Search

Diabetes is a dangerous, chronic disease that frequently causes foot complications. Diabetes patients are at risk for amputation due to the serious complications of foot ulcers. Shoes made specifically for people with diabetes might greatly reduce this issue. It is crucial to wear shoes that are specifically made for the patient based on their anthropometric measurements and the evaluation of foot damage. The foot anthropometric and foot damage study results of 295 female diabetic patients at Khoai Chau District Medical Centre, Hung Yen Province, and the National Hospital of Endocrinology of Vietnam are presented in this research. The results showed that there were differences in measurements of height, width, and foot circumference between the two groups of patients. This discrepancy, which is independent of age, is caused by the level of problems or injuries to the feet. Women with diabetes often experience worsening foot injuries over the course of the illness. According to the level of foot complications, up to 96.69% of female patients with diabetes require “Extra Depth Diabetic Shoes”; 17.9% of patients needed “Custom Molded Inlays/insoles”; 3.1% of patients need to use “Custom Molded Diabetic Shoes” and “Custom Molded Inlays”. [ABSTRACT FROM AUTHOR]

Preeclampsia (PE) is a systemic disorder that appears during pregnancy and results in complications in more than 3-6% of deliveries in developed countries. This disease is also the largest leading cause of maternal mortality in many countries, especially in developing countries such as Indonesia. Hence, early diagnosis of preeclampsia is important in young pregnancy to decrease mortality. Recently, activin A and inhibin A were proposed as new candidates for biomarkers in early diabetes in pregnancy. However, there is no information regarding its value in pre-eclampsia and diabetic pregnancy. Herein we conduct a study to determine the value of activin-A and inhibin-A between of preeclampsia mother and a diabetes mellitus mother. Placental samples were collected from 87 mothers undergoing cesarian delivery, which were 29 samples from healthy mothers, 29 samples from diabetic mothers, and 29 samples from preeclampsia mothers. Placentas were obtained after the mother agreed to informed consent from 3 private hospitals in Surabaya. After undergoing processing and homogenizing, placenta tissue was measured for its activin-A and inhibin-A using the ELISA method. Activin-A level placental from the healthy mother group was 0.62 mIU / ml, diabetic mother group was 1.05 mIU / ml, and preeclampsia mother group was 1.23 mIU / ml. The average level of inhibin-A in healthy mothers was 0.45 mIU / ml, diabetes mother group was 0.97 mIU / ml, and preeclampsia mother group was 1.10 mIU / ml. The conclusion is that placental activin-A and inhibin-A levels both in preeclampsia pregnancy have higher values than in diabetes mothers. [ABSTRACT FROM AUTHOR]

This document explores the complex relationship between type 2 diabetes mellitus (T2DM) and systemic arterial hypertension (SAH) in women. It highlights that women may be more susceptible to the cardiometabolic effects of stress, sleep disorders, and hypertensive crises, which can increase the risk of acute coronary syndrome. Women with T2DM also face a higher risk of various cardiovascular complications and mortality compared to men. The document emphasizes the need for effective pharmacological treatment to reduce these risks and achieve therapeutic goals. [Extracted from the article]

