Management of Diabetes in Pregnancy: A Review of Clinical Guidelines and Practices DOI Open Access

Raniah A Albairmani,

Basheer M Basheer,

May M Macky

и другие.

Cureus, Год журнала: 2025, Номер unknown

Опубликована: Фев. 19, 2025

This literature review assesses clinical guidelines for pre-existing diabetes and gestational mellitus (GDM) in the areas of diagnosis, management, maternal-fetal outcomes. A structured search was conducted across PubMed Google Scholar, supplemented by targeted screening guideline repositories from American Diabetes Association (ADA), National Institute Health Care Excellence (NICE), World Organization (WHO). Included studies were selected based on relevance to therapeutic strategies, or maternal-neonatal outcomes, with exclusion criteria applied non-English publications non-clinical recommendations. comparative analysis ADA, NICE, WHO performed evaluate prevalence, approaches, postpartum management. Early stringent blood glucose control, multidisciplinary care aim avoid macrosomia, congenital abnormalities, neonatal hypoglycemia guide management guidelines. Glycated hemoglobin (HbA1c) (<6.5%) optimization supplementation folic acid are critically required prior conception all women previously diagnosed diabetes. Continuous monitoring (CGM) insulin pump therapy valued but burdened availability access constraints. visit 75 g oral tolerance test (OGTT) at 4-12 weeks is essential detection persistent Variation diagnostic among reflects requirement standardization. Expansion coverage insurance CGM preconception important providing equal access. The cost-effectiveness new technologies health disparities low-resource settings must be addressed future research.

Язык: Английский

The role of real‐time continuous glucose monitoring in diabetes management and how it should link to integrated personalized diabetes management DOI Creative Commons
Monika Reddy, Nick Oliver

Diabetes Obesity and Metabolism, Год журнала: 2024, Номер 26(S1), С. 46 - 56

Опубликована: Март 1, 2024

Abstract Diabetes is a complex metabolic condition that demands tailored, individualized approaches for effective management. Real‐time continuous glucose monitoring (rtCGM) systems have improved in terms of design, usability and accuracy over the years play pivotal role delivery integrated personalized diabetes management (iPDM). iPDM comprehensive multidisciplinary approach combines care strategies utilizing technologies interventions encourages active involvement person with provided. The use stand‐alone rtCGM its integration other technologies, such as hybrid automated insulin delivery, enabled glycaemic quality life outcomes people diabetes. As uptake associated increasing becoming standard diabetes, it important efforts are focused on goals reducing health inequalities access, aligning structured education usage, choosing right technology based needs preferences, minimizing burden while aiming optimal outcomes. Utilizing settings than outpatients cohorts beyond type 1 2 further exploration. This review aims to provide an overview how best link iPDM, highlighting enhancing treatment strategies.

Язык: Английский

Процитировано

13

Magnesium Matters: A Comprehensive Review of Its Vital Role in Health and Diseases DOI Open Access
Ghizal Fatima,

Andrej Džupina,

Hekmat B Alhmadi

и другие.

Cureus, Год журнала: 2024, Номер unknown

Опубликована: Окт. 13, 2024

Magnesium (Mg), an essential mineral abundantly present within the human body, is intricately involved in a multitude of biochemical processes vital for maintaining health and overall well-being. This review aims to delve into multifaceted impact Mg on health, exploring its physiological functions, dietary sources, potential implications deficiency or insufficiency. plays pivotal role various processes, including energy metabolism, muscle contraction, protein synthesis, DNA synthesis. It acts as cofactor more than 300 enzymatic reactions, facilitating conversion adenosine triphosphate (ATP) diphosphate (ADP) production. Moreover, proper functioning ion channels, particularly calcium influencing nerve transmission relaxation. naturally found wide array foods, with green leafy vegetables, whole grains, nuts, seeds, legumes being rich sources. Additionally, certain fortified foods supplements provide supplemental intake. Deficiency insufficiency mg can have profound health. Inadequate levels been associated increased risks chronic diseases, hypertension, type 2 diabetes, osteoporosis, cardiovascular diseases. Furthermore, may manifest symptoms such weakness, fatigue, tremors, irregular heartbeat. Numerous studies elucidated relationship between intake risk developing For instance, epidemiological evidence suggests that higher reduced possibly due vasodilatory effects influence blood pressure regulation mechanisms. Similarly, has implicated pathophysiology contributing insulin resistance impaired glucose metabolism. adequate crucial bone density reducing mineralization Understanding importance physiology underscores significance ensuring through diet supplementation. Healthcare professionals play critical educating individuals about incorporating mg-rich their diets considering supplementation when necessary, at those indispensable far-reaching Its involvement Ensuring preventing deficiency-related complications Further research warranted elucidate optimal strategies therapeutic applications disease prevention management.

