scholarly journals Early Second-Trimester Peptidomic Identification of Serum Peptides for Potential Prediction of Gestational Diabetes Mellitus

2018 ◽  
Vol 51 (3) ◽  
pp. 1264-1275 ◽  
Author(s):  
Lingfeng Yin ◽  
Yingying Huai ◽  
Chun Zhao ◽  
Hongjuan Ding ◽  
Tao Jiang ◽  
...  

Background/Aims: Early screening and diagnosis is important for minimizing gestational adverse outcomes. Routine screening of gestational diabetes mellitus (GDM) at 24–28 weeks with 75 g oral glucose challenge test (OGCT) leaves limited time for intervention and prevention. This study aims to analyze maternal serum peptides in the early second-trimester for prediction of gestational diabetes mellitus (GDM). Methods: Serum samples were collected from 16-18-week pregnant women that visited Nanjing Maternity and Child Health Care Hospital from April to August 2015. According to gestational outcome with or without GDM in late pregnancy, 200 of serum samples from GDM mothers and controls were randomly divided into two subgroups. Peptidomic identification of serum peptides was performed by combining ultrafiltration and liquid chromatography-tandem mass spectrometry (LC-MS/MS) to investigate the differentially-expressed peptides between two groups. Results: A total of 297 identified peptides, originating from 228 proteins, were significantly differentially expressed in the GDM group compared with control. These precursor proteins may play critical roles in cell death of cortical neurons, elongation of cellular protrusions, and stabilization of microtubules. Major networks identified included those involving lipid metabolism, molecular transport and small molecule biochemistry. Conclusion: We provide for the first time a validated peptidome profile of early second-trimester serum in normal and GDM mothers, and we investigated the potential serum biomarkers for GDM. We concluded that 297 peptides could serve as potential biomarkers for GDM.

Author(s):  
Disha Andhiwal Rajput ◽  
Jaya Kundan Gedam

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.


2019 ◽  
Vol 14 (2) ◽  
pp. 42-45
Author(s):  
Manisha Yadav ◽  
Gehanath Baral

Aim: The Diabetes in Pregnancy Study Group of India (DIPSI, 2010) guidelines recommend the non-fasting 75-g oral glucose challenge test (OGCT) as a single-step screening and diagnostic test for gestational diabetes mellitus (GDM). The aim of this study was to assess the validity of DIPSI criteria by comparing with the World Health Organization (WHO) 1999 criteria of diagnosing GDM. Methods: This study was a hospital based prospective comparative study conducted among 282 pregnant women, of gestational age of 24-28 weeks attending antenatal OPD of Patan hospital. The OGCT was performed on them irrespective of fasting state and without any dietary preparation and they were again asked to come after 3 days of unrestricted carbohydrate diet in fasting state for WHO 2-hour oral glucose tolerance test (OGTT) with 75 gram of glucose load. The value of OGCT >140 mg/dl is diagnostic of GDM (DIPSI 2010). For the reliability of this test, it was compared with WHO 2-hour OGTT. Results: Among the study population, the mean age and BMI was 26.04±4.50 and 24.08±3.30 respectively. Out of 282 patients, 8 cases (2.83%) were found to have abnormal non-fasting 75-g OGCT and 4 cases (1.41%) had abnormal WHO 2-hour OGTT. Paired t test was employed to examine the difference of blood glucose level of the tests. There was statistically significant difference (p<0.001) between the tests. The Sensitivity, specificity, positive predictive value and negative predictive value of oral glucose challenge test was 25%, 97.48%, 12.5% and 98.90% respectively. The non- fasting 75-g OGCT was able to detect only 25% of the cases. Conclusions: Though the non-fasting 75-g OGCT test is cost effective and more compliant to pregnant women, the present report suggests that it cannot be used as a single step screening and diagnostic test because of its low sensitivity. However, it is an adequate alternative for screening test in resources limited areas.


2017 ◽  
Vol 16 (2) ◽  
pp. 55-62
Author(s):  
Rinku Joshi ◽  
Rosy Malla ◽  
Madhur Dev Bhattarai ◽  
Dhan Bahadur Shrestha

