking visit OGTT/12 weeks gestational age OGTT may miss late onset GDM cases. All these studies have either been retrospective or comparison groups have been mis-matched. To date there is no prospective direct comparisons, comparing early OGTT results (12 weeks gestation) and late OGTT results (24—28weeks gestations). Physiologically speaking, stress of pregnancy is higher with advancing age of gestation and 24-28 weeks gestational age OGTT seems appropriate however evidence suggests that a few early onset GDM cases are missed. There is a need for prospective comparison at two different time intervals in same group of these high risk patients to answer this question.

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36

Moon, Joon Ho, e Hak Chul Jang. "Gestational Diabetes Mellitus: Diagnostic Approaches and Maternal-Offspring Complications". Diabetes & Metabolism Journal 46, n. 1 (31 gennaio 2022): 3–14. http://dx.doi.org/10.4093/dmj.2021.0335.

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Gestational diabetes mellitus (GDM) is the most common complication during pregnancy and is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. GDM is associated with adverse pregnancy outcomes and long-term offspring and maternal complications. For GDM screening and diagnosis, a two-step approach (1-hour 50 g glucose challenge test followed by 3-hour 100 g oral glucose tolerance test) has been widely used. After the Hyperglycemia and Adverse Pregnancy Outcome study implemented a 75 g oral glucose tolerance test in all pregnant women, a one-step approach was recommended as an option for the diagnosis of GDM after 2010. The one-step approach has more than doubled the incidence of GDM, but its clinical benefit in reducing adverse pregnancy outcomes remains controversial. Long-term complications of mothers with GDM include type 2 diabetes mellitus and cardiovascular disease, and complications of their offspring include childhood obesity and glucose intolerance. The diagnostic criteria of GDM should properly classify women at risk for adverse pregnancy outcomes and long-term complications. The present review summarizes the strengths and weaknesses of the one-step and two-step approaches for the diagnosis of GDM based on recent randomized controlled trials and observational studies. We also describe the long-term maternal and offspring complications of GDM.

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37

Povinelli, Theresa, Caitlin Lim e Deborah A. Raines. "The Infant Born to a Woman with Gestational Diabetes". Neonatal Network 36, n. 4 (2017): 239–44. http://dx.doi.org/10.1891/0730-0832.36.4.239.

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Abstract (sommario):

AbstractGestational diabetes mellitus (GDM) is defined as glucose intolerance with onset during pregnancy. During pregnancy, women with GDM develop insulin resistance, which results in altered glucose tolerance. As a result, there are frequent episodes of hyperglycemia and high levels of circulating amino acids, increasing the transfer of nutrients to the fetus. This article discusses the role of the mother–baby nursing in the care of neonates born to women with gestational diabetes.

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38

Wolf, M., J. Sauk, A. Shah, K. Vossen Smirnakis, R. Jimenez-Kimble, J. L. Ecker e R. Thadhani. "Inflammation and Glucose Intolerance: A prospective study of gestational diabetes mellitus". Diabetes Care 27, n. 1 (23 dicembre 2003): 21–27. http://dx.doi.org/10.2337/diacare.27.1.21.

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39

Sauk, I., M. Wolf, A. Shah, K. Smirnakis, R. Jimenez-Kimble, J. L. Ecker e R. Thadhani. "INFLAMMATION AND GLUCOSE INTOLERANCE: A PROSPECTIVE STUDY OF GESTATIONAL DIABETES MELLITUS." Journal of Investigative Medicine 51, n. 6 (1 novembre 2003): 338.1–338. http://dx.doi.org/10.1136/jim-51-06-24.

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40

Forti, Adriana C., Tania M. B. L. Ferraz, Arley A. Peter, Eni T. F. Pessoa e Rosa M. S. Mota. "Risk factors for persistent glucose intolerance in women with gestational diabetes". Diabetes Research and Clinical Practice 50 (settembre 2000): 102–3. http://dx.doi.org/10.1016/s0168-8227(00)81806-9.

