Placental IGFBP1 levels during early pregnancy and the risk of insulin resistance and gestational diabetes

Nature Medicine, Год журнала: 2024, Номер 30(6), С. 1689 - 1695

Опубликована: Апрель 16, 2024

Abstract Reduced insulin sensitivity (insulin resistance) is a hallmark of normal physiology in late pregnancy and also underlies gestational diabetes mellitus (GDM). We conducted transcriptomic profiling 434 human placentas identified positive association between insulin-like growth factor binding protein 1 gene ( IGFBP1 ) expression the placenta at ~26 weeks gestation. Circulating levels rose over course declined postpartum, which, together with high our samples, suggests placental or decidual source. Higher circulating were associated greater (lesser gestation same cohort two additional cohorts. In addition, low early predicted subsequent GDM diagnosis cohorts pregnant women. These results implicate glycemic suggest role for deficiency pathogenesis.

Язык: Английский

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Gestational diabetes mellitus, hypertension, and dyslipidemia as the risk factors of preeclampsia

Scientific Reports, Год журнала: 2024, Номер 14(1)

Опубликована: Март 14, 2024

Gestational diabetes mellitus (GDM) is a known risk factor for gestational hypertension which further progress toward conditions like proteinuria, dyslipidemia, thrombocytopenia, pulmonary edema leading to Preeclampsia (PE). Pregnancy can be challenging time many women, especially those diagnosed with GDM and PE. Thus, the current prospective study investigates association of OGTT glucose levels systolic diastolic blood pressure lipid profile parameters in pregnant women A total 140 were stratified into (n = 50), PE 40) controls 50). Two hour 75 g oral tolerance test (OGTT) was performed screening GDM. Biochemical analysis OGTT, cholesterol (TC), triglyceride (Tg), high density lipoprotein-cholesterol (HDL-C), low (LDL-C), urinary albumin creatinine tested find ratio (uACR). Statistical using ANOVA followed by post hoc regression analysis. Among studied groups, groups showed no significant difference age increased BMI. Increased 2 h & TC group; elevated uACR, systolic/diastolic pressure, Tg, HDL-C, LDL-C group observed differ significantly (p < 0.0001) other groups. positive effect on (R

Язык: Английский

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Can System Inflammation Response Index or Systemic Immune Inflammation Index predict gestational diabetes mellitus in the first trimester? A prospective observational study

International Journal of Gynecology & Obstetrics, Год журнала: 2024, Номер 166(2), С. 837 - 843

Опубликована: Март 1, 2024

Язык: Английский

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Efficacy and Safety of Different Hybrid Closed Loop Systems for Automated Insulin Delivery in People With Type 1 Diabetes: A Systematic Review and Network Meta‐Analysis

Diabetes/Metabolism Research and Reviews, Год журнала: 2024, Номер 40(6)

Опубликована: Сен. 1, 2024

ABSTRACT Aims To compare the efficacy and safety of different hybrid closed loop (HCL) systems in people with diabetes through a network meta‐analysis. Methods We searched MEDLINE, EMBASE, CENTRAL PubMed for randomised clinical trials (RCTs) enrolling children, adolescents and/or adults type 1 or 2 diabetes, evaluating Minimed 670G, 780G, Control‐IQ, CamAPS Fx, DBLG‐1, DBLHU, Omnipod 5 HCL against other types insulin therapy, reporting time target range (TIR) as outcome. Results A total 28 RCTs, all were included. significantly increased TIR compared subcutaneous therapy without continuous glucose monitoring (SIT). 780G achieved highest ahead Control IQ (mean difference (MD) 5.1%, 95% confidence interval (95% CI) [0.68; 9.52], low certainty), 670G (MD 7.48%, CI [4.27; 10.7], moderate Fx 8.94%, [4.35; 13.54], DBLG1 10.69%, [5.73; 15.65], certainty). All decreased below range, −3.69%, [−5.2; −2.19], high −2.9%, [−3.77; −2.04], certainty) −2.79%, [−3.94; −1.64], exhibiting largest reductions to SIT. The risk severe hypoglycaemia diabetic ketoacidosis was similar therapy. Conclusions show hierarchy among thus providing support decision‐making. Trial Registration: PROSPERO CRD42023453717