Background and Purpose: Type 2 diabetes is one of the most common metabolic diseases known in the world and is the main cause of death in many countries, affecting many people every year. Chronic hyperglycemia caused by type 2 diabetes causes oxidative stress, therefore this study compared the effect of eight weeks of traditional resistance training and Total Body Resistance Exercise (TRX) on some oxidative and anti-oxidative indicators in women with type 2 diabetes. Materials and Methods: Thirty women with type 2 diabetes (age, 40-55 years) participated in the study and randomly were divided into three groups of resistance training (n=10), TRX group (n=10), control group (n=10). The experimental groups performed traditional resistance training and TRX three times a week for eight weeks at an intensity corresponding to 80-65% of a maximum repetition, while the control group did not participate in any training program during this period. Blood samples were taken from all subjects before training and 48 hours after the last training session and were used to determine the serum level of superoxide dismutase (SOD), Glutathione Peroxidase (GPx) and malondialdehyde (MDA). Paired t-test was used to investigate the within-groups differences, and the analysis of covariance using Bonferroni's post-hoc test was used to investigate the differences between groups. Results: Present study showed that after eight weeks of traditional resistance training and TRX, significant increases in SOD and GPX levels were observed in the two experimental groups (p< 0.05). However, no significant difference was observed in the control group. MDA levels decreased in both traditional and TRX resistance training groups. The results of between-group analysis showed that there is no significant difference between the two groups of resistance training and TRX for SOD, GPX and MDA indices (P>0.05). Conclusion: Based on said the findings of present study it could be concluded that both training methods can improve oxidative (SOD and GPX) and anti-oxidative (MDA) indices in women with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Purpose: Gestational diabetes mellitus (GDM) is defined as glucose intolerance with first onset or diagnosis in pregnancy. This study evaluated clinical and biochemical parameters in a possible association between GDM and gingival inflammation.Materials and Methods: A total of 87 pregnant women - 44 with GDM and 43 without (NGDM) - were included. Subgroups were created according to gingival inflammation. Plaque index (PI), bleeding on probing (BOP), and probing depth (PD) were recorded.Results: Age, anthropometric variables and baby weight (g) were all statistically significantly higher in the GDM group (p < 0.0001). Systolic and diastolic blood pressure (mmHg), saliva, serum leptin and adiponectin levels were similar in the GDM and NGDM groups (p = 0.605, p = 0.662, p = 0.737, and p = 0.596, respectively). Salivary adiponectin levels were statistically significantly higher in the two subgroups with gingivitis compared to those with clinically healthy periodontium (p < 0.01). Serum adiponectin levels were statistically significantly higher in the NGDM subgroup with gingivitis than the NGDM group with clinically healthy periodontium (p < 0.05). Statistically significant positive correlations were found between PD, PI, BOP and saliva adiponectin levels in the GDM group (p < 0.05). Positive correlations were also found between clinical periodontal parameters and saliva, serum levels of adiponectin in the control group without GDM (p < 0.05).Conclusion: The higher salivary adiponectin levels in the gingivitis groups suggest that gingival inflammation is more likely to influence local inflammatory parameters both in the presence and absence of GDM. Further larger-scale studies are required to better clarify the possible interactions between gingival inflammation and GDM. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes is one of the most common non-communicable diseases that can be prevented and controlled by following a healthy lifestyle. This study aimed to apply the theory of planned behavior in determining the predictors of nutritional behavior in women with prediabetes referred to the comprehensive health service centers of Mashhad University of Medical Sciences. Methods: This descriptive-analytical study was conducted in 2020. A total of 196 pre-diabetic women referred to Mashhad Comprehensive Health Service Center (Iran) were selected by multi-stage random sampling. To collect the data, a researcher-made questionnaire including demographic information based on the theoretical structures of planned behavior [attitude, subjective norms, behavioral control, and intention to follow a healthy diet] was used. Data were analyzed in SPSS-25 software at a significance level of 0.05. Results: The mean of total scores obtained in Attitude constructs 4.1 ± 0.50, subjective norms 3.67 ± 1.06, perceived behavioral control 4.13 ± 0.55 and behavioral intention 4.00 ± 0.39 and healthy eating behavior 3.00 ± 0.65 was reported. The construct of the subjective norm (ß = 0.254) was a strong predictor in the structure of intention and intention (ß = 0.419) and perceived behavioral control (ß = 0.240) was a strong predictor of nutritional behavior (p <0.001). Planned behavior theory was able to predict 40.5% of eating behavior in women with prediabetes. Conclusion: It seems that by applying the planned theory in the design of educational programs, it is possible to improve the observance of a healthy diet in women with prediabetes. [ABSTRACT FROM AUTHOR]

