Frontiers in Clinical Diabetes and Healthcare,
Journal Year:
2024,
Volume and Issue:
5
Published: Nov. 22, 2024
Gestational
diabetes
mellitus
(GDM)
is
a
complex
and
increasingly
prevalent
condition
that
poses
significant
challenges
to
maternal
fetal
health,
as
well
public
healthcare
costs.
In
this
special
issue,
we
present
collection
of
studies
highlighting
innovative
approaches
GDM
management.
These
include
the
use
technology,
such
integrated
bioinformatics
analysis
data-driven
clusters,
insights
into
pathophysiology
risk
factors.GDM
defined
glucose
intolerance
develops
during
pregnancy,
typically
diagnosed
second
or
third
trimester.
The
current
prevalence
in
Europe
estimated
be
around
10.9%
based
on
recent
meta-analysis
(1).
Rates
are
rising
globally,
partly
explained
by
increasing
obesity
age.
International
association
pregnancy
study
groups
recommendations
diagnosis
classification
hyperglycemia
(IADPSG)
suggest
diagnostic
criteria:
fasting
plasma
(FPG)
≥5.1
mmol/L
(92
mg/dL);
1-hour
≥10.0
(180
mg/dL)
and/or
2-hour
≥8.5
(153
75
g
oral
tolerance
test
(2).
Known
factors
for
development
obesity,
advanced
age,
family
history
type
2
(T2DM),
polycystic
ovary
syndrome,
with
other
under
(3).
Interestingly,
published
issue
Hui
Liu
colleagues,
highest
quartile
liver
function
index
(LFI)
was
linked
heightened
GDM,
odds
ratios
(OR)
ranging
from
1.29
3.15.
Additionally,
noteworthy
interaction
between
AST/ALT
levels
triglycerides
(TG)
identified
regarding
(P
=
0.026).
TG
have
also
been
associated
vascular
dysfunction,
being
possible
common
pathophysiologic
mechanism
hypertensive
disorders
(4).
As
Authors
reported,
found
heterogenous
results
different
markers,
associations
GGT
but
not
AST
ALT.
To
overcome
reverse
causation,
performed
Mendelian
randomization
analysis,
showing
causal
relationship
ALT
an
OR
1.28
(95%
CI:
1.05-1.54).
metabolic
dysfunction
leading
crucial
only
developing
new
scores
better
understanding
GDM.The
etiopathogenesis
unclear,
immune
chronic
inflammation
key
contributors
(5,6).
Elevated
cytotoxic
NK
cells
dysregulated
Tregs
Th17
cells,
alongside
cytokines
like
IL-6,
IL-1β,
TNF-α,
exacerbate
insulin
resistance,
contributing
(5)(6)(7)(8).
Inflammation
plays
role
endothelial
(9)(10)(11)(12)
angiogenic
imbalance
occurrence
cardiovascular
diseases
patients
(13)(14)(15).
However,
microenvironment
remains
limited
(7).
Jie-ling
Chen
colleagues
Special
Issue
comprehensive
bioinformatic
gene
expression
profiles
two
databases
Human
Umbilical
Vein
Endothelial
Cells
(HUVEC)
RNA-seq
data
controls.
Furthermore,
evaluated
six
hub
Differentially
expressed
genes
(DEG)
high
value
cells.
biomarkers
value,
PLAUR
SLIT2,
had
strong
correlation
B
naïve
T
follicular
helper,
respectively.
authors
emphasize
need
animal
validate
their
findings.
context,
another
article
within
same
examined
cell
functionality
models
Yujing
Xiong
colleagues.
Decidual
differ
phenotype
circulating
(16,17).