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Sauk, I., M. Wolf, A. Shah, K. Smirnakis, R. Jimenez-Kimble, J. L. Ecker e R. Thadhani. "INFLAMMATION AND GLUCOSE INTOLERANCE: A PROSPECTIVE STUDY OF GESTATIONAL DIABETES MELLITUS." Journal of Investigative Medicine 51, n. 6 (novembre 2003): 338. http://dx.doi.org/10.1097/00042871-200311000-00024.

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42

GREENBERG, L., T. MOORE e H. MURPHY. "Gestational diabetes mellitus: Antenatal variables as predictors of postpartum glucose intolerance". Obstetrics & Gynecology 86, n. 1 (luglio 1995): 97–101. http://dx.doi.org/10.1016/0029-7844(95)00103-x.

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43

Dawson, Shelagh I. "Long-term risk of malignant neoplasm associated with gestational glucose intolerance". Cancer 100, n. 1 (2003): 149–55. http://dx.doi.org/10.1002/cncr.20013.

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44

Tankó, László B., Yu Z. Bagger e Claus Christiansen. "Long-term risk of malignant neoplasm associated with gestational glucose intolerance". Cancer 100, n. 12 (6 maggio 2004): 2680–81. http://dx.doi.org/10.1002/cncr.20287.

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45

Sauk, I., M. Wolf, A. Shah, K. Smirnakis, R. Jimenez-Kimble, JL Ecker e R. Thadhani. "Inflammation and Glucose Intolerance: A Prospective Study of Gestational Diabetes Mellitus". Journal of Investigative Medicine 51, n. 6 (novembre 2003): 338. http://dx.doi.org/10.1177/108155890305100624.

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46

Sheriff, Dhastagir Sultan. "Gestational Diabetes Mellitus a Dysfunctional Metabolic State-A Perspective". Series of Endocrinology, Diabetes and Metabolism 1, n. 2 (24 giugno 2019): 24–28. http://dx.doi.org/10.54178/jsedmv1i2001.

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Abstract (sommario):

Pregnancy is considered as a test for beta cell reserve. If there is a good function, insulin resistance will overcome. If not, gestational diabetes will occur. Insulin resistance (IR) present in normal pregnancy is required to provide nutrients to the growing fetus. There is a rapid increase of insulin in such an insulin resistant state. The possibility of lipid deposition in muscle fibers (intramyocellular) could be one of the possible mechanism of IR in gestational diabetes mellitus (GDM). The poor response of insulin release, possible fat deposition in the skeletal muscle or ectopic fat deposition may cause dysfunctional homeostasis in GDM. This will definitely influence the fine tuning of metabolic machinery of a growing fetus. Children born with such subtle metabolic state will probably be more prone to glucose intolerance and ectopic lipid deposition. The finding that children born to GDM mothers are prone to glucose intolerance may be an eye-opener to monitor such children for beta cell function.

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47

Nteeba, Jackson, Kaiyu Kubota, Wenfang Wang, Hao Zhu, Jay L. Vivian, Guoli Dai e Michael J. Soares. "Pancreatic prolactin receptor signaling regulates maternal glucose homeostasis". Journal of Endocrinology 241, n. 1 (aprile 2019): 71–83. http://dx.doi.org/10.1530/joe-18-0518.

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Prolactin (PRL) signaling has been implicated in the regulation of glucose homeostatic adaptations to pregnancy. In this report, the PRL receptor (Prlr) gene was conditionally disrupted in the pancreas, creating an animal model which proved useful for investigating the biology and pathology of gestational diabetes including its impacts on fetal and placental development. In mice, pancreatic PRLR signaling was demonstrated to be required for pregnancy-associated changes in maternal β cell mass and function. Disruption of the Prlr gene in the pancreas resulted in fewer insulin-producing cells, which failed to expand appropriately during pregnancy resulting in reduced blood insulin levels and maternal glucose intolerance. This inability to sustain normal blood glucose balance during pregnancy worsened with age and a successive pregnancy. The etiology of the insulin insufficiency was attributed to deficits in regulatory pathways controlling β cell differentiation. Additionally, the disturbance in maternal blood glucose homeostasis was associated with fetal overgrowth and dysregulation of inflammation and PRL-associated transcripts in the placenta. Overall, these results indicate that the PRLR, acting within the pancreas, mediates maternal pancreatic adaptations to pregnancy. PRLR dysfunction is associated with glucose intolerance during pregnancy and pathological features consistent with gestational diabetes.