Introduction: It has been estimated that approximately 16% of pregnancies worldwide are affected by preexisting or gestational insulin-dependent (type 1) or independent (type 2) diabetes mellitus (DM). Diabetes mellitus in pregnancy remains a high-risk condition for both mother and child. This study aimed to investigate pregnancy outcomes regarding DM types. Material and methods: The study included 323 DM patients delivered for 6 years (2012-2017). General and obstetric history data and all complications throughout the pregnancy and the early neonatal period were noted. Based on DM type, women were divided into 4 groups: pre-pregnancy/pre-existing DM, insulin-dependent or independent, and gestational diabetes mellitus with or without insulin therapy. Results: The majority of women had pre-existing insulin-independent DM (type II 62%). Some types of pregnancy/maternal complications were registered in almost 85% of examined pregnancies. However, all babies were live born and mostly with good outcome (36.85% with early neonatal complications). Diabetes mellitus type could not predict the occurrence of neonatal complications (p = 0.342). Pre-existing insulin-dependent DM increased the risk for pregnancy complications (p = 0.031; OR = 1.656). Conclusions: Diabetes mellitus type has a limited impact on pregnancy outcomes and the occurrence of maternal and neonatal complications. With adequate therapy the pregnancy outcome can be good regardless of DM type. [ABSTRACT FROM AUTHOR]

Biofilms are multicellular communities where microorganisms are grown and form an extracellular matrix that protects the pathogenic microorganisms from the immunity system and antimicrobial agents. This study is aimed to identify Candida spp. isolated from urine specimens by using traditional techniques, germ tube, growth on corn meal agar medium and chromogenic medium then determine the ability of isolates to producing biofilm by tube method (TM) and congo red agar method (CRA). In our study urine specimens were obtained from 174 diabetic females in the period of six months at the Al-Wafa Specialized Center for Diabetes and Endocrinology, Mosul city, Iraq. Out of the total 174 specimens, yeast species were isolated from 56 (32.2 %) specimens. Out of the 56 isolates, 50 isolates were positive for Candida spp., especially C. glabrata which appeared maximum in 30 isolates (60 %) and followed by C. albicans 18 isolates (36%) and C. krusei 2 isolates (4 %). In the TM method for biofilm detection, C. albicans showed 16 isolates (88.9%) positive for biofilm formation followed by 29 isolates (96.7%) of C. glabrata. Furthermore, in the CRA method, all isolates (100%) of C. albicans were negative followed by 27 isolates (90%) of C. glabrata, whereas only 3 isolates (10%) of C. glabrata were positive. We can conclude that TM is the best conventional method and is sensitive to detect biofilm-forming yeast when compared with the CRA method. [ABSTRACT FROM AUTHOR]

Objective: Examine the association between grip strength and type 2 diabetes prevalence and severity. Methods: Using data from NHANES 2011-2012, objectively-determined hand grip strength was assessed using the Takei digital grip strength dynamometer, with diabetes assessed via physician diagnosis and glycohemoglobin A1C. Results: A 5 kg greater grip strength was associated with a 14% lower odds of having diabetes for men (ORadjusted = 0.86; 95% CI: 0.79 to 0.94; P = .002). Similarly, for women, a 5 kg greater grip strength was associated with an 18% lower odds of having diabetes (ORadjusted = 0.82; 95% CI: 0.69 to 0.97; P = .03). Grip strength was also associated with glycohemoglobin A1C among women with diabetes (βadjusted = -0.26, 95% CI: -0.39 to -0.12; P = .001), which suggests that grip strength is associated with diabetes severity among women. Conclusions: For both men and women, grip strength is associated with type 2 diabetes presence, and among women, grip strength is associated with severity of type 2 diabetes. [ABSTRACT FROM AUTHOR]