They
interact
fetus
engaging
human
leukocyte
antigen
(HLA)
ligands
extravillous
trophoblasts,
promoting
mother
fetus.
streptozotocin-induced
model
disrupted
homeostasis,
affecting
both
proportions
functions
analyzed
women
vs.
controls
there
no
differences
percentage
total
amount
single
phenotypes.
summary,
abovementioned
submitted
contribute
growing
body
literature
mechanisms
at
basis
pathophysiology,
providing
valuable
types
molecular
involved.Women
face
increased
risks
complications,
including
preeclampsia,
cesarean
delivery,
likelihood
T2D
later
life.
Indeed,
preeclampsia
share
several
pathophysiological
pathways
(3,18).
can
adversely
affect
development,
higher
rates
macrosomia,
neonatal
hypoglycemia,
longterm
issues
child
(19,20).
Approximately
one-third
using
pre-IADPSG
criteria
will
exhibit
indicative
prediabetes
postpartum
assessments
3
months
delivery.
Anna
Lesniara-Stachon
highlighted
point
distinction
induced
reduced
caused
peripheral
resistance.
This
differentiation
underlying
guiding
its
management
therapeutic
strategies.
predictors
1-year
were
among
For
belonging
resistant
cluster,
HOMA-IR
best
predictor
(OR
1.9).
On
hand,
8.7)
FBG
(7.8)
cluster.
A
precision
medicine
approach
considers
subtypes
could
enhance
diagnosis,
assessment,
treatment
strategies.Personalized
medicine,
allowing
recognition
specific
phenotypes
consequent
tailored
treatment,
long
term
follow-up
strategies
reduce
diseases,
translational
research
clarify
inflammatory
pathogenetic
main
areas
addressed
future
GDM.
Addressing
these
would
improve
prevention,
condition.
BMJ,
Journal Year:
2022,
Volume and Issue:
unknown, P. e070244 - e070244
Published: Sept. 21, 2022
To
quantify
the
risk
of
overall
and
type
specific
cardiovascular
cerebrovascular
diseases
as
well
venous
thromboembolism
in
women
with
a
history
gestational
diabetes
mellitus.
Frontiers in Endocrinology,
Journal Year:
2024,
Volume and Issue:
15
Published: April 17, 2024
Gestational
diabetes
mellitus
(GDM)
poses
a
significant
global
health
concern,
impacting
both
maternal
and
fetal
well-being.
Early
detection
treatment
are
imperative
to
mitigate
adverse
outcomes
during
pregnancy.
This
review
delves
into
the
pivotal
role
of
insulin
function
influence
genetic
variants,
including
SLC30A8,
CDKAL1,
TCF7L2,
IRS1,
GCK,
in
GDM
development.
These
variations
affect
beta-cell
activity
crucial
tissues,
such
as
muscle,
disrupting
glucose
regulation
We
propose
hypothesis
that
this
variation
may
disrupt
zinc
transport,
consequently
impairing
production
secretion,
thereby
contributing
onset.
Furthermore,
we
discussed
involvement
inflammatory
pathways,
TNF-alpha
IL-6,
predisposing
individuals
GDM.
Genetic
modulation
these
pathways
exacerbate
metabolism
dysregulation
observed
patients.
also
how
affects
cardiovascular
disease
(CVD)
through
direct
correlation
between
pregnancy
cardiometabolic
function,
increasing
atherosclerosis,
decreased
vascular
dyslipidemia,
hypertension
women
with
history.
However,
further
research
is
unravel
intricate
interplay
genetics,
understanding
for
devising
targeted
gene
therapies
pharmacological
interventions
rectify
other
pertinent
genes.
Ultimately,
offers
insights
pathophysiological
mechanisms
GDM,
providing
foundation
developing
strategies
its
impact.
AJP Cell Physiology,
Journal Year:
2024,
Volume and Issue:
327(3), P. C646 - C660
Published: July 16, 2024
Cardiometabolic
disorders,
such
as
obesity,
insulin
resistance,
and
hypertension,
prior
to
within
pregnancy
are
increasing
in
prevalence
worldwide.
Pregnancy-associated
cardiometabolic
disease
poses
a
great
risk
the
short-
long-term
well-being
of
mother
offspring.
