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Latest & greatest articles for gestational diabetes
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Oral anti-diabetic agents for women with pre-existing diabetes mellitus/impaired glucose tolerance or previous gestationaldiabetes mellitus. While most guidelines recommend the use of insulin in women whose pregnancies are affected by pre-existing diabetes, oral agents have obvious benefits for patient acceptability and adherence. It is necessary, however, to assess the effects of these anti-diabetic agents on maternal and infant health outcomes. Additionally, women with previous gestational (...) diabetes mellitus are increasingly found to be predisposed to impaired glucose tolerance and, despite the potential need for intervention for these women, there has been little evidence about the use of oral anti-diabetic agents by these women pre-conceptionally or during a subsequent pregnancy.To investigate the effect of oral anti-diabetic agents in women with pre-existing diabetes mellitus, impaired glucose tolerance or previous gestationaldiabetes planning a pregnancy or pregnant women
Effects of treatment in women with gestationaldiabetes mellitus: systematic review and meta-analysis. To summarise the benefits and harms of treatments for women with gestationaldiabetes mellitus.Systematic review and meta-analysis of randomised controlled trials.Embase, Medline, AMED, BIOSIS, CCMed, CDMS, CDSR, CENTRAL, CINAHL, DARE, HTA, NHS EED, Heclinet, SciSearch, several publishers' databases, and reference lists of relevant secondary literature up to October 2009. Review methods (...) Included studies were randomised controlled trials of specific treatment for gestationaldiabetes compared with usual care or "intensified" compared with "less intensified" specific treatment.Five randomised controlled trials matched the inclusion criteria for specific versus usual treatment. All studies used a two step approach with a 50 g glucose challenge test or screening for risk factors, or both, and a subsequent 75 g or 100 g oral glucose tolerance test. Meta-analyses did not show significant
Gestationaldiabetes mellitus (GDM). Evidence-based nutrition practice guideline. Guidelines and Measures | Agency for Healthcare Research & Quality HHS.gov Search ahrq.gov Search ahrq.gov Menu Topics A - Z Healthcare Delivery Latest available findings on quality of and access to health care Searchable database of AHRQ Grants, Working Papers & HHS Recovery Act Projects AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund You are here Guidelines and Measures Funding
First-trimester follistatin-like-3 levels in pregnancies complicated by subsequent gestationaldiabetes mellitus OBJECTIVE To determine whether maternal levels of follistatin-like-3 (FSTL3), an inhibitor of activin and myostatin involved in glucose homeostasis, are altered in the first trimester of pregnancies complicated by subsequent gestationaldiabetes mellitus (GDM). RESEARCH DESIGN AND METHODS This was a nested case-control study of subjects enrolled in a prospective cohort of pregnant (...) women with and without GDM (> or =2 abnormal values on a 100-g glucose tolerance test at approximately 28 weeks of gestation). We measured FSTL3 levels in serum collected during the first trimester of pregnancy. Logistic regression analyses were used to determine the risk of GDM. RESULTS Women who developed GDM (n = 37) had lower first-trimester serum levels of FSTL3 compared with women who did not (n = 127) (median 10,789 [interquartile range 7,013-18,939] vs. 30,670 [18,370-55,484] pg/ml, P
Risk factors for gestationaldiabetes mellitus in Chinese women: a prospective study of 16,286 pregnant women in China To determine the incidence of gestationaldiabetes mellitus (GDM) in China and to further identify population specific risk factors for GDM.Following a universal GDM screening recommendation, 16,286 pregnant women who underwent a 50-g glucose challenge test from 18 cities in China were followed up through pregnancy. GDM was confirmed by oral glucose tolerance test according (...) to American Diabetes Association criteria.The incidence of GDM was 4.3%. Previously reported risk factors for GDM, including advanced maternal age, pre-pregnancy obesity and family history of diabetes, were strongly associated with an elevated GDM risk. Moreover, after the adjustment for the above-mentioned risk factors, a history of recurrent vulvovaginal candidiasis, residency in south China and a history of spontaneous abortion were significantly associated with an increased GDM risk; adjusted odds
