scholarly journals Effect of a Mediterranean Diet-Based Nutritional Intervention on the Risk of Developing Gestational Diabetes Mellitus and Other Maternal-Fetal Adverse Events in Hispanic Women Residents in Spain

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3505
Author(s):  
Verónica Melero ◽  
Nuria García de la Torre ◽  
Carla Assaf-Balut ◽  
Inés Jiménez ◽  
Laura del Valle ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Hispanic Women ◽  
Controlled Trial ◽  
Intervention Group ◽  
Nutritional Intervention ◽  
Adverse Outcomes ◽  
Control Group ◽  
Tract Infections

Gestational diabetes mellitus (GDM) is the most frequent morbidity found in pregnancy, and it increases the risk for several maternal-fetal complications. Hispanic women are considered at high risk. The St. Carlos GDM prevention study is a randomized controlled trial (RCT) conducted from 2016–2017. Normoglycemic women were randomized at 12–14 Gestation week (WG) to an intervention group (IG) receiving recommendations based on the MedDiet (supplemented with ExtraVirgin Olive Oil/pistachios), or to a control group (CG), recommended to limit fat intake. After RCT conclusion, IG recommendations were applied to a real-world group (RW) in routine clinical practice. The primary endpoint of the current study is an assessment of the GDM rate in Hispanic participants of the aforementioned studies: 132 RCT, 128 CT, 284 RW participants. The GDM rate was lower in IG: 19/128(14.8%), p = 0.021, and RW: 38/284(13.4%), p = 0.029) than in CG: 34/132(25.8%). Adjusted RR (95%CI) for GDM: 0.72 (0.50–0.97), p = 0.037 in IG and 0.77 (0.61–0.97), p = 0.008 in RW. Rates of urinary tract infections, emergency caesarean-sections and perineal trauma were also lower in IG and RW. Other adverse outcomes were lower in IG vs. CG. In conclusion, a MedDiet-based intervention reduces the rate of GDM and several adverse maternal-fetal outcomes in Hispanic women residing in Spain.

scholarly journals Benefits of Adhering to a Mediterranean Diet Supplemented with Extra Virgin Olive Oil and Pistachios in Pregnancy on the Health of Offspring at 2 Years of Age. Results of the San Carlos Gestational Diabetes Mellitus Prevention Study.

2020 ◽  
Vol 9 (5) ◽  
pp. 1454
Author(s):  
Verónica Melero ◽  
Carla Assaf-Balut ◽  
Nuria García de la Torre ◽  
Inés Jiménez ◽  
Elena Bordiú ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Mediterranean Diet ◽  
Hospital Admissions ◽  
Controlled Trial ◽  
Virgin Olive Oil ◽  
Intervention Group ◽  
Control Group ◽  
Prevention Study

The intrauterine environment may be related to the future development of chronic diseases in the offspring. The St. Carlos gestational diabetes mellitus (GDM) prevention study, is a randomized controlled trial that evaluated the influence of the early (before 12th gestational week) Mediterranean diet (MedDiet) on the onset of GDM and adverse gestational outcomes. Out of 874 women assessed after delivery (440 control group (CG)/434 intervention group (IG)), 703 children were followed (365/338; CG/IG), with the aim to assess whether the adherence to a MedDiet during pregnancy induces health benefits for the offspring during the first two years of life. Logistic regression analysis showed that the IG in children of mothers with pre-gestational body mass index (BMI) < 25 kg/m2 and normal glucose tolerance (NGT), was associated with a lower risk (RR(95% CI)) of suffering from severe events requiring hospitalization due to bronchiolitis/asthma (0.75(0.58–0.98) and 0.77(0.59–0.99), respectively) or other diseases that required either antibiotic (0.80(0.65–0.98) and 0.80(0.65–0.99), respectively), corticosteroid treatment (0.73(0.59–0.90) and 0.79(0.62–1.00) respectively) or both (all p < 0.05). A nutritional intervention based on the MedDiet during pregnancy is associated with a reduction in offspring’s hospital admissions, especially in women with pre-gestational BMI < 25 kg/m2 and NGT.

