scholarly journals Can Common Clinical Parameters Be Used to Identify Patients Who Will Need Insulin Treatment in Gestational Diabetes Mellitus?

Diabetes Care ◽  
2011 ◽  
Vol 34 (10) ◽  
pp. 2214-2216 ◽  
Author(s):  
T. Pertot ◽  
L. Molyneaux ◽  
K. Tan ◽  
G. P. Ross ◽  
D. K. Yue ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Insulin Treatment ◽  
Clinical Parameters

scholarly journals Risk Factors for the Requirement of Antenatal Insulin Treatment in Gestational Diabetes Mellitus

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Mayu Watanabe ◽  
Akihiro Katayama ◽  
Hidetoshi Kagawa ◽  
Daisuke Ogawa ◽  
Jun Wada
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Insulin Therapy ◽  
Pregnant Women ◽  
Plasma Glucose ◽  
Insulin Treatment ◽  
Diet Group ◽  
Glucose Levels

Poor maternal glycemic control increases maternal and fetal risk for adverse outcomes, and strict management of gestational diabetes mellitus (GDM) is recommended to prevent neonatal and maternal complications. However, risk factors for the requirement of antenatal insulin treatment (AIT) are not well-investigated in the pregnant women with GDM. We enrolled 37 pregnant women with GDM and investigated the risk for AIT by comparing the patients with AIT (AIT group;n=10) and without insulin therapy (Diet group;n=27). The 1-h and 2-h plasma glucose levels and the number of abnormal values in 75 g OGTT were significantly higher in AIT group compared with Diet group. By logistic regression analysis, plasma glucose level at 1-h was significant predictor for AIT and the odds ratios were 1.115 (1.004–1.239) using forward selection method and 1.192 (1.006–1.413) using backward elimination method. There were no significant differences in obstetrical outcomes and neonatal complications. 1-h plasma glucose levels in 75 g OGTT are useful parameters in predicting the requirement for AIT in GDM. Both maternal and neonatal complications are comparable in GDM patients with and without insulin therapy.

scholarly journals Efficacy and safety of metformin for the treatment of gestational diabetes: a new approach to the problem

2016 ◽  
Vol 19 (2) ◽  
pp. 164-170 ◽  
Author(s):  
Anna I. Sazonova ◽  
Roza M. Esayan ◽  
Oksana I. Kolegaeva ◽  
Zhanna R. Gardanova
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Insulin Treatment ◽  
Randomized Clinical Trials ◽  
Main Concern ◽  
Efficacy And Safety ◽  
New Approach ◽  
Diabetes Mellitus Treatment ◽  
Foetal Blood

Historically, the following two methods were used to treat gestational diabetes mellitus: non-medical life-style interventions (diet and increased physical activity) and insulin treatment when other interventions were not effective. The possibility of alternative types of treatment such as oral anti-diabetic drugs has been the source of debate in recent years. Metformin is an oral anti-diabetic drug that reduces insulin resistance, which is common during gestation and is considered one of the main pathways of glucose metabolism alteration during pregnancy. The main concern is that metformin can cross the placenta and is found unchanged in foetal blood. This is the reason why oral anti-diabetic drugs are contraindicated during pregnancy in many countries, including Russia (according to the 2012 Russian recommendations for gestational diabetes treatment). In recent years, many studies investigating the safety and efficacy of metformin for maternal and foetal health have been published. We will review recent randomized clinical trials and discuss new international clinical recommendations (FIGO, 2015) and new opportunities for gestational diabetes mellitus treatment. 

scholarly journals Differential placental ceramide levels during gestational diabetes mellitus (GDM)

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Juan F. Mejia ◽  
Kelsey M. Hirschi ◽  
Kary Y. F. Tsai ◽  
Matthew G. Long ◽  
Benton C. Tullis ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Mitochondrial Respiration ◽  
Fetal Development ◽  
Caspase 3 ◽  
Insulin Treatment ◽  
Serine Palmitoyltransferase ◽  
Rate Limiting ◽  
Active Caspase

Abstract Background Gestational diabetes mellitus (GDM) is associated with important factors that influence fetal development. Sphingolipids are known to be associated with the development of diabetes. Our objective was to examine ceramide, a key sphingolipid, hyperosmolarity, and apoptosis in placentas from GDM patients treated with insulin or diet. Methods Ceramide levels were assessed in placental tissues using immunohistochemistry. Immunoblot was performed to quantify serine palmitoyltransferase (SPT), the rate-limiting enzyme in ceramide biosynthesis, NFAT5, SMIT, AR, caspase 3 and the X-linked inhibitor of apoptosis. Trophoblast cells were treated with insulin or ceramide and assessments for mitochondrial respiration, caspase 3 and XIAP were also performed. Results Immunohistochemistry showed increased ceramides in the placental villous trophoblasts of the insulin-treated GDM patients. Nuclear SPT was upregulated only in the insulin-treated GDM placenta when compared to controls. Nuclear NFAT5 was also increased in the GDM placenta. Active caspase 3 was elevated in placentas from both insulin- and diet-treated GDM patients. Mitochondrial respiration was decreased in trophoblasts treated with ceramide. Active caspase was not changed while XIAP protein was increased in trophoblasts treated with ceramide. Conclusions Our findings confirm the presence of ceramide in the human placenta of control and GDM patients. Furthermore, we conclude that ceramide is increased in the placental trophoblast during insulin treatment and that its upregulation correlates with elevated NFAT5, SMIT, increased apoptosis and decreased trophoblast mitochondrial respiration.

Sign in / Sign up

Export Citation Format

Share Document