Hypertensive
pregnancy,
notably
preeclampsia,
well
gestational
diabetes
major
diseases
growing
result
prevalence.
The
mechanisms
whereby
diabetes,
other
comorbidities
lead
preeclampsia
incompletely
understood
continually
evolving
literature.
In
addition,
novel
therapeutic
avenues
currently
being
explored
these
patients
offset
cardiometabolic-induced
adverse
outcomes
preeclamptic
pregnancies.
this
review,
we
discuss
emerging
pathophysiological
context
most
recent
preclinical
clinical
updates
pathogenesis
treatment
conditions.
PLoS Medicine,
Journal Year:
2024,
Volume and Issue:
21(4), P. e1004378 - e1004378
Published: April 1, 2024
Background
Antenatal
corticosteroids
for
women
at
risk
of
preterm
birth
reduce
neonatal
morbidity
and
mortality,
but
there
is
limited
evidence
regarding
their
effects
on
long-term
health.
This
study
assessed
cardiovascular
outcomes
50
years
after
antenatal
exposure
to
corticosteroids.
Methods
findings
We
the
adult
offspring
who
participated
in
first
randomised,
double-blind,
placebo-controlled
trial
betamethasone
prevention
respiratory
distress
syndrome
(RDS)
(1969
1974).
The
717
mothers
received
2
intramuscular
injections
12
mg
or
placebo
24
h
apart
subsequent
398
equivalent
volume
placebo.
Follow-up
included
a
health
questionnaire
consent
access
administrative
data
sources.
co-primary
were
prevalence
factors
(any
hypertension,
hyperlipidaemia,
diabetes
mellitus,
gestational
prediabetes)
age
major
adverse
event
(MACE)
(cardiovascular
death,
myocardial
infarction,
coronary
revascularisation,
stroke,
admission
peripheral
vascular
disease,
heart
failure).
Analyses
adjusted
entry,
sex,
clustering.
Of
1,218
infants
born
1,115
mothers,
we
followed
up
424
(46%
survivors;
212
[50%]
female)
mean
(standard
deviation)
49.3
(1.0)
years.
There
no
differences
between
those
exposed
(159/229
[69.4%]
versus
131/195
[67.2%];
relative
1.02,
95%
confidence
interval
[CI]
[0.89,
1.18;];
p
=
0.735)
MACE
(adjusted
hazard
ratio
0.58,
CI
[0.23,
1.49];
0.261).
also
components
these
composite
any
other
secondary
outcomes.
Key
limitations
follow-up
rate
lack
in-person
assessments.
Conclusions
that
increase
incidence
events
age.
Established
benefits
are
not
outweighed
by
an
disease.
International Journal of Women s Health,
Journal Year:
2025,
Volume and Issue:
Volume 17, P. 139 - 152
Published: Jan. 1, 2025
Young
women
are
at
risk
of
acute
coronary
syndrome
(ACS).
They
represent
a
unique
population
exposed
to
traditional
cardiovascular
factors
and
female
sex-specific,
non-traditional
factors.
The
current
study
aimed
describe
ACS
in
young
from
the
Middle
East.
present
used
data
Jordanian,
nationwide,
multicenter,
case-control
study,
ANCORS-YW.
Bivariate
analyses
logistic
regression
models
were
predict
independent
using
adjusted
odds
ratios
(AOR)
95%
confidence
intervals
(CI).
included
572
(≤50-years)
with
median
age
45-years,
divided
into
an
group
(n=154,
26.9%)
control
no
atherosclerotic
disease
(n=418,
73.1%).
most
common
presentation
was
non-ST-elevation
(n=98,
64%).
group,
compared
had
higher
proportions
type-2
diabetes
(41.6%vs.11.7%,
p<0.001),
hypertension
(53.9%vs.23.4%,
tobacco
use
(37.7%vs.24.2%,
p=0.001),
family
history
(53.2%vs.23.4%,
metabolic
(14.3%vs.2.4%,
preterm
delivery
(24.7%vs.16.7%,
p=0.032).
nonsignificantly
greater
hypertensive
disorders
pregnancy
(29.2%vs.22.7%,
p=0.109)
gestational
(15.6%vs.10.3%,
p=0.081).
