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Background/Objectives: The effect of maternal macronutrient composition on the risk of large for gestational age (LGA) neonates among women with gestational diabetes mellitus (GDM) is not well understood. This study aimed to investigate these associations in a pregnant cohort in Northern Greece, considering both pre-pregnancy and early pregnancy dietary intake, and stratifying women by pre-pregnancy body mass index (BMI). Methods: From a total of 797 eligible pregnant women, the 117 (14.7%) who developed GDM (and thus were included in the study) completed the validated Food Frequency Questionnaires (FFQs). Macronutrient intake was assessed for the six months before pregnancy and until mid-gestation, prior to the oral glucose tolerance test. Data were compared with European Food Safety Authority (EFSA) guidelines, and participants were stratified by pre-pregnancy BMI (normal vs. overweight/obese). Multivariate logistic regression was used to estimate adjusted odds ratios (aORs) for LGA risk. Results: In normal-BMI women with GDM, higher dietary fiber (aOR = 1.39) and vegetable protein (aOR = 1.61) intake before pregnancy were both significantly associated with an increased risk of LGA. During early pregnancy, the elevated risk from vegetable protein persisted (aOR = 1.51). Among overweight/obese women, no significant pre-pregnancy associations were observed. However, during early pregnancy, a higher percentage of total carbohydrate intake was linked to increased LGA risk (aOR = 1.11), while maintaining saturated fatty acids "as low as possible" reduced the odds of LGA (aOR = 0.71). Elevated vegetable protein intake also increased LGA risk (aOR = 1.61). Conclusions: Maternal macronutrient intake prior to and during early pregnancy may influence LGA risk in GDM, with distinct patterns according to pre-pregnancy BMI. These findings underscore the importance of tailoring dietary recommendations—especially regarding fiber, vegetable protein, carbohydrates, and saturated fat—to mitigate the risk of LGA in women with GDM. [ABSTRACT FROM AUTHOR]

Background: Gestational Diabetes Mellitus (GDM) prevalence is rising worldwide, but optimal dietary strategies remain unclear. The eMOM pilot RCT compared a plant-protein rich Healthy Nordic Diet (HND) and a moderately carbohydrate restricted diet (MCRD) and their potential effects on time in glucose target range (≤ 7.8 mmol/L, %TIR), and on newborn body composition. Methods: Forty-two participants were randomized to either HND (n = 20) or MCRD (n = 22) face-to-face nutritional counseling from gestational weeks (GW) 24 + 0—28 + 6 (baseline) until delivery. The HND intervention had no restriction in carbohydrate intake and emphasized plant-based protein sources and Nordic food, while the MCRD had a moderate carbohydrate restriction (~ 40% in proportion to total daily energy consumption, E%). Continuous glucose monitoring was worn for 14 days to assess glucose levels and %TIR. Blood samples for glucose and lipid metabolism and 3-day food diaries were collected at baseline and at GW 34 + 0—35 + 6. Neonatal body composition was measured by air displacement plethysmography. Difference between groups were analysed with t-test and Wilcoxon test. Results: Thirty-two women completed the study. Both groups maintained the %TIR during majority of the time (98.9 and 99.3% for MCRD and HND respectively, p = 0.921) in GW 34 + 0 – 35 + 6. The mean glucose was lower in the MCRD group compared to the HND group (5.0 SD 1.03 vs. 5.2 SD 0.96 mmol/l, p < 0.001). No differences were observed in glucose variability, lipid metabolism, gestational weight gain, or in the body composition of the newborns. HND had lower diet macronutrient adherence than the MCRD, resulting in similar macronutrient composition in both groups. The mean macronutrient intakes were fat: 40.6 vs. 39.5 E%, carbohydrate: 40.5 vs. 42.4 E%, protein: 18.9 vs. 18.1 E% for the MCRD and HND groups, respectively. The HND decreased intake of meat and increased fish consumption significantly compared to the MCRD. Conclusions: Both a moderately restricted carbohydrate diet and a diet focused on plant-based protein effectively maintained a large time within the treatment target range in women with GDM. Further research could explore the impact of protein quantity and sources in maternal diets on glycemic control and newborn outcomes. Trial registration: The eMOM pilot trial is registered in Clinicaltrials.gov (21/09/2018, NCT03681054). [ABSTRACT FROM AUTHOR]

Background: Women and people diagnosed with diabetes in pregnancy, are recommended to have frequent monitoring and careful management for optimal pregnancy outcomes. This health care management should be supported by a multidisciplinary healthcare team. For individuals living in rural areas, there are increased barriers to healthcare access, with subsequent worse health outcomes compared to those in metropolitan regions. Despite this, there remains a lack of research into the experiences of healthcare delivery for rural women and people with diabetes in pregnancy. Methods: Survey invitations were sent via the National Diabetes Services Scheme email list. The survey included multiple choice and open-ended questions. Responses from the open-ended question asking participants the changes they would want made to their care delivery were interpreted using qualitative content analysis. Responses were separated into metropolitan and rural categories using the Modified Monash Model criteria. Results: There were 668 survey responses, with 409 responding to the open-ended qualitative survey question/s. 71.6% of respondents were metropolitan and 27.6% lived rurally. A total of 31 codes were established from the open-ended responses, with the five overarching themes of 'quality of care', 'practice & communication', 'individual's experience', 'access' and 'burden of care' identified. The most frequently occurring codes irrespective of location included education or information (n = 45), frequency and timeliness of care (n = 42), no changes (n = 42) and improved health professional communication (n = 40). Local care options was the only code with more rural quotes compared to metropolitan. Conclusions: The most frequently occurring codes had strong representation from metropolitan and rural respondents, indicating that those with previous diabetes in pregnancy had similar priorities for changes in their healthcare delivery regardless of location. Rural respondents identifying local care options as a priority for change is likely indicative of the rural healthcare landscape with limited access to care options. Recommendations from this study supported by previous research include focusing on improving health professional communication both with women and people with diabetes in pregnancy and with other relevant professionals. Recommendations for rural locations should focus on improving local care options whilst considering resource limitation, such as telehealth clinics. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Methods Results Conclusion Impacts Patient To identify the barriers and enablers in the implementation of evidence‐based physical activity (PA) programmes for the improvement of health outcomes among pregnant women with gestational diabetes mellitus (GDM), and to develop strategies for implementing this evidence in clinical practice.A convergent mixed‐methods study was conducted, integrating a descriptive qualitative research design with a cross‐sectional survey. In‐depth interview was used to collect the views and cognitions about physical activity from medical staff, leaders and pregnant women. The qualitative data was analysed using directed content analysis, guided by the Ottaw Model of Research Use (OMRU). A self‐designed questionnaire, which was based on the current best evidence for physical activity during pregnancy, was administered to gather data regarding nurse’ knowledge of physical activity (PA safety, managing blood glucose with PA, etc.), their management practice (timing of assessments, provision of information, etc.), as well as the knowledge levels of physical activity among pregnant women with GDM (principles of exercise, PA precautions, etc.).A total of 12 medical staff members and 14 pregnant women were interviewed. Ten nurses and 102 pregnant women with GDM completed the questionnaire. We generated 12 subthemes organised within three themes of the OMRU from the data, including insufficient professional autonomy, positive attitudes towards evidence implementation, shortage of nursing staff, implementation climate, etc. The average knowledge score of physical activity among nurses and pregnant women was 5 (SD 2.36) points and 5.2 (SD 1.70) points, respectively. Ten strategies for overcoming barriers and amplifying enablers for the implementation of the physical activity improvement programme for pregnant women with GDM, under the guidance of the OMRU were constructed.An accumulation of evidence, adopters and practice environment factors across the OMRU domains explains why physical activity improvement initiatives for pregnant women with GDM are hard to implement.This study helps to recognise barriers and facilitators to physical activity improvement particularly at the evidence, potential adopter and practical environment level.Healthcare workers (doctors, nurses, etc.) and pregnant women with GDM in a university hospital located in Sichuan Province. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus (GDM) is a complex metabolic disease that has short-term and long-term adverse effects on mothers and infants. However, the specific pathogenic mechanism has not been elucidated. Objective: The aim of this study was to confirm the associations between candidate genetic variants (rs4134819, rs720918, rs2034410, rs11109509, and rs12524768) and GDM risk and prediction in a southern Chinese population. Methods: Candidate variants were genotyped in 538 GDM cases and 626 healthy controls. The odds ratio (OR) and its corresponding 95% confidence interval (CI) were calculated to assess the associations between genotypes and GDM risk. Then, the false-positive report probability (FPRP) analysis was adopted to confirm the significant associations, and bioinformatics tools were used to explore the potential biological function of studied variants. Finally, risk factors of genetic variants and clinical indicators identified by logistics regression were used to construct a nomogram model for GDM prediction. Results: It was shown that the XAB2 gene rs4134819 was significantly associated with GDM susceptibility (CT vs. CC: adjusted OR = 1.38, 95% CI: 1.01–1.87, p = 0.044; CT/TT vs. CC: crude OR = 1.42, 95% CI: 1.08–1.86, p = 0.013). Functional analysis suggested that rs4134819 can alter the specific transcription factors (CPE bind and GATE-1) binding to the promoter of the XAB2 gene, regulating the transcription of XAB2. The nomogram established with factors such as age, FPG, HbA1c, 1hPG, 2hPG, TG, and rs4134819 showed a good discriminated and calibrated ability with an area under the curve (AUC) = 0.931 and a Hosmer–Lemeshow test p -value > 0.05. Conclusion: The variant rs4134819 can significantly alter the susceptibility of the Chinese population to GDM possibly by regulating the transcription of functional genes. The nomogram prediction model constructed with genetic variants and clinical factors can help distinguish high-risk GDM individuals. [ABSTRACT FROM AUTHOR]

