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1.
Eur J Neurol ; 29(1): 199-207, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34570429

RESUMO

BACKGROUND AND PURPOSE: The aim of this study was to define the prevalence of pre-eclampsia, gestational hypertension (HT), chronic HT, and gestational diabetes during pregnancy in a defined population of patients with saccular intracranial aneurysms (sIAs). METHODS: We included all patients with sIA, first admitted to the Neurosurgery Department of Kuopio University Hospital from its defined catchment population between 1990 and 2015, who had given birth for the first time in 1990 or later. The patients' medical records were reviewed, and clinical data were linked with prescription drug usage, hospital diagnoses and causes of death, obtained from nationwide registries. The prevalences of pre-eclampsia, other hypertensive disorders and gestational diabetes in patients were compared with a matched control population (n = 324). In addition, the characteristics of sIA disease in patients with pre-eclampsia were compared to those of sIA patients without pre-eclampsia. RESULTS: A total of 169 patients with sIA fulfilled the inclusion criteria. Of these, 22 (13%) had pre-eclampsia and 32 (19%) had other hypertensive disorders during pregnancy. In 324 matched controls who had given birth, the prevalence of pre-eclampsia was 5% (n = 15) and other hypertensive disorders were diagnosed in 10% (n = 34). There was no significant difference in prevalence of gestational diabetes (12% vs. 11%). Patients with sIA with pre-eclampsia more frequently had irregularly shaped aneurysms (p = 0·003). CONCLUSIONS: Pre-eclampsia was significantly more frequent in patients with sIA than in their population controls. Irregularly shaped aneurysms were more frequent in sIA patients with pre-eclampsia. Further studies are required to determine whether history of pre-eclampsia may indicate an elevated risk for sIA formation or rupture.


Assuntos
Diabetes Gestacional , Hipertensão Induzida pela Gravidez , Aneurisma Intracraniano , Pré-Eclâmpsia , Estudos de Casos e Controles , Diabetes Gestacional/epidemiologia , Feminino , Humanos , Hipertensão Induzida pela Gravidez/epidemiologia , Aneurisma Intracraniano/complicações , Aneurisma Intracraniano/epidemiologia , Pré-Eclâmpsia/epidemiologia , Gravidez
2.
BMC Pregnancy Childbirth ; 22(1): 241, 2022 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-35321691

RESUMO

BACKGROUND: Sonography based estimate of fetal weight is a considerable issue for delivery planning. The study evaluated the influence of diabetes, obesity, excess weight gain, fetal and neonatal anthropometrics on accuracy of estimated fetal weight with respect to the extent of the percent error of estimated fetal weight to birth weight for different categories. METHODS: Multicenter retrospective analysis from 11,049 term deliveries and fetal ultrasound biometry performed within 14 days to delivery. Estimated fetal weight was calculated by Hadlock IV. Percent error from birth weight was determined for categories in 250 g increments between 2500 g and 4500 g. Estimated fetal weight accuracy was categorized as accurate ≤ 10% of birth weight, under- and overestimated by > ± 10% - ± 20% and > 20%. RESULTS: Diabetes was diagnosed in 12.5%, obesity in 12.6% and weight gain exceeding IOM recommendation in 49.1% of the women. The percentage of accurate estimated fetal weight was not significantly different in the presence of maternal diabetes (70.0% vs. 71.8%, p = 0.17), obesity (69.6% vs. 71.9%, p = 0.08) or excess weight gain (71.2% vs. 72%, p = 0.352) but of preexisting diabetes (61.1% vs. 71.7%; p = 0.007) that was associated with the highest macrosomia rate (26.9%). Mean percent error of estimated fetal weight from birth weight was 2.39% ± 9.13%. The extent of percent error varied with birth weight with the lowest numbers for 3000 g-3249 g and increasing with the extent of birth weight variation: 5% ± 11% overestimation in the lowest and 12% ± 8% underestimation in the highest ranges. CONCLUSION: Diabetes, obesity and excess weight gain are not necessarily confounders of estimated fetal weight accuracy. Percent error of estimated fetal weight is closely related to birth weight with clinically relevant over- and underestimation at both extremes. This work provides detailed data regarding the extent of percent error for different birth weight categories and may therefore improve delivery planning.