Multivariable
identified
five
predictors
ACS:
(AOR,
CI:
3.45,
1.98─5.99),
(3.33,
2.15─5.17),
(2.01,
1.26─3.21),
(1.72,
1.07─2.78),
(4.35,
1.72─11.03).
Modifiable
play
important
role
among
women.
Efforts
should
be
made
improve
primordial
primary
prevention
this
population.
Diabetes Obesity and Metabolism,
Journal Year:
2024,
Volume and Issue:
26(7), P. 2915 - 2924
Published: April 28, 2024
Abstract
Aim
To
investigate
the
association
of
gestational
diabetes
mellitus
(GDM)
with
premature
mortality
and
cardiovascular
(CVD)
outcomes
risk
factors.
Materials
Methods
Parous
women
recruited
to
UK
Biobank
cohort
during
2006‐2010
were
followed
up
from
their
first
delivery
until
31
October
2021.
The
data
linked
Hospital
Episode
Statistics
registries.
Multivariate
Cox
proportional
hazard
models
investigated
associations
GDM
all‐cause
mortality,
CVD,
diabetes,
hypertension
dyslipidaemia.
Results
maximum
total
analysis
time
at
under
observation
was
9
694
090
person‐years.
Among
220
726
women,
1225
self‐reported
or
had
a
recorded
diagnosis
GDM.
After
adjusting
for
confounders
behavioural
factors,
associated
increased
[hazard
ratio
(HR):
1.44,
95%
confidence
interval
(CI):
1.12‐1.86],
particularly
CVD‐related
death
(HR:
2.38,
CI:
1.63‐3.48),
as
well
incident
CVD
1.50,
1.30‐1.74),
non‐fatal
1.41,
1.20‐1.65),
14.37,
13.51‐15.27),
1.49,
1.38‐1.60),
dyslipidaemia
1.30,
1.22‐1.39).
greater
in
who
did
not
later
develop
than
those
diabetes.
Conclusions
Women
are
have
CV
risk,
emphasizing
importance
interventions
prevent
If
develops,
represents
an
opportunity
future
surveillance
intervention
reduce
improve
long‐term
health.
Cardiovascular Diabetology,
Journal Year:
2024,
Volume and Issue:
23(1)
Published: Feb. 1, 2024
Background
To
investigate
the
association
between
gestational
diabetes
mellitus
(GDM)
without
subsequent
overt
and
long-term
all-cause
cardiac
mortality.
Methods
This
prospective
cohort
study
included
10,327
women
(weighted
population:
132,332,187)
with
a
pregnancy
history
from
National
Health
Nutrition
Examination
Survey
(2007
to
2018).
Participants
were
divided
into
three
groups
(GDM
alone,
diabetes,
no
diabetes).
Mortality
data
was
linked
Death
Index
up
December
31,
2019.
Multivariable
Cox
regression
analysis
performed
examine
GDM
alone
mortality
Data
October
2022
April
2023.
Results
Among
participants,
510
5.3%)
had
1862
14.1%)
diabetes.
Over
median
follow-up
period
of
6.7
years
(69,063
person-years),
there
758
deaths.
The
group
did
not
show
an
increased
risk
(hazard
ratio
[HR]
0.67;
95%
CI,
0.25–1.84),
while
significantly
higher
(HR
1.95;
1.62–2.35).
Similarly,
exhibit
elevated
1.48;
0.50–4.39),
whereas
2.37;
1.69–3.32).
Furthermore,
sensitivity
focusing
on
aged
50
or
above
showed
that
HR
for
1.14
(95%
0.33–3.95)
1.74
0.49–6.20).