Women with type 1 diabetes mellitus (DMt1) have a higher incidence of menstrual and reproductive disorders with recent studies showing an increased incidence of the PCOS-like phenotype. Polycystic ovary syndrome (PCOS) is a leading cause of ovulatory dysfunction in women of active reproductive age. The Anti-Mèllerian Hormone (AMH) is a valuable diagnostic tool for PCOS and the most widely used biomarker for ovarian reserve in clinical practice. Determining its levels in women with DM1 would contribute to the better understanding of the pathogenetic mechanisms leading to ovarian dysfunction. Aim of the study: to perform a comperative analysis of AMH levels in women with DMt1 and clinically healthy women of similar reproductive age and BMI, as well as to assess the relation of the hormone with anamnestic, clinical and hormonal indices. Materials and methods: The study included 37 women with DMt1 and 38 clinically healthy women serving as a control group. The women with DMt1 were divided into 2 subgroups – with PCOS (n = 15) and without PCOS (n = 22). A detailed anamnesis was taken regarding the duration of diabetes, insulin administered, total daily insulin dose, gynecological history: including age at menarche, duration of the menstrual cycle (MC), dysmenorrhea, pregnancies, births, miscarriages. Anthropometric measurements and basal levels of AMH, testosterone (T), thyroid-stimulating hormone (TSH) and serum prolactin were studied in all participants. Body mass index (BMI), total daily insulin dose per kg body weight (TDD / kg) were calculated. Results: Serum levels of AMH as well as T were significantly higher in the DMt1 group compared to healthy controls (р=0,01, resp. p<0,001) at similar mean age (p = 0,26) and mean BMI (p = 0,57). When subdividing the group with DM1 into two subgroups – with and without PCOS and comparing them with healthy controls, there was again no significant difference in age and BMI (p = 0,20 vs. p = 0,85), serum levels of AMH and T remained significantly higher only in the subgroup with PCOS (p <0,001), while in the subgroup without PCOS they were comparable with those in the control group (p = 0,96, respectively p = 0,34). Women with DMt1 presented with a higher number of pregnancies (p = 0,005), births (p = 0,03) and miscarriages (p = 0,03). Only in the subgroup of DMt1 without PCOS, however, the frequency of pregnancies (p = 0,036) and births (p = 0,033) remained higher compared to the healthy controls. The relative share of women with dysmenorrhea was higher in the DMt1 group (51,4%) compared to controls (23,7%) (z-test, p <0,05). The group with DMt1 demonstrated positive correlations of AMH and T (p <0,0010), the presence of dysmenorrhea (p = 0,003) and the MC interval (p = 0,01) Although there is no statistically significant difference in the presence of dysmenorrhea and the interval of MC between women with DMt1 without PCOS and healthy controls, in this pathological subgroup there is still a positive relationship between the two variables (r=0,445, p=0,04). Conclusion: AMH was elevated in women with DMt1 only in the presence of a PCOS-like phenotype. Women with DMt1 without PCOS did not show significant differences in ovarian reserve and even had a higher number of pregnancies and births compared to healthy controls. The results of the present study determine the need for an in-depth assessment of the development of hyperandrogenic condition in women with DMt1 in the course of the insulin treatment leading to reproductive disorders. [ABSTRACT FROM AUTHOR]

Importance: Gestational diabetes is associated with adverse maternal and offspring outcomes.Objective: To determine whether rates of gestational diabetes among individuals at first live birth changed from 2011 to 2019 and how these rates differ by race and ethnicity in the US.Design, Setting, and Participants: Serial cross-sectional analysis using National Center for Health Statistics data for 12 610 235 individuals aged 15 to 44 years with singleton first live births from 2011 to 2019 in the US.Exposures: Gestational diabetes data stratified by the following race and ethnicity groups: Hispanic/Latina (including Central and South American, Cuban, Mexican, and Puerto Rican); non-Hispanic Asian/Pacific Islander (including Asian Indian, Chinese, Filipina, Japanese, Korean, and Vietnamese); non-Hispanic Black; and non-Hispanic White.Main Outcomes and Measures: The primary outcomes were age-standardized rates of gestational diabetes (per 1000 live births) and respective mean annual percent change and rate ratios (RRs) of gestational diabetes in non-Hispanic Asian/Pacific Islander (overall and in subgroups), non-Hispanic Black, and Hispanic/Latina (overall and in subgroups) individuals relative to non-Hispanic White individuals (referent group).Results: Among the 12 610 235 included individuals (mean [SD] age, 26.3 [5.8] years), the overall age-standardized gestational diabetes rate significantly increased from 47.6 (95% CI, 47.1-48.0) to 63.5 (95% CI, 63.1-64.0) per 1000 live births from 2011 to 2019, a mean annual percent change of 3.7% (95% CI, 2.8%-4.6%) per year. Of the 12 610 235 participants, 21% were Hispanic/Latina (2019 gestational diabetes rate, 66.6 [95% CI, 65.6-67.7]; RR, 1.15 [95% CI, 1.13-1.18]), 8% were non-Hispanic Asian/Pacific Islander (2019 gestational diabetes rate, 102.7 [95% CI, 100.7-104.7]; RR, 1.78 [95% CI, 1.74-1.82]), 14% were non-Hispanic Black (2019 gestational diabetes rate, 55.7 [95% CI, 54.5-57.0]; RR, 0.97 [95% CI, 0.94-0.99]), and 56% were non-Hispanic White (2019 gestational diabetes rate, 57.7 [95% CI, 57.2-58.3]; referent group). Gestational diabetes rates were highest in Asian Indian participants (2019 gestational diabetes rate, 129.1 [95% CI, 100.7-104.7]; RR, 2.24 [95% CI, 2.15-2.33]). Among Hispanic/Latina participants, gestational diabetes rates were highest among Puerto Rican individuals (2019 gestational diabetes rate, 75.8 [95% CI, 71.8-79.9]; RR, 1.31 [95% CI, 1.24-1.39]). Gestational diabetes rates increased among all race and ethnicity subgroups and across all age groups.Conclusions and Relevance: Among individuals with a singleton first live birth in the US from 2011 to 2019, rates of gestational diabetes increased across all racial and ethnic subgroups. Differences in absolute gestational diabetes rates were observed across race and ethnicity subgroups. [ABSTRACT FROM AUTHOR]