Assuntos
Diabetes Gestacional , Peso Fetal , Peso ao Nascer , Diabetes Gestacional/epidemiologia , Feminino , Humanos , Recém-Nascido , Obesidade/epidemiologia , Gravidez , Estudos Retrospectivos
3.
Ugeskr Laeger ; 184(43)2022 Oct 24.
Artigo em Dinamarquês | MEDLINE | ID: mdl-36331167

RESUMO

Gestational diabetes mellitus (GDM) is associated with a number of complications, including developmental disorders in the child but the specific association is unclear. The purpose of this review is to summarize the latest knowledge about the association between GDM and one of the developmental disorders, namely autism spectrum disorder (ASF) in the child. Large cohort studies found that GDM increases the risk of ASF in the child, and that the risk increases the earlier the mother is diagnosed with GDM.


Assuntos
Transtorno do Espectro Autista , Diabetes Gestacional , Gravidez , Criança , Feminino , Humanos , Diabetes Gestacional/diagnóstico , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/etiologia , Mães
4.
BMC Endocr Disord ; 22(1): 268, 2022 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-36329422

RESUMO

BACKGROUND: The role of the Endocannabinoids (ECs) in insulin resistance, and their association with visceral obesity and metabolic profile have been studied extensively. Since the association between ECs and metabolic factors in Gestational Diabetes Mellitus (GDM) are not clear, we aimed to evaluate the levels of N-Arachidonoylethanolamide (AEA) and 2-Arachidonoylglycerol (2-AG) and their association with C-reactive protein (CRP), glycemic indices, blood pressure, and anthropometric indices in pregnant women with GDM. METHODS: The present case-control study was conducted among 96 singleton pregnant women aged 18-40 years, including 48 healthy pregnant women (control group) and 48 women with a positive diagnosis of GDM (case group). Odds Ratios (ORs) and 95% Confidence Intervals (CIs) for GDM were checked according to endocannabinoids and anthropometric indices using Multivariable Logistic Regression. RESULTS: AEA was significantly associated with increased risk of GDM in models 1, 2 and 3 (OR = 1.22, 95% CI: 1.06-1.41; OR = 1.54, 95% CI: 1.19-1.97; OR = 1.46, 95% CI:1.11-1.91). A positive but no significant association was found for AEA in model 4 (OR = 1.38,95% CI: 0.99-1.92). Similar to AEA, 2-AG was also positively associated with the likelihood of GDM in Models 1, 2, and 3 but the association attenuated to null in model 4 (OR = 1.25; 95% CI: 0.94- 1.65). CONCLUSIONS: Our findings showed that levels of ECs were significantly higher in pregnant women with GDM compared to healthy ones. Also, ECs levels were associated with the likelihood of GDM, independent of BMI and weight gain.


Assuntos
Diabetes Gestacional , Feminino , Gravidez , Humanos , Estudos de Casos e Controles , Gestantes , Endocanabinoides , Fatores de Risco , Índice de Massa Corporal
5.
Nutrients ; 14(21)2022 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-36364883