Язык: Английский

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Current barriers to initiating insulin therapy in individuals with type 2 diabetes

Frontiers in Endocrinology, Год журнала: 2024, Номер 15

Опубликована: Март 14, 2024

Insulin is an essential drug in the treatment of diabetes, often necessary for managing hyperglycemia type 2 diabetes mellitus (T2DM). It should be considered cases severe requiring hospitalization, after failure other treatments, advanced chronic kidney disease, liver cirrhosis, post-transplant or during pregnancy. Moreover, specific patient subgroups, early initiation insulin crucial control and prevention complications. Clinical guidelines recommend initiating when treatments fail, although there are barriers that may delay its initiation. The timing depends on individual characteristics. Typically, insulinization starts by adding basal to patient’s existing and, if necessary, progresses gradually introducing prandial insulin. Several have been identified hinder insulin, including fear hypoglycemia, lack adherence, need glucose monitoring, injection method administration, social rejection associated with stigma injections, weight gain, a sense therapeutic at initiation, experience among some healthcare professionals, delayed reactive positioning recent clinical guidelines. These contribute, factors, inertia intensifying patients’ non-adherence. In this context, development once-weekly formulations could improve initial acceptance, satisfaction, consequently, quality life patients. Currently, two insulins, icodec BIF, which different stages development, help. Their longer half-life translates lower variability reduced risk hypoglycemia. This review addresses T2DM, under circumstances, current treatment, potential role as solution facilitate timely insulinization, would reduce achieve better people T2DM.

Язык: Английский

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Cost-effectiveness of diagnosis and treatment of early gestational diabetes mellitus: economic evaluation of the TOBOGM study, an international multicenter randomized controlled trial

EClinicalMedicine, Год журнала: 2024, Номер 71, С. 102610 - 102610

Опубликована: Апрель 24, 2024

BackgroundA recently undertaken multicenter randomized controlled trial (RCT) "Treatment Of BOoking Gestational diabetes Mellitus" (TOBOGM: 2017–2022) found that the diagnosis and treatment of pregnant women with early gestational mellitus (GDM) improved pregnancy outcomes. Based on data from trial, this study aimed to assess cost-effectiveness GDM (from <20 weeks') among risk factors for hyperglycemia in compared usual care (no until 24–28 a healthcare perspective.MethodsParticipants' resource utilization were collected their self-reported questionnaires hospital records, valued using unit costs obtained standard Australian national sources. Costs reported US dollars ($) purchasing power parity (PPP) estimates facilitate comparison across countries. Intention-to-treat (ITT) principle was followed. Missing cost replaced multiple imputations. Bootstrapping method used estimate uncertainty around mean difference results. Bootstrapped cost–effect pairs plot (CE) plane acceptability curve (CEAC).FindingsDiagnosis more effective tended be less costly, i.e., dominant (cost-saving) [−5.6% composite adverse outcome (95% CI: −10.1%, −1.2%), −$1373 −$3,749, $642)] care. Our findings confirmed by both CE (88% bootstrapped fall south-west quadrant), CEAC (the probability intervention being cost-effective ranged 84% at willingness-to-pay (WTP) threshold value $10,000–99% WTP $100,000 per prevented). Sub-group analyses demonstrated higher glycemic range (fasting blood glucose 95–109 mg/dl [5.3–6.0 mmol/L], 1-h ≥191 [10.6 mmol/L] and/or 2-h 162–199 [9.0–11.0 mmol/L]) costly (dominant) [−7.8% −14.6%, −0.9%), −$2795 −$6,638, −$533)]; [−8.9% −15.1%, −2.6%), −$5548 −$16,740, $1547)] diagnosed before 14 weeks' gestation as well.InterpretationOur highlight potential health economic benefits supports its implementation. Long-term follow-up studies are recommended key future area research long-term consequences intervention.FundingNational Health Medical Research Council (grants 1104231 2009326), Region O¨rebro Committee Dnr OLL-970566 OLL-942177), Scientific Fund Mayor Vienna (project 15,205 project 23,026), South Western Sydney Local District Academic Unit (grant 2016), University Ainsworth Trust Grant (2019).