Introduction: This study aims to explore the risk factors in the progression of gestational diabetes mellitus (GDM) to type 2 diabetes mellitus (T2DM). Material and methods: Relevant studies were comprehensively searched from PubMed, Web of Science, Cochrane Library, and Embase up to March 12. Data extraction was performed. Differences in risk factors were presented as odds ratios (OR) and corresponding 95% confidence intervals (CI). The quality of the included studies was assessed through the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality scale. Results: This meta-analysis encompassed 46 studies involving a total of 196,494 patients. The factors most strongly associated with the risk of developing T2DM following GDM were the use of progestin-only contraceptives (odds ratio [OR]: 2.12, 95% confidence interval [CI] = 1.00–4.45, P = 0.049), recurrence of GDM (OR: 2.63, 95% CI = 1.88–3.69, P < 0.001), insulin use during pregnancy (OR: 4.35, 95% CI = 3.17–5.96, P < 0.001), pre-pregnancy body mass index (BMI) (OR: 2.97, 95% CI = 2.16–4.07, P < 0.001), BMI after delivery (OR: 4.17, 95% CI = 2.58–6.74, P < 0.001), macrosomia (OR: 3.30, 95% CI = 1.45–7.49, P = 0.04), hypertension (OR: 5.19, 95% CI = 1.31–20.51, P = 0.019), and HbA1c levels (OR: 3.32, 95% CI = 1.81–6.11, P < 0.001). Additionally, age (OR: 1.71, 95% CI = 1.23–2.38, P = 0.001), family history of diabetes (OR: 1.47, 95% CI = 1.27–1.70, P < 0.001), BMI during pregnancy (OR: 1.06, 95% CI = 1.00–1.12, P = 0.056), fasting blood glucose (FBG) (OR: 1.58, 95% CI = 1.36–1.84, P < 0.001), 1-hour oral glucose tolerance test (OGTT) (OR: 1.38, 95% CI = 1.02–1.87, P = 0.037), and 2-hour OGTT (OR: 1.54, 95% CI = 1.28–1.58, P < 0.001) were identified as moderate-risk factors for the development of T2DM. Conclusion: The systematic review and meta-analysis identified several moderate- to high-risk factors associated with the progression of T2DM in individuals with a history of GDM. These risk factors include the use of progestin-only contraceptives, pre-pregnancy BMI, BMI after delivery, macrosomia, hypertension, persistently elevated levels of HbA1c, fasting blood glucose (FBG), 1-hour and 2-hour oral glucose tolerance tests (OGTT), age, and family history of diabetes. Our findings serve as evidence for the early prevention and clinical intervention of the progression from GDM to T2DM and offer valuable insights to guide healthcare professionals in formulating customized management and treatment strategies for female patients with diverse forms of GDM. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/ , identifier CRD42024545200. [ABSTRACT FROM AUTHOR]

Background: Antenatal care strategies (ANC) play a pivotal role in ensuring a healthy gestational period for expectant mothers and promote optimal outcomes for their babies. Implementing these interventions can contribute to a supportive environment for pregnant women, resulting in positive perinatal and neonatal outcomes. Summary: We summarize evidence for a total of twenty-seven interventions pertaining to ANC from Every Newborn Series published in The Lancet 2014 by identifying the most recent systematic reviews, extracting data from each review, and conducting a subgroup analysis for low-income and lower-middle-income countries (LMICs) for outcomes relevant to maternal and neonatal health. Findings from our paper suggest a paucity in evidence from LMICs, and consolidated efforts are required to narrow this gap to build on more inclusive evidence on ANC. Key Messages: Evidence from LMICs suggests that antenatal multiple micronutrient supplementation when compared to iron and folic acid had a significant effect on stillbirth, small for gestational age, and low birthweight (LBW). Vitamin D supplementation reduced the risks of preterm birth and LBW. High-dose calcium supplementation, when compared to placebo in pregnancy, lowered the likelihood of developing high blood pressure, preeclampsia, and preterm birth. Antihypertensives significantly reduced the probability of developing severe hypertension, proteinuria/preeclampsia, and severe preeclampsia. Metformin for GDM reduced the risk of neonatal death or serious morbidity composite. Cervical cerclage had no effect on stillbirth, preterm birth, or perinatal and neonatal mortality. Data for anti-D administration for rhesus alloimmunization were limited to HICs. Background: Antenatal care strategies (ANC) play a pivotal role in ensuring a healthy gestational period for expectant mothers and promote optimal outcomes for their babies. Implementing these interventions can contribute to a supportive environment for pregnant women, resulting in positive perinatal and neonatal outcomes. Summary: We summarize evidence for a total of twenty-seven interventions pertaining to ANC from Every Newborn Series published in The Lancet 2014 by identifying the most recent systematic reviews, extracting data from each review, and conducting a subgroup analysis for low-income and lower-middle-income countries (LMICs) for outcomes relevant to maternal and neonatal health. Findings from our paper suggest a paucity in evidence from LMICs, and consolidated efforts are required to narrow this gap to build on more inclusive evidence on ANC. Key Messages: Evidence from LMICs suggests that antenatal multiple micronutrient supplementation when compared to iron and folic acid had a significant effect on stillbirth, small for gestational age, and low birthweight (LBW). Vitamin D supplementation reduced the risks of preterm birth and LBW. High-dose calcium supplementation, when compared to placebo in pregnancy, lowered the likelihood of developing high blood pressure, preeclampsia, and preterm birth. Antihypertensives significantly reduced the probability of developing severe hypertension, proteinuria/preeclampsia, and severe preeclampsia. Metformin for GDM reduced the risk of neonatal death or serious morbidity composite. Cervical cerclage had no effect on stillbirth, preterm birth, or perinatal and neonatal mortality. Data for anti-D administration for rhesus alloimmunization were limited to HICs. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine the effects of gestational diabetes mellitus (GDM) on the risk of pregnancy complications in twin pregnancies and to investigate the relationship between glycemic levels and the risk of preeclampsia (PE) and abnormal fetal growth. Patients and Methods: A retrospective cohort study of 736 twin pregnancies was conducted at a tertiary hospital. Propensity score matching and multivariable logistic models were utilized to compare maternal and neonatal outcomes between twin pregnancies with GDM and those without GDM. Multivariable logistic regressions were performed to address the intertwin correlation between glycemic levels and the primary outcomes. Results: There was no significant difference in the risk of PE between non-GDM and GDM pregnancies (OR, 0.70; 95% CI: 0.38– 1.27; P = 0.238). No statistically significant differences were observed in the prevalence of small for gestational age and large for gestational age between the study groups. A comparative analysis of twin pregnancies affected by PE and GDM versus those without GDM revealed that the former group exhibited similar maternal and neonatal outcome risks. Women with fasting blood glucose levels from 5.1 mmol/L (92mg/dL) to less than 5.3 mmol/L (95.6mg/dL) had a significantly higher risk of PE compared with women without GDM (OR, 2.90; 95% CI: 1.12– 7.51; P = 0.028). In subgroups of glycosylated hemoglobin (HbA1c), HbA1c ≥ 5.5% had the highest risk of PE in the second and third trimesters compared with women without GDM (OR, 4.90; 95% CI: 1.00– 24.12; P = 0.05). Conclusion: The risk of PE was not increased in twin pregnancies complicated with GDM, but significantly increased in women with an HbA1c ≥ 5.5%. No significant associations were observed between the co-occurrence of GDM and PE and the incidence of pregnancy complications in twin pregnancies. Strict glycemic control may decrease the risk of PE in twin pregnancies with GDM. [ABSTRACT FROM AUTHOR]

Background: Dyslipidemia is linked to pregnancy complications, but its causal role remains uncertain. This two-sample Mendelian Randomization (MR) study investigated the causal relationship between lipid traits and pregnancy complications and evaluated the impact of lipid-modifying drug targets. Methods: Genetic instruments for lipid traits and targets for lipid-modifying drugs were obtained from the Global Lipids Genetics Consortium. Three pregnancy complications' summary statistics came from the FinnGen R9 database. Significant drug targets underwent further analysis using Expression Quantitative Trait Loci data, and mediation analysis identified potential mediators. Results: Increased high-density lipoprotein cholesterol (HDL-C) reduced the incidence of preeclampsia (OR: 0.755, 95% CI: 0.639– 0.891, p=0.001, FDR=0.012) and gestational diabetes mellitus (GDM) (OR: 0.835, 95% CI: 0.741– 0.942, p=0.003, FDR=0.018). Genetic proxies for cholesteryl ester transfer protein (CETP) inhibition correlated with a decreased risk of preeclampsia (OR: 0.863, 95% CI: 0.786– 0.947, p=0.002, FDR=0.027), while genetic inhibition of HMG-CoA reductase (HMGCR) increased preeclampsia risk (OR: 1.700, 95% CI: 1.189– 2.431, p=0.004, FDR=0.036). Genetically mimicking the enhancement of lipoprotein lipase (LPL) related to a reduced risk of GDM (OR: 0.681, 95% CI: 0.560– 0.829, p=1.29× 10− 4, FDR=0.004). Higher LPL expression in subcutaneous adipose tissue also reduced GDM risk (OR: 0.642, 95% CI: 0.454– 0.909, p=0.013). Waist circumference (4.2%) and waist-to-hip ratio adjusted by BMI (5.7%) partially mediated LPL's effect on GDM risk. Conclusion: Elevated HDL-C levels help prevent preeclampsia and GDM. CETP and LPL could be therapeutic targets for preeclampsia and GDM, respectively. However, caution is advised with HMGCR-targeting drugs, as they may increase the preeclampsia risk. [ABSTRACT FROM AUTHOR]

Introduction: Gestational Diabetes Mellitus (GDM) is associated with an increased risk of feto-maternal and neonatal complications. Many of these complications can be reduced or eliminated, if GDM can be predicted in early pregnancy. Current risk prediction models lack a strong predictive value. In this study, we aim to evaluate the early trimester maternal parameters for future prediction of GDM. Methods: In this prospective observational study, we screened 581 consecutive healthy women with singleton pregnancy for GDM during their first antenatal visit. After informed consent, fasting blood samples were collected and stored at −80°C. GDM was diagnosed as per IADPSG criteria. During prospective follow-up, a total of 55 patients developed GDM. A total of 110 age and BMI-matched controls were recruited for comparison. In all women, we measured the Oral Glucose Tolerance test with 75 gm anhydrous glucose, fasting insulin, HbA1c, hsCRP, uric acid, and lipid Profile. HOMA-IR, HOMA-β, and QUICKI were also assessed. Results: The GDM cohort had significantly higher median waist circumference, 2 hr plasma glucose, HbA1c, fasting insulin, HOMA-IR, hsCRP, uric acid, and serum triglyceride levels. Multiple regression analysis revealed HbA1c (OR 5.264; P = 0.007), 2 hr PPG (OR 1.026; P = 0.035), QUICKI (OR 1.057; P = 0.016), uric acid (OR 1.931; P = 0.013) and neutrophil: lymphocyte ratio (OR 1.545; P = 0.008) to be independently associated with GDM outcome with combined area under the curve (AUC) of 0.850, a sensitivity of 72.7%, and a specificity of 87.3%. Conclusion: Fasting Insulin, HbA1c, HOMA-IR, hsCRP, and Uric acid levels are significantly increased in early pregnancy in individuals who subsequently develop GDM. [ABSTRACT FROM AUTHOR]