Assessment of Gestational Diabetes Mellitus Outcomes for Hispanic Women Living in the Rio Grande Valley

2019 ◽  
Vol 17 (3) ◽  
pp. 111-117 ◽  
Author(s):  
Norma Somohano-Mendiola ◽  
Jane Dimmitt Champion ◽  
Kristina Vatcheva
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Hispanic Women ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
Oral Glucose ◽  
Mexican Origin ◽  
Adverse Neonatal Outcomes

Introduction: Gestational diabetes mellitus (GDM) among women living along the U.S.–Mexico border are approximately twice that of the general population of pregnant U.S. women. This study compared outcomes for Hispanic pregnant women diagnosed and treated for GDM (i.e., two abnormal 3-hour oral glucose tolerance tests [OGTT]) with those who were screened but had only one abnormal 3-hour OGTT and therefore received no treatment. Methods: Retrospective chart review of pregnant Hispanic women of Mexican origin ( N = 95), with GDM ( N = 41) or one abnormal 3-hour OGTT value ( N = 54) who delivered between January 1, 2015, and December 31, 2017. Results: No significant differences were found between the two groups with regard to sociodemographic variables, hyperbilirubinemia, or other adverse neonatal outcomes. Comparisons identified differences between women with and without adverse neonatal outcomes concerned type of delivery; there were more C-sections among women with GDM. Conclusion: Pregnant women with one abnormal 3-hour OGTT value are at risk of giving birth to neonates with biomarkers similar to those diagnosed and treated for GDM. The treatment of hyperglycemia in Hispanic women of Mexican origin with one abnormal 3-hour OGTT value may improve the health outcomes and quality of life of the mother and the neonate. More research is warranted to clarify the risk of adverse outcomes of diverse pregnant women who do not meet guidelines for diagnosis of GDM.

scholarly journals Lifestyle intervention to prevent gestational diabetes mellitus and adverse maternal outcomes among pregnant women at high risk for gestational diabetes mellitus

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052097913
Author(s):  
Xueyan Lin ◽  
Ting Yang ◽  
Xueqin Zhang ◽  
Wei Wei
Keyword(s):  
Diabetes Mellitus ◽  
Logistic Regression ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Lifestyle Intervention ◽  
Intervention Group ◽  
Control Group ◽  
Maternal Outcomes ◽  
Multivariate Logistic Regression

Objective We assessed the effects of a lifestyle intervention on gestational diabetes mellitus (GDM) incidence and risk of adverse maternal outcomes among pregnant women at high risk for GDM. Methods From July to December 2018, we enrolled 1822 eligible pregnant women; of these, 304 had at least one risk factor for GDM. Participants were randomly allocated to the intervention or control group. Usual prenatal care was offered to both groups; the intervention group also received individually modified education on diet, physical activity, and weight control. The GDM diagnosis was based on an oral glucose tolerance test at 24–28 gestational weeks. Multivariate logistic regression was used to evaluate the effects of the lifestyle intervention on risk of GDM and adverse maternal outcomes. Results A total of 281 women (139 in the intervention group and 142 controls) were included. Incidences of GDM and adverse maternal outcomes were all significantly lower in the intervention than in the control group. Multivariate logistic regression indicated that women in the intervention group had a lower risk of GDM and adverse maternal outcomes, after adjusting potential confounding factors. Conclusion The present lifestyle intervention was associated with lower risks of GDM and adverse maternal outcomes.

scholarly journals FREQUENCY AND RISKS OF ADVERSE OUTCOMES ASSOCIATED WITH GESTATIONAL DIABETES MELLITUS IN NEONATES

2019 ◽  
Vol 19 (2) ◽  
pp. 30-34
Author(s):  
Yu.Yu. Klymchuk
Keyword(s):  
Diabetes Mellitus ◽  
Mechanical Ventilation ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Respiratory Distress ◽  
Adverse Outcomes ◽  
Control Group ◽  
Group I ◽  
Increased Risk ◽  
Neonatal Respiratory Distress

Gestational diabetes mellitus (GDM) is one of the most common endocrinopathies during pregnancy. The issue on the prevalence of its adverse outcomes depending on the time of diabetes onset – before or during pregnancy – is still remaining unclear. The aim of this study was to determine the prevalence and risk of adverse outcomes associated with GDM in neonates in Poltava region. Materials and methods. We conducted a retrospective study that included 10.025 infants born to primigravidae under 28 weeks. Group I included infants (n = 35) who were born to mothers with GDM, and group II covered infants (n = 82) who were born to mothers with pre-gestational diabetes mellitus (PGDM). The control group included 9908 infants who were born to mothers without diabetes. Results. The risks of neonatal respiratory distress were significantly higher in neonates born to women with PGDM and GDM than in women without diabetes (RR 59.6 (95% CI 39.9-88.9) and RR 81.7 (95% CI 38.1- 175), whereas the risk of asphyxia was higher only in women with GDM (RR 16.4 (95% CI 6.5-41.4). Among the mothers with PGDM and GDM, no significant differences were observed in the number of infants with macrosomia (51.4% and 61.0%), hypoglycemia (37.1% and 31.7%), hospitalization in the intensive care unit (31.4% and 48.8%) and mechanical ventilation (20.0% and 23.2%). Conclusion. Diabetes mellitus is associated with an increased risk of developing maternal and neonatal adverse outcomes. The incidence of preeclampsia, premature birth, neonatal respiratory distress, macrosomia, and the use of mechanical ventilation in infants are the same in mothers with gestational and pre-gestational diabetes mellitus.

