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Latest & greatest articles for gestational diabetes
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Continuous glucose monitoring results in lower HbA1c in Malaysian women with insulin-treated gestationaldiabetes: a randomized controlled trial To determine if therapeutic, retrospective continuous glucose monitoring (CGM) improves HbA1c with less hypoglycaemia in women with insulin-treated gestationaldiabetes mellitus (GDM).This prospective, randomized controlled, open-label trial evaluated 50 women with insulin-treated GDM randomized to either retrospective CGM (6-day sensor) at 28, 32 (...) and 36 weeks' gestation (Group 1, CGM, n = 25) or usual antenatal care without CGM (Group 2, control, n = 25). All women performed seven-point capillary blood glucose (CBG) profiles at least 3 days per week and recorded hypoglycaemic events (symptomatic and asymptomatic CBG < 3.5 mmol/l; non-fasting < 4.0 mmol/l). HbA1c was measured at 28, 33 and 37 weeks. In Group 1, both CGM and CBG data were used to manage diabetes, whereas mothers in Group 2 were managed based on CBG data alone.Baseline
Gestationaldiabetes Evidence Maps - Trip Database or use your Google+ account Find evidence fast ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4
Safety of non-insulin glucose-lowering drugs in pregnant women with pre-gestationaldiabetes: A cohort study To evaluate the association between use of non-insulin antidiabetics in early pregnancy and the risk of miscarriages, stillbirths and major structural malformations.A cohort of 1511 pregnant women with pre-gestationaldiabetes linked to live births was identified using electronic medical records from The Health Improvement Network (THIN) for the period 1995 to 2012. Information (...) on prescriptions, foetal outcomes and potential confounders was ascertained from both codes and free text in the THIN database. Odds ratios (OR) and 95% confidence intervals (CI) of adverse foetal outcomes in women treated with non-insulin antidiabetics during the first trimester compared to those on insulin were estimated using logistic regression to adjust for type of diabetes, glycaemic control and other maternal characteristics.Among 311 pregnant women on non-insulin antidiabetics, 21.9% had a miscarriage
Effect of Glyburide vs Subcutaneous Insulin on Perinatal Complications Among Women With GestationalDiabetes: A Randomized Clinical Trial. Randomized trials have not focused on neonatal complications of glyburide for women with gestational diabetes.To compare oral glyburide vs subcutaneous insulin in prevention of perinatal complications in newborns of women with gestational diabetes.The Insulin Daonil trial (INDAO), a multicenter noninferiority randomized trial conducted between May 2012 (...) and November 2016 (end of participant follow-up) in 13 tertiary care university hospitals in France including 914 women with singleton pregnancies and gestationaldiabetes diagnosed between 24 and 34 weeks of gestation.Women who required pharmacologic treatment after 10 days of dietary intervention were randomly assigned to receive glyburide (n=460) or insulin (n=454). The starting dosage for glyburide was 2.5 mg orally once per day and could be increased if necessary 4 days later by 2.5 mg and thereafter
The impact of a daily smartphone-based feedback system among women with gestationaldiabetes on compliance, glycemic control, satisfaction, and pregnancy outcome: a randomized controlled trial Patient compliance and tight glycemic control have been demonstrated to improve outcome in pregnancies complicated by gestationaldiabetes mellitus. The use of advanced technological tools, including smartphone-based platforms, to improve medical care and outcomes has been demonstrated in various fields (...) of medicine, but only a few small studies were performed with gestationaldiabetes mellitus patients.We aimed to study the impact of introducing a smartphone-based daily feedback and communication platform between gestationaldiabetes mellitus patients and their physicians, on patient compliance, glycemic control, pregnancy outcome, and patient satisfaction.This is a prospective, single-center, randomized controlled trial. Newly diagnosed gestationaldiabetes mellitus patients presenting to our
Planned birth at or near term for improving health outcomes for pregnant women with gestationaldiabetes and their infants. Gestationaldiabetes is a type of diabetes that occurs during pregnancy. Women with gestationaldiabetes are more likely to experience adverse health outcomes such as pre-eclampsia or polyhydramnios (excess amniotic fluid). Their babies are also more likely to have health complications such as macrosomia (birthweight > 4000 g) and being large-for-gestational age (...) (birthweight above the 90th percentile for gestational age). Current clinical guidelines support elective birth, at or near term in women with gestationaldiabetes to minimise perinatal complications, especially those related to macrosomia.This review replaces a review previously published in 2001 that included "diabetic pregnant women", which has now been split into two reviews. This current review focuses on pregnant women with gestationaldiabetes and a sister review focuses on women with pre-existing
