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Abstract The main purpose of this study was to find out a possible association between ABO blood groups or Rh and diabetes mellitus (DM) in the local population of eight (8) different towns of Karachi, Pakistan. For this purpose a survey was carried out in Karachi to have a practical observation of these towns during the period of 9 months from June 2019 to Feb. 2020. Out of eighteen (18) towns of Karachi, samples (N= 584) were collected from only eight (8) Towns of Karachi and gave a code-number to each town. Diabetic group sample was (n1=432) & pre-diabetes sample was (n2 =152). A standard Abbot Company Glucometer for Random Blood Sugar (RBS) and Fasting Blood Sugar (FBS) tests, standard blood anti sera were used for ABO/Rh blood type. Health assessment techniques were performed ethically by taking informed consent from all registered subjects. Finally data was analyzed by SPSS version 20.0. In our current study, the comparison of ABO blood groups frequencies between diabetic and pre-diabetic individuals were carried out. The percentage values of blood Group-B as given as: (32% in DM vs. 31% in pre-diabetics), followed by blood Group-O as: (18% in DM vs. 11% in pre-diabetics). Contrary to Group-B & O, blood Group-A and Group-AB were distribution percentage higher pre-diabetic as compared to DM patients, as given as: Group-A (32% in pre-diabetics vs. 26% in DM) & Group-AB (26% in pre-diabetics vs. 24% in diabetics patients). In addition, percentage distribution of Rh system was also calculated, in which Rh+ve Group was high and more common in DM patients as compared to pre-diabetics; numerically given as: Rh+ve Group (80% in DM vs. 72% in pre-diabetics). Different views and dimensions of the research topic were studied through literature support, some have found no any association and some established a positive association still some were not clear in making a solid conclusion. It is concluded that DM has a positive correlation with ABO blood groups, and people with Group-B have increased susceptibility to DM disease.
Resumo O objetivo principal deste estudo foi descobrir uma possível associação entre grupos sanguíneos ABO ou Rh e diabetes mellitus (DM) na população local de oito (8) diferentes cidades de Karachi, Paquistão. Para tanto, foi realizado um levantamento em Karachi para observação prática dessas cidades durante o período de 9 meses de junho de 2019 a fevereiro de 2020.De dezoito (18) cidades de Karachi, as amostras (N = 584) foram coletadas de apenas oito (8) cidades de Karachi e deram um número-código para cada cidade. A amostra do grupo de diabéticos foi (n1 = 432) e a amostra de pré-diabetes foi (n2 = 152). Um glicômetro padrão da Abbot Company para testes de açúcar no sangue aleatório (RBS) e açúcar no sangue em jejum (FBS), antissoros de sangue padrão foram usados para o tipo de sangue ABO / Rh. As técnicas de avaliação de saúde foram realizadas de forma ética, tomando o consentimento informado de todos os indivíduos registrados. Finalmente, os dados foram analisados pelo SPSS versão 20.0.No presente estudo, foi realizada a comparação das frequências dos grupos sanguíneos ABO entre diabéticos e pré-diabéticos. Os valores percentuais do sangue do Grupo-B são dados como: (32% em DM vs. 31% em pré-diabéticos), seguido pelo sangue do Grupo-O como: (18% em DM vs. 11% em pré-diabéticos). Ao contrário dos Grupos B e O, sangue do Grupo-A e Grupo-AB tiveram distribuição percentual maior de pré-diabéticos em comparação com pacientes com DM, dado como: Grupo-A (32% em pré-diabéticos vs. 26% em DM) e Grupo AB (26% em pré-diabéticos vs. 24% em pacientes diabéticos). Além disso, também foi calculada a distribuição percentual do sistema Rh, no qual o Grupo Rh + ve foi elevado e mais comum em pacientes com DM em comparação aos pré-diabéticos; dados numericamente como: Grupo Rh + ve (80% em DM vs. 72% em pré-diabéticos). Diferentes visões e dimensões do tema de pesquisa foram estudadas com o suporte da literatura, alguns não encontraram nenhuma associação e alguns estabeleceram uma associação positiva, embora alguns não estivessem claros em fazer uma conclusão sólida. Conclui-se que o DM tem correlação positiva com os grupos sanguíneos ABO, e as pessoas com o Grupo B têm maior suscetibilidade à doença DM.