Язык: Английский

Процитировано

13

Metformin beyond type 2 diabetes: Emerging and potential new indications DOI Creative Commons
John R. Petrie

Diabetes Obesity and Metabolism, Год журнала: 2024, Номер 26(S3), С. 31 - 41

Опубликована: Июль 4, 2024

Abstract Metformin is best known as a foundational therapy for type 2 diabetes but also used in other contexts clinical medicine with number of emerging and potential indications. Many its beneficial effects may be mediated by modest on weight loss insulin sensitivity, it has multiple mechanisms action. Current uses beyond include: polycystic ovarian syndrome; pregnancy/gestational diabetes; prevention prediabetes; adjunct 1 diabetes. As metformin been use almost 70 years, much the underpinning evidence these conditions is, definition, based trials conducted before advent contemporary evidence‐based medicine. result, some above‐established are ‘off‐label’ many regulatory territories their varies accordingly different countries. Going forward, several current ‘repurposing’ investigational being investigated: cancer (including Li Fraumeni syndrome), renal protection, Alzheimer's disease, metabolic dysfunction‐associated steatotic liver disease promotion healthy ageing. Despite longevity important roles medicine, further research ongoing.

Язык: Английский

Процитировано

12

Case series of a hybrid closed loop therapy system used in pregnancy DOI
Trinity L. Brigham, Matthew P. Klein, Janet K. Snell‐Bergeon

и другие.

Acta Diabetologica, Год журнала: 2025, Номер unknown

Опубликована: Фев. 13, 2025

Язык: Английский

Процитировано

2

Diabetes Management in Detention Facilities: A Statement of the American Diabetes Association DOI Open Access

Daniel L. Lorber,

Nuha A. ElSayed, Raveendhara R. Bannuru

и другие.

Diabetes Care, Год журнала: 2024, Номер 47(4), С. 544 - 555

Опубликована: Март 25, 2024

This statement provides guidance for diabetes care in detention facilities. It focuses on areas where the processes delivery of to people with facilities may differ from those community, and key points are made at end each section. Areas emphasis, which inform multiple aspects discussed this statement, include 1) timely identification or diagnosis treatment needs continuity (at reception/intake, during transfers, upon discharge), 2) nutrition physical activity, 3) access management tools (insulin, blood glucose monitoring, tracking data, current technologies, etc.), 4) whole person (self-management education, mental health support, monitoring addressing long-term complications, specialty care, etc.).

Язык: Английский

Процитировано

9

Point-of-Care HbA1c in Clinical Practice: Caveats and Considerations for Optimal Use DOI
David B. Sacks, M. Sue Kirkman, Randie R. Little

и другие.

Diabetes Care, Год журнала: 2024, Номер 47(7), С. 1104 - 1110

Опубликована: Март 29, 2024

Hemoglobin A1c (A1C) is widely used for the diagnosis and management of diabetes. Accurate measurement A1C necessary optimal clinical value. Assay standardization has markedly improved accuracy consistency testing. Devices to measure at point care (POC) are commercially available, allowing rapid results when patient seen. In this review, we describe how testing was achieved, leading high-quality in laboratories. We address use POC situations summarize advantages disadvantages emphasize importance considering limitations these devices following correct procedures ensure that accurate obtained patients.

Язык: Английский

Процитировано

8

Type 2 Diabetes DOI

Allison L. Crawford,

Neda Laiteerapong

Annals of Internal Medicine, Год журнала: 2024, Номер 177(6), С. ITC81 - ITC96

Опубликована: Июнь 1, 2024

Type 2 diabetes (T2D) is a prevalent disease that increases risk for vascular, renal, and neurologic complications. Prevention treatment of T2D its complications are paramount. Many advancements in care have emerged over the past 5 years, including increased understanding importance early intensive glycemic control, mental health, social determinants healthy eating patterns, continuous glucose monitoring, benefits some drugs preventing cardiorenal disease. This review summarizes evidence supporting prevention treatment, focusing on aspects commonly purview primary physicians.

