Oral anti-diabetic agents for women with established diabetes/impaired glucose tolerance or previous gestational diabetes planning pregnancy, or pregnant women with pre-existing diabetes.
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ABSTRACT:
SUBMITTER: Tieu J
PROVIDER: S-EPMC6485334 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Gestational diabetes mellitus (GDM), defined as any degree of glucose intolerance with onset or first recognition during pregnancy, is characterized by underlying maternal defects in the ?-cell response to insulin during pregnancy. Women with a previous history of GDM have a greater than 7-fold higher risk of developing postpartum diabetes compared with women without GDM. Various risk factors for postpartum diabetes have been identified, including maternal age, glucose levels in pregnancy, family history of diabetes, pre-pregnancy and postpartum body mass index, dietary patterns, physical activity, and breastfeeding. Genetic studies revealed that GDM shares common genetic variants with type 2 diabetes. A number of lifestyle interventional trials that aimed to ameliorate modifiable risk factors, including diet, exercise, and breastfeeding, succeeded in reducing the incidence of postpartum diabetes, weight retention, and other obesity-related morbidities. The present review summarizes the findings of previous studies on the incidence and risk factors of postpartum diabetes and discusses recent lifestyle interventional trials that attempted to prevent postpartum diabetes.
| S-EPMC5214732 | biostudies-literature
Project description:Total RNA was isolated from lymphocyte. We compared the miRNA expression profiles between healthy and GDM women by RNA sequencing, and determined the signaling pathways associated with the changes. Our study offers new insights into circulating biomarkers of GDM and thus provides a valuable resource for future investigations.
2023-01-06 | GSE218696 | GEO
Project description:OBJECTIVE: This study aimed to examine possible genetic effects of some retinol binding protein-4 (RBP4) single nucleotide polymorphisms (SNPs) on the risk of gestational diabetes mellitus (GDM). In addition, the SNPs were examined for their possible association with insulin resistance at 6 weeks after delivery. METHODS: This was a prospective study of 100 women with GDM and 100 participants with normal gestation who were evaluated at gestational week 30 and 6 weeks postpartum. Three SNPs of RBP4 (rs3758539, rs116736522, and rs34571439) were genotyped using TaqMan assay. The genotype distributions between GDM patients and normal controls were analyzed using logistic regression models. In addition, differences in clinical characteristics among subjects grouped by genotype were assessed using the analysis of covariance test. RESULTS: The frequencies of the rare alleles were not significantly different between GDM patients and controls. However, we identified two variants rs3758539 and rs34571439 associated with insulin levels and insulin resistance in women with previous GDM. CONCLUSION: Noncoding SNPs of the RBP4 gene are not associated with GDM, but two SNPs showed associations with insulin resistance and insulin levels in women with prior GDM. Additional studies with increased sample size will be necessary in other GDM cohorts.
| S-EPMC3934384 | biostudies-literature
Project description:Gestational diabetes mellitus is a condition similar to type 2 diabetes mellitus (T2DM) in that patients are unable to compensate for the degree of insulin resistance, and both conditions are often treated with metformin. The comparative pharmacodynamic response to metformin in these 2 populations has not been studied. This study characterized insulin sensitivity, β-cell responsivity, and disposition index following a mixed-meal tolerance test utilizing a minimal model of glucose, insulin, and C-peptide kinetics before and during treatment with metformin. The study included women with gestational diabetes mellitus (n = 34), T2DM (n = 14), and healthy pregnant women (n = 30). Before treatment, the gestational diabetes mellitus group had significantly higher baseline (45%), dynamic (68%), static (71%), and total β-cell responsivity (71%) than the T2DM group. Metformin significantly increased insulin sensitivity (51%) as well as disposition index (97%) and decreased mixed-meal tolerance test peak glucose concentrations (8%) in women with gestational diabetes mellitus after adjustment for gestational age-dependent effects; however, in women with T2DM metformin only significantly affected peak glucose concentrations (22%) and had no significant effect on any other parameters. Metformin had a greater effect on the change in disposition index (Δ disposition index) in women with gestational diabetes mellitus than in those with T2DM (P = .01). In conclusion, response to metformin in women with gestational diabetes mellitus is significantly different from that in women with T2DM, which is likely related to the differences in disease severity.
| S-EPMC7064374 | biostudies-literature
Project description: Not available
| S-EPMC6481507 | biostudies-literature
Project description:Recent evidence has shown that gut microbiota dysbiosis is associated with development of gestational diabetes mellitus (GDM). However, the gut microbiota composition of non-obese women with GDM, which accounts for a relatively large percentage of Asian GDM, is unknown. We investigated the characteristics of gut microbiota of Japanese pregnant women with GDM. Fecal samples from Japanese pregnant women with GDM (n=20) and normal glucose tolerance (NGT, n=16) were collected at the time of GDM diagnosis (T1), at 35-37 weeks of gestation (T2), and at 4 weeks postpartum (T3). Gut microbiota composition was characterized from fecal DNA by sequencing of 16S rRNA genes. Serum samples were collected late in the third trimester, and the circulating levels of adiponectin and IL-6 were measured by ELISA. At the genus level, Peptostreptococcaceae Romboutsia was enriched in GDM women at T1 (p=0.008) and T2 (p=0.047). The women with lower serum adiponectin tended to have more Romboutsia. The Shannon index was significantly lower in the GDM women at T3 than in the NGT women (p=0.008), and that of the GDM women decreased significantly from T2 to T3 (p=0.02). No significant difference in bacterial community structure was found in a beta diversity analysis. The non-obese GDM women (body mass index <25.0 kg/m2) showed a lower abundance of Coriobacteriaceae Collinsella at T1 (p=0.03) and higher abundance of Akkermansia at T2 (p=0.04) than the normal control. The non-obese GDM women had the distinctive gut microbiota profiles. Analysis of gut microbiota is potentially useful for risk assessment of GDM in non-obese pregnant women.