ABSTRACT
Abstract The main purpose of this study was to find out a possible association between ABO blood groups or Rh and diabetes mellitus (DM) in the local population of eight (8) different towns of Karachi, Pakistan. For this purpose a survey was carried out in Karachi to have a practical observation of these towns during the period of 9 months from June 2019 to Feb. 2020. Out of eighteen (18) towns of Karachi, samples (N= 584) were collected from only eight (8) Towns of Karachi and gave a code-number to each town. Diabetic group sample was (n1=432) & pre-diabetes sample was (n2 =152). A standard Abbot Company Glucometer for Random Blood Sugar (RBS) and Fasting Blood Sugar (FBS) tests, standard blood anti sera were used for ABO/Rh blood type. Health assessment techniques were performed ethically by taking informed consent from all registered subjects. Finally data was analyzed by SPSS version 20.0. In our current study, the comparison of ABO blood groups frequencies between diabetic and pre-diabetic individuals were carried out. The percentage values of blood Group-B as given as: (32% in DM vs. 31% in pre-diabetics), followed by blood Group-O as: (18% in DM vs. 11% in pre-diabetics). Contrary to Group-"B" & "O", blood Group-A and Group-AB were distribution percentage higher pre-diabetic as compared to DM patients, as given as: Group-A (32% in pre-diabetics vs. 26% in DM) & Group-AB (26% in pre-diabetics vs. 24% in diabetic's patients). In addition, percentage distribution of Rh system was also calculated, in which Rh+ve Group was high and more common in DM patients as compared to pre-diabetics; numerically given as: Rh+ve Group (80% in DM vs. 72% in pre-diabetics). Different views and dimensions of the research topic were studied through literature support, some have found no any association and some established a positive association still some were not clear in making a solid conclusion. It is concluded that DM has a positive correlation with ABO blood groups, and people with Group-B have increased susceptibility to DM disease.
Resumo O objetivo principal deste estudo foi descobrir uma possível associação entre grupos sanguíneos ABO ou Rh e diabetes mellitus (DM) na população local de oito (8) diferentes cidades de Karachi, Paquistão. Para tanto, foi realizado um levantamento em Karachi para observação prática dessas cidades durante o período de 9 meses de junho de 2019 a fevereiro de 2020.De dezoito (18) cidades de Karachi, as amostras (N = 584) foram coletadas de apenas oito (8) cidades de Karachi e deram um número-código para cada cidade. A amostra do grupo de diabéticos foi (n1 = 432) e a amostra de pré-diabetes foi (n2 = 152). Um glicômetro padrão da Abbot Company para testes de açúcar no sangue aleatório (RBS) e açúcar no sangue em jejum (FBS), antissoros de sangue padrão foram usados para o tipo de sangue ABO / Rh. As técnicas de avaliação de saúde foram realizadas de forma ética, tomando o consentimento informado de todos os indivíduos registrados. Finalmente, os dados foram analisados pelo SPSS versão 20.0.No presente estudo, foi realizada a comparação das frequências dos grupos sanguíneos ABO entre diabéticos e pré-diabéticos. Os valores percentuais do sangue do Grupo-B são dados como: (32% em DM vs. 31% em pré-diabéticos), seguido pelo sangue do Grupo-O como: (18% em DM vs. 11% em pré-diabéticos). Ao contrário dos Grupos "B" e "O", sangue do Grupo-A e Grupo-AB tiveram distribuição percentual maior de pré-diabéticos em comparação com pacientes com DM, dado como: Grupo-A (32% em pré-diabéticos vs. 26% em DM) e Grupo AB (26% em pré-diabéticos vs. 24% em pacientes diabéticos). Além disso, também foi calculada a distribuição percentual do sistema Rh, no qual o Grupo Rh + ve foi elevado e mais comum em pacientes com DM em comparação aos pré-diabéticos; dados numericamente como: Grupo Rh + ve (80% em DM vs. 72% em pré-diabéticos). Diferentes visões e dimensões do tema de pesquisa foram estudadas com o suporte da literatura, alguns não encontraram nenhuma associação e alguns estabeleceram uma associação positiva, embora alguns não estivessem claros em fazer uma conclusão sólida. Conclui-se que o DM tem correlação positiva com os grupos sanguíneos ABO, e as pessoas com o Grupo B têm maior suscetibilidade à doença DM.