scholarly journals Cod-Liver Oil Improves Metabolic Indices and hs-CRP Levels in Gestational Diabetes Mellitus Patients: A Double-Blind Randomized Controlled Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-13
Author(s):  
Shuli Yang ◽  
Ruixin Lin ◽  
Lihui Si ◽  
Zhuo Li ◽  
Wenwen Jian ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Cod Liver Oil ◽  
Perinatal Complications ◽  
Secondary Outcomes ◽  
Hs Crp

Objective. To investigate the effects of cod-liver oil on metabolic status and high-sensitivity C-reactive protein (hs-CRP) in patients with gestational diabetes mellitus (GDM). Methods. This study was a randomized, double-blinded, placebo-controlled trial with the allocation ratio of 1 : 1. The contents of EPA and DHA in cod-liver oil were measured using a gas chromatograph. A total of 550 GDM patients were randomly divided into the intervention group (cod-liver oil) and the control group (placebo, mineral oil), and both groups were given regular dietary care. Glycosylated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), 2-hour plasma glucose (2hPG), lipid profiles, homeostatic model assessment insulin resistance (HOMA-IR), and hs-CRP were measured. Primary outcomes were different in HbA1c, FPG, 2hPG, and HOMA-IR between the two groups after 4-week randomization. Secondary outcomes were the blood glucose levels and perinatal complications (pregnancy-induced hypertension, polyhydramnios, premature delivery, postpartum hemorrhage, postpartum infection, premature rupture of membranes, and cesarean section) between the two groups before and after 12-16 weeks of cod-liver oil intervention from middle pregnancy to late pregnancy. Results. EPA and DHA were the main components of cod-liver oil with 76 mg/mL and 150 mg/mL, respectively. There was no significant difference for primary outcomes in the levels of HbA1c, FPG, 2hPG, HOMA-IR, and lipid profiles between the two groups (P>0.05). For the secondary outcomes, the levels of HbA1c, FPG, 2hPG, triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol ratio (LDL-C), HOMA-IR, and hs-CRP in the intervention group were significantly lower than those in the control group (P<0.05). The incidence of perinatal complications in the intervention group was lower than that in the control group too (P<0.05). Conclusions. Cod-liver oil consumption effectively reduced the levels of blood glucose, lipid levels, hs-CRP, and HOMA-IR and the incidence of perinatal complications.

scholarly journals The Effect of a Single Mega dose Injection of Vitamin D on serum Adiponectin concentration at First Gestational Diabetes Mellitus: A Randomized Controlled Clinical Trial

2019 ◽  
Author(s):  
Mahdieh Hosseinzadeh ◽  
Elham Razmpush ◽  
Elham Shareghfarid ◽  
Elham Hosseinzadeh ◽  
Hossein Hadinedoushan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Clinical Trial ◽  
Vitamin D ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Intramuscular Injection ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Adiponectin Concentration

Abstract Background: vitamin D is being increasingly recognized for its important non-skeletal functions including endocrine actions. This study investigated if a single, large, intramuscular post‐artum injection of vitamin D improve adiponectin levels among women with gestational diabetes mellitus (GDM). Methods: A total of 45 pregnant women with GDM participated in this randomized clinical trial. They were randomly divided into intervention and control group. The intervention group received an intramuscular injection of 300,000 IU of vitamin D during 3 to 10 days after their child delivery, but controls did not. Serum 25‐hydroxyvitamin D, fasting blood glucose, HbA1c and serum adiponectin were measured at baseline and after 3 months of intervention. Results: Serum 25 OH vitamin D increase significantly in the intervention but not in the control group from 24.25 to 62.10 (nmol/l) (p-value< 0.01). Comparison in within group showed that adiponectin level increased significantly only among intervention group after the vitamin D injection from 7.45 to 8.98 (ngr/dl) (P-value=0.01), while between group comparisons showed no significant differences in adiponectin concentration after the intervention (P-value<0.05). Between and within group comparisons reported no significant alterations in the levels of glycated hemoglobin (HbA1c) and FPG (fasting plasma glucose), as well. Conclusions: The 300,000 IU single dose of intramuscular injection of vitamin D is regarded as an effective procedure to improve vitamin D status which significantly increased the adiponectin levels among mothers with gestational diabetes after delivery. Trial registration: The trial was registered in Iranian Registry of Clinical Trials available at http://www.irct.ir. The reference number is IRCT138902113840N1.

