Gestational diabetes mellitus (GDM) reflects defects in insulin secretion in response to the metabolic demands of pregnancy. While GDM is increasingly common worldwide due in large part to the obesity epidemic, its frequency is relatively low in Korean women. In this report, the prevalence and risk factors for GDM, perinatal outcomes, and postpartum course are compared in non-Korean and Korean women. While Koreans and non-Koreans with GDM share pathophysiology and complications, there may be differences in the role of obesity and thus the effectiveness of interventions targeting obesity in GDM women. Further investigations of the effectiveness of weight loss interventions and pharmacotherapy specifically among Korean women are needed. Dietary and other lifestyle data from Korean populations could inform prevention and treatment strategies in other countries which suffer from significantly higher prevalences of GDM.
Diabetes, Gestational* ; Drug Therapy ; Epidemiology ; Female ; Humans ; Insulin ; Life Style ; Obesity ; Postpartum Period ; Pregnancy ; Prevalence ; Risk Factors ; Weight Loss

Objective To evaluate the effects of vitamin D supplementation on serum lipid profiles and neonatal prognosis in gestational diabetes mellitus(GDM)patients.Methods The electronic databases including PubMed,Web of Science,Embase,CNKI,and Wanfang Data were searched from inception to February 1,2020.All randomized controlled trials that compared vitamin D supplementation with placebo or without supplementation for GDM women were included.Paper selection,data extraction,meta-analysis and sensitivity analysis were conducted independently by two authors.Risk of bias was assessed using the Cochrane Risk of Bias Tool.The data were analyzed in RevMan 5.3 software and Stata 12.0.Results Totally 17 randomized controlled trials involving 1432 patients(704 in the intervention group and 728 in the control group)were included in the meta-analysis.The results showed that vitamin D supplementation significantly reduced serum total cholesterol [MD=-6.11,95% CI=(-7.17,-5.04)],low-density lipoprotein cholesterol [MD=-10.80,95% CI=(-14.72,-6.89)],and triglyceride [MD=-8.11,95% CI=(-10.09,-6.13)],while significantly increased serum 25-hydroxyvitamin D3 level [MD=45.45,95% CI=(41.98,48.92)] and high-density lipoprotein cholesterol [MD=2.77,95% CI=(1.59,3.96)].In addition,vitamin D supplementation significantly reduced the incidence rate of hyperbilirubinemia [RR=0.49,95% CI=(0.35,0.68)],premature birth [RR=0.44,95% CI=(0.27,0.72)],and neonatal hospitalization [RR=0.44,95% CI=(0.29,0.67)].Conclusions Vitamin D supplementation may regulate the serum lipid profiles in patients with GDM and reduce the incidence of adverse neonatal outcomes.More high-quality RCTs are needed to confirm the findings in our study.
Diabetes, Gestational/drug therapy* ; Dietary Supplements ; Female ; Humans ; Infant, Newborn ; Pregnancy ; Premature Birth ; Randomized Controlled Trials as Topic ; Vitamin D ; Vitamins

Gestational diabetes mellitus(GDM)can cause blood glucose disorders in pregnant women and result in adverse maternal-neonatal outcomes.Vitamin D(VD)can improve glucose tolerance and insulin sensitivity,and thus theoretically,VD supplementation during pregnancy could improve glycemic control as well as maternal-neonatal outcomes in GDM patients.Although studies have shown that VD deficiency is associated with poor maternal-neonatal outcomes in GDM patients,no solid conclusion has been drawn with regard to the effects of VD supplementation on these patients.Therefore,here we summarized the research progress of the effects of VD supplementation on glycemic control and adverse maternal-neonatal outcomes in GDM patients,in an effort to guide the clinical VD supplementation during pregnancy.
Blood Glucose ; Diabetes, Gestational/drug therapy* ; Dietary Supplements ; Female ; Glycemic Control ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Outcome ; Vitamin D

OBJECTIVETo evaluate the antioxidant activity of astragalus and its therapeutic effect on gestational diabetes.

METHODSEighty-four pregnant women with gestational diabetes were divided into insulin and insulin plus astragalus groups after regular dietary control and insulin treatment to maintain stable blood glucose level. The 43 patients in insulin group received insulin injection, whereas the 41 patients in the other group received treatment with both insulin and astragalus. The SOD activity, MDA level, blood lipids and renal function were determined in both groups after the treatments.

RESULTSThe patients with both insulin and astragalus treatments showed significantly increased serum SOD activity and decreased MDA level, renal function and blood lipids in comparison with those with exclusive insulin treatment.

CONCLUSIONAstragalus can effectively control blood glucose, reduce the free radicals, and promote the antioxidative activity, and may play a role in the prevention and treatment of gestational diabetes.