Objective To evaluate the association between gestational diabetes mellitus (GDM) and genitourinary tract infections during pregnancy (GUTIs) through retrospective analysis and Mendelian randomization (MR) analysis. Methods A retrospective analysis was conducted on 7 751 pregnant women who underwent prenatal check-ups and delivered between 2020 and 2022, comparing the rates of GUTIs between women with GDM and those without. Additionally, data from genome-wide association studies (GWAS) were selected, and the inverse-variance weighted (IVW) method was employed as the primary analytical approach, supplemented by weighted median (WM), weighted mode (WM), and MR-Egger regression methods. Sensitivity analyses were performed using MR-Egger regression, Cochran's Q test, and leave-one-out analysis to investigate the causal relationship between GDM and GUTIs. Results Both univariate chi-square tests (P=2.2x10-16) and multivariate stepwise logistic regression analyses (P=2x10-16) revealed a significant correlation between GDM and GUTIs. The two-sample MR study further confirmed a significant association between the two (IVW: β=0.211, P=0.013). The MR-Egger regression method did not indicate significant horizontal pleiotropy (P=0.813), and leave-one-out analysis and Cochran's Q test showed no significant heterogeneity among all SNPs (P=0.876, P=0.938). Conclusion The presence of GDM may increase the risk of GUTIs. Effective screening and management of GDM patients could help reduce and prevent GUTIs. [ABSTRACT FROM AUTHOR]

Background Gestational Diabetes Mellitus (GDM) is a significant health concern during pregnancy, characterized by elevated blood glucose levels first identified during pregnancy. Pregnancy induces insulin resistance due to placental hormones, but excessive resistance can lead to GDM, which poses risks to both maternal and fetal health. In India, GDM prevalence varies widely, exacerbated by factors such as demographics, healthcare access, and diagnostic methods. The increasing prevalence of GDM, particularly in developing countries, necessitates a better understanding of contributing factors to improve maternal and neonatal health outcomes. Objective This study aims to determine the prevalence of Gestational Diabetes Mellitus (GDM) among pregnant women attending the outpatient department of SCB Medical College and Hospital in Cuttack, Odisha, India, and to identify associated risk factors such as age, family history, obstetric history, diet, BMI, and physical activity. Methodology A cross-sectional study was conducted from July 2018 to June 2019, involving 483 pregnant women who were screened for GDM using the 75 g, 2-hour oral glucose tolerance test (OGTT), following WHO diagnostic criteria. Data on age, family history of diabetes, obstetric history, diet patterns, BMI, and physical activity were collected through structured interviews and questionnaires. Statistical analysis was performed using the Chi-square test with a significance threshold of p<0.05. Results The overall prevalence of GDM in the study population was 15.9%. The highest prevalence was observed in the 25-29 age group (23.7%), and no significant association was found between age and GDM (p=0.234). A family history of diabetes was linked to higher prevalence, with women having both parents diabetic showing a significantly higher rate of GDM (49.4%). Obstetric history showed a significant association with GDM, with women with a good obstetric history having a higher prevalence (21.0%) compared to those with a bad obstetric history (9.2%). Diet patterns, particularly a higher prevalence of GDM in non-vegetarian women (61.0%), were also significant (p=0.001). Women with higher BMI, especially those classified as obese (BMI ≥ 30 kg/m²), exhibited a significantly higher prevalence of GDM (45.7%) compared to those with normal BMI (5.7%) (p=0.001). Additionally, physical inactivity was associated with higher GDM prevalence (57.1% in sedentary women). Discussion The study confirms that GDM is a major concern during pregnancy, with significant associations identified between various risk factors such as obesity, family history of diabetes, diet, and physical inactivity. Women with a higher BMI, poor dietary habits, and lack of physical activity were more likely to develop GDM. The results align with global studies linking obesity and poor lifestyle choices with increased risk of GDM. Interestingly, a family history of diabetes was also found to increase the risk, underscoring the genetic predisposition in GDM development. Moreover, women with good obstetric histories showed a higher prevalence of GDM, suggesting that factors beyond the current pregnancy, such as pre-existing metabolic conditions, may contribute. Conclusion The prevalence of Gestational Diabetes Mellitus in Cuttack, Odisha, India is high, particularly among women with higher BMI, sedentary lifestyles, and poor dietary patterns. Early screening, lifestyle modifications such as maintaining a healthy weight, improving diet, and engaging in regular physical activity are essential strategies to reduce the risk of GDM and its complications. There is a pressing need for public health initiatives and further research to mitigate the growing burden of GDM and ensure better maternal and neonatal health outcomes in India. [ABSTRACT FROM AUTHOR]

Introduction: There are limited data on the prevalence of cardiovascular risk factors/diseases (diabetes, obesity, hypertension, and dyslipidemia) and their composite scores reflecting overall cardiovascular health among young (< 50 years old) married couples. Methods: We have an established longitudinal prospective cohort of postpartum women with a history of hyperglycemia [pre-existing diabetes (PED; n = 101), overt diabetes in pregnancy (ODiP; n = 92), gestational diabetes (GDM; n = 643)], and normoglycemia (n = 183) in pregnancy and their spouses (n = 819). In this study, we report data from baseline cross-sectional evaluation of these 819 young couples regarding the burden of cardiovascular risk factors/diseases, their concordance and associations. Results: The mean (SD) age was 33.5 (4.9) years for women and 36.9 (5.4) years for men, and the evaluation was performed at a median (IQR) postpartum interval of 30 (20–45) months. Diabetes, hypertension, obesity, and dyslipidemia were present in 25.0%, 6.9%, 25.6%, and 4.0% of women and 15.8%, 20.2%, 14.3%, and 8.2% of men, respectively. Among men, dysglycemia (diabetes/prediabetes) and adverse cardiovascular score (average/poor) showed a significant trend in progression according to the antenatal categories of their partner (highest in DIP, intermediate in GDM, and lowest in normoglycemia). The concordance was higher for adverse cardiovascular score (58.5%), overweight/obesity (48.7%), and dysglycemia (42.4%) compared to prehypertension/hypertension (29.2%) and hypercholesterolemia (8.2%). The odds ratios were significant for all associations evaluated, except for elevated blood pressure, being strongest (OR > 2.0) for overweight/obesity and adverse cardiovascular score. Conclusions: Nearly three in five young couples evaluated in the study showed concordance for adverse cardiovascular scores. The cardiovascular risk in men increased in a graded manner across the increasing severity of antenatal glycemic categories of their partners. Plain Language Summary: There is a lack of data on the comprehensive cardiovascular health scores proposed by the American Heart Association for women with prior gestational diabetes and their spouses. Furthermore, the risk of cardiometabolic risk factors for couples regarding different antenatal glycemic categories (normoglycemia, gestational diabetes, and diabetes in pregnancy) of the women has not been evaluated. In our CHIP-F study (Cohort Study of Indian Women with Hyperglycemia in Pregnancy and their Families), we have established a relatively large cohort of women and their spouses. We evaluated for diabetes, obesity, hypertension, dyslipidemia, and their composite scores, reflecting overall cardiovascular health among young (< 50 years old) married couples. We found that the burden of cardiometabolic risk factors among spouses of women who had either gestational diabetes or diabetes in pregnancy is substantial. Among men, dysglycemia (diabetes/prediabetes) and adverse cardiovascular score (average/poor) showed a significant trend in progression according to the antenatal categories of their partner (highest in DIP, intermediate in GDM, and lowest in normoglycemia). The concordance was higher for adverse cardiovascular score, overweight/obesity, and dysglycemia compared to prehypertension/hypertension and hypercholesterolemia. Nearly 60% of the young couples evaluated in the study showed concordance for adverse cardiovascular scores. [ABSTRACT FROM AUTHOR]

There has been accumulating evidence over the past two decades that metformin can be an effective treatment for gestational diabetes mellitus (GDM) in women whose diet and exercise fail to attain optimal glycemic control. The objective of this review was to comprehensively analyze all studies investigating the effectiveness of metformin compared to insulin and other drugs utilized for the treatment of GDM. After a comprehensive literature review based on PRISMA 2020, 35 studies were included after a selection process utilizing predetermined inclusion and exclusion criteria. A variety of short-term maternal and neonatal outcomes were assessed. Metformin is a highly efficient medication for attaining optimal control of blood sugar levels in women with GDM, resulting in a significant reduction in the amount of weight gained during pregnancy. Regarding additional maternal outcomes, such as pregnancy-induced hypertension and cesarean deliveries, some studies demonstrate a link between metformin and a reduced occurrence of both conditions. In contrast, others do not find an association. Regarding short-term neonatal outcomes, metformin does not exhibit any changes in gestational age at delivery. In contrast, metformin demonstrated substantial decreases in the likelihood of greater gestational birth weight and neonatal hospitalization when compared to other drugs. When compared primarily to insulin, metformin decreases the probability of several short-term outcomes related to pregnancy and newborns. Additional data are necessary for extended follow-up studies, including patients with GDM treated with metformin. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Objectives Methods Conclusion Vitamin B12 (B12), playing the role of a coenzyme in one‐carbon metabolism, is an important vitamin necessary for human health.To systematically review evidence to identify the complications of B12 deficiency among women.We conducted a systematic search of quantitative studies on disorders associated with B12 deficiency among women, published in English in the last 25 years (1999–2024), using electronic databases such as Scopus, Web of science, CINAHL, PubMed, and Medline.The search produced 28 full‐text articles. B12 deficiency prevalence among women identified by the selected studies ranges from 0.6% to 45.5%. The deficiency of B12 is connected with the risk for depression/post‐partum depression, breast cancer, recurrent pregnancy loss, gestational diabetes mellitus, insulin resistance, and obesity among women. It is necessary to monitor and correct the B12 deficiency among women in order to prevent complications [ABSTRACT FROM AUTHOR]

Adipokines related to gestational diabetes mellitus (GDM) are an emerging area of interest. The aim of this study was to evaluate the associations between GDM and adipokine levels in human milk. This was an observational cohort study targeting mothers with gestational diabetes, which evaluated the association of maternal hyperglycemia severity, classified as GDM-G1 (diet treatment) and GDM-G2 (insulin treatment), with colostral adipokines involved in pro- and anti-inflammatory processes. Colostrum was collected from hyperglycemic (N = 34) and normoglycemic (N = 26) mothers, and adipokine levels were determined by immunoenzymatic assay. Among anti-inflammatory adipokines, only for irisin and vaspin, but not for obestatin and adropin, were significantly different levels noted between the GDM-G1, GDM-G2 and non-GDM cohorts. Colostrum of the GDM-G2 subgroup contained more vaspin (4.77 ng/mL) than that of normoglycemic mothers (3.12 ng/mL) and more irisin (26.95 μg/mL) than in the GDM-G1 subgroup (17.59 μg/mL). The levels of pro-inflammatory adipokines, namely, dermcidin, chemerin and visfatin, were at similar levels irrespective of maternal glycemia. Moreover, irisin showed a negative correlation with dermcidin in GDM-G2 and non-GDM cohorts. Associations were observed between colostral irisin and maternal preconception BMI, dermcidin and gestational age, and vaspin and maternal age. This study provides evidence that the way of restoring glucose homeostasis in pregnant women has an impact on the anti-inflammatory adipokines irisin and vaspin, but not on obestatin and adropin. GDM, regardless of severity, did not influence the colostral pro-inflammatory adipokines visfatin, chemerin and dermcidin. [ABSTRACT FROM AUTHOR]