Subject(s)
Humans , Rh-Hr Blood-Group System , Diabetes Mellitus/epidemiology , Pakistan/epidemiology , ABO Blood-Group System , CitiesABSTRACT
Melatonin receptor 1B (MT2, encoded by the MTNR1B gene), a high-affinity receptor for melatonin, is associated with glucose homeostasis including glucose uptake and transport. The rs10830963 variant in the MTNR1B gene is linked to glucose metabolism disorders including gestational diabetes mellitus (GDM); however, the relationship between MT2-mediated melatonin signaling and a high birth weight of GDM infants from maternal glucose abnormality remains poorly understood. This article aims to investigate the relationship between rs10830963 variants and GDM development, as well as the effects of MT2 receptor on glucose uptake and transport in trophoblasts. TaqMan-MGB (minor groove binder) probe quantitative real-time polymerase chain reaction (qPCR) assays were used for rs10930963 genotyping. MT2 expression in the placenta of GDM and normal pregnant women was detected by immunofluorescence, western blot, and qPCR. The relationship between MT2 and glucose transporters (GLUTs) or peroxisome proliferator-activated receptor γ (PPARγ) was established by western blot, and glucose consumption of trophoblasts was measured by a glucose assay kit. The results showed that the genotype and allele frequencies of rs10830963 were significantly different between GDM and normal pregnant women (P<0.05). The fasting, 1-h and 2-h plasma glucose levels of G-allele carriers were significantly higher than those of C-allele carriers (P<0.05). Besides, the protein and messenger RNA (mRNA) expression of MT2 in the placenta of GDM was significantly higher than that of normal pregnant women (P<0.05). Melatonin could stimulate glucose uptake and GLUT4 and PPARγ protein expression in trophoblasts, which could be attenuated by MT2 receptor knockdown. In conclusion, the rs10830963 variant was associated with an increased risk of GDM. The MT2 receptor is essential for melatonin to raise glucose uptake and transport, which may be mediated by PPARγ.
Subject(s)
Female , Humans , Pregnancy , Blood Glucose/metabolism , Diabetes, Gestational/metabolism , Glucose/metabolism , Melatonin/metabolism , Polymorphism, Genetic , PPAR gamma , Receptor, Melatonin, MT2/geneticsABSTRACT
Background Gestational Diabetes Mellitus [GDM] is de?ned as Carbohydrate intolerance with recognition or onset during pregnancy and resolves postpartum. Prevalence of GDM in India varies from 3.8 - 21% with different demography and diagnostic methods used. As early diagnosis and control of maternal hyperglycaemia plays a vital role in prevention of adverse outcomes, universal screening is almost mandatory due to high prevalence, we need a simple economical, feasible test with higher sensitivity to diagnose GDM. To compare diagnostic accuracy of two non- Aim fasting tests DIPSI & HBAIC and fasting WHO criteria for diagnosis of GDM. To compare DIPSI with WHO criteria as Objectives standard. To compare HBA1C with WHO criteria as standard This study was done on 100 ANC cases to compare Results: diagnostic accuracy of DIPSI & HBAIC with fasting World Health Organization Glucose Tolerance Test. Mean age of participants was 27.18±4.60 years. 39% patients were in age group of 21 to 25 years and 34% patients were in age group of 26 to 30 years. Majority (45%) of the patients were in gestational age of 26 to 30 weeks. In this study, gestational diabetes mellitus was diagnosed in 47 (47%) patients according to WHO GTT, in 48 (48%) patients according to DIPSI and in 34 (34%) patients according to Glycated Haemoglobin. Mean gestational age of patients during diagnosis of gestational diabetes mellitus was 29.21±2.84 weeks by DIPSI, 28.83±2.82 weeks by WHO GTT and 29.29±3.15 weeks by Glycated Haemoglobin. Mean blood sugar parameters of gestational diabetes mellitus women were 174.96±16.58 mg/dl by DIPSI, 173.21±17.58 mg/dl by WHO GTT and 9.41±1.91 gm% by Glycated Haemoglobin. The sensitivity of DIPSI with regard to WHO GTT was 89.36%, speci?city 88.68%, positive predictive value 87.50%, negative predictive value 90.38%, diagnostic accuracy 89.00% and chi square value of 60.78. These values convey that DIPSI is as good as gold standard WHO GTT criteria. The sensitivity of Glycated Haemoglobin with regard to WHO GTT was 51.06%, speci?city 81.13%, positive predictive value 70.59%, negative predictive value 65.15%, diagnostic accuracy 67.00% and chi square value of 11.51. These values convey that Glycated Haemoglobin is not as good as gold standard WHO GTT. Based on ?ndings from this study it can be concluded that DIPSI is Conclusions: equally as good as World Health Organization Glucose Tolerance Test criteria in diagnosing gestational diabetes mellitus in antenatal women of south India. Since DIPSI does not require fasting it is more feasible than World Health Organization criteria. Glycated haemoglobin estimation is another test to detect diabetes mellitus which does not require fasting however its results are not close to gold standard WHO criteria unlike DIPSI