RESUMO

The efficacy of different types and doses of dietary fiber supplementation in the treatment of gestational diabetes (GDM) remains controversial. The purpose of this study is to investigate the effect of dietary fiber on blood glucose control in pregnant women with gestational diabetes mellitus, and further observe the effect on their blood lipids and pregnancy outcomes. We searched on Web of Science, PubMed, Embase, Scopus, and Cochrane, and included several articles on additional fortification with dietary fiber for gestational diabetes interventions. This meta-analysis included 8 trials. We found that additional dietary fiber supplements significantly reduced fasting glucose (Hedges'g = -0.3; 95% CI [-0.49, -0.1]), two-hour postprandial glucose (Hedges'g = -0.69; 95% CI [-0.88, -0.51]), glycated hemoglobin (Hedges'g = -0.5; 95% CI [-0.68, -0.31]), TC (Hedges'g = -0.44; 95% CI [-0.69, -0.19]), TG (Hedges'g = -0.3; 95% CI [-0.4, -0.2]) and LDL-C (Hedges'g = -0.48; 95% CI [-0.63, -0.33]). It also significantly reduced preterm delivery (Hedges'g = 0.4, 95% CI [0.19~0.84]), cesarean delivery (Hedges'g = 0.6; 95% CI [0.37~0.97]), fetal distress (Hedges'g = 0.51; 95% CI [0.22~1.19]), and neonatal weight (Hedges'g = -0.17; 95% CI [-0.27~-0.07]). In a subgroup analysis comparing dietary fiber type and dose, insoluble dietary fiber was more effective than soluble dietary fiber in reducing fasting glucose (Hedges'g = -0.44; 95% CI [-0.52, -0.35]). ≥12 g fiber per day may be more effective in improving glycemic lipid and pregnancy outcomes than <12 g/day, but the difference was not statistically significant. In conclusion, our meta-analysis showed that dietary fiber supplementation significantly improved glycolipid metabolism and pregnancy outcomes in gestational diabetes. Dietary fiber may be considered adjunctive therapy for gestational diabetes, and an additional supplement with insoluble dietary fiber is more recommended for those with poor fasting glucose. However, more high-quality studies are needed on the further effect of fiber type and the dose-effect relationship.


Assuntos
Diabetes Gestacional , Recém-Nascido , Feminino , Gravidez , Humanos , Gestantes , Suplementos Nutricionais , Glicemia , Fibras na Dieta
6.
Acta Clin Croat ; 61(1): 95-106, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36398082

RESUMO

Pregnancies burdened with gestational diabetes (GDM) are more likely to end in birth of a macrosomic child, where the frequency of operative termination of pregnancy is more common, accompanied with more complications and injuries of both mother and child in comparison to the general population. The need to calculate fetal weight right before delivery has led to the development of numerous methods for greater estimation accuracy. We reviewed the related literature from 1980 to 2020, using the terms macrosomia, ultrasound assessment, gestational diabetes, and relevant articles were considered in preparation of this article. The most frequently used methods are based on two-dimensional ultrasound measurements of individual fetal biometric parameters and their combination in a mathematical regression model. Some methods involve the addition of other mother and child conditions to increase reliability of the method in recognizing macrosomia. In daily work, especially with pregnant women suffering from GDM, it is necessary to have reliable data on the estimated fetal weight before making the correct clinical decision on how to terminate the pregnancy. In this regard, we bring a review of the literature related to the assessment of fetal macrosomia, especially in women with GDM.


Assuntos
Diabetes Gestacional , Macrossomia Fetal , Criança , Feminino , Humanos , Gravidez , Macrossomia Fetal/diagnóstico por imagem , Macrossomia Fetal/epidemiologia , Diabetes Gestacional/diagnóstico por imagem , Diabetes Gestacional/epidemiologia , Peso Fetal , Reprodutibilidade dos Testes , Aumento de Peso
7.
Genet Res (Camb) ; 2022: 1500768, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36325267