Conclusions
associated
mortality,
both
types
Diabetes Metabolic Syndrome and Obesity,
Journal Year:
2024,
Volume and Issue:
Volume 17, P. 1491 - 1502
Published: March 1, 2024
Purpose:
This
study
explores
the
impact
of
gestational
diabetes
mellitus
(GDM)
subtypes
classified
by
oral
glucose
tolerance
test
(OGTT)
values
on
maternal
and
perinatal
outcomes.Patients
Methods:
multicenter
prospective
cohort
(May
2019-December
2022)
included
participants
from
Mexican
Cuido
mi
Embarazo
(CME).Women
were
into
four
groups
per
75-g
2-h
OGTT:
1)
normal
(normal
OGTT),
2)
GDM-Sensitivity
(isolated
abnormal
fasting
or
in
combination
with
1-h
results),
3)
GDM-Secretion
at
their
combination),
4)
GDM-Mixed
(three
values).Cesarean
delivery,
neonates
large
for
age
(LGA),
pre-term
birth
rates
among
outcomes
compared.Between-group
comparisons
analyzed
using
either
t-test,
chi-square
test,
Fisher's
exact
test.Results:
Of
2,056
pregnant
women
CME
cohort,
294
(14.3%)
had
GDM;
53.7%,
34.4%,
11.9%
as
GDM-Sensitivity,
GDM-Secretion,
subtypes,
respectively.Women
GDM
older
(p
=
0.0001)
more
often
multiparous
0.119)
vs
without
GDM.Cesarean
delivery
(63.3%;
p
0.02)
neonate
LGA
(10.7%;
0.078)
higher
group
than
overall
(55.6%
8.4%,
respectively).Pre-term
was
common
(10.2%
8.5%,
respectively;
p=0.022).At
6
months
postpartum,
prediabetes
frequent
(31.6%
25.5%).Type
2
(10.0%vs
3.3%).Conclusion:
effectively
stratified
risks.GDM-Mixed
subtype
increased
risk
cesarean
LGA,
type
postpartum.GDM
may
help
personalize
clinical
interventions
optimize
outcomes.
Journal of Internal Medicine,
Journal Year:
2024,
Volume and Issue:
295(6), P. 774 - 784
Published: April 17, 2024
Abstract
Background
The
impact
of
gestational
diabetes
mellitus
(GDM)
on
incident
dementia
is
unknown.
Our
aim
was
to
evaluate
the
relationship
between
GDM
and
all‐cause
mediating
effects
chronic
diseases
this
relationship.
Methods
This
prospective
cohort
study
included
women
from
UK
Biobank
who
were
grouped
based
history.
Multivariate
Cox
proportional
hazard
models
used
explore
associations
dementia.
We
further
analysed
interactions
covariates.
Results
A
total
1292
with
204,171
without
a
history
included.
During
median
follow‐up
period
45
years
after
first
birth,
2921
diagnosed
Women
had
67%
increased
risk
(hazard
ratio
1.67,
95%
confidence
interval:
1.03–2.69)
compared
those
According
mediation
analyses,
type
2
diabetes,
coronary
heart
disease,
kidney
disease
comorbidities
(diagnosed
any
two
three
diseases)
explained
34.5%,
8.4%,
5.2%
18.8%
effect
Subgroup
analyses
revealed
that
physical
activity
modified
association
(
p
for
interaction
=
0.030).
Among
physically
inactive
women,
significantly
associated
dementia;
however,
not
observed
among
active
women.
Conclusions
greater
Type
partially
mediated
Strategies
prevention
might
be
considered
GDM.
Cardiovascular Diabetology,
Journal Year:
2024,
Volume and Issue:
23(1)
Published: Aug. 28, 2024
We
aimed
to
summarize
the
association
between
gestational
diabetes
mellitus
(GDM)
and
its
intergenerational
cardiovascular
diseases
(CVDs)
impacts
in
both
mothers
offspring
post-delivery
existing
literature.