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Gestational diabetes mellitus (GDM) is characterized by glycemia and insulin disorders. Bile acids (BAs) have emerged as vital signaling molecules in glucose metabolic regulation. BA change in GDM is still unclear, which exerts great significance to illustrate the change of BAs in GDM. GDM patients and normal pregnant women were enrolled during the oral glucose tolerance test (OGTT) screening period. Fasting serums were sampled for the measurement of BAs. BA metabolism profiles were analyzed in both pregnant women with GDM and those with normal glucose tolerance (NGT). Delivery characteristics, delivery gestational age, and infant birthweight were extracted from medical records. GDM patients presented distinctive features compared with NGT patients, including higher body mass index (BMI), elevated serum glucose concentration, raised insulin (both fasting and OGTT), and increased hemoglobin A1c (HbA1c) levels. Higher homeostasis model assessment of insulin resistance (HOMA-IR) and decreased β-cell compensation (i.e., oral disposition index (DI
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Objective To investigate the prevalence of gestational diabetes mellitus (GDM) among pregnant women in Wuhan, and to explore the application value of oral glucose tolerance test (OGTT) results in the screening, diagnosis and treatment of GDM. Methods A retrospective analysis was carried out on the OGTT results of 26 558 pregnant women from Hubei Maternal and Child Health Hospital from January 2018 to December 2018. Results (1) A total of 1 754 cases were diagnosed with GDM, with a positive rate of 6.60%. Among them of 776 had fasting blood glucose ≥5.1mmol/L, 880 had 1-hour blood glucose ≥10.0mmol/L, and 798 had 2-hour blood glucose ≥8.5mmol/L. (2) The positive rates of fasting blood glucose, 1-hour blood glucose, and 2-hour blood glucose in the ≥35-year-old age group were all over two times higher than those in the <35-year-old age group (all P<0.01). (3) The ratio of people with single-point positive, two-point positive and three-point positive was 7:2:1. (4) FBG, 1-hour blood glucose and 2-hour blood glucose concentrations were all positively correlated with each other (all P＜0.01). Among these, the positive correlation between 1-hour blood glucose and 2-hour blood glucose was the most significant (r=0.618, P＜0.01). Conclusions The incidence rate of GDM among pregnant women in Wuhan reached 6.60%, and the prevalence in pregnant women over 35 years old was significantly higher. Blood glucose level during pregnancy should be monitored for early detection and intervention to prevent the development of GDM. The relationship between blood glucose concentrations at different time points in the OGTT test had reference value for clinical diagnosis and treatment.
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Introduction: Gestational Diabetes Mellitus is thedevelopment of carbohydrate intolerance of variable severitywith onset or first recognition during pregnancy. Many studieshad suggested that an elevated serum ferritin level in maternalblood in early as well as mid-pregnancy is an independent riskfactor for development of GDM. In the present study we aimto find the association of serum ferritin levels with serum ironand Hb% in the GDM patients at the time of delivery and alsocorrelate it with cord blood Hb% and iron levels of the newborn.Material and Methods: The study group was composed of50 diagnosed cases of GDM and the control group comprisedof age matched 50 cases of normal pregnancy. Maternal bloodwas used to measure mother’s hemoglobin, iron levels, serumferritin and hsCRP. Cord blood sample was used to estimatehemoglobin and iron levels of the newborns.Results: Our study shows that in the GDM cases the levelof serum ferritin was significantly higher (p <0.001) than inthe non GDM controls at the time of delivery. Cord bloodhemoglobin is negatively correlated with maternal serumferritin levels in GDM.Conclusion: Elevated serum ferritin level in GDM is a markerof inflammation due to increased ROS production caused byiron overload. This oxidative stress might affect the placentaliron transfer to the fetus and fetal Hb synthesis.