Язык: Английский

Процитировано

8

Optimizing metformin therapy in practice: Tailoring therapy in specific patient groups to improve tolerability, efficacy and outcomes DOI Creative Commons
Giovanni Antonio Silverii

Diabetes Obesity and Metabolism, Год журнала: 2024, Номер 26(S3), С. 42 - 54

Опубликована: Июль 10, 2024

Metformin is the first-line medication for type 2 diabetes. It effective and safe, provided some caution taken in specific populations. In patients with chronic kidney disease, metformin may provide long-term benefits, it a therapy diabetes, but estimated glomerular filtration rate (eGFR) must be assessed regularly, to minimize risk accumulation. When eGFR 30-60 mL/min/1.73m

Язык: Английский

Процитировано

8

Contraception and nonalcoholic fatty liver disease in women with prior gestational diabetes mellitus DOI Creative Commons
Supatsri Sethasine,

Sasiwan Suthasmalee,

Siriwan Tangjitgamol

и другие.

Contraception, Год журнала: 2025, Номер unknown, С. 110860 - 110860

Опубликована: Фев. 1, 2025

Nonalcoholic fatty liver disease (NAFLD) is an increasing concern among women with a history of gestational diabetes mellitus (GDM). Hormonal contraceptives may affect metabolism, potentially NAFLD risk. This study examined the association between different contraceptive methods and risk approximately one year postpartum in prior GDM. We conducted prospective cohort involving 130 categorized these into three groups based on their use: no contraception or non-hormonal (n = 86); progestin-only (POCs), including pills (POPs), depot medroxyprogesterone acetate (DMPA), implants 29); combined oral (COCs) 15). At postpartum, we measured controlled attenuation parameter to assess hepatic steatosis diagnose NAFLD. used multivariable logistic regression analyses evaluate The POC group had highest median (307 dB/m) prevalence (55.2%), followed by (237 dB/m; 30.2%), lowest values COC (213 13.3%). POCs, particularly POPs DMPA, significantly increased compared (adjusted odds ratio 4.28, 95% confidence interval 1.55-11.85). In contrast, COCs did not show significant risk, whereas showed such association. These findings have important implications for counseling

Язык: Английский

Процитировано

1

Comprehensive Quantification of Fetal Cardiac Function in Gestational Diabetes Mellitus Using Advanced Fetal HQ Imaging Techniques DOI
Jing Wang, Yan Liu, Wei Cai

и другие.

Echocardiography, Год журнала: 2025, Номер 42(4)

Опубликована: Апрель 1, 2025

ABSTRACT Objective Gestational diabetes mellitus (GDM) is a transient metabolic disorder associated with hyperglycemia, insulin resistance, and endothelial dysfunction. Although GDM typically resolves after delivery, it can have long‐term effects on both maternal fetal health, including potential cardiovascular complications for the offspring. This study aims to evaluate impact of hyperglycemia cardiac function using advanced HQ (fetal heart quantification) imaging technology. Methods A prospective was conducted from July 2019 November 2024, involving 303 pregnant women in their second third trimesters, 105 (well‐controlled) 198 healthy controls. Fetal assessed imaging, two‐dimensional speckle‐tracking echocardiography technique. Measurements global longitudinal strain (GLS), fractional area change (FAC), shortening (FS) were obtained left (LV) right (RV) ventricles. Correlations between factors (BMI, HbA1c, triglycerides) parameters also evaluated. Intra‐ inter‐rater reliability all measurements. Results The group exhibited significantly lower LV GLS compared control (−21.5 ± 5.5% vs. −24.5 4.9%, p = 0.000), indicating impaired myocardial deformation. No significant differences found RV GLS, FAC, or ejection fraction (EF). Significant 24‐segment FS values observed RV, showing across most segments, suggesting subclinical Reliability analysis demonstrated high intra‐ consistency measurements, excellent intra‐rater (ICC 0.912) strong 0.725). HbA1c triglycerides negatively correlated that may affect ventricular function. Conclusion demonstrates function, particularly deformation, as measured by FS. Maternal factors, triglycerides, are linked these alterations. reliable method assessing provides valuable insights into fetus.

Язык: Английский

Процитировано

1