Gestational Diabetes Mellitus: Post-partum Risk and Follow Up.

BACKGROUND: Women with gestational diabetes mellitus (GDM) are at an increased risk for developing metabolic syndrome, type 2 diabetes mellitus (T2DM), and cardiovascular disease. In this review, we will discuss postpartum cardiovascular and diabetes risk in women with a history of GDM and different ways to improve postpartum screening. METHODS: This review involves a comprehensive literature review on gestational diabetes and postpartum risk for cardiovascular disease and diabetes mellitus as well as post-partum screening methods. RESULTS: Cardiovascular risk post-partum is potentiated by increased inflammatory markers leading to worsening atherosclerosis and cardiovascular events downstream. Decreased insulin sensitivity and ß cell compensation, recurrent GDM, maternal factors such as pre and post-partum weight gain and lactation may contribute to T2DM risk. Postpartum glucose testing is essential in screening women as hyperglycemia in pregnancy has long term effects on both cardiovascular disease and diabetes risk on the mother. CONCLUSION: Long and short term improvement to post-partum glucose testing is essential to decreasing cardiometabolic and diabetes risk in women with gestational diabetes mellitus.

Two cases of malignant struma ovarii with metastasis to pelvic bone.

Histologically, malignant struma ovarii metastasizes rarely, and only a few cases reported bone metastasis. Here, we describe 2 cases of biologically malignant struma ovarii with pelvic bone metastasis. Case 1 is a 22-year-old female who was found to have a large left ovarian mass during routine prenatal ultrasound. Papillary thyroid cancer arising in struma ovarii was identified after laparoscopic salpingo-oophorectomy. After total thyroidectomy, radioactive iodine whole-body scan revealed extrathyroidal iodine uptake in left anterior pelvis. Subsequent I-131 treatment resolved the pelvic metastasis. Case 2 is a 49-year-old female who was diagnosed with malignant struma ovarii in 1996 and presented in 2007 with pelvic recurrence and extensive left hip metastasis. Treatment with resection of the pelvic tumor, total thyroidectomy, and multiple I-131 ablation led to eventual resolution of the abdominal and left hip foci. In conclusion, we present 2 rare cases of malignant struma ovarii, both with metastasis to the pelvic bone. This report makes pelvic bone the most frequent site for bone metastasis in malignant struma ovarii. It also emphasizes the importance of total thyroidectomy in allowing identification and treatment of bony metastasis with radioactive iodine.

Treatment and awareness of type 2 diabetes in Beijing, China, compared to New York.

PURPOSE: The purpose of this study was to determine awareness and treatment of type 2 diabetes among Beijingers. METHODS: Surveys generated in Mandarin and English were used to poll 75 Beijingers with type 2 diabetes, 29 Beijingers without diabetes, and 23 New Yorkers without diabetes. Beijing data were compared with diabetes statistics on exercise and blood glucose testing frequency from the 2002 New York City Department of Health and Mental Hygiene Community Health Survey and the 2003, 2004, and 2005 New York State Behavioral Risk Factor Surveillance System. RESULTS: The surveyed Beijingers with diabetes used primarily only Western pills to treat their type 2 diabetes, and a smaller percentage used traditional Chinese medicine. Most of the surveyed Beijingers with diabetes wrote that they exercised regularly. Most exercised at least 7 times per week. About half of the surveyed Beijingers with diabetes had no food restrictions. Virtually all of the surveyed Beijingers with diabetes tested their blood glucose, but approximately half of these individuals tested less than 1 time per week. Beijingers with diabetes were less aware than New York respondents who did not have diabetes of what diabetes is and the consequences of poor diabetes treatment. Beijingers who did not have diabetes were less aware than New Yorkers who did not have diabetes of what diabetesis, the symptoms, the causes, the treatments, and the consequences of poor diabetes treatment. CONCLUSIONS: The results indicate that compared to New Yorkers with diabetes, Beijingers with diabetes tended to exercise much more frequently but tested their blood glucose less frequently. With the projected increase of type 2 diabetes in Beijing, more efforts need to be made to increase the frequency of blood glucose testing and basic diabetes awareness.