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Background: GDM represents a high risk factor in pregnancy. Prevalence of GDM is increasing globally. Aims & Objectives: To evaluate the prevalence and risk factors for gestational diabetes mellitus among pregnant females at high risk for GDM attending a tertiary care hospital. Methods: The present study was a prospective Observational study. Pregnant women between 24-28 weeks of gestation irrespective of the age and parity with risk factors like overweight, history of diabetes mellitus in first degree relatives, previous history of macrosomic baby or congenital malformations, history of difficult instrumental deliveries, polyhydramnios were included . Detailed history, physical examination and routine investigations were carried out. The screening was done by Glucose challenge test using 50gms of oral glucose .The women found positive on screening test were subjected to 3 hours, 100gm glucose tolerance test (GTT). Results: A total of 350 randomly selected pregnant females who met the inclusion criteria were included. Out of 350 women, 74 (21.1%) turned out to be positive for screening test. The screening test positive women when subjected to confirmatory test of GDM by oral glucose tolerance test, 22 (6.3%) women were found to have GDM. Factors associated with increased prevalence were increasing age(1.8% vs 5% vs 16% p=0.001 in age groups <25 , 25-29 and > 30 years respectively) , parity (10.6% vs 4.2% p=0.03 more than two children and less than or equal to two children respectively) , obesity(25% vs 2.6% p<0.05 Obese vs non obese ), those with history of previous abortion(5.2% vs 10.7% vs 25% p=0.013 ,no abortion, one abortion ,two or more abortion respectively), those with history of GDM in previous pregnancy( 57.1% vs 5.2 % p=0.001) and those with history of diabetes mellitus in first degree relatives(37.5 vs 5.6% p=0.001). Conclusion: The prevalence of GDM was 6.3%. GDM was found more commonly in those with higher age, parity, women with history of abortions during previous pregnancy, obese, those with history of GDM in previous pregnancy and those with history of diabetes mellitus in first degree relatives. Screening should be offered to all pregnant women especially women with risk factors.
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Background: Gestational diabetes mellitus (GDM) is a growing epidemiological problem. GDM is defined as glucose intolerance during pregnancy. Treatment of GDM is important to avoid maternal and fetal complication. The objective of this study is to assess the knowledge about gestational diabetes mellitus among antenatal mothers from rural area.Methods: A descriptive cross-sectional study was done among 193 antenatal mothers in rural hospital, Murud. A study was done between July 2018 to August 2018. A pretested questionnaire was used to assess knowledge about GDM among all antenatal mothers.Results: Among the participants, 48.19% were in the age group 21-25 years and 90.15% antenatal mothers were literate. 80% heard about diabetes mellitus and 38% mothers knows that diabetes can occur first time in pregnancy. Only 28.50% mothers heard about GDM from different source of information.Conclusions: The study shows average knowledge about gestational diabetes mellitus among antenatal mother.
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The article "Prevalence of gestational diabetes mellitus and associated risk factors amongst antenatal women attending urban health centre of Rajkot City, Gujarat" is retracted by the Editor-in-Chief, due to violation of the policies and practices of International Journal of Community Medicine and Public Health. The article is retracted due to dispute in authorship.
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Background: The prevalence of diabetes mellitus (DM) is increasing worldwide and more in developing countries like India. The diabetic epidemic experienced in India can be due to strong genetic factors coupled with increasing urbanization, sedentary lifestyle, changes in the dietary patterns and increasing obesity. Indians are at an 11-fold increased risk of developing gestational glucose intolerance and hence universal screening is essential. Uric acid is a known marker of oxidative stress. Hyperuricemia in early pregnancy may be an indicator of the existing metabolic disturbance which can hinder the maternal physiological adaptations generally seen in pregnancy thus making the pregnant women more vulnerable to the development of gestational diabetes mellitus. The objective of this study was to investigate the association between elevated uric acid levels in the first trimester of pregnancy with gestational diabetes.Methods: This prospective observational study was conducted in Chinmaya mission hospital, Bangalore from June 2016 to March 2017 (10 months). Three hundred and twelve (312) pregnant women of gestational age less than 12 weeks who attended the OBG outpatient department within this time of period for regular antenatal check-up were enrolled in the study. Along with the other antenatal investigations serum uric acid levels were estimated before 12 weeks and also between 24-28 weeks. At 24-28 weeks screening for GDM was done by OGCT using 75 gms of glucose (IADPISG criteria). Other parameters like age, parity, BMI, family history of diabetes was noted and compared.Results: In our study, among the 312 pregnant women, 88 (28%) developed GDM. Of these 74 Women (84%) with GDM had uric acid levels above 3.5 mg/dl and 14 women (15.9%) with GDM had uric acid levels below 3.5 mg/dl. Women with higher BMI showed high uric acid levels.Conclusions: Elevated serum uric acid in the first trimester has a significant correlation with development of GDM. In present study; the cut-off level of maternal serum uric acid of 3.5 mg/dl in the first trimester appears to have a good sensitivity and specificity in identifying those patients who are most likely to develop GDM later in pregnancy.