| S-EPMC8727054 | biostudies-literature
Project description:Background: Type 2 diabetes is increasing among the young, and gestational diabetes (GDM) offers a unique opportunity for diabetes prevention. We aimed to systematically review postpartum randomized trials to summarize the benefits of lifestyle interventions for women with previous GDM. Methods:We searched for RCTs involving women with previous GDM that compared lifestyle interventions-diet, physical activity or breastfeeding-at postpartum with usual care up to May 2018. Results:Of 1,895 abstracts identified, we selected 15 studies investigating incidence of diabetes or changes in glycemia. Most interventions focused on changes in diet and physical activity, only one also on incentive to breastfeeding. Meta-analysis of 8 studies investigating incidence of diabetes revealed a homogeneous (I2 = 10%), reduction of 25% (RR = 0.75; 95%CI: 0.55-1.03) borderline statistically significant. Only trials offering intervention soon after delivery (< 6 months post-partum) were effective (RR = 0.61; 95%CI: 0.40-0.94; p for subgroup comparison = 0.11). Overall, no benefit was found regarding measures of glycemia. Although moderate reductions in weight (MD = -1.07 kg; -1.43-0.72 kg); BMI (MD = -0.94 kg/m2; -1.79 -0.09 kg/m2); and waist circumference (MD = -0.98 cm; -1.75 -0.21 cm) were observed, effects were larger with longer follow-up. Conclusions:Summary results of the available evidence support benefits of lifestyle interventions at postpartum for women with previous GDM. Benefits, although smaller than those of major trials based in older subjects receiving intensive interventions, appear clinically relevant for this young subset of woman. Further studies are needed to improve the quality of the evidence and to further tailor interventions to this specific setting.
| S-EPMC6182069 | biostudies-other
Project description:Total RNA was isolated from WBCs. For the analysis of genome-wide expression differences in small non-coding RNAs (sncRNAs) and long-coding and non-coding RNAs (mRNAs and lncRNAs), NGT and GDM pregnant women were selected. Twenty-nine GDM-associated mature micro-RNAs (miRNAs) with increased expression and one hundred sixty-three mRNAs with reduced expression associated with GDM were found (P<0.05 and FDR<0.1).
2017-12-31 | GSE92772 | GEO
Project description:ObjectiveTo examine the feasibility of an individualized exercise program to prevent gestational diabetes mellitus (GDM) in obese pregnant women.Research design and methodsThe study was a pilot randomized controlled trial with obese pregnant women (intervention group, individualized exercise program [n = 25]; control group, usual care [n = 25]). Average weekly energy expenditure (MET hours per week and kilocalories per week) of exercise-specific activity was assessed during pregnancy using the Pregnancy Physical Activity Questionnaire. Fasting glucose and insulin and homeostasis model assessment of insulin resistance (HOMA-IR) were assessed at baseline and 20, 28, and 36 weeks' gestation.ResultsOf the women in the intervention group, 16 of 22 (73%) achieved more than 900 kcal/week of exercise-based activity at 28 weeks compared with 8 of 19 women in the control group (42%), P = 0.047. However, insulin resistance (HOMA-IR) did not differ between the groups.ConclusionThis intervention was feasible and prompted a modest increase in physical activity. However, we are not confident that this intervention would be sufficient to prevent GDM.
| S-EPMC2890340 | biostudies-literature
Project description:Genome-wide association studies have identified loci that are firmly associated with obesity. The Src-homology-2 B adaptor protein 1 (SH2B1) loci is abundantly expressed in the brain, liver, heart, muscle, and fat tissues. Gestational diabetes mellitus (GDM) is a growing health concern that usually appears during the latter half of pregnancy, and it is characterized by carbohydrate intolerance of variable severity. The SH2B1 gene polymorphism has been linked with an increased risk of weight gain in several but not all population studies. This study aimed to investigate the genetic association of rs4788102 variants in the SH2B1 gene with GDM in Saudi pregnant women. Genomic DNA samples from 200 women with GDM and 300 women without GDM were genotyped using the TaqMan method. The distribution of the GG, GA, and AA genotypes was significantly different between GDM and non-GDM women (p < 0.05). Thus, we identified rs4788102 variants as additional risk factors for GDM in Saudi women, and we suggest that these variants may have a prognostic value.
| S-EPMC4250482 | biostudies-literature