scholarly journals The Efficacy of an Intensive Lifestyle Modification Program on Psychosocial Outcomes among Rural Women with Prior Gestational Diabetes Mellitus: Six Months Follow-Up of a Randomized Controlled Trial

2021 ◽  
Vol 18 (4) ◽  
pp. 1519
Author(s):  
Jia Guo ◽  
Qing Long ◽  
Jundi Yang ◽  
Qian Lin ◽  
James Wiley ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Social Support ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Perceived Stress ◽  
Lifestyle Modification ◽  
Intervention Group ◽  
Control Group ◽  
Significant Group ◽  
Lifestyle Modification Program

Women with prior gestational diabetes mellitus (GDM) are at a higher risk of type 2 diabetes and other health issues after delivery. They may have a lower quality of life (QoL), experience more medical-related stress, and need more support than those without it. This study aimed to examine the six-month efficacy of an intensive lifestyle modification program on perceived stress, social support, and QoL among women with prior GDM in rural China. A total of 320 women with prior GDM were randomly assigned to an intervention group (n = 160) and a control group (n = 160). Participants in the intervention group received an intensive lifestyle modification (ILSM) program, including a series of six biweekly face-to-face sessions and five biweekly phone sessions delivered by trained local health workers. The control group received the usual care. Data about perceived stress, social support, QoL, and HbA1c were collected at baseline, at three months, and at six-month follow-ups. Generalized estimating equation analysis was used to assess the efficacy of the intervention. There were significant improvements in the psychological domain (β = 0.479 ± 0.153, p = 0.002) and environmental domain (β = 0.462 ± 0.145, p = 0.001) of QoL over six months; there were significant group effects (β = −0.718 ± 0.280, p = 0.010) and time effects (β = 0.453 ± 0.211, p = 0.032) in physiological domain, and there were significant group effects in the social relations domain (β = −0.669 ± 0.321, p = 0.037). The ILSM group had a more pronounced downward trend in HbA1c than the control group (β = −0.050 ± 0.026, p = 0.059). The ILSM program can help women with GDM improve their psychological and environmental domain of QoL. It can be recommended as a form of health promotion for improving QoL among women with prior GDM in rural primary care settings in developing countries.

scholarly journals Study on the Effects of Individualized Nutritional Intervention on Pregnancy Outcome and Neonatal Immune Function in Patients with Gestational Diabetes Mellitus

2022 ◽  
Vol 2022 ◽  
pp. 1-7
Author(s):  
Xiaofeng Zhang ◽  
Yudan Wu ◽  
Liye Miao
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Immune Function ◽  
Plasma Glucose ◽  
Nutritional Intervention ◽  
Control Group ◽  
Fasting State ◽  
Experimental Group ◽  
Spontaneous Delivery

Objective. To study the effects of individualized nutritional intervention on pregnancy outcome and neonatal immune function in patients with gestational diabetes mellitus (GDM). Methods. A retrospective analysis was conducted on 100 GDM patients from the obstetrics and gynecology department of our institute between February 2019 and February 2020. The patients were allocated into the control group given regular intervention and the experimental group given individualized nutritional intervention according to different intervention measures, with 50 cases in each group. The comparison was carried out for patients in the two groups with regard to their modality of delivery, neonatal health, their plasma glucose in fasting state, 2 h after eating, and before bedtime; glycohemoglobin at 8 months of pregnancy, at 9 months of pregnancy, during labor, and 1 month after delivery; their complications; and neonatal CD3+, CD4+, and CD8+ levels. Results. The experimental group outperformed the control group in terms of the spontaneous delivery rate, the number of healthy neonates, and neonatal CD3+, CD4+, and CD8+ levels ( P < 0.05 ). The plasma glucose in fasting state, 2 h after eating, and before bedtime; the glycohemoglobin at 8 months of pregnancy, at 9 months of pregnancy, during labor, and 1 month after delivery; and the incidence of complications of the experimental group were significantly lower than those of the control group ( P < 0.05 ). Conclusion. Individualized nutritional intervention increases the rate of spontaneous delivery in GDM patients, enhances neonatal immune function, stabilizes plasma glucose, and reduces complications.