Gestationaldiabetes mellitus Gestationaldiabetes mellitus - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Gestationaldiabetes mellitus Last reviewed: February 2019 Last updated: April 2018 Summary Develops during pregnancy and is usually diagnosed at 24 to 28 weeks of gestation on the basis of elevated plasma glucose levels on glucose tolerance testing. Goal of therapy is to achieve maternal glucose levels (...) that are as close to normal as possible in order to avoid fetal macrosomia and complications. Initial therapy for gestationaldiabetes is usually dietary modification. Insulin is started when acceptable glucose levels cannot be maintained with diet alone. Maternal postnatal testing for diabetes or impaired glucose tolerance is performed at least 6 weeks following delivery. The risk for recurrence of GDM in subsequent pregnancies or progression to type 2 diabetes is high. Definition Gestationaldiabetes mellitus
SMFM Statement Pharmacological treatment of gestationaldiabetes SMFM Statement: Pharmacological treatment of gestationaldiabetes - American Journal of Obstetrics & Gynecology Email/Username: Password: Remember me Search Terms Search within Search Share this page: Access provided by Volume 218, Issue 5, Pages B2–B4 SMFM Statement: Pharmacological treatment of gestationaldiabetes Society of Maternal-Fetal Medicine (SMFM) Publications Committee ∗ Society for Maternal-Fetal Medicine, Washington (...) , DC DOI: | Publication History Published online: February 03, 2018 Expand all Collapse all Treatment for gestationaldiabetes mellitus (GDM) is associated with improved perinatal outcomes that include reduced frequency of hypertensive disorders of pregnancy, delivery of a large-for-gestational-age (LGA) infant, shoulder dystocia, and cesarean delivery. x 1 Landon, M.B., Spong, C.Y., Thom, E. et al. A multicenter, randomized trial of treatment for mild gestationaldiabetes. N Engl J Med . 2009
Post-Partum Screening and Monitoring for GestationalDiabetes: Clinical Effectiveness and Guidelines Post-Partum Screening and Monitoring for GestationalDiabetes: Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Post-Partum Screening and Monitoring for GestationalDiabetes: Clinical Effectiveness and Guidelines Post-Partum Screening and Monitoring for GestationalDiabetes: Clinical Effectiveness and Guidelines Last updated: August 28, 2018 Project Number: RB1251 (...) -000 Product Line: Research Type: Other Diagnostics Report Type: Summary of Abstracts Result type: Report Question What is the clinical effectiveness of an intervention to screen and monitor patients post-partum gestationaldiabetes? What are the evidence-based guidelines regarding post-partum gestationaldiabetes screening or monitoring? Key Message Three systematic reviews, two randomized controlled trials, six non-randomized studies, and four evidence-based guidelines were identified regarding
Comparison of umbilical artery Doppler and non-stress test in assessment of fetal well-being in gestationaldiabetes mellitus: A prospective cohort study Gestationaldiabetes mellitus (GDM) is one of the most common medical complications of pregnancy and is related to poor perinatal outcomes. Reduction of neonatal complications of GDM is feasible by assessment of fetal well-being. Both fetal Doppler and NST are used for the screening of high-risk pregnancies.We aimed to compare the non-stress (...) test (NST) and umbilical artery (UA) Doppler assessments for evaluation of the adverse perinatal outcomes in GDM.We conducted a prospective cohort study on 50 pregnant women with GDM in Jame Zanan Hospital, Tehran, Iran, from Oct 2014 to Sep 2015. A convenient sampling method was used for patient recruitment. Inclusion criteria were women with GDM, singleton pregnancies, and gestational age>32 weeks who had neither medical conditions nor fetal anomalies. Adverse perinatal outcomes were defined
miR-494 protects pancreatic Î²-cell function by targeting PTEN in gestationaldiabetes mellitus Gestationaldiabetes mellitus (GDM) is one of the most common pregnancy complications characterized by insulin resistance and pancreatic β-cell dysfunction. Increasing evidence suggests that microRNAs (miRNAs) play key roles in the diverse types of diabetes, including GDM. However, the underlying mechanisms remain largely unknown. The purpose of this study is to investigate the role of microRNAs (...) in GDM. The microarray data of dysregulated miRNAs in blood and placenta was retrieved in the GEO dataset under the accession number GSE19649. Quantitative reverse transcription PCR (qRT-PCR) was performed to analyze the expression levels of miR-494 in peripheral blood from twenty pairs of gestationaldiabetes (GDM) women and healthy women. Then, we investigated the effects of miR-494 on the insulin secretion of pancreatic β-cells. Moreover, the role of this miR-494 in regulating the proliferation