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Background: Maternal Nutrition plays an important role in shaping the mother’s and fetal health. Therefore intake of high salt, high fat, high sugar in the diet might lead to over nutrition among pregnant women due to varied food choices of the since most of the subjects consumed outside food, Sugar Sweetened Beverages such as (Cola, Pepsi, Thumps Up, Soda, Sherbet etc), Processed Food such as(Ready to eat food, Mayonnaise, Cheese spread etc) which consist of increase amount of preservative which might affect the mother and foetal’s health. Since there was increase intake of above food groups and decrease intake of macro and micronutrients in the diet through food group such as Fruits, Nuts and Oilseed, Green Leafy Vegetables etc. Therefore there might be increased risk of Over nutrition among women which might lead to GDM (Gestational Diabetes Mellitus), IUGR(Intra Uterine Growth Retardation), Low Birth weight etc.Aim: To study the impact of dietary pattern on Nutritional of pregnant women in Low and High Strata. Method: A purposive random sampling was done among pregnant women because only 2ndtrimester pregnant women were selected for the study. The 50 subjects were divided into LSES (Lower Socioeconomic Strata) &HSES (Higher Socioeconomic Strata) on the basis of Kuppuswamy Index. The dietary pattern of the subjects was assessed through FFQ (Food Frequency Questionnaire) & 3 Day Diet Recall. Result: There was increase consumptionof High Fat, High Salt, High Sugar in the diet through consumption if food group such as Outside Food, Processed Food, Sugar Sweetened Beverages etc and in comparison the consumption of Macro and Micronutrient rich food group was lower which included Fruits, Green Leafy Vegetables, Nuts and oilseed etc. In Lower Strata the consumption of above food group was low because they were financially not stable therefore they were given additional services where the company paid their ration balance so that they could consume selective food group which were costing comparatively more. Since the RDA(Recommended Dietary Allowances) requirements were not met therefore the women were prescribed Iron, Calcium and Folic Acid supplements in the diet to decrease the risk ofMaternal and fetal complication such as GDM(Gestational Diabetes Mellitus), NTD(Neural Tube Defect), IUGR(Intra Uterine Growth Retardation) etc.Conclusion: Therefore to decrease the risk of Maternal and Fetal Complications intake of Macro and Micro nutritions in the diet is imperative and it is important to organize Nutrition Intervention programmes and counsel the pregnant women about Maternal Nutrition and how decrease intake of Nutrients in the diet might lead to Maternal Under nutrition and over nutrition and its related risk
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Background: Gestational diabetes mellitus is a common medical complication of pregnancy associated with several fetal and maternal complications. There are several screening tools for detecting gestational diabetes mellitus including recent DIPSI criteria of non-fasting single plasma 2-hour value after 75 grams glucose (single step test). The present study was aimed at calculating prevalence of GDM, sensitivity and specificity using non-fasting single plasma 2-hour value after 75 grams glucose for screening and diagnosis of gestational diabetes mellitus and to study the high-risk characteristics for GDM in this study population.Methods: This was a prospective study conducted for a period of one year. 750 antenatal women attending Antenatal outpatient department(OPD) with period of gestation 24-28 weeks were enrolled in the study. All women were first tested by 75 gm glucose and then by OGTT for confirmation. Prevalence rates, sensitivity, specificity, positive predictive value and negative predictive value were studied. History based questionnaire was used to study the risk characteristics for GDM.Results: Prevalence rate, sensitivity, specificity, positive predictive value and negative predictive value for patients were 14.13%, 73.58%, 95.03%, 70.90% and 95.67%. Among the risk factors 7.2% patients were more than 30 years in age. 0.93% had GDM in previous pregnancy.4.21% had GCA in previous pregnancy, 12.4% had SB/IUD/NND in previous pregnancy. 1.17% had previous pregnancy with birth weight more than 3.5 kg and 9.73% had family history of diabetes mellitus. Past history of GDM (50%) was the most common risk factor in GDM group followed by age > 30 years (29.6%), and family history (24.6%).Conclusions: Screening using DIPSI criteria has good sensitivity and negative predictive values. It can serve as both screening and diagnostic test besides being simple, user friendly, cost effective and evidence-based test in less resource countries like India.