Background: Gestational Diabetes Mellitus (GDM) is a common complication during pregnancy. Late diagnosis can have significant implications for both the mother and the fetus. This research aims to create an early prediction model for GDM in the first trimester of pregnancy. This model will help obstetricians and gynecologists make appropriate decisions for treating and preventing GDM complications. Methods: This applied descriptive study was conducted at the fertility health center of Vali-e-Asr Hospital in Tehran, Iran. The dataset was collected from the records of pregnant women registered in the hospital's system from 2020 to 2022. Risk factors for designing predictive models were identified through literature review, expert opinions, and clinical specialists' input. The extracted information underwent preprocessing, and six machine learning (ML) methods were developed and evaluated for GDM prediction in the first trimester of pregnancy: decision tree (DT), multilayer perceptron (MLP), k-nearest neighbors (KNN), Naïve Bayes (NB), random forest (RF), and extreme gradient boosting (XGBoost). Results: Models were evaluated using accuracy, precision, sensitivity, and the area under the receiver operating characteristic curve (AUC). Based on the glucose tolerance test (GTT) results, the RF model achieved the best performance in GDM prediction, with 89% accuracy, 86% precision, 92% recall, and 94% AUC, using demographic variables, medical history, and clinical findings. In modeling based on insulin consumption, the RF model achieved the best results with 62% accuracy, 60% precision, 63% recall, and 63% AUC in predicting GDM using demographic variables and medical history. Conclusion: The results of this study demonstrate that ML algorithms, especially RF, have acceptable accuracy in the early prediction of GDM during the first trimester of pregnancy. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Anti–tumor necrosis factor (anti-TNF) therapy may improve insulin sensitivity, and its impact during pregnancy remains unclear. We aimed to assess the risk of gestational diabetes mellitus (GDM) associated with anti-TNF treatment among pregnant women with inflammatory bowel disease (IBD). METHODS: This nationwide cohort study included patients with IBD in Korea from 2010 to 2021. Anti-TNF exposure was identified from the last menstrual period (LMP) to LMP + 140 days. The development of GDM was assessed from LMP + 141 days to delivery. We performed overlap weighting to balance the covariates and used a generalized linear mixed model to measure the risk ratio (RR) and 95% confidence intervals (CIs). The anti-TNF group was compared with the unexposed group, as well as with the immunosuppressant, 5-aminosalicylate, and untreated groups. RESULTS: A total of 3,695 pregnancies in women with IBD were identified, of which 338 (9.2%) were exposed to anti-TNFs. GDM was found in 7.1% of the pregnancies exposed to anti-TNFs as compared with 11.0% of those unexposed. The crude and weighted RRs for GDM risk were 0.64 (95% CI 0.43–0.96) and 0.68 (95% CI 0.55–0.84), respectively. The weighted RR when compared with the immunosuppressant, 5-aminosalicylate, and untreated groups was 0.70 (95% CI 0.41–1.18), 0.71 (95% CI 0.52–0.95), and 0.85 (95% CI 0.59–1.24), respectively. DISCUSSION: This nationwide cohort reported a decreased risk of GDM among patients who used anti-TNFs during early pregnancy compared with those unexposed. GDM risk may become a consideration in the decision-making process when choosing treatment options for pregnant women with a risk factor for GDM. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus (GDM) is one of the risk factors for postpartum urinary incontinence. Pelvic floor muscle training (PFMT) improves pelvic floor dysfunction in puerperal women, but patient compliance is low. Mobile Health (mHealth) is a promising solution. Objective: To investigate PFMT compliance and effects on pelvic floor muscles in GDM puerperal women guided by the mobile fitness app Keep. Methods: This randomized controlled trial included puerperal women with GDM (n = 72) who were delivered at a tertiary general hospital, selected from November 2021 to April 2022 using convenience sampling, and randomly divided into control (n = 36) and experimental (n = 36) groups. The control group performed PFMT based on routine postpartum PFMT training instruction. The experimental group performed PFMT based on Keep. Both groups had a 4-week intervention period. The PFMT compliance, International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Pelvic Muscle Self-efficacy Scale, and the Knowledge, Attitude, Belief, and Practice (KAP) scores of PFMT in puerperal women in the groups were compared pre- and post-intervention. Pelvic floor surface electromyographic biofeedback was used to compare the post-intervention pelvic floor muscle strength between the two groups. Results: Compared with the control group, the test group had higher post-intervention maternal PFMT compliance, pelvic floor muscle strength, pelvic floor muscle self-efficacy, and KAP scores (p < 0.05); incontinence scores were lower (p < 0.05). Pelvic floor muscles in both groups recovered better post-intervention (p < 0.05). Conclusion: The Keep app can improve PFMT adherence, urinary incontinence, KAP scores, self-efficacy, and pelvic floor muscle strength in GDM puerperal women and promote pelvic floor rehabilitation after delivery. [ABSTRACT FROM AUTHOR]

To compare the effectiveness of outpatient nutritional guidance supplemented by digital media with exclusively standard outpatient nutritional guidance in pregnant women with gestational diabetes mellitus (GDM). This was a randomized, patient-blinded clinical trial conducted at the Diabetes and Pregnancy outpatient clinic from February 2021 to January 2023. Pregnant women with GDM were randomly allocated into two groups: the control group received exclusively outpatient nutritional guidance, and the Intervention Group received outpatient nutritional guidance along with reminders via WhatsApp. Dietary intake (calories, carbohydrates, lipids, proteins, and fibers) was evaluated using 24 h dietary recalls. Glycemic control and the need for pharmacological treatment were also assessed. A total of 81 women were included, 34 allocated to the control group, and 47 to the intervention group. Patients were followed for a period of 4–8 weeks. Significant differences were observed in some points of glycemic control between the two groups over the follow-up period. There were no statistical differences in pharmacological therapy (p=0.498); 188 24 h dietary recall were conducted in the control group and 290 in the intervention group. A statistically significant increase in lipid intake was observed in the intervention group over the follow-up period compared to the control group (p<0.001). No changes in calorie intake, other macronutrients, or fiber consumption were noted. Glycemic control was significantly improved with the addition of frequent text reminders about dietary choices, and a significant increase in lipid intake was seen in all women, more so in the reminder group. [ABSTRACT FROM AUTHOR]

To compare the cord blood alarin levels of infants in different birth weight groups with those of infants born to mothers diagnosed with gestational diabetes mellitus (GDM) who were not subgrouped according to birth weight. This prospective study was conducted between September 2023 and January 2024. Healthy term babies whose families agreed to participate in the study were divided into four groups according to their birth weight (small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA)) and whether their mothers had GDM. There was a significant difference between the cord blood alarin levels of the AGA and SGA groups (p=0.014). There was also a significant difference between the cord blood alarin levels of the AGA and GDM groups (p=0.012). However, the cord blood alarin levels of the LGA group (whose mothers did not have GDM) were similar to those of the AGA group (p=0.394). We found evidence that alarin levels in umbilical cord blood are associated with low birth weight and GDM. [ABSTRACT FROM AUTHOR]

Aims: To investigate immunometabolic associations of CD4+ T cell phenotypes with gestational diabetes mellitus (GDM). Methods: A nested case-control study was conducted comprising 53 pairs of GDM patients and matched controls within a prospective cohort. Metabolomic signatures related to both CD4+ T cell phenotypes and glycemic traits among pregnant women were investigated by weighted gene co-expression network analysis (WGCNA). Multivariable-adjusted generalized linear models were used to explore the associations of CD4+ T cell phenotypes and selected metabolites with GDM. Mediation analysis was conducted to evaluate the mediating effect of selected metabolites on the relationship between CD4+ T cell phenotypes and glycemic traits. Results: Higher levels of Treg cells (OR per SD increment (95%CI): 0.57 (0.34, 0.95), p = 0.031) and increased expression of Foxp3 (OR per SD increment (95%CI): 0.59 (0.35, 0.97), p = 0.039) and GATA3 (OR per SD increment (95%CI): 0.42 (0.25, 0.72), p = 0.002) were correlated with a decreased risk of GDM. Plasma pyruvaldehyde, S-adenosylhomocysteine (SAH), bergapten, and 9-fluorenone mediated the association between Tregs and fasting plasma glucose (FPG), with mediation proportions of 46.9%, 39.6%, 52.4%, and 56.9%, respectively. Conclusions: Treg cells and Foxp3 expressions were inversely associated with GDM risk, with potential metabolic mechanisms involving metabolites such as pyruvaldehyde and SAH. [ABSTRACT FROM AUTHOR]

Aims: To monitor fetal size and identify predictors for birthweight in women with gestational diabetes (GDM) and normal glucose tolerance (NGT). Methods: Cohort study of 1843 women universally screened for GDM, with routine ultrasounds each trimester. Women with GDM and NGT were categorized in subgroups by birthweight centile. Results: Of the total cohort, 231 (12.5%) women were diagnosed with GDM. Fetal size, incidence of large-for-gestational age (LGA: 12.3% of GDM vs. 12.9% of NGT, p = 0.822) and small-for-gestational age (SGA) neonates (4.8% of GDM vs. 5.1% of NGT, p = 0.886) were similar between GDM and NGT. GDM women with LGA neonates were more insulin resistant at baseline and had more often estimated fetal weight (EFW) ≥ P90 on the 28–33 weeks ultrasound (p = 0.033) than those with AGA (appropriate-for-gestational age) neonates. Compared to NGT women with AGA neonates, those with LGA neonates were more often obese and multiparous, had higher fasting glycemia, a worse lipid profile, and higher insulin resistance between 24 -28 weeks, with more often excessive gestational weight gain. On the 28–33 weeks ultrasound, abdominal circumference ≥ P95 had a high positive predictive value for LGA neonates in GDM (100%), whereas, in both GDM and NGT, EFW ≥ P90 and ≤ P10 had a high negative predictive value for LGA and SGA neonates (> 88%), respectively. Conclusions: There were no differences in fetal size throughout pregnancy nor in LGA incidence between GDM and NGT women. EFW centile at 28–33 weeks correlated well with birthweight. This indicates that GDM treatment is effective and targeted ultrasound follow-up is useful. Trial registration ClinicalTrials.gov: NCT02036619. Registration date: January 15, 2014. https://clinicaltrials.gov/ct2/show/NCT02036619. [ABSTRACT FROM AUTHOR]