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48

Catalano, P. M. "The impact of gestational diabetes and maternal obesity on the mother and her offspring". Journal of Developmental Origins of Health and Disease 1, n. 4 (5 marzo 2010): 208–15. http://dx.doi.org/10.1017/s2040174410000115.

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Thein uteromaternal metabolic environment is important relative to both short and long term development of the offspring. Although poor fetal growth remains a significant factor relative to long-term outcome, fetal overgrowth is assuming greater importance because of the increase in obesity in the world’s populations. Maternal obesity and gestational diabetes are the most common metabolic complications of pregnancy related to fetal overgrowth and more specifically adiposity.Women with gestational diabetes have increased insulin resistance and inadequate insulin response compared with weight-matched controls. Gestational diabetes increases the risk of maternal hypertensive disease (preeclampsia) as well as cesarean delivery. At birth the neonate has increased adiposity and is at risk for birth injury. Multiple studies have reported that children of women with gestational diabetes have a greater prevalence childhood obesity and glucose intolerance; even at glucose concentrations less than currently used to define gestational diabetes, compared with normoglycemic women.Obese women also have increased insulin resistance, insulin response and inflammatory cytokines compared with average weight women both before and during pregnancy. They too are at increased risk for the metabolic syndrome-like disorders during pregnancy that is hypertension, hyperlipidemia, glucose intolerance and coagulation disorders. Analogous to women with gestational diabetes, neonates of obese women are heavier at delivery because of increased fat and not lean body mass. Similarly, these children have an increased risk of childhood adiposity and metabolic dysregulation. Hence, the preconceptional and perinatal period offers a unique opportunity to modify both short and long term risks for both the woman and her offspring.

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Seshiah, V., N. Bhavatharini, Sanjeev V. K., Changanidi A. R. A. e R. Aruyerchelvan. "Problems and solutions for the diagnosis of gestational diabetes mellitus in non metropolitan areas in India". International Journal Of Community Medicine And Public Health 7, n. 4 (26 marzo 2020): 1607. http://dx.doi.org/10.18203/2394-6040.ijcmph20201482.

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Abstract (sommario):

Management of gestational diabetes mellitus and hyperglycemia in pregnancy is challenging in developing country like India. There are several logistic, socioeconomic and cultural issues faced by the care providers and the patients alike. In order to tackle these challenges, Diabetes in Pregnancy Study Group of India (DIPSI) recommendations consisting of a single glucose challenge test is ideal to evaluate the glucose intolerance and early initiation of doctors’ prescription. This review article explores the practical challenges associated with managing gestational diabetes mellitus and recommendations to overcome these challenges in the public health system.

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Gillmer, M. D. G., M. Maresh, R. W. Beard, R. S. Elkeles, C. Alderson e B. Bloxham. "Low energy diets in the treatment of gestational diabetes". Acta Endocrinologica 113, n. 3_Suppl (agosto 1986): S44—S49. http://dx.doi.org/10.1530/acta.0.111s0044.

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Abstract. A randomised prospective study of treatment with dietary restriction alone or insulin therapy with dietary advice was performed in 15 women with glucose intolerance diagnosed early in the third trimester of pregnancy. Twentyfour hour profiles of plasma glucose and 3-hydroxybutyrate were performed before and four weeks after commencing treatment. The effect on neonatal outcome was assessed. The case history of one of the patients in the study was sent to British physicians with a special interest in diabetes to obtain their opinion about the appropriate initial treatment of women with gestational diabetes.

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