RESUMO

Objective: Insulin resistance (IR) plays a key role in gestational diabetes mellitus (GDM) pathogenesis. The antiaging protein klotho has been proven to be closely related to IR. The purpose of this study was to investigate the effect of klotho on IR in GDM trophoblast cells. Methods: The GDM cell model of HTR-8/SVneo cells was induced by high glucose (HG). Plasmid transfection was used to mediate the overexpression or silencing of klotho. The effects of klotho on cell viability, IR, and the IGF-1/PI3K pathways were observed by RT-qPCR, western blot, Cell Counting Kit-8 detection, glucose uptake assay, and immunofluorescence detection. Results: Klotho expression was up-regulated in HG-induced cells. Overexpression of klotho could reduce the cell viability, insulin signaling molecules (INSR-α, INSR-ß, IRS1, IRS2, and GLUT4), and glucose uptake in HTR-8/SVneo cells of the HG group. In addition, the overexpression of klotho inhibited the levels of IGF-1, IGF-1R/p-IGF-1R, and the phosphorylation and activation of the signal transduction molecules PI3K/Akt/mTOR. On the contrary, klotho deletions could reverse these changes of HTR-8/SVneo cells induced by HG. Conclusion. In a word, the results of this study showed that the regulation of klotho played an important role in the IR of trophoblast cells induced by HG, which was mediated at least in part by the IGF-1/PI3K/Akt/mTOR pathway.


Assuntos
Diabetes Gestacional , Resistência à Insulina , Feminino , Humanos , Gravidez , Diabetes Gestacional/genética , Glucose/metabolismo , Resistência à Insulina/genética , Fator de Crescimento Insulin-Like I/genética , Fator de Crescimento Insulin-Like I/metabolismo , Fosfatidilinositol 3-Quinases/genética , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/genética , Proteínas Proto-Oncogênicas c-akt/metabolismo , Serina-Treonina Quinases TOR/metabolismo , Trofoblastos/metabolismo , Trofoblastos/patologia , Regulação para Cima/genética , Proteínas Klotho/metabolismo
8.
Artigo em Inglês | MEDLINE | ID: mdl-36361016

RESUMO

Diet quality and protein source are associated with type 2 diabetes, however relationships with GDM are less clear. This study aimed to determine whether prepregnancy diet quality and protein source are associated with gestational diabetes mellitus (GDM). Participants were 1314 Black and White women without diabetes, who had at least one birth during 25 years of follow-up in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort study. The CARDIA A Priori Diet Quality Score (APDQS) was assessed in the overall cohort at enrollment and again at Year 7. Protein source and branched-chain amino acid (BCAA) intake were assessed only at the Year 7 exam (n = 565). Logistic regression analysis was used to determine associations between prepregnancy dietary factors and GDM. Women who developed GDM (n = 161) were more likely to have prepregnancy obesity and a family history of diabetes (p < 0.05). GDM was not associated with prepregnancy diet quality at enrollment (Year 0) (odds ratio [OR]: 1.01; 95% confidence interval [CI] 0.99, 1.02) or Year 7 (odds ratio [OR]: 0.97; 95% confidence interval [CI] 0.94, 1.00) in an adjusted model. Conversely, BCAA intake (OR:1.59, 95% CI 1.03, 2.43) and animal protein intake (OR: 1.06, 95% CI 1.02, 1.10) as a proportion of total protein intake, were associated with increased odds of GDM, while proportion of plant protein was associated with decreased odds of GDM (OR: 0.95, 95% CI 0.91, 0.99). In conclusion, GDM is strongly associated with source of prepregnancy dietary protein intake but not APDQS in the CARDIA study.


Assuntos
Diabetes Mellitus Tipo 2 , Diabetes Gestacional , Gravidez , Humanos , Animais , Feminino , Diabetes Gestacional/epidemiologia , Estudos de Coortes , Proteínas na Dieta , Vasos Coronários , Fatores de Risco
9.
Front Endocrinol (Lausanne) ; 13: 916883, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36387861

