scholarly journals Insulin Resistance in the Third Trimester of Pregnancy Suffering from Gestational Diabetes Mellitus or Impaired Glucose Tolerance

10.5772/20937 ◽  
2011 ◽  
Author(s):  
Mohammed Helmy Faris Shalayel ◽  
Mohammed Chyad ◽  
Salah A.M.
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Impaired Glucose Tolerance ◽  
Third Trimester ◽  
The Third

scholarly journals Impact of gestational diabetes mellitus diagnosed during the third trimester on pregnancy outcomes: a case-control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ryosuke Shindo ◽  
Shigeru Aoki ◽  
Sayuri Nakanishi ◽  
Toshihiro Misumi ◽  
Etsuko Miyagi
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Pregnancy Outcomes ◽  
Caesarean Delivery ◽  
Third Trimester ◽  
The Third ◽  
Elective Caesarean Delivery ◽  
Caesarean Delivery Rate

Abstract Background In 2010, the International Association of Diabetes and Pregnancy Study Group (IADPSG) proposed new criteria indicating that gestational diabetes mellitus (GDM) can be diagnosed if the fasting threshold of ≤92 mg/dL, 1-h threshold of ≤180 mg/dL, or 2-h threshold of ≤153 mg/dL are exceeded during the 75-g 2-h oral glucose tolerance test (OGTT) performed at 24–28 weeks of gestation. The World Health Organization (WHO) recommends using the proposed diagnostic threshold values of the IADPSG to diagnose GDM; however, it does not limit the timing of the 75-g OGTT. Since 2010 in Japan, GDM has been diagnosed using the same criteria as that proposed by the WHO. However, neither the JSOG nor the WHO has provided any evidence that it is appropriate to use a threshold beyond the range recommended by the IADPSG. Methods This was a single-centre retrospective study based on the medical records and delivery registry database of our centre. We included women who underwent a 50-g glucose challenge test (GCT) with results < 140 mg/dL at 24–28 weeks of gestation and subsequently underwent a 75-g OGTT after 29 weeks of gestation with abnormal glucose tolerance suspected based on clinical findings. The reference values for the 75-g OGTT followed the IADPSG criteria. Subjects were classified into the normal glucose tolerance (NGT) group and the GDM group. The type of delivery and neonatal outcomes of the two groups were compared. A multivariable analysis was performed to match the backgrounds of both groups. Results In total, the NGT and GDM group comprised 189 and 49 women, respectively. Emergency caesarean delivery rates were similar in the GDM and NGT groups (10.6 and 12.2%, respectively; adjusted odds ratio [OR], 1.25; 95% confidence interval [CI], 0.43–3.64; p = 0.74); however, the elective caesarean delivery rate was higher in the GDM group than in the NGT group (16.3 and 5.3%, respectively, adjusted OR, 3.60; 95% CI, 1.27–10.19; p = 0.01). No significant differences were observed in other maternal and neonatal outcomes between both groups. Conclusion Although a diagnosis of GDM during the third trimester does not improve pregnancy outcomes, it increases the elective caesarean delivery rate.

scholarly journals Impact of gestational diabetes mellitus diagnosed during the third trimester on pregnancy outcomes: A case control study

2020 ◽  
Author(s):  
Ryosuke Shindo ◽  
Shigeru Aoki ◽  
Sayuri Nakanishi ◽  
Toshihiro Misumi ◽  
Etsuko Miyagi
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Pregnancy Outcomes ◽  
Caesarean Delivery ◽  
Neonatal Outcomes ◽  
World Health ◽  
Third Trimester ◽  
The Third

Abstract Background: In 2010, the International Association of Diabetes and Pregnancy Study Group (IADPSG) proposed new criteria indicating that gestational diabetes mellitus (GDM) can be diagnosed if the fasting threshold of ≤92 mg/dL, 1-hour threshold of ≤180 mg/dL, or 2-hour threshold of ≤153 mg/dL are exceeded during the 75-g 2-hour oral glucose tolerance test (OGTT) performed at 24–28 weeks of gestation. The World Health Organization (WHO) recommends using the proposed diagnostic threshold values of the IADPSG to diagnose GDM, but it does not limit the timing of the 75-g OGTT. Since 2010 in Japan, GDM has been diagnosed using the same criteria as that proposed by the WHO. Nevertheless, there is no justification for these thresholds during specific time windows.Methods: This was a single-centre retrospective study based on the medical records and delivery registry database of our centre. We included women who underwent a 50-g glucose challenge test (GCT) with results <140 mg/dL at 24–28 weeks of gestation and subsequently underwent a 75-g OGTT after 29 weeks of gestation with abnormal glucose tolerance suspected based on clinical findings. The reference values for the 75-g OGTT followed the IADPSG criteria. Subjects were classified as the normal glucose tolerance (NGT) group and the GDM group. The type of delivery and neonatal outcomes of the two groups were compared. A multivariable analysis was performed to match the backgrounds of both groups.Results: A total of 189 women comprised the NGT group and 49 women comprised the GDM group. Emergency caesarean delivery rates were similar in the GDM and NGT groups (10.6% and 12.2%, respectively; adjusted odds ratio [OR], 1.25; 95% confidence interval [CI], 0.43-3.64; p=0.74), but the elective caesarean delivery rate was higher in the GDM group than in the NGT group (16.3% and 5.3%, respectively, adjusted OR, 3.60; 95% CI, 1.27-10.19; p=0.01). There were no differences in other maternal and neonatal outcomes between groups.Conclusion: Whether diagnosing GDM during the third trimester can improve pregnancy outcomes is unknown. However, pregnant women diagnosed with GDM during the third trimester are more likely to undergo caesarean delivery.