Aims: Women with gestational diabetes mellitus (GDM) have a high risk of developing type 2 diabetes (T2D). Readiness for behaviour change to mitigate this risk may be low after pregnancy and may further decrease over time without appropriate interventions. This study aimed to evaluate readiness for behaviour change in the first and second postpartum years in women with recent GDM to determine the best timing for lifestyle interventions to prevent T2D. Methods: This study included a subset of women with GDM between 2009 and 2013 in Ontario, Canada from a larger prospective cohort study who completed a survey in the first and second postpartum years (N = 329). The primary outcome was stage of readiness for behaviour change for diet and physical activity, compared between the first and second postpartum years. Results: The mean age was 34.3 ± 4.4 standard deviation (SD) years and mean pre‐pregnancy body‐mass index (BMI) was 26.7 ± 6.9 kg/m2. In the first postpartum year, 86% of women reported a pre‐action stage of change, which was 87% by the second postpartum year (p = 0.646). Non‐Caucasian ethnicity was associated with lower odds of being in the action stage of readiness for behaviour change overall and for physical activity in both time periods. Conclusions: Most postpartum women with recent GDM are in a pre‐action stage of change after delivery, which does not increase by the second postpartum year. Behavioural interventions should continue to be prioritized in postpartum women with GDM to optimize this slim window of opportunity for T2D prevention. [ABSTRACT FROM AUTHOR]

Gestational diabetes mellitus (GDM) is a common metabolic disorder in pregnancy and leads to serious harm to the mother and the fetus. A variety of lncRNAs play a key role in GDM. This meta-analysis was performed to explore the potential value of lncRNAs in GDM diagnosis. Articles correlated with lncRNA and GDM were screened from Embase, Medline, EBSCO, PubMed, Chinese National Knowledge Infrastructure, and WanFang databases. Summary receiver operator characteristic (SROC) was performed to evaluate the pooled area under curve (AUC). Forest plot was conducted to calculate the sensitivity, specificity, diagnostic likelihood ratio (LR), diagnostic score, and diagnostic odds ratio (DOR). Deeks' funnel plot was utilized to evaluate the publication bias. Eleven articles containing 12 tests (1060 GDM patients and 1066 controls) were included in this meta-analysis. AUC (0.89, 95%CI=0.86–0.92), sensitivity (0.84, 95%CI=0.80–0.87), and specificity (0.81, 95%CI=0.77–0.85)of the SROC curve showed a high diagnostic value of lncRNA for GDM. Positive LR (PLR 4.40, 95%CI=3.45–5.60) and negative LR (NLR 0.20, 95%CI=0.15–0.26) results indicated that the diagnosis of lncRNA for GDM had low clinical utility. Diagnostic score (3.09, 95%CI=2.62–3.57) and DOR (22.04, 95%CI=13.68–35.51) results suggested lncRNAs have good discriminative effect on GDM. Heterogeneity was significantly higher, but not induced by the subgroups. LncRNAs had high diagnostic value and good discriminative effect for GDM, but the clinical utility was not high. This meta-analysis study offers a potential target for GDM diagnosis. [ABSTRACT FROM AUTHOR]

Objective To investigate the expression and clinical significance of miR-483-3p in patients with gestational diabetes mellitus (GDM). Methods A total of 100 GDM patients with 24-32 weeks of gestation who underwent routine obstetric examination in Anqiu People′s Hospital were selected as the normal glucose tolerance (NGT) group, and a total of 98 healthy pregnant women of the same age of 24-32 gestational weeks were selected as the NGT group. The expression level of miR-483-3p was detected by RT-qPCR, the diagnostic value of miR-483-3p in GDM was analyzed by receiver operating characteristic (ROC) curve, the correlation between the expression levels of miR-483-3p and clinical indicators in the GDM group was analyzed by chi-square test, and the risk factors of GDM were analyzed by Logistic regression. Dual luciferase reporter gene assay was used to verify the targeting relationship between miR-483-3p and autophagy-related protein 7(ATG7). CCK8, flow cytometry and Transwell assays were used to detect the proliferation, apoptosis, and migration and invasion ability of cells, respectively. Results The expression level of miR-483-3p in the serum of patients in the GDM group was significantly higher than that in the NGT group. The expression of miR-483-3p had diagnostic value for GDM. Pre-pregnancy BMI, FBG, FINS, HOMA-IR and TG were significantly correlated with serum miR-483-3p expression. In addition, BMI and TG before pregnancy were risk factors leading to GDM. miR-483-3p regulated HG-treated HTR-8/SVneo cell proliferation, apoptosis, migration and invasion by targeting at ATG7. Conclusions miR-483-3p is involved in the disease progression of GDM and is a potential biomarker of GDM diagnosis. [ABSTRACT FROM AUTHOR]

Aims/Introduction: The relationship between economic disadvantages and the risk of developing gestational diabetes mellitus (GDM), as well as its impact on birth outcomes, remains uncertain. Materials and Methods: From the Taiwan Maternal and Child Health Database, we identified 984,712 pregnant women between 1 January 2007 and 31 December 2018. Using propensity score matching, we selected 5,068 pairs of women across four income levels: very low, low, middle and high. We used a multivariable Cox regression model to assess the risk of GDM in these pregnant women and analyzed the birth outcomes. Results: The mean age of the pregnant women was 30.89 years. We found no significant difference in GDM risk among pregnant women with different family income. However, newborns of women with GDM and very low‐income were at higher risk for several adverse conditions, such as small for gestational age (adjusted odds ratio (aOR) 1.17, 95% confidence interval (CI) 1.04–1.31), large for gestational age (aOR 1.27, 95% CI 1.08–1.51), hypoxic–ischemic encephalopathy (aOR 3.19, 95% CI 1.15–8.86), respiratory distress (aOR 1.58, 95% CI 1.14–2. 19), congenital anomalies (aOR 1.32, 95% CI 1.08–1.62), jaundice requiring phototherapy or exchange transfusion (aOR 1.14, 95% CI 1.05–1.24) and so on. Conclusions: This study found that low family income alone was not associated with GDM development. However, for a GDM pregnancy, pregnant women with lower income had worse birth outcomes. Improving maternal health and nutrition among low‐income pregnant women with GDM might be critical to improving birth outcomes. [ABSTRACT FROM AUTHOR]

Objective: To investigate the correlation between maternal glucose and lipid metabolism indicators, triglyceride-glucose (TyG) index, and macrosomia in gestational diabetes mellitus (GDM) during the second and third trimesters of pregnancy. Methods: Based on a GDM cohort, pregnant women who underwent cesarean section delivery at the Nanjing Maternity and Child Health Hospital from January to August 2022 were selected according to strict inclusion and exclusion criteria. Participants were divided into three groups based on GDM status and newborn birth weight: normal control group (NC, n=23), GDM non-macrosomia group (GDM-N, n= 23), and GDM macrosomia group (GDM-M, n=23). General information and glucose and lipid metabolism indicators from the second and third trimesters were collected for all three groups. The TyG index and the homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. Spearman correlation analysis and linear regression models were used to analyze the correlation between maternal indicators in the second and third trimesters and GDM macrosomia. Results: In the second trimester, the GDM - M group showed elevated levels of fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), and TyG index, while direct bilirubin (DBIL) and creatinine (Cr) levels were decreased. The 1 h and 2 h postprandial glucose levels were higher than the NC group but lower than the GDM-N group (P < 0.05). In the third trimester, C-peptide (CP), triglycerides (TG), HbA1c, and TyG index were increased, and alanine aminotransferase (ALT) was higher than the NC group but lower than the GDM - N group (P < 0.05). Spearman correlation analysis indicated that neonatal birth weight was positively correlated with maternal FPG and HbA1c in the second trimester, and with CP, HbA1c, TG, and TyG in the third trimester (P < 0.05). Negative correlations were observed with DBIL and Cr in the second trimester (P < 0.05). Multiple linear regression analysis revealed that maternal FPG, HbA1c, and DBIL in the second trimester, and HbA1c, TG, and TyG index in the third trimester were significant factors influencing macrosomia (P < 0.05). Conclusion: Maternal glucose and lipid metabolism indicators and TyG index in the second and third trimesters are closely associated with the occurrence of macrosomia in GDM. HbA1c, FPG, TG, and TyG can serve as important monitoring and assessment indicators for the occurrence of macrosomia in GDM pregnancies. [ABSTRACT FROM AUTHOR]

Aims: This study aims to determine whether postpartum body mass index (BMI) trajectories and its time in target range (TTR) are associated with long‐term type 2 diabetes risk in women with a history of gestational diabetes mellitus (GDM). Materials and Methods: The present study included 1057 women with a history of GDM who participated in the Tianjin Gestational Diabetes Mellitus Prevention Program (TGDMPP). Oral glucose tolerance tests or physician‐diagnosed information were used to diagnose type 2 diabetes after a median follow‐up period of 8.47 years. Latent class modelling was applied to identify trajectories of BMI after delivery. TTR was defined as the proportion of time that BMI was within the standard range (18.5 ≤ BMI < 24.0 kg/m2). The associations of BMI trajectories and TTR with type 2 diabetes risk were analysed using multivariable Cox modelling. Results: Five distinct trajectories of postpartum BMI were identified. Compared with low‐stable class, the multivariable‐adjusted hazard ratios of type 2 diabetes were 2.02 (95% confidence interval 0.99–4.10) for median‐stable class, 3.01 (1.17–7.73) for high‐stable class, 2.15 (0.63–7.38) for U‐shape class and 7.15 (2.08–24.5) for inverse U‐shape class (p for trend = 0.012), respectively. Multivariable‐adjusted hazard ratios of type 2 diabetes associated with postpartum BMI TTR of 100%, >43.4%–<100%, >0%–≤43.4% and 0% were 1.00, 1.84 (0.72–4.73), 2.75 (1.23–6.15) and 2.31 (1.05–5.08) (p for trend = 0.039), respectively. Conclusions: Postpartum BMI trajectories of high‐stable and inverse U‐shape class as well as lower TTR were associated with an increased risk of type 2 diabetes among women with a history of GDM. Reducing BMI to a normal range in the early postpartum period and maintaining stable over time could attenuate the development of long‐term type 2 diabetes. [ABSTRACT FROM AUTHOR]