RESUMO

Objective: The prediction of gestational diabetes mellitus (GDM) by body composition-related indicators in the first trimester was analyzed under different body mass index (BMI) values before pregnancy. Methods: This was a retrospective analysis of pregnant women who were treated, had documented data, and received regular perinatal care at the Third Affiliated Hospital of Zhengzhou University from January 1, 2021, to December 31, 2021. Women with singleton pregnancies who did not have diabetes before pregnancy were included. In the first trimester (before the 14th week of pregnancy), bioelectric impedance assessment (BIA) was used to analyze body composition-related indicators such as protein levels, mineral levels, fat volume, and the waist-hip fat ratio. The Pearman's correlation coefficient was used to evaluate the linear relationship between the continuous variables and pre-pregnancy body mass index (BMI). In the univariate body composition analysis, the association with the risk of developing GDM was included in a multivariate analysis using the relative risk and 95% confidence interval obtained from logarithmic binomial regression, and generalized linear regression was used for multivariate regression analysis. Furthermore, the area under the curve (AUC) was calculated by receiver operating characteristic (ROC) curves. The optimal cutoff value of each risk factor was calculated according to the Youden Index. Results: In a retrospective study consisting of 6698 pregnant women, we collected 1109 cases of gestational diabetes. Total body water (TBW), protein levels, mineral levels, bone mineral content (BMC), body fat mass (BFM), soft lean mass (SLM), fat-free mass (FMM), skeletal muscle mass (SMM), percent body fat (PBF), the waist-hip ratio (WHR), the visceral fat level (VFL), and the basal metabolic rate (BMR) were significantly higher in the GDM group than in the normal group (P<0.05). Under the pre-pregnancy BMI groupings, out of 4157 pregnant women with a BMI <24 kg/m2, 456 (10.97%) were diagnosed with GDM, and out of 2541 pregnant women with a BMI ≥24 kg/m2, 653 (25.70%) were diagnosed with GDM. In the generalized linear regression model, it was found that in all groups of pregnant women, pre-pregnancy BMI, age, gestational weight gain (GWG) in the first trimester, and weight at the time of the BIA had a certain risk for the onset of GDM. In Model 1, without adjusting for confounders, the body composition indicators were all positively correlated with the risk of GDM. In Model 3, total body water, protein levels, mineral levels, bone mineral content, soft lean mass, fat-free mass, skeletal muscle mass, and the basal metabolic rate were protective factors for GDM. After Model 4 was adjusted for confounders, only the waist-hip ratio was positively associated with GDM onset. Among pregnant women with a pre-pregnancy BMI <24 kg/m2, the body composition-related indicators in Model 2 were all related to the onset of GDM. In Model 3, total body water, soft lean mass, fat-free mass, and the basal metabolic rate were negatively correlated with GDM onset. In the body composition analysis of among women with a pre-pregnancy BMI ≥ 24 kg/m2, only Model 1 and Model 2 were found to show positive associations with GDM onset. In the prediction model, in the basic data of pregnant women, the area under the receiver operating characteristic curve predicted by gestational weight gain for GDM was the largest (0.795), and its cutoff value was 1.415 kg. In the body composition results, the area under the receiver operating characteristic curve of body fat mass for predicting GDM risk was larger (0.663) in all pregnant women. Conclusions: Through this retrospective study, it was found that the body composition-related indicators were independently associated with the onset of GDM in both the pre-pregnancy BMI <24 kg/m2 and pre-pregnancy BMI ≥24 kg/m2 groups. Body fat mass, the visceral fat level, and the waist-hip ratio had a higher correlation with pre-pregnancy BMI. Total body water, protein levels, mineral levels, bone mineral content, soft lean mass, fat-free mass, skeletal muscle mass, and the basal metabolic rate were protective factors for GDM after adjusting for some confounders. In all pregnant women, the waist-hip ratio was found to be up to 4.562 times the risk of GDM development, and gestational weight gain had the best predictive power for GDM. Gestational weight gain in early pregnancy, body fat mass, and the waist-hip ratio can assess the risk of GDM in pregnant women, which can allow clinicians to predict the occurrence of GDM in pregnant women as early as possible and implement interventions to reduce adverse perinatal outcomes.