Antioxidants ; metabolism ; Astragalus Plant ; Diabetes, Gestational ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Malondialdehyde ; metabolism ; Oxidation-Reduction ; Phytotherapy ; Pregnancy ; Superoxide Dismutase ; metabolism ; Treatment Outcome

BACKGROUND: An early identification of the risk groups might be beneficial in reducing morbidities in patients with gestational diabetes mellitus (GDM). Therefore, this study aimed to assess the biochemical predictors of glycemic conditions, in addition to fasting indices of glucose disposal, to predict the development of GDM in later stage and the need of glucose-lowering medication.METHODS: A total of 574 pregnant females (103 with GDM and 471 with normal glucose tolerance [NGT]) were included. A metabolic characterization was performed before 15+6 weeks of gestation by assessing fasting plasma glucose (FPG), fasting insulin (FI), fasting C-peptide (FCP), and glycosylated hemoglobin (HbA1c). Thereafter, the patients were followed-up until the delivery.RESULTS: Females with NGT had lower levels of FPG, FI, FCP, or HbA1c at the early stage of pregnancy, and therefore, showed an improved insulin action as compared to that in females who developed GDM. Higher fasting levels of FPG and FCP were associated with a higher risk of developing GDM. Moreover, the predictive accuracy of this metabolic profiling was also good to distinguish the patients who required glucose-lowering medications. Indices of glucose disposal based on C-peptide improved the predictive accuracy compared to that based on insulin. A modified quantitative insulin sensitivity check index (QUICKIc) showed the best differentiation in terms of predicting GDM (area under the receiver operating characteristics curve [ROC-AUC], 72.1%) or need for pharmacotherapy (ROC-AUC, 83.7%).CONCLUSION: Fasting measurements of glucose and C-peptide as well as the surrogate indices of glycemic condition could be used for stratifying pregnant females with higher risk of GDM at the beginning of pregnancy.
Blood Glucose ; C-Peptide ; Diabetes, Gestational ; Drug Therapy ; Fasting ; Female ; Glucose Metabolism Disorders ; Glucose ; Hemoglobin A, Glycosylated ; Humans ; Insulin ; Insulin Resistance ; Metabolic Diseases ; Metabolism ; Pregnancy ; ROC Curve

OBJECTIVE: Psychotropic drugs use in pregnant mothers with psychiatric disorders raises issues of safety not only with the mothers but also with fetal development and the postpartum prognosis of the neonate. Several studies have reported on the harmful effects of antenatal exposure to psychotropic drugs. However, debatable disregard of the psychiatric disorder itself and issues of necessary and useful pharmacotherapy clouds the results. Hence, the purpose of this study was to retrospectively examine the association between prenatal psychotropic exposure and clinically evident fetal adverse effects. METHODS: From January 1994 to December 2011, a retrospective chart review of patients diagnosed with a major psychiatric disorder from the department of psychiatry and who also had a history of giving birth at the department of obstetrics and gynecology at Ajou University Hospital was conducted. Participants were divided into two groups: those taking psychotropic drugs during pregnancy were designated to the case group and the control group consisted of those not on psychotropics during pregnancy. Psychotropics included antidepressants, antipsychotics and benzodiazepines used in clinical dosages. Then the two groups were compared on factors such as gestational age, the offspring's birth weight, bitemporal diameter, and Apgar scores. After then, we analyzed relatively risk potential to the preterm labor in such variables (old age pregnancy, gestational diabetes, gestational hypertension and exposure psychotropics in pregnancy). T-test and logistic regression analysis of the data was performed. RESULTS: Demographic and clinical characteristics did not differ significantly between the groups. Also, there was no significant difference in gestational age, birth weight, bitemporal diameter and Apgar scores between the exposure and non-exposure groups. There was no significant relationship between psychotropic exposure during pregnancy, old age pregnancy, gestational diabetes and preterm labor. However, the relationship between gestational hypertension and preterm labor was significant. CONCLUSION: Psychotropic drugs are considered as significant clinical treatment options to control symptoms of psychiatric disorders during pregnancy. In the clinical setting there was no statistically significant relationship between psychotropic exposure and gestational age on fetal development. However the retrospective nature of the study limits the interpretation of the data and constant close monitoring of pregnant patients in the clinical setting is advised.
Antidepressive Agents ; Antipsychotic Agents ; Benzodiazepines ; Birth Weight ; Diabetes, Gestational ; Drug Therapy ; Female ; Fetal Development ; Fetus* ; Gestational Age ; Gynecology ; Humans ; Hypertension, Pregnancy-Induced ; Infant, Newborn ; Logistic Models ; Mothers ; Obstetric Labor, Premature* ; Obstetrics ; Parturition ; Postpartum Period ; Pregnancy ; Prognosis ; Psychotropic Drugs ; Retrospective Studies