India has observed the most devastating increase in cases of diabetes today--especially Type 2 diabetes mellitus (T2DM). The high prevalence of diabetes mellitus is due to rapid urbanization of the suburban regions. Diabetes mellitus continues to increase as a result of rapid cultural and social changes, such as increasing urbanization, ageing populations, dietary changes, reduced physical activity, and unhealthy behavior. Development and maintenance of healthy lifestyle behaviors can be the most effective strategy in reducing complications and premature death among women living with T2DM. There is currently insufficient information available on the prevalence of T2DM and associated factors in the women population of Bengaluru. With this context, the present study was undertaken to determine the prevalence of diabetes mellitus and its association with various risk factors among the women population of Bengaluru, Karnataka. Diabetes was found to be prevalent in women in the under 40 years of age group and was prevalent in all categories of workers, i.e., heavy, moderate, and sedentary. Most of the detected diabetes cases had a Body Mass Index (BMI) >25 and Waist Hip Ratio (WHR) > 0.85, both risk factors for the development of diabetes. Most of them had a positive family history and didn't exercise or practice dietary restrictions. The association between increasing age, low educational status, obesity, waist circumference, and diabetes mellitus was found to be significant. It was observed that the association between family history of diabetes and other risk factors in females and diabetes mellitus was highly significant. [ABSTRACT FROM AUTHOR]

A new study published in the Journal of Epidemiology & Community Health has found that men with diabetes have a higher risk of disease-related complications compared to women with diabetes. The study analyzed data from the 45 and Up Study, which included over 267,000 men and women aged over 45 in New South Wales, Australia. The results showed that men with diabetes had a greater risk of cardiovascular disease, lower limb and kidney complications, and diabetic retinopathy compared to women. These sex differences in risk were consistent regardless of the duration of diabetes. The study suggests a need for targeted screening and prevention strategies for complications in men with diabetes. [Extracted from the article]

The authors talk about the maternal weight before and during pregnancy in women suffering from gestational diabetes. Topics discussed include the progress in controlling gestational weight gain, the challenge of optimizing pre-pregnancy body mass index (BMI), and association between BMI and adverse obstetrical outcomes.

Mitochondrial dysfunction is an important factor of the aging process and may play a key role in various diseases. Mitochondrial DNA copy number (mtDNA-CN) is an indirect measure of mitochondrial dysfunction and is associated with type 2 diabetes mellitus (T2DM); however, whether mtDNA-CN can predict the risk of developing T2DM is not well-known. We quantified absolute mtDNA-CN in both prevalent and incident T2DM by well-optimized droplet digital PCR (ddPCR) method in a population-based follow-up study of middle aged (50–59 years) Swedish women (n = 2387). The median follow-up period was 17 years. Compared to those who were free of T2DM, mtDNA-CN was significantly lower in both prevalent T2DM and in women who developed T2DM during the follow-up period. Mitochondrial DNA-copy number was also associated with glucose intolerance, systolic blood pressure, smoking status and education. In multivariable Cox regression analysis, lower baseline mtDNA-CN was prospectively associated with a higher risk of T2DM, independent of age, BMI, education, smoking status and physical activity. Moreover, interaction term analysis showed that smoking increased the effect of low mtDNA-CN at baseline on the risk of incident T2DM. Mitochondrial DNA-copy number may be a risk factor of T2DM in women. The clinical usefulness of mtDNA-CN to predict the future risk of T2DM warrants further investigation. [ABSTRACT FROM AUTHOR]