Assuntos
Diabetes Gestacional , Ganho de Peso na Gestação , Feminino , Gravidez , Humanos , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/epidemiologia , Diabetes Gestacional/etiologia , Estudos Retrospectivos , Composição Corporal , Índice de Massa Corporal
10.
Front Endocrinol (Lausanne) ; 13: 1016613, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36387921

RESUMO

Background: There is a relative lack of data that systematically investigates the breadth and validity of the association between bariatric surgery and health-related outcomes. We aimed to evaluate the quantity, validity, and credibility of evidence regarding the association between bariatric surgery and health-related outcomes using an umbrella review of meta-analyses. Methods: We systematically searched PubMed, Embase, and the Web of Science databases from inception until December 2, 2021, to identify meta-analyses of observational or interventional studies that investigated the association between bariatric surgery and multiple health outcomes. We extracted the summary effect size and 95% confidence interval (CI) data. The Assessment of Multiple Systematic Reviews (AMSTAR-2) and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) guidelines were used for methodological and evidence quality assessments, respectively. Results: Twenty-eight studies with 82 different health-related outcomes were included in this umbrella review. Beneficial effects of bariatric surgery have been observed in cancer incidence, mortality, cardiovascular risk, polycystic ovary syndrome (PCOS), anxiety symptoms, depressive symptoms, gestational diabetes mellitus, gestational hypertension, large for gestational age (LGA), macrosomia, post-term birth, risk of kidney stones, albuminuria, urinary incontinence, fecal incontinence, Barrett's esophagus, and diabetic retinopathy. However, adverse effects of bariatric surgery were observed for maternal anemia, perinatal mortality, congenital anomalies, preterm birth, neonatal intensive care unit (NICU) admission, intrauterine growth restriction, small for gestational age (SGA), fracture risk, upper limb fracture, suicide, self-harm, and alcohol use disorder (AUD). Conclusions: Current evidence suggests that bariatric surgery improves the majority of health-related outcomes; however, caution is advised given it may increase the risk of adverse mental effects, perinatal problems, and fractures.


Assuntos
Cirurgia Bariátrica , Diabetes Gestacional , Hipertensão Induzida pela Gravidez , Nascimento Prematuro , Gravidez , Feminino , Recém-Nascido , Humanos , Nascimento Prematuro/epidemiologia , Cirurgia Bariátrica/efeitos adversos , Resultado da Gravidez/epidemiologia , Diabetes Gestacional/epidemiologia , Hipertensão Induzida pela Gravidez/epidemiologia , Hipertensão Induzida pela Gravidez/etiologia , Aumento de Peso , Retardo do Crescimento Fetal/etiologia
11.
PLoS One ; 17(11): e0277330, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36399472

RESUMO

OBJECTIVE: Gestational diabetes mellitus (GDM) is increasing in the United States, with higher rates among minoritized racial and ethnic populations and lower income populations. GDM increases risk for type 2 diabetes (T2DM), and postpartum diabetes screening and prevention are imperative. This qualitative study examines barriers and facilitators to postpartum T2DM screening and prevention among non-privately insured individuals with a history of GDM in a state prior to Medicaid expansion. METHODS: Thirty-six non-privately insured women with a history of GDM completed semi-structured interviews. Four focus groups and seven interviews were conducted with 30 nurse practitioners, physicians, physician assistants, nurses and registered dietitians from Federally Qualified Health Centers in St. Louis, MO. Interviews and focus groups were audio-recorded and transcribed. Data were analyzed using an integrative thematic analysis informed by the socio-ecological model. RESULTS: Barriers and facilitators to T2DM screening and prevention occur across multiple environments (society, healthcare system, interpersonal, and individual). Societal barriers include insurance issues, unemployment, and lack of transportation, childcare, safe housing, and healthy food access, while facilitators include government sponsored programs and community organizations. Healthcare system barriers include care fragmentation, scheduling policies and time constraints while facilitators include care coordination, pregnancy support groups, and education materials. Interpersonal barriers include negative care experiences, cultural differences, communication challenges, competing priorities, and lack of a social support network, while facilitators include family and friend support and positive care experiences. Individual barriers include health complications and unhealthy food and exercise patterns, while facilitators include child wellbeing, empowered attitudes and healthy food and exercise patterns. CONCLUSIONS: The socioecological model highlights the societal and systemic determinants that encompass individual and interpersonal factors affecting postpartum T2DM screening and prevention. This framework can inform multi-level interventions to increase postpartum T2DM screening and prevention in this high-risk population, including policy changes to alleviate higher-level barriers.