Introduction: Diabetes has become a significant health problem all over the world and its prevalence is increasing rapidly, including in Nepal. Prevalence of gestational diabetes mellitus (GDM) is directly related to the prevalence of type 2 diabetes. Women who areoverweight or obese before they become pregnant are more at risk of GDM irrespective of other factors.Though the risk of developing GDM in shown to be higher in overweight or obese women, there are very few studies done to show such observation in the urban population of Nepal.Methods: This was a hospital based cross-sectional prospective study conducted among the women attending ante partum clinic, in a tertiary level hospital, located at Lalitpur for one-year duration in 2009. All overweight (pre-pregnancy body mass index (BMI)>23) urban women at 24-28 weeks of gestation were enrolled.Fasting blood glucose, screening 50-g oral glucose challenge test(OGTT) and 2-hr OGTT following overnight fastingwas done as per need based on their test results and GDM was diagnosed based on standard guidelines.Results: Out of 256 women majority of women had BMI >25 kg/m2 (n=180),and 151(59%) were multiparous and 105 (41%) were primiparas. Positive screening test was obtained in 51 women (19.9%).The incidence of GDM by ADA and WHO criteria was 10 (3.9%) and 16 (6.3%) respectively. There was statistically non-significant difference in the rate of positive screening test and BMI (p=0.09). The abnormal screening test between primiparous and multiparous was significant (p=0.01).Conclusion: This study showed a high pre-pregnancy BMI and the incidence of GDMamong the patients enrolled. The rate of positive screening test is also higher than the previous studies so, GDM is a growing issue and must be well addressed.


Author(s):  
Poojita Tummala ◽  
Munikrishna M. ◽  
Kiranmayee P.

Background: Gestational diabetes mellitus (GDM) is carbohydrate intolerance at the onset of pregnancy which induces pathological short term or long term outcomes for both mother and baby. The aim of the present study was to know the prevalence of GDM in pregnant women who were attending the antenatal care (ANC) center at a tertiary care hospital in Kolar, Karnataka, India.Methods: This prospective study was conducted in Department of Obstetrics and Gynecology, Sri Devaraj Urs Medical College, a constituent of Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India. The duration of the study was two months. In this study, 108 pregnant women above 24 weeks of gestation were screened for GDM by oral glucose tolerance test. Fasting 2 milli liter blood was collected and were given 75 grams of glucose in 200 milli liters of water and asked to drink within 5 minutes. Again 2 milli liters venous blood was collected after 1 hour and 2 hours from all participants. Plasma sample was used for the estimation of glucose by glucose oxidase and peroxidase (GOD-POD) method.Results: Out of 108, 12 women (11.1%) were diagnosed with GDM. The prevalence rate was higher in the age group of 26-30 years (41.6%).  Among 12 diabetic women, five (47.2%) exercised regularly and seven (58.3%) did not doing exercise. Out of 12 GDM subjects, eight of them had family history of diabetes in first degree relatives; among which one was hypertensive and five were suffering from thyroid problems.Conclusions: In the present study, the prevalence of GDM was found to be 11.1%. Prevalence of GDM might be influenced by increasing age, pre pregnancy weight, family history of diabetes, past history of pregnancy complications, status of literacy and exercise.


2016 ◽  
Vol 23 (01) ◽  
pp. 015-019
Author(s):  
Afsheen Qazi ◽  
Amin Fahim ◽  
Aneela Qureshi3 ◽  
Mazhar ul Haque

Objectives: The present study was designed to find the importance of properscreening and early diagnosis of gestational diabetes mellitus. Study Design: A prospective/descriptive study Place of Study: tertiary care hospital Hyderabad. Duration of Study: fromSeptember 2014 to November 2014. Materials and Methods: A total of 168 pregnant femalesbetween the ages of 20-40 years & in their 24th to 28th week of gestation were enrolled for thestudy. Oral Glucose Tolerance Test of all the participants was done after an overnight fasting of10-12 hours. All the participants were given 75gm of glucose per 100 ml of distilled water. Theblood samples were collected after two hours time for serum glucose levels. Results: Mostof the participants were below 26 years of age 47(27.9%) with the mean age of 30.2±5.83years. However the highest prevalence of GDM was observed in age group 31-35 years (36%).Among the 25 cases of gestational diabetes mellitus the highest number of patients with GDMwere multipara (40%) followed by parity of 3-4 gravida (32%). Twenty seven women (16%)women had family history of diabetes mellitus. Among these 12/27 (44.4%) women were foundwith GDM, compared to 15/141 (10.6%) who have no family history of diabetes mellitus. Total14 (8.33%) women were found obese, out of these 8 (57%) women had GDM while only 6(42.8%) women had no GDM. Conclusion: The prevalence of GDM in the present study isfound to be 14.8%. A prevalence of GDM was higher in the elderly multiparous females whowere overweight and had family history of diabetes mellitus.