What is known about options and approaches to intrapartum management of women with gestationaldiabetes mellitus (GDM)? KTA Evidence Summary: Intrapartum Management of Patients with GestationalDiabetes Mellitus (GDM) Page 1 of 19 May 2010 May 2010 – Knowledge to Action Evidence Summary What is known about options and approaches to fetal surveillance and intrapartum management of women with gestationaldiabetes mellitus (GDM)? This report aims to summarize the evidence around the intrapartum (...) management of women with gestationaldiabetes mellitus (GDM) to help inform evidence-based guidelines and advance practice in the province of Ontario. Key Messages ? GestationalDiabetes Mellitus (GDM) can cause serious complications in the intrapartum care of pregnant women and their fetuses. The impact and treatment differs somewhat from that of Type 1 and Type 2 diabetes. ? Fetal surveillance is a key aspect of the intrapartum care of the fetus. The most prominent methods appear to be: fetal movement
Post Partum Care for GestationalDiabetes Mellitus KTA Evidence Summary: Postpartum Intervention for Women with History of GDM Page 1 of 19 March 2010 March 2010 – Knowledge to Action Evidence Summary What is known about postpartum intervention for women with history of GDM? Gestationaldiabetes mellitus (GDM) is a sentinel event in the life of a woman of reproductive age that confers risk to both mother and baby for future development of type 2 diabetes mellitus (T2D) and a host of other (...) to provide some context; these statements are not meant to address all of the evidence in existence on the subject, rather, that which is featured in this document. KTA Evidence Summary: Postpartum Intervention for Women with History of GDM Page 2 of 19 March 2010 Background According to the 2008 Canadian Diabetes Association Clinical Practice Guidelines, the prevalence of gestationaldiabetes mellitus (GDM) in Canada varies around 3.7% for non-Aboriginals and ranges from 8-18% in the Aboriginal
[Medtronic-Minimed Continuous Glucose Monitoring System for patients with type 1 diabetes mellitus and gestationaldiabetes: efficacy and safety] Sistemes de monitoratge continu de glucosa de Medtronic-Minimed a pacients amb diabetis mellitus de tipus 1 i gestacional: eficacia i seguretat [Medtronic-Minimed Continuous Glucose Monitoring System for patients with type 1 diabetes mellitus and gestationaldiabetes: efficacy and safety] Sistemes de monitoratge continu de glucosa de Medtronic-Minimed (...) a pacients amb diabetis mellitus de tipus 1 i gestacional: eficacia i seguretat [Medtronic-Minimed Continuous Glucose Monitoring System for patients with type 1 diabetes mellitus and gestationaldiabetes: efficacy and safety] Solans M, Kotzeva A, Almazan C Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Solans M, Kotzeva A, Almazan C. Sistemes de
Oral hypoglycemic agents vs insulin in management of gestationaldiabetes: a systematic review and metaanalysis Oral hypoglycemic agents vs insulin in management of gestationaldiabetes: a systematic review and metaanalysis Oral hypoglycemic agents vs insulin in management of gestationaldiabetes: a systematic review and metaanalysis Dhulkotia JS, Ola B, Fraser R, Farrell T CRD summary This review found no significant differences between oral hypoglycaemic agents and insulin in glycaemic (...) control or pregnancy outcomes in women with gestationaldiabetes. Patient satisfaction was higher with the oral agents because of ease of administration. The small numbers of included studies mostly with small sample sizes and of poor quality should be considered when interpreting the results Authors' objectives To compare the effects of oral hypoglycaemic agents (OHA) to insulin treatment in pregnant women with gestationaldiabetes Searching MEDLINE, EMBASE, National Health Service Library
Effects of treatment in women with gestationaldiabetes mellitus: systematic review and meta-analysis Effects of treatment in women with gestationaldiabetes mellitus: systematic review and meta-analysis Effects of treatment in women with gestationaldiabetes mellitus: systematic review and meta-analysis Horvath K, Koch K, Jeitler K, Matyas E, Bender R, Bastian H, Lange S, Siebenhofer A CRD summary This well-conducted systematic review aimed to determine the benefits and harms of specific (...) treatments for women with gestationaldiabetes mellitus. The authors concluded that treatment appeared to lower the risk of some perinatal or neonatal complications, but that insufficient data were available to draw conclusions on possible long-term effects of treatment. These conclusions are likely to be reliable. Authors' objectives To determine the benefits and harms of specific treatments for women with gestationaldiabetes mellitus. Searching MEDLINE, EMBASE, AMED, BIOSIS Previews, CCMed (Current