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Background: The aim of this study was to find role of SHBG as an early predictor for gestational diabetes mellitus.Methods: A hospital based prospective/observational/diagnostic and explorative study. The necessary information was collected from the participants through the prepared set of questionnaires. Pregnant women between 11 to 14 weeks of gestation who visited JSS OPD for antenatal checkup satisfying inclusion and exclusion criteria giving informed and written consent for the study were examined clinically. 3ml of venous blood was drawn with aseptic precautions for the estimation of SHBG and adiponectin. OGTT with 75gms glucose first done at 11 to 14weeks and again at 24-28 weeks and 32-36 weeks were done to the same patient to find out whether the patient developed GDM or not. These mothers were followed periodically till delivery. The sensitivity and specificity of SHBG were assessed and compared in patients who developed GDM.Results: 100 cases were selected for the study. About 12 patients were diagnosed as gestational diabetes mellitus in present study by OGCT at 32 weeks to 36 weeks. In present study about 14 patients had low level of SHBG. Low level of SHBG is found to be statistically significant in predicting GDM in first trimester.Conclusions: The combination of SHBG can be used as predictor of GDM in first trimester.
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Background: Gestational Diabetes Mellitus (GDM) accounts for almost 90% of all pregnancies complicated by diabetes. Its prevalence in the Indian population ranges from 5.5% to 11.5 %.Methods: The present study was undertaken to assess the incidence of GDM among antenatal mothers admitted in Goa Medical College for a period of 18 months and also to study the risk factors associated with GDM amongst such cases.Results: Present study revealed that among 7717 antenatal mothers who were admitted and delivered in our Hospital, 424 women were diagnosed with GDM. Of these women diagnosed with GDM, almost one third were in the age group of 31- 35 years (35.8%); 56.2 % of these women were multigravidas. Advancing maternal age, rising parity, obesity, family history of Diabetes Mellitus (DM) and past history of GDM were among the risk factors found to be significantly associated with GDM.Conclusions: The incidence of GDM in present study population was 5.49%. Advancing maternal age, maternal obesity, family history of DM and past history of GDM were found to be important determinants of GDM.
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Background: Gestational diabetes mellitus (GDM) is a diabetic metabolic disorder that occurs in 4% of all pregnant women and 14% of ethnic groups with more prevalence of type II diabetes. It can be defined as increased or abnormal insulin resistance, decreased insulin sensitivity or glucose intolerance with first diagnosis during pregnancy. Aims/Objectives: 1. To find out prevalence of GDM. 2. To study associated risk factors. Methods: The study was conducted at the metabolic clinic; in the department of Biochemistry located at SIMS, Hapur. A semi-structured pretested questionnaire was used for data collection. Following the DIPSI guidelines, patients with plasma glucose values >140 mg/dl were labeled as GDM. Statistical methods used were OR (CI95%), percentage, Chi square. Results: ‘Out of 500, 6.72% had GDM. Among all GDM patients, 64.71% had age more than 30 years, 70.59% had BMI more than 25, 41.18% had gravida more than 3 and p- value was significant with regard to age and BMI. P value was found to be significant for risk factors namely positive family history of Diabetes Mellitus, history of big baby and presence of more than one risk factor. Conclusion: GDM is associated with high BMI, early pregnancy loss, family history of DM and previous history of big baby and there could be more than one risk factor. Thus universal screening followed by close monitoring of the pregnant women for early detection of GDM may help improving maternal and fetal outcomes.
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@#Introduction: The role of dietary intake on maternal glucose is uncertain. This study described the dietary characteristics of women with gestational diabetes mellitus (GDM) and examined the differences in dietary characteristics based on GDM diagnosis. Methods: This study recruited GDM women (n =45; age =31.1±5.1 years old) from health clinics in Seremban. Dietary intake, glycemic index (GI) and glycemic load (GL) were assessed using a semi-quantitative food frequency questionnaire (SFFQ) during first and second trimester of pregnancy. GDM diagnosis was made at 28 weeks gestation with the following cut-off for FPG ≥ 5.1 or 2hPG ≥ 7.8 mmol/L following oral glucose tolerance test. Results: Women with GDM had a reasonable intake of protein and fat but consumed high-carbohydrate at second trimester and high-sugar diet at both trimesters. Fibre, iron and calcium from the food sources did not meet the recommended nutrient intakes for pregnancy. About 75.6% (n = 34) GDM women had high 2hPG (9.3 ± 1.5 mmol/L) with a normal FPG (4.7 ± 0.7 mmol/L). While dietary characteristics were not significantly different, women with a higher 2hPG tended to take a higher proportion of protein at first trimester and a higher dietary GI, serving of rice, and sugars and creamer at second trimester than high FPG. Conclusion: Suboptimal maternal nutrition in women with GDM are of particular concern. Dietary characteristics of women with high fasting and 2-hour glucose were comparable but not optimal. The needs of tailored nutritional intervention are evident in women known to be at high risk of GDM.