Objective: This retrospective cohort study aimed to investigate the effects of parity on gestational weight gain (GWG) and its association with maternal and neonatal outcomes in women with gestational diabetes mellitus (GDM). Methods: This retrospective cohort study data from 2,909 pregnant women with GDM who delivered between 2021 and 2023 at Fujian Maternity and Child Health hospital, were analyzed. Participants were categorized into nulliparous (no previous births), primiparous (one previous birth), and multiparous (two or more previous births) groups. Women aged 18–45 years with singleton pregnancies were included, while those with multiple pregnancies, pre-existing diabetes, hypertension, thyroid disorders, or incomplete BMI data were excluded. Data extracted from hospital records included demographic information, BMI, GWG at various gestational stages, and pregnancy outcomes. Statistical analysis involved logistic regression models, adjusting for confounders such as maternal age, BMI, and gestational age at delivery. P-values < 0.05 were considered significant. Results: Primiparous and multiparous women exhibited significantly higher GWG than nulliparous women (p < 0.01). Primiparous women had reduced risks of pregnancy-induced hypertension (adjusted OR, 0.64; 95% CI, 0.45–0.92) and premature rupture of membranes (adjusted OR, 0.58; 95% CI, 0.48–0.70). Both primiparous and multiparous women had lower risks of delivering large-for-gestational-age newborns or those with neonatal jaundice. Conclusion: Parity significantly influences GWG and maternal/neonatal outcomes in GDM pregnancies, highlighting the need for parity-specific guidelines. [ABSTRACT FROM AUTHOR]

Background & Objective: The specific influence of the pre-pregnancy body mass index (PPBMI) on women with gestational diabetes mellitus (GDM) is unclear. Our objective was to investigate how PPBMI categories affect pregnancy and neonatal outcomes in women with GDM. Methods: A retrospective cohort study was conducted using data from patients attending the Fujian Maternity and Child Health Hospital (Fuzhou, China) from 2021 to 2023. The participant records were stratified into four groups according to their BMI values: underweight, normal-weight, overweight, and obese. The pregnancy and neonatal outcomes for these BMI categories were analyzed using multivariable logistic regression. Results: The study included data from 2,909 pregnant women diagnosed with GDM. Underweight women with GDM showed significantly lower risks of pregnancy-induced hypertension (PIH) (adjusted OR, 0.26) and cesarean sections (adjusted OR, 0.55) but higher risks of low body weight (LBW) infants (adjusted OR, 3.40). Overweight and obese women experienced higher risks of PIH (adjusted OR, 2.96), cesarean sections (adjusted OR, 1.62), and macrosomia (adjusted OR, 1.43). Conclusion: PPBMIs significantly impact pregnancy outcomes in women with GDM. Both underweight and overweight/ obese categories are associated with adverse outcomes, highlighting the need for pre-pregnancy counseling and interventions to achieve and maintain a healthy BMI. [ABSTRACT FROM AUTHOR]

Aims/Background Gestational diabetes mellitus (GDM) is a common complication during pregnancy. This retrospective study investigates the correlation between umbilical blood flow index and maternal-fetal outcomes in pregnant women with GDM, aiming to contribute to evidence-based risk assessment and management strategy in this high-risk obstetric population. Methods This retrospective study recruited 119 pregnant women with GDM who were admitted to the Yichang Central People's Hospital, between January 2022 and January 2024. Based on the umbilical blood flow index, the study participants were divided into a normal umbilical blood flow (UBF) index group (n = 56) and a high UBF index group (n = 63). Colour Doppler ultrasound was used to assess umbilical blood flow, and relevant data on maternal, fetal, and neonatal outcomes were obtained from the hospital's electronic medical records. Results We observed that, compared to the normal UBF index group, the high UBF index group exhibited significantly higher rates of adverse pregnancy outcomes, including the cesarean section (p = 0.022), preterm delivery (p = 0.020), gestational hypertension (p = 0.019), neonatal hypoglycemia (p = 0.015), as well as increased incidence of neonatal complications such as respiratory distress syndrome (p = 0.009), neonatal jaundice (p = 0.022), neonatal intensive care unit (NICU) admission (p = 0.015), lower 5-minute Apgar scores (p = 0.013), and neonatal sepsis (p = 0.005). Furthermore, significant differences were observed in fetal biometric parameters and placental morphology between the two groups (fetal weight: p = 0.003; estimated fetal weight percentile: p = 0.017; femur length: p = 0.018; placental weight: p = 0.019; placental volume: p = 0.021). Additionally, correlation analyses indicated significant associations between umbilical blood flow index and maternal and fetal outcomes (p < 0.05). Conclusion We observed a significant correlation between umbilical blood flow indices and maternal and fetal outcomes in pregnant women with gestational diabetes mellitus, implying its utility as a non-invasive parameter for risk stratification and personalized management in this high-risk obstetric population. [ABSTRACT FROM AUTHOR]

Background/Objectives: Limited evidence links maternal macronutrient intake to gestational diabetes mellitus (GDM) risk. Therefore, we evaluated these intakes both before and during pregnancy, comparing macronutrient data against the European Food and Safety Authorities' (EFSA) Dietary Reference Values (DRVs). Methods: Data were prospectively collected from the Greek BORN2020 epidemiologic pregnant cohort, which included 797 pregnant women, of whom 14.7% were diagnosed with GDM. A multinomial logistic regression model assessed the association between macronutrient intake and GDM, adjusting for maternal, lifestyle, and pregnancy-related factors. Results: Women with GDM had higher maternal age (34.15 ± 4.48 vs. 32.1 ± 4.89 years), higher pre-pregnancy BMI (median 23.7 vs. 22.7 kg/m2), and were more likely to smoke during mid-gestation (17.95% vs. 8.82%). Pre-pregnancy energy intake exceeding EFSA recommendations was associated with increased GDM risk (aOR = 1.99, 95%CI: 1.37–2.86). During mid-gestation, higher dietary fiber intake (aOR = 1.05, 95%CI: 1.00–1.10), higher protein intake (aOR = 1.02, 95% CI: 1.00–1.04), and higher protein percentage of energy intake (aOR = 1.08, 95%CI: 1.01–1.17) were all significantly associated with increased GDM risk. Changes from pre-pregnancy to pregnancy showed significant increases in dietary fiber intake (aOR = 1.07, 95%CI: 1.04–1.10), protein (aOR = 1.00, 95%CI: 1.00–1.01), fat (aOR = 1.00, 95%CI: 1.00–1.01), vegetable protein (aOR = 1.01, 95%CI: 1.00–1.03), animal protein (aOR = 1.00, 95%CI: 1.00–1.01), and monounsaturated fatty acid (MUFA) intake (aOR = 1.01, 95%CI: 1.00–1.02), all of which were associated with increased GDM risk. Conclusions: Energy intake above upper levels set by EFSA, as well as increased protein, MUFA, and fiber intake, although beneficial in balanced intakes, may negatively affect gestation by increasing GDM likelihood when consumed beyond requirements. [ABSTRACT FROM AUTHOR]

Background/Objectives: Studies have shown that chronobiological factors may adversely affect glycemic control in patients with type 2 diabetes mellitus. We assessed the association of chronobiological factors with glycemic control and neonatal birth weight in women with GDM. Methods: A prospective cohort study included 208 women aged 18–45 years with a singleton pregnancy who were randomly selected from among women undergoing follow-up for GDM at the Maternal-Fetal Medicine Unit of a tertiary medical center. Nutrition, sleep, and lifestyle patterns were assessed from onset of GDM until birth along with glycemic control and birth outcomes. Results: Multivariate analyses on a cohort of 208 women revealed that suboptimal glycemic control was associated with a late breakfast (RR = 2.26; 95% CI 1.09–4.67), increased carbohydrate intake in the evening (RR = 1.19; 95% CI 1.003–1.42), and poor sleep quality (RR = 2.14; 95% CI 1.04–4.41). The adjusted relative risk for neonatal birth weight above the 85th percentile was associated with increased carbohydrate intake in the morning (RR = 1.70; 95% CI 1.30–2.23) and increased carbohydrate intake in the evening (RR = 1.39; 95% CI 1.16–1.67). Conclusions: Chronobiological factors are associated with suboptimal glycemic control and birth weight above the 85th percentile in women with GDM. The study was registered under ClinicalTrials.gov.org, identifier: NCT02916667. [ABSTRACT FROM AUTHOR]

Introduction: Metformin has been part of treatment algorithms for type 2 diabetes mellitus (T2DM) for decades. While it has formal approval in the U.S.A. for treatment of T2DM, it is used off-label in gestational diabetes mellitus (GDM), polycystic ovarian syndrome (PCOS), and ovarian hyperstimulation prevention. Its role as an insulin sensitizer has made it an attractive therapeutic to address the insulin resistance seen in these syndromes. In 2022, the European Union approved metformin as the only oral antidiabetic medication for diabetes in pregnancy. While its safety and benefits for the mother are well documented, it does cross the placenta with plasma concentrations comparable between mother and child at delivery. Areas covered: This special report will focus on major randomized control trials investigating metformin use in pregnancies impacted by PCOS, GDM, T2DM, and obesity and their offspring follow-up trials. Expert Opinion: For the mother, metformin can be beneficial, with reduction in insulin therapeutic burden, weight gain, hypoglycemia and in certain situations, pre-eclampsia. For the neonate, benefits may include reduction in hypoglycemia and no increased risk of congenital anomalies. It is the long-term data in the offspring that remains unknown with some areas of concerns (SGA, altered anthropometrics) requiring continued research. [ABSTRACT FROM AUTHOR]

Objectives: Gestational diabetes mellitus (GDM) is the first type of diabetes induced by abnormal maternal glucose metabolism after pregnancy. Long non-coding RNA (lncRNA) has been found to be of great value in the study of its pathogenesis and treatment. This study aimed to explore the expression and diagnostic value of lncRNA HCG18 in GDM. Material and methods: The expression levels of HCG18 in serum of participating GDM patients and healthy controls were detected by polymerase chain reaction (RT-qPCR). The correlation between the expression of HCG18 and the blood glucose level was clarified by the detection of blood glucose levels in GDM patients. The receiver operating characteristic curve (ROC) was used to evaluate the clinical diagnostic value of HCG18 for GDM. Furthermore, multivariate logistic analysis was used to verify the diagnostic value of HCG18 in GDM. Results: This study concluded that the expression level of HCG18 was upregulated in the serum of GDM patients compared with the control group. ROC curve showed that the AUC was 0.916, the sensitivity was 80.5%, the specificity was 90.2%, and multivariate logistic regression analysis verified that HCG18 (OR = 6.984, 95% CI = 3.751–13.005, p < 0.001) was significantly associated with GDM, which suggesting that HCG18 has diagnostic significance for GDM. In addition, the expression of HCG18 was positively correlated with fasting blood glucose, 1h blood glucose and 2 h blood glucose of patients. Conclusions: LncRNA HCG18 was elevated in patient serum and might serve as a diagnostic biomarker for GDM. [ABSTRACT FROM AUTHOR]