Gestationaldiabetes: fasting capillary glucose as a screening test in a multi-ethnic, high-risk population In populations at high risk of gestationaldiabetes mellitus (GDM), screening every pregnant woman by an oral glucose tolerance test (OGTT) is very demanding. The aim of this study was to determine the value of the fasting capillary glucose (FCG) as a screening test for GDM.FCG was measured by a plasma-correlated glucometer in 1465 pregnant women who underwent a one-step diagnostic 75-g (...) OGTT for universal screening of GDM.One hundred and ninety-six (13.4%) women had GDM as defined by the criteria of the American Diabetes Association. The area under the receiver operating characteristic curve (AUC) of the FCG was 0.83 (95% confidence interval 0.80-0.86). A FCG threshold of 4.7 mmol/l (at an acceptable sensitivity of 86.0%) independently could rule-out GDM in 731 (49.9%) women, while the FCG could rule-in GDM (100% specificity) in 16 (1.1%) additional women; therefore, approximately
Adolescent manifestations of metabolic syndrome among children born to women with gestationaldiabetes in a general-population birth cohort The association between maternal gestationaldiabetes (GDM) and manifestations of metabolic syndrome among Caucasian adolescents was studied with data from the population-based Northern Finland 1986 Birth Cohort. This is a longitudinal cohort study from early pregnancy until offspring age 16 years and includes data from a risk group-based GDM screen (...) %, 7.5%), and fasting insulin (10.20 vs. 9.30 milliunits/L, 95% CI: 5.9%, 26.0%) were higher, and homeostatic model assessment-insulin sensitivity (74.7 vs. 82.3, 95% CI: -20.6%, -5.4%) was lower in the OGDM group. These differences were similar after an additional adjustment for birth weight and gestational age. The differences in waist circumference, insulin, and homeostatic model assessment-insulin sensitivity were attenuated but remained statistically significant after additional adjustment
Iron supplement in pregnancy and development of gestationaldiabetes--a randomised placebo-controlled trial To test the hypothesis that iron supplement from early pregnancy would increase the risk of gestationaldiabetes mellitus (GDM).Randomised placebo-controlled trial.A university teaching hospital in Hong Kong.One thousand one hundred sixty-four women with singleton pregnancy at less than 16 weeks of gestation with haemoglobin (Hb) level between 8 and 14 g/dl and no pre-existing diabetes (...) weeks (OR: 1.04, 95% confidence interval [CI]: 0.7-1.53 at 90% power) or 36 weeks. Maternal Hb and ferritin levels were higher in the iron supplement group at delivery (P < 0.001 and P= 0.003, respectively). Elective caesarean section rate was lower in the iron supplement group (OR: 0.58, 95% CI: 0.37-0.89). Infant birthweight was heavier (P= 0.001), and there were fewer small-for-gestational-age babies in the iron supplement group (OR: 0.46, 95% CI: 0.24-0.85).Iron supplement from early pregnancy
Type 2 diabetes mellitus after gestationaldiabetes: a systematic review and meta-analysis. Women with gestationaldiabetes are at increased risk of developing type 2 diabetes, but the risk and time of onset have not been fully quantified. We therefore did a comprehensive systematic review and meta-analysis to assess the strength of association between these conditions and the effect of factors that might modify the risk.We identified cohort studies in which women who had developed type 2 (...) diabetes after gestationaldiabetes were followed up between Jan 1, 1960, and Jan 31, 2009, from Embase and Medline. 205 relevant reports were hand searched. We selected 20 studies that included 675 455 women and 10 859 type 2 diabetic events. We calculated and pooled unadjusted relative risks (RRs) with 95% CIs for each study using a random-effects model. Subgroups analysed were the number of cases of type 2 diabetes, ethnic origin, duration of follow-up, maternal age, body-mass index, and diagnostic
Gestationaldiabetes: the need for a common ground. Gestationaldiabetes mellitus is a substantial and growing health concern in many parts of the world. Certain populations are especially vulnerable to developing this condition because of genetic, social, and environmental factors. Gestationaldiabetes has serious, long-term consequences for both baby and mother, including a predisposition to obesity, metabolic syndrome, and diabetes later in life. Early detection and intervention can greatly (...) improve outcomes for women with this condition and their babies. Unfortunately, screening and diagnostic tests are not uniform worldwide, which could lead not only to underdiagnosis but also undermanagement of the illness. Here, we report the controversies surrounding the causes, screening, diagnosis, management, and prevention of gestationaldiabetes, and give specific recommendations for research studies to address the major issues of this medical condition.
