Incidence of pregnant diabetes ranges from 1 to 14%, depending on region, race and diagnostic criteria. Studying on 196 pregnant women who were given antenatal care at Ha Noi Obstetric Gynecological Hospital provided some findings as follow: the incidence of pregnant diabetes in studied population was 3.6% when using diagnostic criteria of the National Diabetes Data Group (NDDG) 1979; the incidence of NDNG was 4.1%. The overall incidence for diabetes and GDNG was 7.65% and is was increased further by 2% when applying new diagnostic criteria of Counstan and Carpenter 1982. The incidence was increased in pregnant women who had some risk factors such as history of diabetes in family, obese (BMI was 25 or more), urinary glucose (+) and older age of pregnant woman.
Pregnancy in Diabetics ; Pregnant Women

Female ; Humans ; Infant, Newborn ; Lower Extremity ; Pregnancy ; Pregnancy in Diabetics ; Thrombophlebitis ; etiology ; therapy

OBJECTIVE: To evaluate the Philippine Obstetrical and Gynecological Society Clinical Practice Guidelines (POGS-CPG) and the International Association of Diabetes and Pregnancy Study Group (IADPSG) diagnostic criteria for gestational diabetes mellitus (GDM) against pregnancy outcomes.
METHODS: This is a randomized controlled trial which enlisted patients attending the Out-patient clinic of our institution. All women included in the study were requested to take a 2-hour 75-gram oral glucose tolerance test (OGTT) between estimated 24th and 28th gestational weeks. In order to diagnose GDM, POGS-CPG consensus required a fasting plasma glucose of >92 mg/dl (5.1 mmol/L) or a 2-hour post-glucose load of >140 mg/dl (7.8 mmol/ml) while lADPSG criteria required 92 mg/dL (5.1 mmol/L) for fasting plasma glucose, 180 mg/dL (10 mmol/L)
1-hour post-glucose load, or 153 mg/dL (8.5 mmol/L) 2-hour post-glucose load. Only 1 abnormal value on the OGTT is needed on both criteria to diagnose GDM. Women with diabetes antedating pregnancy were excluded in this study. Based on the 75-g OGTT result, the patients were divided into 4 groups and were followed through delivery. Pregnancy out-comes of the 4 groups were then compared.
RESULTS: Among the 389 patients studied, POGS-CPG group had a GDM prevalence rate of 29% whereas the IADPSG group had 16%. Trends have shown that in patients diagnosed with GDM under IADSGP and POGS criteria, no significant differences in the birth-weight status (p=0.156), mode of delivery (p=1.000), indication of cesarean section (p=1.000), and other complications (p=1.000) were noted. The 75 g OGTT values of patients in both groups were not significant predictors of APGAR scores. However, the 1-hour post-glucose load value was shown to be a significant
predictor of birth weight. Yet, the regression models of FBS parameters in predicting APGAR scores and birth weight were still weak.
CONCLUSION: There was no significant difference noted between the IADPSG group versus the POGS-CPG group in terms of maternal neonatal outcome.

Human ; Female ; Adult ; Pregnancy ; Glucose Tolerance Test ; Diabetes, Gestational ; Pregnancy Outcome ; Blood Glucose ; Birth Weight ; Glucose ; Cesarean Section ; Pregnancy In Diabetics

Congenital heart disease (CHD) is the most common birth defect at present and has a complex etiology which involves the combined effect of genetic and environmental factors. Pregestational diabetes mellitus is significantly associated with the development of CHD, but the detailed mechanism remains unknown. This article reviews the research advances in the molecular mechanism of CHD caused by pregestational diabetes mellitus.
Animals ; Apoptosis ; Cell Movement ; Female ; Heart Defects, Congenital ; etiology ; Humans ; Neural Crest ; physiology ; Pregnancy ; Pregnancy in Diabetics ; Reactive Oxygen Species ; metabolism

The link between diabetes mellitus and magnesium deficiency is well known. A growing body of evidence suggests that magnesium plays a pivotal role in reducing cardiovascular risks and may be involved in the pathogenesis of diabetes itself. While the benefits of oral magnesium supplementation on glycemic control have yet to be demonstrated in patients, magnesium supplementation has been shown to improve insulin sensitivity. Effects of Magnesium (Mg) supplementation on the glycemic control of 63 mild gestational diabetic patients were investigated. The use of an ionic, liquid minerals containing concentrated amounts of magnesium and chloride (CMD) was used for supplementation during the two week period and showed good glycemic control in the study group without additional need foe insulin injections.

Human ; Female ; Magnesium Deficiency ; Magnesium ; Insulin Resistance ; Ionic Liquids ; Cardiovascular Diseases ; Diabetes Mellitus ; Blood Glucose ; Pregnancy In Diabetics ; Insulin ; Minerals

Nowadays in Korea, the number of pregnant women with diabetes mellitus is steadily growing due to increases in advanced maternal age and obesity in combination with changes in lifestyle and diet patterns. Pregnancy complicated with diabetes mellitus, whether it is gestational or pregestational, is associated with an increased number of maternal morbidities and adverse obstetric outcomes. Therefore, it is very important to screen, diagnose, manage, and prevent diabetes mellitus during, and even before, pregnancy. In order to improve maternal and perinatal outcomes of pregnancies complicated by diabetes mellitus, research is needed on the standardization of screening and the diagnostic criteria for gestational diabetes, appropriate surveillance techniques for diabetic mothers and fetuses, and the optimal timing of delivery. To facilitate compliance of women with diabetes, randomized studies on the long-term safety and effects of oral hypoglycemics are also needed.
Compliance ; Diabetes Mellitus ; Diabetes, Gestational ; Diet ; Female ; Fetus ; Humans ; Hypoglycemic Agents ; Korea ; Life Style ; Mass Screening ; Maternal Age ; Mothers ; Obesity ; Pregnancy in Diabetics ; Pregnancy* ; Pregnant Women

INTRODUCTIONThe use of oral hypoglycaemic drugs in pregnancy is not recommended because of reports of foetal anomalies and other adverse outcomes in animal studies and in some human cases. However, recent studies have suggested that some oral hypoglycaemic drugs may be used in pregnancy. This review will examine these studies critically.