Background & Objective: In diabetic pregnancies, maternal hyperglycemia can lead to complications affecting both the mother and fetus. Understanding the associations between maternal characteristics and Doppler ultrasound findings is crucial for managing these pregnancies. This study aims to explore these associations in diabetic pregnancies with appropriate-for-gestational-age (AGA) fetuses, focusing on how maternal factors influence Doppler ultrasound results. Materials & Methods: This descriptive cross-sectional study evaluated Doppler ultrasound findings of uterine, umbilical, and middle cerebral arteries in diabetic mothers with AGA fetuses at Imam Khomeini Hospital, Ahvaz from 2018 to 2022. Data was collected from medical records of the patients. Doppler assessments included blood flow velocity waveforms and pulsatility index calculations. The Chi-square test or Fisher's exact test was used to assess the relation between maternal characteristics and Doppler ultrasound findings. Results: The study found that most diabetic mothers with AGA fetuses were over 35 years old, with a high prevalence of obesity. Most Doppler assessments showed normal blood flow patterns, with 97.59% normal in the umbilical artery, 81.90% in the uterine artery, and 93.28% in the middle cerebral artery. Preeclampsia was present in 10% of participants and was significantly associated with abnormal Doppler findings in the umbilical, uterine, and middle cerebral arteries (P<0.05). The Abnormal uterine artery Doppler results were linked to higher maternal age and BMI, while abnormal middle cerebral artery results were associated with poor blood sugar control (P<0.05) and maternal age. Conclusion: Our study showed that maternal characteristics such as preeclampsia, age, BMI, and blood sugar control significantly influence Doppler ultrasound findings in diabetic pregnancies with AGA fetuses. [ABSTRACT FROM AUTHOR]

The Lingguizhugan decoction (LGZGD) is a promising traditional Chinese medicine for the treatment of gestational diabetes mellitus (GDM). However, its bioactive compounds and therapeutic mechanisms remain unknown. The main chemical composition of LGZGD was analyzed by high‐performance liquid chromatography–mass spectrometry (HPLC–MS). Furthermore, the underlying mechanisms of LGZGD against GDM were elucidated through network pharmacology and molecular docking. The therapeutic efficacy and targets of LGZGD were further confirmed via an in vitro GDM model (high glucose [HG]‐treated HTR‐8/SVneo cells). Four compounds of LGZGD, namely, cinnamaldehyde, glycyrrhizic acid, 2‐atractylenolide, and pachymic acid, were detected. A total of 26 targets for LGZGD treating GDM were obtained, which were mainly involved in oxidative stress and the PI3K–AKT signaling pathway. The protein–protein interaction (PPI) network unveiled that AKT1, TLR4, TP53, and NOS3 were hub therapeutic targets. Molecular docking showed that these targets had strong affinity with key compounds. In vitro experiments confirmed that LGZGD treatment promoted HG‐induced cell viability, migration, and invasion ability while inhibited the apoptosis rate and oxidative stress. Mechanically, western blot revealed that LGZGD may protect HG‐treated cells by activating the PI3K–AKT pathway and suppressing TLR4 expression. Our study preliminarily explored the mechanism of LGZGD in GDM treatment, providing a scientific basis for the clinical application of LGZGD. [ABSTRACT FROM AUTHOR]

Aims/hypothesis: We aimed to determine whether a history of gestational diabetes mellitus (GDM) is associated with cognitive function in midlife. Methods: We conducted a secondary data analysis of the prospective Nurses' Health Study II. From 1989 to 2001, and then in 2009, participants reported their history of GDM. A subset participated in a cognition sub-study in 2014–2019 (wave 1) or 2018–2022 (wave 2). We included 15,906 parous participants (≥1 birth at ≥18 years) who completed a cognitive assessment and were free of CVD, cancer and diabetes before their first birth. The primary exposure was a history of GDM. Additionally, we studied exposure to GDM and subsequent type 2 diabetes mellitus (neither GDM nor type 2 diabetes, GDM only, type 2 diabetes only or GDM followed by type 2 diabetes) and conducted mediation analysis by type 2 diabetes. The outcomes were composite z scores measuring psychomotor speed/attention, learning/working memory and global cognition obtained with the Cogstate brief battery. Mean differences (β and 95% CI) in cognitive function by GDM were estimated using linear regression. Results: The 15,906 participants were a mean of 62.0 years (SD 4.9) at cognitive assessment, and 4.7% (n=749) had a history of GDM. In models adjusted for age at cognitive assessment, race and ethnicity, education, wave of enrolment in the cognition sub-study, socioeconomic status and pre-pregnancy characteristics, women with a history of GDM had lower performance in psychomotor speed/attention (β −0.08; 95% CI −0.14, −0.01) and global cognition (β −0.06; 95% CI −0.11, −0.01) than those without a history of GDM. The lower cognitive performance in women with GDM was only partially explained by the development of type 2 diabetes. Conclusions/interpretation: Women with a history of GDM had poorer cognition than those without GDM. If replicated, our findings support future research on early risk modification strategies for women with a history of GDM as a potential avenue to decrease their risk of cognitive impairment. [ABSTRACT FROM AUTHOR]

Abstract During antenatal care, gestational diabetes mellitus (GDM) screening is crucial for early diagnosis and treatment to ameliorate clinical outcomes and limit health care expenses. Dietary management and physical activity are central to GDM treatment, however, adherence is often influenced by personal preferences, socioeconomic barriers, and psychological stress. Pharmacologically, insulin and oral hypoglycemic medications, are the main GDM treatment that can be subject to patients' resistance due to fears of needles and side effects. Metformin is increasingly preferred for its ease of administration and lower cost. In the postpartum stage, regular screening for type 2 diabetes mellitus (T2DM) should always be considered despite the possible limitations that could arise, including communication gaps, lack of long‐term focus, and personal barriers. Overall, women with GDM prefer personalized, flexible management plans that consider their lifestyle, support from health care professionals (HCPs), and family involvement. Addressing psychological and socioeconomic barriers through education, counseling, and support networks is crucial for improving adherence and health outcomes. Enhancing patient‐centered care and shared decision‐making can empower women with GDM to manage their condition effectively and maintain lifestyle changes postpartum. Therefore, this review aimed to assess pregnant women's preferences in GDM management, focusing on screening, dietary recommendations, physical activity, and treatment. Additionally, this review examined GDM care in terms of these patients' quality of life and postpartum experiences.

Meng Zhou,&ast; Yapei Feng,&ast; Chunxia Zhang, Xiangwen Tian, Mingde Li, Yujie Zheng Department of Obstetrics and Gynecology, Shengli Oilfield Central Hospital, Dongying, Shandong, 257000, China&ast;These authors contributed equally to this workCorrespondence: Yujie Zheng, Email youjie0897666@163.comObjective: To investigate the significance and relationship of glucose and lipid metabolism, placental resistin, and human lipid carrier protein (LCN— 2) expression in pregnant women with gestational diabetes mellitus (GDM) complicated by severe preeclampsia (SPE).Methods: A total of 89 patients with GDM and SPE (G+S group) and 89 patients with GDM alone (GDM group) were included. Blood samples were collected to measure glucose and lipid metabolism indicators [fasting blood glucose (FBG), fasting insulin (FINS), glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglycerides (TG), HDL-C, and LDL-C], and immunohistochemistry was used to assess placental resistin and LCN— 2 levels. Delivery conditions and adverse maternal and neonatal outcomes were compared. Pearson correlation analysis was conducted to explore the relationship between placental resistin, LCN— 2, and glucose and lipid metabolism indicators.Results: FBG, FINS, HbA1c, TC, and TG levels were higher, and HDL-C was lower in the G+S group compared to the GDM group (P< 0.05). The positive expression rates of resistin and LCN— 2 in placental tissue were also higher in the G+S group (P< 0.05). The G+S group had lower gestational weeks, neonatal birth weight, and higher postpartum hemorrhage than the GDM group (P< 0.05). The G+S group showed higher rates of adverse maternal outcomes (postpartum hemorrhage, intrauterine infection) and neonatal outcomes (preterm birth, fetal distress) (P< 0.05). Pearson analysis showed that placental resistin and LCN— 2 expression were positively correlated with FBG, FINS, TC, and TG, and negatively correlated with HDL-C (P< 0.05).Conclusion: Pregnant women with GDM and SPE have higher risks of glucose and lipid metabolism disorders, placental resistin and LCN— 2 expression, and adverse maternal and neonatal outcomes compared to GDM patients. Resistin and LCN— 2 may influence glucose and lipid metabolism, affecting pregnancy outcomes.Keywords: gestational diabetes mellitus, severe preeclampsia, placental resistin, human lipid carrier protein, correlation

Abstract Background This study investigates the association of blood cell components and blood cell-derived inflammatory indices in early pregnancy with the development of gestational diabetes mellitus (GDM). Methods This research is part of the Qazvin maternal and neonatal metabolic study (QMNMS) conducted in Iran from 2018 to 2021. Pregnant women with gestational age ≤ 14 weeks were enrolled in the study. The association of blood cells and inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), systemic inflammatory response index (SIRI), systemic immune inflammation index (SII), and aggregate systemic inflammatory response index (AISI), in early pregnancy with subsequent GDM development was examined using multivariate logistic regression. This analysis was adjusted for age, pre-pregnancy body mass index (BMI), weight gain, and GDM history in previous pregnancies (Model 1), as well as for these factors in addition to the homeostatic model assessment for insulin resistance (HOMA-IR) (Model 2). The correlation of blood cells and inflammatory indices with insulin resistance was assessed through Spearman partial correlation, adjusted for the same risk factors. Results The final analysis included 612 participants, among whom GDM developed in 96 participants (15.7%). Neutrophil, platelet, and lymphocyte counts showed significant correlations with HOMA-IR (r = 0.14, r = 0.22, and r = 0.17, respectively; P

Introduction: Gestational diabetes mellitus (GDM) is a condition of glucose intolerance during pregnancy, with potential adverse effects on both maternal and neonatal outcomes. Detecting and treating GDM early is crucial to prevent complications. Various diagnostic criteria and methods, such as the Diabetes in Pregnancy Study Group of India (DIPSI) criteria, IADPSG (International Association of the Diabetes and Pregnancy Study Groups) have been debated for GDM screening. This study is aimed to compare the DIPSI and IADSP criteria which is widely used in India with the World Health Organization (WHO) criteria and assess their diagnostic accuracy. Methods: A cross-sectional study involving 100 antenatal mothers was conducted in a tertiary care hospital. Sociodemographic data, risk assessments, gestational age, and clinical measurements (height, weight) were collected. Participants underwent both OGTT (using WHO criteria) and DIPSI tests. The blood sugar values were classified, and diagnostic accuracy was measured using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The correlation between the two methods was also examined. Results: The study demonstrated a lower sensitivity, and a high specificity compared to OGTT (WHO criteria). A new cutoff of 120 mg/dl for DIPSI was obtained by ROC curve analysis for our study which had a specificity and sensitivity of 78.02% and 77.78% respectively. The correlation between OGTT fasting/postprandial and DIPSI measurements was weak. Conclusion: The study assessed the diagnostic accuracy of the DIPSI method compared to the OGTT, particularly in resource-constrained settings like India. Given the DIPSI method's observed low sensitivity, relying solely on it for GDM diagnosis is ill-advised. Failure to identify true positive cases could have significant clinical implications, impacting maternal and neonatal outcomes and overburdening healthcare systems. Further research with larger and diverse populations is needed to establish more accurate diagnostic thresholds for GDM using the DIPSI method or alternative criteria.