Improved Insulin Resistance through Cajanus cajan extract in Gestational Diabetes Mellitus of Wistar Rat

2019 ◽  
Vol 15 (4) ◽  
pp. 257-269
Author(s):  
Nikita Saraswat ◽  
Pranay Wal ◽  
Ankita Wal ◽  
Rashmi Saxena Pal
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Ethyl Acetate ◽  
Cajanus Cajan ◽  
Intervention Group ◽  
Chloroform Extract ◽  
Control Group ◽  
Pregnant Rats

Background: Gestational Diabetes Mellitus (GDM) has a serious impact on maternal health as well as on the health of the infant. This is also very closely related to adverse outcomes in pregnancy. A mother suffering from gestational diabetes mellitus (GDM) has high incidences of showing significant risks to the fetus health, growth and development. As the incidences of GDM are increasing day by day, therefore, maternal health, age and obesity parameters are of major concern for reflecting GDM during their pregnancy conditions. It has been studied and investigated that IR (Insulin Resistance) is a common pathway in GDM and T2DM (Type 2 Diabetes Mellitus). Objective: To explore the effect of Cajanus cajan in treating gestational diabetes mellitus (GDM) in Wistar rats. Methods: The study was conducted on 30 female rats which were caged along with male rats. We obtained 26 pregnant rats which were weighed. The pregnant rats in the control group, intervention group, and GDM group were equally randomized. When the pregnancy was verified, the Intervention and the GDM (Gestational Diabetes Mellitus) group were given 45 mg/kg streptozotocin by the peritoneal injection for inducing GDM while the control group was given an equal volume of the citrate buffer. When the model was established accurately then the intervention group was administered orally with the extracts of leaves of Cajanus cajan chloroform extract (270mg/kg), Methanol extract (270mg/kg) and Ethyl acetate extract (270mg/kg). Whereas the other groups were administered with water and diet. The blood samples were collected and the fetal rats along with placental weight were recorded on the 19th day of the pregnancy. The serum glucose levels, serum insulin levels, and lipid levels were recorded in pregnant rats before the delivery. Results: The rats were weighed before and after delivery, fetal weight was recorded, placental weight of the GDM group was found to be lower than the control group as well as the intervention groups. Treating with (Chloroform extract, Methanol extract, Ethyl acetate extract (270mg/kg) different extracts of Cajanus cajan leaf in the intervention groups the lipid levels of the intervention group significantly increased in case of the Methanolic extract whereas the other extracts were also effective. The levels of antioxidant enzymes of the GDM group in pancreas and liver tissue were lower in intervention groups as compared to control and GDM group whereas the antioxidant enzyme levels in the liver and pancreas were equivalent to the control group. : The results showed that the ethyl acetate and methanol extracts of the Cajanus cajan leaves might have bioactive and hypoglycemic nature. Further research is required for the complete evaluation of the active compound in various animal models to justify the nature of the compound. Conclusion: Cajanus cajan leaf extract suppresses oxidative stress and insulin resistance, therefore, improves the blood glucose levels in GDM rats.

Ameliorative potential of acupressure on gestational diabetes mellitus: A randomized controlled trial

2018 ◽  
Vol 16 (1) ◽  
Author(s):  
Fayiz F. El-Shamy ◽  
Sanad S. El-Kholy ◽  
Mahmoud Labib ◽  
Ahmed M. Kabel
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Antenatal Care ◽  
Controlled Trial ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Oral Glucose ◽  
Female Patients

Abstract Background and aim Gestational diabetes mellitus (GDM) poses a threat to the mother and child. The aim of this study was to examine the effect of acupressure on the glycemic control and insulin requirement of GDM females. Materials and methods Thirty GDM female patients were randomized to either the study group (SG; n=15), which was treated with acupressure and the standard antenatal care, or the control group (CG; n=15), which was treated with the standard antenatal care. Fasting and 2-h post-prandial blood glucose levels, requirement for insulin and insulin resistance were measured at 24 and 36 weeks’ gestation (WG). Also, neonatal outcomes were registered at delivery. Results The pre intervention showed no statistically significant differences between SG and CG for baseline characteristics of participants (p>0.05). Within group analyses, after 12 weeks intervention had shown that 75 g oral glucose tolerance test (OGTT), insulin resistance, number of required insulin and measure of utilized insulin were significantly reduced (p<0.05), with significant increase in body mass index (BMI) (p<0.05) in both groups. All outcome measures were not significantly changed (p>0.05) between both groups at 24 and 36 WG. No significant differences (p>0.05) in pregnancy and neonatal outcomes between both groups at labor. Conclusions Acupressure may help to reduce gestational diabetes or insulin treatment for overweight female patients with GDM.

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