Author(s):  
Sukesh R. S. ◽  
Laxmy Rajmohan

Background: Gestational diabetes mellitus is common complications of pregnancy. Physical activity is associated with a lower risk of type 2 diabetes mellitus. The present study aimed to know association between physical activity and gestational diabetes mellitus in the first 20 weeks of their pregnancy.Methods: In the current case-control study, 50 pregnant females with gestational diabetes mellitus as the case group and 50 pregnant females as control group were selected. To diagnose gestational diabetes mellitus using diagnostic criteria. Females with abnormal oral glucose challenge test (>140mg/dL) were asked to perform the three-hour 100 g oral glucose tolerance test. The details of physical activity were collected by pregnancy physical activity questionnaire. Anthropometric and other data were recorded for all of the participants.Results: Females with low total physical activity at early pregnancy were at a significantly higher risk of developing gestational diabetes mellitus compared to the ones with higher levels of physical activity. After adjusting for age, body mass index (BMI), gravidity and a family history of diabetes, females with low physical activity during 20 weeks of pregnancy were at a significantly higher risk of developing gestational diabetes mellitus. Females with the low intensity of sedentary, light and moderate physical activity are at a higher risk of developing gestational diabetes mellitus compared to females with a higher intensity of sedentary, light and moderate physical activity.Conclusions: Females should be encouraged to do regular daily physical activity during pregnancy, if there is no specific contraindication to it. 


Author(s):  
Sedat Akgol ◽  
Mehmet Sukru Budak

<p><strong>Objective:</strong> The aim of this study was to evaluate obstetric and neonatal outcomes of pregnancies with mild gestational hyperglycemia diagnosed at gestational diabetes mellitus screening.</p><p><strong>Study design:</strong> Between September 2016 and August 2017, the pregnant women diagnosed as normal glycaemia or mild gestational hyperglycemia according to the results of gestational diabetes mellitus screening with 50 g oral glucose challenge test, and 100 g oral glucose tolerance test were compared [Normal glycaemia: Blood glucose value &lt;140 mg/dL 1 hour after 50 g oral glucose challenge test].</p><p><strong>Results:</strong> The following results were obtained in the normal glycaemia and mild gestational hyperglycemia groups respectively: Mean gestational age at birth, 38.9±1.6 and 39±1.9 weeks; preterm, term, post-term birth rates, 6%, 86.2% 7.8% and 6.8%, 86.4% and 6.8%; cesarean delivery rate, 30.9% and 34.9%; birth weight 3227.9±394.9 and 3241.05±418.5 g; small for gestational age, 4.4% and 2.3%; large for gestational age 4.6% and 7%; without any significant difference between the groups. Five minute APGAR scores were significantly lower in the mild gestational hyperglycemia group compared to the normal glycaemia group.</p><p><strong>Conclusion:</strong> There was no significant increase in adverse pregnancy outcomes such as preterm birth, post-term birth, increased caesarean delivery rate, small for gestational age and large for gestational age, except for a significant decrease in 5 minute APGAR scores in the mild gestational hyperglycemia group compared to the normal glycaemia group in our study.</p>


2018 ◽  
Vol 50 (09) ◽  
pp. 671-674
Author(s):  
Necati Hancerliogullari ◽  
Hatice Celik ◽  
Burcu Karakaya ◽  
Aytekin Tokmak ◽  
Yasemin Tasci ◽  
...  

AbstractThe aim of this study was to investigate the association between fasting duration before screening with 50 g glucose challenge test (GCT) and the test outcome. For this cross-sectional study, we enrolled 508 low-risk pregnant women who underwent 50 g GCT between the 24 and 28 weeks of gestation. We excluded women with pregestational diabetes, multiple gestations or a history of gestational diabetes mellitus (GDM), and macrosomia. We evaluated fasting durations, GCT results, and demographic features. A significant positive correlation was found between fasting duration and 50 g GCT values (r=0.122; p=0.006), and the best cut-off value was found to be 6.5 h, with 85.85% sensitivity and 38.61% specificity (relative risk, 2.73; 95% CI, 1.893–3.936; p<0.0001). Further, we divided the patients into two groups: study (fasting, <6.5 h; n=146) and control (fasting,>6.5 h; n=362) groups. Notably, the mean glucose levels, number of patients with GCT>140 mg/dl, and rates of unnecessary 100 g loadings were significantly higher in the study group. We found no significant differences between the groups in terms of the fasting plasma glucose levels and GDM prevalence. According to our findings, fasting duration of>6.5 h resulted in 2.7 times more unnecessary 100 g glucose tolerance tests (GTT). We recommend that patients having fasted for>6.5 h receive a one-step 75 g GTT after completing 8-h fasting.


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