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Latest & greatest articles for gestational diabetes
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Fetal biometry for guiding the medical management of women with gestationaldiabetes mellitus for improving maternal and perinatal health. Gestationaldiabetes mellitus (GDM) is a common medical condition that complicates pregnancy and causes adverse maternal and fetal outcomes. At present, most treatment strategies focus on normalisation of maternal blood glucose values with use of diet, lifestyle modification, exercise, oral anti-hyperglycaemics and insulin. This has been shown to reduce (...) the incidence of adverse outcomes, such as birth trauma and macrosomia. However, this involves intensive monitoring and treatment of all women with GDM. We propose that using medical imaging to identify pregnancies displaying signs of being affected by GDM could help to target management, allowing low-risk women to be spared excessive intervention, and facilitating better resource allocation.We wanted to address the following question: in women with gestationaldiabetes, does the use of fetal imaging plus
Efficacy of Fish Oil and/or Probiotic Intervention on the Incidence of GestationalDiabetes Mellitus in an At-Risk Group of Overweight and Obese Women: A Randomized, Placebo-Controlled, Double-Blind Clinical Trial To assess whether the risk of gestationaldiabetes mellitus (GDM) may be lowered and glucose metabolism improved by daily administration of fish oil and/or probiotic supplements in overweight and obese pregnant women.We randomized in a double-blind manner 439 women (mean 13.9 ± 2.1 (...) gestational weeks [gw]) into four intervention groups: fish oil + placebo, probiotics + placebo, fish oil + probiotics, and placebo + placebo. Fish oil (1.9 g docosahexaenoic acid and 0.22 g eicosapentaenoic acid) and probiotic supplements (Lactobacillus rhamnosus HN001 and Bifidobacterium animalis ssp. lactis 420, 1010 colony-forming units each) were provided for daily consumption from randomization beyond delivery. Primary outcomes were the incidence of GDM diagnosed with oral glucose tolerance test
Association of Long-term Child Growth and Developmental Outcomes With Metformin vs Insulin Treatment for GestationalDiabetes Metformin is an emerging option for treating gestationaldiabetes (GDM). However, because metformin crosses the placenta, patients and clinicians are concerned with its long-term effect on child health.To estimate the association of treating GDM with metformin vs insulin with child growth and development.Population-based cohort study of New Zealand women treated (...) with metformin or insulin for GDM from 2005 to 2012 and their children. This study linked national health care data to create a cohort of mothers and their children, including data from maternity care, pharmaceutical dispensing, hospitalizations, demographic records, and the B4 School Check (B4SC) preschool health assessment. Women treated pharmacologically with metformin or insulin during pregnancy were included. We excluded pregnancies with evidence of diabetes and deliveries prior to 2013. Liveborn
Clinical and metabolic outcomes in pregnant women at risk for gestationaldiabetes mellitus supplemented with myo-inositol: a secondary analysis from 3 RCTs Gestationaldiabetes mellitus is defined as carbohydrate intolerance that begins or is first recognized during pregnancy. Insulin sensitizing substances such as myo-inositol have been considered for the prevention of gestationaldiabetes mellitus and related complications.Because previous studies failed to show a clear reduction (...) of gestationaldiabetes mellitus complications, the aim of this study was to evaluate clinical and metabolic outcomes in women who are at risk for gestationaldiabetes mellitus supplemented with myo-inositol since the first trimester.A secondary analysis of databases from 3 randomized, controlled trials (595 women enrolled) in which women who were at risk for gestationaldiabetes mellitus (a parent with type 2 diabetes mellitus, obese, or overweight) were supplemented with myo-inositol (4 g/d) throughout
A Pre-Pregnancy Biomarker Risk Score Improves Prediction of Future GestationalDiabetes Previous studies have not examined the ability of multiple preconception biomarkers, considered together, to improve prediction of gestationaldiabetes mellitus (GDM).To develop a preconception biomarker risk score and assess its association with subsequent GDM.A nested case-control study among a cohort of women with serum collected as part of a health examination (1984 to 1996) and subsequent pregnancy (...) of diabetes, previous GDM; area under the curve = 0.73 vs 0.67, P = 0.002).The improved, predictive ability of the biomarker risk score beyond established risk factors suggests clinical use of the biomarker risk score in identifying women at risk for GDM before conception for targeted prevention strategies.
Association of GestationalDiabetes With Maternal Disorders of Glucose Metabolism and Childhood Adiposity. The sequelae of gestationaldiabetes (GD) by contemporary criteria that diagnose approximately twice as many women as previously used criteria are unclear.To examine associations of GD with maternal glucose metabolism and childhood adiposity 10 to 14 years' postpartum.The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study established associations of glucose levels during pregnancy (...) with perinatal outcomes and the follow-up study evaluated the long-term outcomes (4697 mothers and 4832 children; study visits occurred between February 13, 2013, and December 13, 2016).Gestationaldiabetes was defined post hoc using criteria from the International Association of Diabetes and Pregnancy Study Groups consisting of 1 or more of the following 75-g oral glucose tolerance test results (fasting plasma glucose ≥92 mg/dL; 1-hour plasma glucose level ≥180 mg/dL; 2-hour plasma glucose level ≥153 mg/dL
Gestationaldiabetes Top results for gestationaldiabetes - Trip Database or use your Google+ account Turning Research Into Practice 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) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Latest & greatest articles for gestationaldiabetes The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials
Continuation of Atypical Antipsychotic Medication During Early Pregnancy and the Risk of GestationalDiabetes Some atypical antipsychotics are associated with metabolic side effects, which are risk factors for gestationaldiabetes. The authors examined the risk of developing gestationaldiabetes associated with the continuation of treatment with aripiprazole, ziprasidone, quetiapine, risperidone, and olanzapine during pregnancy compared with discontinuation of these antipsychotic (...) dispensings ("continuers") were compared with women with no dispensings ("discontinuers") during the first half of pregnancy. A generalized linear model and propensity-score stratification were used to obtain absolute and relative risks of developing gestationaldiabetes, with adjustment for confounders.Women who continued antipsychotic treatment during pregnancy generally had higher comorbidity and longer baseline antipsychotic use. The crude risk of developing gestationaldiabetes among continuers
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
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