scholarly journals Visfatin concentration is decreased in women with gestational diabetes mellitus in the third trimester

2008 ◽  
Vol 31 (7) ◽  
pp. 610-613 ◽  
Author(s):  
M. Akturk ◽  
A. E. Altinova ◽  
I. Mert ◽  
U. Buyukkagnici ◽  
A. Sargin ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Third Trimester ◽  
The Third

scholarly journals CTRP-1 levels are related to insulin resistance in pregnancy and gestational diabetes mellitus

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Carola Deischinger ◽  
Karoline Leitner ◽  
Sabina Baumgartner-Parzer ◽  
Dagmar Bancher-Todesca ◽  
Alexandra Kautzky-Willer ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
High Risk Population ◽  
Sensitivity Index ◽  
Phase Index ◽  
Matsuda Index ◽  
In Pregnancy

Abstract Recent studies have shown higher levels of CTRP-1 (C1QTNF-related protein) in patients with type 2 diabetes compared to controls. We aimed at investigating CTRP-1 in gestational diabetes mellitus (GDM). CTRP-1 levels were investigated in 167 women (93 with normal glucose tolerance (NGT), 74 GDM) of a high-risk population for GDM. GDM was further divided into GDM subtypes depending on a predominant insulin sensitivity issue (GDM-IR) or secretion deficit (GDM-IS). Glucose tolerance was assessed with indices [Matsuda index, Stumvoll first phase index, insulin-secretion-sensitivity-index 2 (ISSI-2), area-under-the-curve (AUC) insulin, AUC glucose] derived from an oral glucose tolerance test (oGTT) performed at < 21 and 24–28 weeks of gestation. In pregnancy, CTRP-1 levels of GDM (76.86 ± 37.81 ng/ml) and NGT (82.2 ± 35.34 ng/ml; p = 0.104) were similar. However, GDM-IR women (65.18 ± 42.18 ng/ml) had significantly lower CTRP-1 levels compared to GDM-IS (85.10 ± 28.14 ng/ml; p = 0.009) and NGT (p = 0.006). CTRP-1 levels correlated negatively with weight, AUC insulin, Stumvoll first phase index, bioavailable estradiol and positively with HbA1c, Matsuda Index and ISSI-2. A multiple regression analysis revealed bioavailable estradiol (β = − 0.280, p = 0.008) and HbA1c (β = 0.238; p = 0.018) as the main variables associated with CTRP-1 in GDM. Postpartum, waist and hip measurements were predictive of CRTP-1 levels instead. CTRP-1 levels were higher postpartum than during pregnancy (91.92 ± 47.27 vs.82.44 ± 38.99 ng/ml; p = 0.013). CTRP-1 is related to insulin resistance in pregnancy and might be a metabolic biomarker for insulin resistance in GDM. CTRP-1 levels were significantly lower during pregnancy than postpartum, probably due to rising insulin resistance during pregnancy.

scholarly journals The Role of Gestational Diabetes Mellitus and Pelvic Floor 3D-Ultrasound Markers at the Second and Third Trimester of Pregnancy Predicting 6-18 Months Postpartum Urinary Incontinence: Preliminary Results From a Prospective Cohort

2021 ◽  
Author(s):  
Carlos Izaias Sartorão Filho ◽  
Fabiane Affonso Pinheiro ◽  
Luiz Takano ◽  
Raghavendra Hallur Lakshmana Shetty ◽  
Sthefanie K. Nunes ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pelvic Floor ◽  
Univariate Analysis ◽  
3D Ultrasound ◽  
Third Trimester ◽  
The Third ◽  
Hiatal Area

Abstract Background Gestational Diabetes Mellitus and long-term urinary incontinence (UI) have a severe impact on women's health. New methods to identify pregnant predictor risk factors of UI are needed. Our study investigated clinical and pelvic floor 3D-ultrasound markers in pregnant women at the second and third trimesters to predict 6-18 months postpartum UI. Methods This ongoing prospective cohort study included one hundred five nulliparous pregnant women with universal GDM screening and diagnosis, treated with nutritional and healthy lifestyle intervention. Pelvic floor 3DUltrasound was performed at the second and third trimesters of gestation. Clinical and pelvic floor 3DUltrasound biometry were collected. The ICIQ-SF and ISI questionnaires for UI were applied in the third trimester and 6-18 months postpartum. We performed univariate analysis (P<.20) to extract risk factors variables and multivariate logistic regression analysis (P<.05) to obtain the adjusted relative ratio for 6-18 months postpartum UI. Results In a preliminary result, a total of 93 participants concluded the follow-up. Using the variables obtained by the univariate analysis and after the adjustments for potential confounders, logistic regression analysis revealed that Gestational Diabetes Mellitus exposure was a strong and independent risk factor for 6-18 months postpartum UI (Adjusted RR 8.088; 95%CI 1.17-55.87; P:.034). In addition, higher hiatal area distension at rest from the second to the third trimester was negatively correlated with 6-18 months postpartum UI (Adjusted RR 0.966; 95%CI 0.93-0.99; P: .023). Conclusion Gestational Diabetes Mellitus was positively correlated with 6-18 months postpartum UI, and a higher hiatal area distension was negatively correlated with 6-18 months postpartum UI development. Trial registration: Regulatory approval was obtained from the Institutional Review Board (number 1.716.895) by “Botucatu Medical School of São Paulo State University (Unesp)” Ethics Committee.

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