BACKGROUND: The level of glycemia at different points of the glucose tolerance test measure different phases of insulin secretion, accordingly the groups of pregnant women with GDM diagnosed at different points of the test have differences.AIM: to evaluate the impact of oral glucose tolerance test results for frequency of insulin treatment, incidence of preeclampsia and pregnancy outcomes in women with GDM.MATERIALS AND METHODS: Retrospective analysis of 200 maternal medical cards and hospital cards of birth in women with GDM for the period 2021–2022. The patients were divided into two groups according the results of OGTT: 1st group — 102 pregnant women with fasting hyperglycemia, 2nd group — 98 pregnant women with hyperglycemia in 1 and 2 hours after glucose intake. Differences in age, body weight, BMI, weight gain during pregnancy, therapy of GDM were studied, and the incidence of preeclampsia and pregnancy outcomes were assessed in both groups.RESULTS: women of the 1st group had significantly higher weight and initial BMI. Pregnant women of both groups with a BMI over 25 kg/m2 more often required insulin treatment. The incidence of preeclampsia, newborn weight and the incidence of macrosomia were higher in 1st group.CONCLUSION: Fasting hyperglycemia in OGTT is associated with overweight and obesity, and these women are more likely to require insulin therapy. Women with GDM diagnosed by fasting hyperglycemia are at grate risk of developing preeclampsia and macrosomia.

Abstract Background Gestational Diabetes Mellitus (GDM) prevalence is rising worldwide, but optimal dietary strategies remain unclear. The eMOM pilot RCT compared a plant-protein rich Healthy Nordic Diet (HND) and a moderately carbohydrate restricted diet (MCRD) and their potential effects on time in glucose target range (≤ 7.8 mmol/L, %TIR), and on newborn body composition. Methods Forty-two participants were randomized to either HND (n = 20) or MCRD (n = 22) face-to-face nutritional counseling from gestational weeks (GW) 24 + 0—28 + 6 (baseline) until delivery. The HND intervention had no restriction in carbohydrate intake and emphasized plant-based protein sources and Nordic food, while the MCRD had a moderate carbohydrate restriction (~ 40% in proportion to total daily energy consumption, E%). Continuous glucose monitoring was worn for 14 days to assess glucose levels and %TIR. Blood samples for glucose and lipid metabolism and 3-day food diaries were collected at baseline and at GW 34 + 0—35 + 6. Neonatal body composition was measured by air displacement plethysmography. Difference between groups were analysed with t-test and Wilcoxon test. Results Thirty-two women completed the study. Both groups maintained the %TIR during majority of the time (98.9 and 99.3% for MCRD and HND respectively, p = 0.921) in GW 34 + 0 – 35 + 6. The mean glucose was lower in the MCRD group compared to the HND group (5.0 SD 1.03 vs. 5.2 SD 0.96 mmol/l, p

According to international research data, COVID-19 increases the risk of developing hypertensive and metabolic disorders. Aim of the study was to assess the risks of hypertensive and metabolic disorders in pregnant women with COVID-19 and to identify potential markers of these conditions. Material and methods. The study involved 265 pregnant women, infected in the first, second, and third trimesters of pregnancy, and uninfected with COVID-19, from 2020 to 2022. Spectrophotometric methods were used to evaluate blood level of glucose, total cholesterol, high- and low-density lipoprotein (LDL), and triglycerides. ELISA was used to measure content of oxidized LDL and apolipoprotein B (apo B). Results. Gestational arterial hypertension (GAH) developed more frequently in women with COVID-19 infected in the second trimester compared to those infected in the third trimester (15.7 and 6.1 % cases, respectively, p = 0.044). Gestational diabetes mellitus (GDM) was more commonly diagnosed in pregnant women with COVID-19 than in those uninfected (17.2 and 4.0 % cases, respectively, p = 0.015), particularly in those infected in the second and third trimesters (17.6 and 18.9 %, respectively). Pregnant women with COVID-19 showed an increase in glucose levels by 1.14 times (p = 0.001), oxidized LDL by 1.24 times (p = 0.042), and apo B protein by 1.14 times (p = 0.025) in blood serum. Conclusions. Infection with COVID-19 in the second trimester of pregnancy increases the risk of GAH by 2.56 times, and in the second and third trimesters, the risk of GDM by 4.3 times. Increase of glucose, oxidized LDL, and apo B content in blood serum may have prognostic significance in the development of hypertensive disorders.

Abstract Innate lymphoid cells (ILCs) are a newly discovered subset of immune cells that are responsible for regulation of the immune microenvironment. In particular, the ILC categories ILC2s and regulatory ILCs (ILCregs) are associated with immunosuppression and chronic inflammation. Chronic low-grade inflammation leads to insulin resistance, a major etiological factor in gestational diabetes mellitus (GDM). However, the influence of ILCs on GDM remains poorly understood. Therefore, this study aims to investigate the potential role of ILCs in the development and progression of GDM. This study included 19 patients diagnosed with GDM and 19 age- and body mass index-matched individuals in the control group. Flow cytometry was employed to assess the frequency and function of ILC subsets in peripheral blood (PB), cord blood (CB), and placental tissues. Additionally, ELISA was utilized to measure the levels of the cytokines TNF-α, IFN-γ, TGF-β, and IL-4/10/13/22 in the serum samples of patients. Compared to the control group with normal pregnancy, significantly elevated levels of ILC2s, Arg1+ILC2s, and ILCregs were detected in the PB, CB, and placental tissues of the GDM group. With regard to inflammation-related cytokines, the levels of IL-13/22 in PB serum were significantly elevated, while the TGF-β levels were significantly reduced in the GDM group compared to the control group (CG). Further, in the CB serum samples, IL-13 levels were elevated in the GDM group. Additionally, a negative correlation was observed between the number of ILC3s and the number of ILCregs present in umbilical cord blood, while the IL-13 level in peripheral blood was negatively correlated with the number of ILC3s. The present findings indicate that chronic low-grade inflammation mediated by Arg-1+ILC2s and ILCregs is closely associated with the pathogenesis of GDM.

Abstract Background Triglyceride-glucose (TyG) index was suggested as a possible surrogate for insulin resistance and a predictor for cardiovascular diseases and diabetes in the non-pregnant population. However, the relationship between TyG index in early pregnancy and adverse pregnancy outcomes (APOs), and the contribution of pre-pregnancy body mass index (BMI) was still illusive. Methods A large retrospective cohort study involving 67,936 pregnant Chinese women between 2017 and 2022 was conducted. Data collection and laboratory tests were performed during the usual patient care. TyG index was calculated using ln [fasting plasma triglyceride (TG; mmol/L) × 88.5 × glucose (FPG; mmol/L) × 18.02/2]. Multivariable logistic regression models were applied to explore the relationship between TyG index and APOs. Interaction and stratification analyses were performed to assess the influence of pre-pregnancy BMI on the association. In addition, ROC curves were used to evaluate the potential predictive value of the TyG index and pre-pregnancy BMI. Results Positive associations between maternal early pregnancy TyG index and APOs, including gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), large for gestational age (LGA) and preterm birth (PTB) were demonstrated (all P

BACKGROUND: Although gestational diabetes mellitus and delivering high-birthweight infants are known to predict a higher risk of future type 2 diabetes mellitus, the association of hypertensive disorders of pregnancy and other adverse pregnancy outcomes with type 2 diabetes mellitus is not well established. OBJECTIVE: This study aimed to examine the associations between different types of adverse pregnancy outcomes and incident type 2 diabetes mellitus among postmenopausal women. STUDY DESIGN: The Womens Health Initiative, a nationwide cohort of postmenopausal women, collected self-reported history of adverse pregnancy outcomes, including gestational diabetes mellitus, hypertensive disorders of pregnancy, preterm birth, and delivering low- birthweight (4500 g) infants. Participants were followed up annually for self-reported incident type 2 diabetes mellitus treated with medication from baseline (1993-1998) to March 2021. This study used logistic regression to examine the associations of any and individual adverse pregnancy outcomes with diabetes mellitus. Stratified analyses were performed to assess effect modification by body mass index, race and ethnicity, education, parity, breastfeeding, and age at first birth. RESULTS: This analysis included 49,717 women without a history of diabetes mellitus at enrollment who had a least 1 pregnancy and responded to the questionnaire about adverse pregnancy outcomes. After adjusting for body mass index, demographic, lifestyle, and reproductive factors, gestational diabetes mellitus (odds ratio, 2.26; 95% confidence interval, 1.94-2.63), high birthweight (odds ratio, 1.30; 95% confidence interval, 1.18-1.44), and hypertensive disorders of pregnancy (odds ratio, 1.18; 95% confidence interval, 1.08-1.30) were independently associated with higher odds of type 2 diabetes mellitus, whereas preterm birth and low birthweight were not associated with diabetes mellitus risk. A history of ≥2 adverse pregnancy outcomes was associated with higher odds of type 2 diabetes mellitus (odds ratio, 1.55; 95% confidence interval, 1.28-1.88). This study further observed higher odds of type 2 diabetes mellitus (odds ratio, 3.69; 95% confidence interval, 2.38-5.70) among women with a history of both gestational diabetes mellitus and hypertensive disorders of pregnancy than those without any adverse pregnancy outcomes. CONCLUSION: Postmenopausal women with a history of gestational diabetes mellitus, those delivering high-birthweight infants, or those with hypertensive disorders of pregnancy are at risk of future type 2 diabetes mellitus. In addition, women with ≥2 conditions had an augmented risk and might be prioritized for screening and prevention efforts for type 2 diabetes mellitus.