METHODSLiterature review of articles obtained from a PubMed search of peer-reviewed journals on oral hypoglycaemic drug use in pregnancy.

RESULTSIn two prospective studies, one of which was a randomised controlled trial, glibenclamide was as effective and safe as insulin in gestational diabetes. In several studies, metformin did not increase foetal anomalies or malformations when used during pregnancy in women with polycystic ovary syndrome (PCOS). In one prospective study on infants born to mothers who used metformin in pregnancy, follow-up for 18 months showed no adverse effects. In several prospective and retrospective studies on women with PCOS, metformin was shown to prevent early pregnancy loss, decrease insulin resistance, reduce insulin and testosterone levels, and decrease the incidence of gestational diabetes when these women got pregnant while on metformin and continued to take it throughout their pregnancy. In a single small study, acarbose did not cause any adverse effects during pregnancy.

CONCLUSIONSRecent evidence shows promising findings in the safety and efficacy of some oral hypoglycaemic agents in treating pregnant diabetics. However, larger clinical studies will be needed to ensure the safety and efficacy of these drugs in pregnancy.

Administration, Oral ; Contraindications ; Evidence-Based Medicine ; Female ; Humans ; Hypoglycemic Agents ; administration & dosage ; therapeutic use ; Pregnancy ; Pregnancy in Diabetics ; drug therapy ; Safety Management ; Singapore

OBJECTIVE: Gestational diabetes mellitus (GDM) is defined as glucose intolerance first detected during pregnancy. It can result in pregnancy complications such as birth injury, stillbirth. Fatty acid-binding protein 4 (FABP4), found in adipose tissue, is associated with insulin resistance, and type 2 diabetes. The aim of this study was to investigate whether FABP4 in the placenta and decidua of pregnant women with GDM is higher than that in normal pregnant women, and whether serum from pregnant women with GDM may cause adipocytes to secrete more FABP4 than does serum from a normal pregnant group. METHODS: We obtained placentas, deciduas, and serum from 12 pregnant women with GDM and 12 normal pregnant women and performed enzyme-linked immunosorbent assay, real time quantitative-polymerase chain reaction. We cultured human pre-adipocytes for 17 days with GDM and non-GDM serum and performed western blot, real time quantitative-polymerase chain reaction, and oil red O staining. RESULTS: Expression of FABP4 in serum, placenta and decidua of pregnant women with GDM was significantly higher than that in normal pregnant women. Serum from pregnant women with GDM increased the expression of FABP4 mRNA and decreased the expression of adiponectin mRNA in human pre-adipocytes significantly. Adipocyte cultured in GDM serum showed significantly greater lipid accumulation than those cultured in normal serum. CONCLUSION: Our results suggest that FABP4 is higher in placenta and decidua from pregnant women with GDM. Increased circulating FABP4 in maternal serum from pregnant women with GDM may originate from adipocytes and the placenta. Circulating FABP4 can induce increased insulin resistance and decreased insulin sensitivity.
Adipocytes ; Adiponectin ; Adipose Tissue ; Birth Injuries ; Blotting, Western ; Decidua ; Diabetes, Gestational* ; Enzyme-Linked Immunosorbent Assay ; Female ; Glucose Intolerance ; Humans ; Humans* ; Insulin Resistance ; Placenta ; Pregnancy ; Pregnancy Complications ; Pregnancy in Diabetics ; Pregnant Women* ; RNA, Messenger* ; Stillbirth

The effect of dexamethasone of the maturation of the fetal lungs of rats with streptozotocin-induced diabetes was studied morphologically and biochemically. By light and electron microscopy there was little difference in fetal pulmonary maturation between the untreated control group and the untreated diabetic group, but when both groups were treated with dexamethasone the fetuses showed accelerated pulmonary maturation, approximately one day earlier with an increase of air spaces per unit area and an earlier appearance of type II pneumocytes. The number of osmiophilic inclusion bodies per alveolus and per type II pneumocyte, and the lecithin/sphingomyelin ratio in amniotic fluid increased markedly and they were statistically significant in both groups injected with dexamethasone, but were decreased in the untreated diabetic group, though only the L/S ratio of the animals of the 19th day gestation was statistically significant. Phosphatidylglycerol was present in the amniotic fluid of the groups injected with dexamethasone one day earlier than the untreated control and the untreated diabetic groups. However, the intensity of phosphatidylglycerol tended to be lower in the untreated diabetic group. It is concluded that the prenatal administration of dexamethasone to the diabetic pregnant rats will accelerate fetal pulmonary maturation morphologically and promote the synthesis of surfactant biochemically.
Animal ; Blood Glucose/analysis ; Body Weight ; Comparative Study ; Dexamethasone/pharmacology* ; Diabetes Mellitus, Experimental* ; Female ; Fetal Organ Maturity/drug effects ; Fetus/cytology ; Lung/drug effects ; Lung/embryology* ; Lung/pathology ; Pregnancy ; Pregnancy in Diabetics* ; Rats ; Rats, Inbred Strains