Язык: Английский

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The Role of the Glycemic Index and Glycemic Load in the Dietary Approach of Gestational Diabetes Mellitus

Nutrients, Год журнала: 2024, Номер 16(3), С. 399 - 399

Опубликована: Янв. 30, 2024

Gestational diabetes mellitus (GDM) is a common metabolic disorder that often develops during pregnancy, characterized by glucose intolerance and insulin resistance (IR). To ensure the well-being of both mother fetus, body undergoes multiple immunological changes result in peripheral IR and, under certain hereditary or acquired abnormalities, GDM predisposed women. The adverse short- long-term effects impact fetus. Nutrition seems to play an important role prevent improve its evolution. An emphasis has been given proportion carbohydrates (CHO) relative protein lipids, as well dietary patterns, GDM. CHO on postprandial concentrations are reflected glycemic index (GI) load (GL). Diets rich GI GL may induce exacerbate IR, whereas diets low appear enhance sensitivity control. These positive outcomes be attributed direct interactions with homeostasis indirect through improved composition weight management. This comprehensive narrative review aims explore significance nutrition, focus critical evaluation management women

Язык: Английский

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Using metabolomics and proteomics to identify the potential urine biomarkers for prediction and diagnosis of gestational diabetes

EBioMedicine, Год журнала: 2024, Номер 101, С. 105008 - 105008

Опубликована: Фев. 17, 2024

Gestational diabetes mellitus (GDM) is one of the most common metabolic complications during pregnancy, threatening both maternal and fetal health. Prediction diagnosis GDM not unified. Finding effective biomarkers for particularly important achieving early prediction, accurate timely intervention. Urine, due to its accessibility in large quantities, noninvasive collection easy preparation, has become a good sample biomarker identification. In recent years, number studies using metabolomics proteomics approaches have identified differential expressed urine metabolites proteins patients. this review, we summarized these potential prediction elucidated their role development GDM.

Язык: Английский

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The Association Between Epicardial Adipose Tissue Thickness and the Triglyceride-glucose Index in Prediabetic Obese Patients

Angiology, Год журнала: 2025, Номер unknown

Опубликована: Фев. 21, 2025

Obesity and pre-diabetes are metabolic disorders associated with insulin resistance (IR). Excess epicardial adipose tissue is also increased IR. The triglyceride-glucose index (TyG) has been evaluated as an alternative measure of the IR in a variety cardiovascular disorders. However, its relationship EAT thickness not studied yet. study included 176 prediabetic obese patients. was assessed using echocardiography. thickness, TyG index, anthropometric obesity indices (body mass (BMI), waist circumference (WC), waist-hip ratio (WHR)), homeostatic model assessment (HOMA-IR), biochemical parameters were compared. following correlations between related observed: WC ( r = .529), BMI .514), ALT .358), .338), HOMA-IR .322; P < .001 for all). Multiple regression analysis showed that (Beta .428; .004), age .223; .001), .196; .029), .168; .012), .128; .049) strongest independent variables correlated thickness. A based on WC, BMI, age, provided best R-square (.387) estimating .001). significant EAT, suggesting it may be useful indicator

Язык: Английский

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Perceived Stress and Early Postpartum Depressive Symptoms in Women with Recent GDM: Implications for Postpartum Lifestyle Programs

Maternal and Child Health Journal, Год журнала: 2025, Номер unknown

Опубликована: Фев. 7, 2025

Язык: Английский

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