GestationalDiabetes Mellitus as a Herald of Type 2 Diabetes Mellitus: An Opportunity for a Lifetime 19465213 2009 06 08 2018 11 13 1474-547X 373 9677 2009 May 23 Lancet (London, England) Lancet Gestationaldiabetes mellitus: an opportunity of a lifetime. 1738-40 10.1016/S0140-6736(09)60958-2 Bentley-Lewis Rhonda R Brigham and Women's Hospital, Division of Endocrinology, Diabetes, and Hypertension, Boston, MA 02115, USA. firstname.lastname@example.org eng K23 RR023333 RR NCRR NIH HHS United States (...) K23 RR023333-02 RR NCRR NIH HHS United States L32 MD001077 MD NIMHD NIH HHS United States L32 MD001077-03 MD NIMHD NIH HHS United States Comment Journal Article England Lancet 2985213R 0140-6736 AIM IM Lancet. 2009 Aug 29;374(9691):684 19716959 Lancet. 2009 May 23;373(9677):1773-9 19465232 Cohort Studies Diabetes Mellitus, Type 2 epidemiology etiology prevention & control Diabetes, Gestational epidemiology etiology prevention & control Female Health Services Needs and Demand Humans Incidence
Interpregnancy weight gain and cesarean delivery risk in women with a history of gestationaldiabetes Along with the rising prevalence of obesity, rates of gestationaldiabetes mellitus (GDM) and associated adverse outcomes also have increased. We conducted a population-based, retrospective cohort study to assess the association of weight gain between pregnancies with cesarean delivery for the subsequent pregnancy among women with a history of GDM.Using linked birth-certificate data for women
Teratogenicity associated with pre-existing and gestationaldiabetes. Guidelines and Measures | Agency for Healthcare Research & Quality HHS.gov Search ahrq.gov Search ahrq.gov Menu Topics A - Z Healthcare Delivery Latest available findings on quality of and access to health care Searchable database of AHRQ Grants, Working Papers & HHS Recovery Act Projects AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund You are here Guidelines and Measures Funding for the National
Risk factors for type 2 diabetes among women with gestationaldiabetes: a systematic review We conducted a systematic review of studies examining risk factors for the development of type 2 diabetes among women with previous gestationaldiabetes. Our search strategy yielded 14 articles that evaluated 9 categories of risk factors of type 2 diabetes in women with gestationaldiabetes: anthropometry, pregnancy-related factors, postpartum factors, parity, family history of type 2 diabetes, maternal (...) lifestyle factors, sociodemographics, oral contraceptive use, and physiologic factors. The studies provided evidence that the risk of type 2 diabetes was significantly higher in women having increased anthropometric characteristics with relative measures of association ranging from 0.8 to 8.7 and women who used insulin during pregnancy with relative measures of association ranging between 2.8 and 4.7. A later gestational age at diagnosis of gestationaldiabetes, >24 weeks gestation on average
Active Compared With Expectant Delivery Management in Women With GestationalDiabetes: A Systematic Review We conducted a systematic review to estimate benefits and harms of the choice of timing of induction or elective cesarean delivery based on estimated fetal weight or gestational age in women with gestationaldiabetes mellitus (GDM).An electronic literature search was performed using MEDLINE, EMBASE, the Cumulative Index to Nursing and Allied Health Literature, and The Cochrane Central (...) Register of Controlled Trials from inception to January 2007.Two investigators independently reviewed titles and abstracts, assessed article quality, and abstracted data. Maternal outcomes included cesarean delivery and operative vaginal delivery. Neonatal outcomes included birth weight, macrosomia, large for gestational age, shoulder dystocia, birth trauma, neonatal intensive care admissions, and perinatal mortality.Five studies met our inclusion criteria: one randomized controlled trial (RCT