Response to Dr. Coustan: Costs of gestational diabetes (comment on Danyliv, A.et al. Short- and long-term effects of gestational diabetes mellitus on healthcare cost: a cross-sectional comparative study in the ATLANTIC DIP cohort)

2016 ◽  
Vol 33 (6) ◽  
pp. 851-852 ◽  
Author(s):  
A. Danyliv
2021 ◽  
Vol 27 ◽  
Author(s):  
Chatzakis Christos ◽  
Cavoretto Paolo ◽  
Sotiriadis Alexandros

: Gestational diabetes mellitus (GDM) is one of the most common medical complications of pregnancy and is defined as glucose intolerance that first emerges or is first recognized during pregnancy. Several factors increase the risk of a pregnant woman to develop gestational diabetes mellitus and several interventions have been tested for the prevention of GDM development. The most common pharmacological interventions that have been assessed are metformin administration , probiotics administration and vitamin D administration. However, no intervention appears to be universally superior to placebo / no intervention for the prevention of GDM. Administration of insulin is the preferred medication for treating hyperglycemia in gestational diabetes mellitus. Metformin and glyburide are not regarded as first-line agents, as both cross the placenta to the fetus. Even though there are sufficient data indicating that administration of metformin is safe and effective in women with GDM there are very limited data concerning the long-term effects of metformin on offspring. Furthermore, glyburide should be used with caution, as increases the risk of neonatal hypoglycemia and some studies showed that increases also the risk of macrosomia. Overall, oral agents may be a therapeutic option in women with GDM after a discussion of the known risks and the need for more long-term safety data in offspring . The present review aims to highlight that current scientific status regarding the prevention and treatment of GDM.


Author(s):  
Cara Trivett ◽  
Zoe J. Lees ◽  
Dilys J. Freeman

AbstractGestational diabetes mellitus (GDM) is a common disorder of pregnancy with short- and long-term consequences for mother and baby. Pre-eclampsia is of major concern to obstetricians due to its sudden onset and increased morbidity and mortality for mother and baby. The incidence of these conditions continues to increase due to widespread maternal obesity. Maternal obesity is a risk factor for GDM and pre-eclampsia, yet our understanding of the role of adipose tissue and adipocyte biology in their aetiology is very limited. In this article, available data on adipose tissue and adipocyte function in healthy and obese pregnancy and how these are altered in GDM and pre-eclampsia are reviewed. Using our understanding of adipose tissue and adipocyte biology in non-pregnant populations, a role for underlying adipocyte dysfunction in the pathological pathways of these conditions is discussed.


2021 ◽  
Vol 22 (14) ◽  
pp. 7649
Author(s):  
Dominik Franciszek Dłuski ◽  
Ewa Wolińska ◽  
Maciej Skrzypczak

Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance that appears or is for the first time diagnosed during pregnancy. It can lead to many complications in the mother and in the offspring, so diagnostics and management of GDM are important to avoid adverse pregnancy outcomes. Epigenetic studies revealed the different methylation status of genes in pregnancies with GDM compared to pregnancies without GDM. A growing body of evidence shows that the GDM can affect not only the course of the pregnancy, but also the development of the offspring, thus contributing to long-term effects and adverse health outcomes of the progeny. Epigenetic changes occur through histone modification, DNA methylation, and disrupted function of non-coding ribonucleic acid (ncRNA) including microRNAs (miRNAs). In this review, we focus on the recent knowledge about epigenetic changes in GDM. The analysis of this topic may help us to understand pathophysiological mechanisms in GDM and find a solution to prevent their consequences.


Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 408
Author(s):  
Sumali S. Hewage ◽  
Xin Yu Hazel Koh ◽  
Shu E. Soh ◽  
Wei Wei Pang ◽  
Doris Fok ◽  
...  

(1) Background: Breastfeeding has been shown to support glucose homeostasis in women after a pregnancy complicated by gestational diabetes mellitus (GDM) and is potentially effective at reducing long-term diabetes risk. (2) Methods: Data from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study were analyzed to understand the influence of breastfeeding duration on long-term dysglycemia (prediabetes and diabetes) risk in women who had GDM in the index pregnancy. GDM and dysglycemia four to seven years postpartum were determined by the oral glucose tolerance test (OGTT). A Poisson regression model with a robust error variance was used to estimate incidence rate ratios (IRRs) for dysglycemia four to seven years post-delivery according to groupings of the duration of any breastfeeding (<1, ≥1 to <6, and ≥6 months). (3) Results: Women who had GDM during the index pregnancy and complete breastfeeding information and OGTT four to seven years postpartum were included in this study (n = 116). Fifty-one women (44%) had postpartum dysglycemia. Unadjusted IRRs showed an inverse association between dysglycemia risk and ≥1 month to <6 months (IRR 0.91; 95% confidence interval [CI] 0.57, 1.43; p = 0.68) and ≥6 months (IRR 0.50; 95% CI 0.27, 0.91; p = 0.02) breastfeeding compared to <1 month of any breastfeeding. After adjusting for key confounders, the IRR for the ≥6 months group remained significant (IRR 0.42; 95% CI 0.22, 0.80; p = 0.008). (4) Conclusions: Our results suggest that any breastfeeding of six months or longer may reduce long-term dysglycemia risk in women with a history of GDM in an Asian setting. Breastfeeding has benefits for mothers beyond weight loss, particularly for those with GDM.


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