[Pregnancy complicated by diabetes mellitus]. / Ciaza powiklana cukrzyca.

Interdisciplinary team work and recommendations of diabetologist and obstetrician is the condition of success of antenatal care and consequently perinatal outcome in pregnancy complicated by diabetes. Careful insight into the metabolic, haemodynamic and vascular disturbances is the basic of contemporary surveillance in diabetic pregnancy. The authors emphasise that a diabetic pregnant woman must not only pay attention to adequate nutrition and balanced exercise, but also be aware of and cope with characteristic, momentary swings in glycemia in order to overcome them by appropriate insulin therapy. Continuous supervision for several other complications associated with diabetic pregnancy, viz. hypertension, retinopathy, thyroid dysfunction, nephropathy and the threat of in utero foetal death is justified. Briefly, rigorous measures to sustain normoglycemia and normal blood pressure, examination of the retina, thyroid and renal functions as well as foetal status evaluation are paramount in appropriate management of major common diabetic complications in pregnancy.

[Postpartum maternal plasma leptin levels and their relationship to gestational diabetes mellitus]. / Poporodowa ocena sekrecji leptyny u kobiet z rozpoznana cukrzyca ciezarnych.

UNLABELLED: Leptin is a protein hormone mainly produced by the adipocytes. Apart from its autocrine role within the placenta in humans, plasma circulating leptin contributes to the endocrine function. Leptin levels may serve as an index of metabolic and energy balance in pregnancy. Recent reports have shown a positive correlation between leptin concentrations and plasma levels of glycated haemoglobin (HbA(1c)) in patients with gestational diabetes mellitus (GDM). OBJECTIVES: The aim of the present study was to evaluate leptin levels after delivery in GDM and normal glucose tolerance (NGT) women. MATERIALS AND METHODS: Plasma leptin concentration and insulin, c-peptide and glycated haemoglobin were measured in both. NGT women and in patients with a history of GDM in all patients total LDL - and HDL cholesterol concentrations were estimated. We also calculated the anthropometric parameters of the mother and birth weight in both groups. RESULTS: The plasma leptin concentration after delivery was not different in patients with GDM in comparison with the NGT individuals. CONCLUSIONS: We concluded that in patients with GDM and normal BM1 the postpartum leptin level was not different in comparison with the NGT patients.

[Autoimmunological basis of gestational diabetes mellitus]. / Autoimmunologiczne podloze cukrzycy ciezarnych.

This paper is a review of recent reports on autoimmune aspects of gestational diabetes mellitus (GDM). In a subgroup of GDM patients distinct phenotypic and genotypic features could be distinguished. Islet autoantibodies with variable frequency are present in samples of sera taken from women with GDM. Beta-cell destruction may follow different time course patterns. For this reasons GDM patients may develop variable forms of autoimmune DM. We believe that women who experienced autoimmune GDM are at risk of type l DM and simultaneously, they are candidates for possible immunomodulatory preventive therapy in the future.