Combined diet and exercise interventions for preventing gestationaldiabetes mellitus. Gestationaldiabetes mellitus (GDM) is associated with a wide range of adverse health consequences for women and their infants in the short and long term. With an increasing prevalence of GDM worldwide, there is an urgent need to assess strategies for GDM prevention, such as combined diet and exercise interventions. This is an update of a Cochrane review that was first published in 2015.To assess the effects (...) ); and childhood adiposity (BMI z score) (MD 0.05, 95% CI -0.29 to 0.40; 794 participants; 2 RCTs; Tau² = 0.04; I² = 59%; low-quality evidence). However, there was evidence of less gestational weight gain in the diet and exercise intervention group compared with the control group (mean difference (MD) -0.89 kg, 95% CI -1.39 to -0.40; 5052 women; 16 RCTs; Tau² = 0.37; I² = 43%;moderate-quality evidence). No data were reported for maternal postnatal depression or type 2 diabetes; childhood/adulthood type 2
Insulin for the treatment of women with gestationaldiabetes. Gestationaldiabetes mellitus (GDM) is associated with short- and long-term complications for the mother and her infant. Women who are unable to maintain their blood glucose concentration within pre-specified treatment targets with diet and lifestyle interventions will require anti-diabetic pharmacological therapies. This review explores the safety and effectiveness of insulin compared with oral anti-diabetic pharmacological (...) therapies, non-pharmacological interventions and insulin regimens.To evaluate the effects of insulin in treating women with gestational diabetes.We searched Pregnancy and Childbirth's Trials Register (1 May 2017), ClinicalTrials.gov, WHO International Clinical Trials Registry Platform (ICTRP) (1 May 2017) and reference lists of retrieved studies.We included randomised controlled trials (including those published in abstract form) comparing:a) insulin with an oral anti-diabetic pharmacological therapy;b
Health app: GDm-Health for people with gestationaldiabetes Health app: GDm-Health for people with Health app: GDm-Health for people with gestationaldiabetesgestationaldiabetes Medtech innovation briefing Published: 13 November 2017 nice.org.uk/guidance/mib131 pathways Summary Summary About this app GDm-Health is a health application designed for people with gestationaldiabetes to allow for remote monitoring of blood glucose levels and communication with healthcare professionals. The mobile (...) a positive impact for people with gestationaldiabetes. There is some evidence that the app is a reliable method to communicate blood glucose levels and improves patient satisfaction with their care. However, there is currently no evidence comparing GDm-Health with standard care and so the impact on clinical outcomes is uncertain. Cost and resource impact Cost and resource impact: Cost savings may arise from reducing the need for face-to-face appointments but the overall resource impact has not been
Different methods and settings for glucose monitoring for gestationaldiabetes during pregnancy. Incidence of gestationaldiabetes mellitus (GDM) is increasing worldwide. Blood glucose monitoring plays a crucial part in maintaining glycaemic control in women with GDM and is generally recommended by healthcare professionals. There are several different methods for monitoring blood glucose which can be carried out in different settings (e.g. at home versus in hospital).The objective (...) , for blood glucose monitoring for women with GDM.Two authors independently assessed study eligibility, risk of bias, and extracted data. Data were checked for accuracy.We assessed the quality of the evidence for the main comparisons using GRADE, for:- primary outcomes for mothers: that is, hypertensive disorders of pregnancy; caesarean section; type 2 diabetes; and- primary outcomes for children: that is, large-for-gestational age; perinatal mortality; death or serious morbidity composite; childhood
microRNA-503 contribute to pancreatic beta cell dysfunction by targeting the mTOR pathway in gestationaldiabetes mellitus Loss of pancreatic β cells is involved in pathogenesis of gestationaldiabetes mellitus (GDM). Recently, several studies have elucidated the connection between microRNAs (miRNAs) and diabetes mellitus (DM), but the role of miRNAs in GDM remains unclear. The aim of this study was to evaluate the potential functions of miRNAs in GDM and to investigate the underlying
Oral anti-diabetic agents for women with established diabetes/impaired glucose tolerance or previous gestationaldiabetes planning pregnancy, or pregnant women with pre-existing diabetes. While most guidance recommends the use of insulin in women whose pregnancies are affected by pre-existing diabetes, oral anti-diabetic agents may be more acceptable to women. The effects of these oral anti-diabetic agents on maternal and infant health outcomes need to be established in pregnant women with pre (...) -existing diabetes or impaired glucose tolerance, as well as in women with previous gestationaldiabetes mellitus preconceptionally or during a subsequent pregnancy. This review is an update of a review that was first published in 2010.To investigate the effects of oral anti-diabetic agents in women with established diabetes, impaired glucose tolerance or previous gestationaldiabetes who are planning a pregnancy, or pregnant women with pre-existing diabetes, on maternal and infant health. The use