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Objective • To investigate the differences of intestinal flora between gestational diabetes mellitus (GDM) pregnant women and healthy pregnant women. Methods • In this study, 74 pregnant women from the Department of Obstetrics in Xinhua Hospital, Shanghai Jiao Tong University School of Medicine from Aug. 2017 to Jan. 2019 were recruited, including 51 GDM pregnant women (GDM group) and 23 healthy pregnant women (healthy group). High-throughput sequencing was performed on bacterial gene sequences from the fresh feces of all pregnant women by using Illumina MiSeq platform. Linear discriminant analysis (LDA) and LDA EffectSize (LEfSe) were used to detect the α diversity and expression abundance of intestinal flora of the two groups. Results • Compared with the healthy group, the intestinal flora richness of pregnant women in the GDM group was significantly higher (P=0.027). Porphyromonadaceae and Alcaligenaceae in Family, and Bacteroides in Genus of microbiota in the GDM group were significantly higher (all P<0.05). Compared with the GDM group, Burkholderiales, Lactobacillales and Bacillales in Order, Lachnospirace in Family, and Neisseria, Streptococcus, Butyricicoccusm, Gardnerella and Atopobium in Genus of microbiota in the healthy group were significantly higher (all P<0.05). Conclusion • There are significant differences of intestinal flora between GDM pregnant women and healthy pregnant women.
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Abstract@#Women with gestational diabetes mellitus (GDM) during their pregnancy have a greater risk of developing overt diabetes mellitus and dysglycemia (prediabetes, impaired glucose tolerance or impaired fasting glucose) later in future, compared to mothers with normal pregnancy. Postpartum screening is crucial for early identification of type 2 diabetes (T2DM) in women with GDM. Nevertheless, despite various strategies, its rate remains low. A systematic review using databases of PubMed/Medline, Science Direct and CINAHL from 2008 to 2018, was conducted to identify the factors influencing the attendance of postpartum diabetes screening. Open access English articles, focusing on observational studies were reviewed. Primary screening of titles and abstracts of 91 articles were done, secondary screening of 31 articles resulted in 6 articles, included in this manuscript. Various factors identified to be associated with the attendance to postpartum diabetes screening, which are age, education, ethnicity, some obstetric factors like multiparty, and history of insulin usage previously. Many women fail to be screened for diabetes during the postpartum period, and this delays T2DM diagnosis, which in turn gives rise to various complications. Further research that considers these factors is necessary for developing interventions to improve postpartum T2DM screening for mothers with GDM during their pregnancy
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Objective: To explore the expression level of protein kinase AMP-activated catalytic subunit α1 (PRKAA1) in placental tissues of gestational diabetes mellitus (GDM) women, and the influence of high glucose (HG) on PRKAA1 expression and proliferation viability of trophoblast cells in vitro. Methods: The placental samples of GDM women (n=19) and normal pregnant women (n=20) of the corresponding period were collected. Real-time qPCR and Western blotting assay were used to detect the mRNA and protein levels of PRKAA1 in these biopsies, respectively. Trophoblast cells were treated by HG in vitro and then expression level of PRKAA1 was tested. CCK8 assay was used to detect proliferation viability of the cells treated by HG medium or inhibitor of PRKAA1, dorsomorphin. Results: Comparing to normal pregnant women, both mRNA and protein levels of PRKAA1 in placental tissues of GDM women significantly decreased (both P<0.05). HG treatment drastically downregulated expression of PRKAA1 in trophoblast cells in vitro (P<0.05). Both HG medium and dorsomorphin suppressed proliferation viability of trophoblast cells (both P<0.05). Conclusion: Expression level of PRKAA1 is dampened in placental tissues of GDM women. HG suppresses proliferation viability of trophoblast cells probably via downregulating PRKAA1 level in vitro.