Assuntos
Diabetes Mellitus Tipo 2 , Diabetes Gestacional , Humanos , Gravidez , Criança , Feminino , Estados Unidos , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/epidemiologia , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/prevenção & controle , Diabetes Mellitus Tipo 2/epidemiologia , Período Pós-Parto , Programas de Rastreamento/efeitos adversos , Pesquisa Qualitativa
12.
Front Endocrinol (Lausanne) ; 13: 1013663, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36339424

RESUMO

Objectives: The aim of this study is to explore the daily insulin dose and the percentage change in preprandial and basal insulin dosage of women with different types of hyperglycemia in pregnancy (HIP) during the whole gestation and postpartum period. Methods: A total of 121 subjects with HIP requiring insulin therapy were enrolled from a prospective cohort consisted of 436 pregnant women with hyperglycemia. The subjects were divided into three groups: Group 1 [type 1 diabetes mellitus (T1DM) and maturity onset diabetes of the young (MODY)], Group 2 [type 1 diabetes mellitus (T2DM)], and Group 3 [gestation diabetes mellitus (GDM)]. The primary study measurements included daily dose and percentage of different types of exogenous insulin requirements across gestation in different groups. Results: Insulin total daily dosage of Group 1 was highest among the three groups and increased significantly from the first to the second/third trimester. Percentage of preprandial insulin increased from 53.8% (46.7, 60.0) and 54.5% (42.3, 62.9) in the first trimester to 63.6% (54.9, 75.0) and 67.2% (51.8, 73.7) in the second/third trimester in Group 1 and Group 2. All subjects with T1DM and 18.6% of subjects with T2DM still required insulin administration after delivery, with a 26.9% (19.0, 46.0) and 36.7% (26.9, 52.6) decrease in total insulin dose, respectively, whereas subjects with GDM and MODY weaned off insulin completely. Conclusion: The insulin requirements for pregnancy complicated with T1DM and MODY were higher than those for T2DM and GDM. In the subjects with PGDM, the insulin requirement and percentage of preprandial insulin increased gradually from early to mid- and late pregnancy.


Assuntos
Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Diabetes Gestacional , Hiperglicemia , Gravidez em Diabéticas , Feminino , Gravidez , Humanos , Insulina/uso terapêutico , Diabetes Mellitus Tipo 1/tratamento farmacológico , Estudos Prospectivos , Teste de Tolerância a Glucose , Diabetes Gestacional/tratamento farmacológico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Gravidez em Diabéticas/tratamento farmacológico , Hiperglicemia/tratamento farmacológico
13.
Front Endocrinol (Lausanne) ; 13: 955821, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36339414

RESUMO

Diabetes mellitus is a chronic disease caused by the interaction of genetics and the environment that can lead to chronic damage to many organ systems. Genome-wide association studies have identified accumulating single-nucleotide polymorphisms related to type 2 diabetes mellitus and gestational diabetes mellitus. Genetic risk score (GRS) has been utilized to evaluate the incidence risk to improve prediction and optimize treatments. This article reviews the research progress in the use of the GRS in diabetes mellitus in recent years and discusses future prospects.


Assuntos
Diabetes Mellitus Tipo 2 , Diabetes Gestacional , Gravidez , Feminino , Humanos , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/genética , Diabetes Gestacional/terapia , Estudo de Associação Genômica Ampla , Predisposição Genética para Doença , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/terapia , Alelos , Fatores de Risco
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