Background: Maternal and fetal outcomes of pregnancy amongst cardiac transplant recipients are limited in the current literature.Methods: We describe five pregnancies in three cardiac transplant recipients managed between a tertiary centre for obstetric medicine and an associated state-wide transplant centre between 2014-2018, and provide a narrative review of the literature.Results: Pre-conception counselling was undertaken. There were no recent rejection episodes and all women demonstrated good baseline cardiac function. Median maternal age was 27 years (range 23-38 yrs.). Median time from transplantation to pregnancy was 5 years (range 2-14 yrs.). All women were managed with modified immunosuppressant regimens and multidisciplinary care. Cardiac function, tacrolimus levels and renal function were closely monitored with frequent monitoring for common complications of pregnancy. There were no maternal or fetal deaths. There was no evidence of graft rejection and no deterioration in cardiac function. Tacrolimus doses were increased to maintain therapeutic targets. Gestational diabetes occurred in three women and cholestasis of pregnancy occurred in one. Each infant was delivered by vaginal delivery. One mother had postpartum haemorrhage in both pregnancies. Pre-eclampsia did not occur. Median gestation at delivery was 37 weeks (range 35+4-40+5 days) with two preterm deliveries. One (1) infant was born with low birth weight. One (1) infant had jaundice requiring phototherapy. All infants were breastfed.Conclusion: Pregnancy in transplant recipients confers risk to the mother and fetus. Pre-conception counselling, immunosuppressant tailoring and regular monitoring are paramount to avoid rejection and possible teratogenic complications. Favourable pregnancy outcomes are achievable with specialist multidisciplinary care. [ABSTRACT FROM AUTHOR]

Background: Gender differences in valvular heart disease are increasingly recognised. A prior study has suggested better surgical outcomes in women with symptomatic aortic stenosis (AS). We investigate gender differences in medically managed severe AS.Method: We studied 347 patients with severe AS (aortic valve area index <0.6 cm2/m2) in terms of baseline clinical background, echocardiographic characteristics, and clinical outcomes. Appropriate univariate and multivariate models were employed, while Kaplan-Meier curves were constructed to compare mortality outcomes.Results: In total, 205 (59%) patients were women. Despite higher incidences of hypertension (75.6% vs 47.3%) and diabetes mellitus (46.5% vs 29.5%) in women, women had improved survival (Kaplan-Meier log-rank = 6.24, p = 0.012). After adjusting for age (hazard ratio [HR], 1.034; 95% confidence interval [CI], 1.014-1.054), hypertension (HR, 1.469; 95% CI, 0.807-2.673), diabetes (HR, 1.219; 95% CI, 0.693-2.145), and indexed aortic valve area (HR 0.145, 95% CI 0.031-0.684) on multivariate analyses, female gender remained independently associated with lower mortality (HR, 0.561; 95%, CI 0.332-0.947). Women tended to have smaller body surface area (BSA), left ventricular (LV) internal diastolic diameter, and smaller LV outflow tract diameter but were similar to men in terms of LV ejection fraction, AS severity, and patterns of LV remodelling.Conclusions: Women appeared to have better outcomes compared to men in medically managed severe AS. These gender differences warrant further study and may affect prognosis, follow-up, and timing of valve surgery. [ABSTRACT FROM AUTHOR]

Background and Objective: Hypertensive disorders of pregnancy (HDPs) affect 5%-10% of pregnancies and have been associated with excess maternal cardiovascular disease (CVD) risk. The primary aim of this study was to reliably estimate absolute and relative risks of CVD after HDP.Methods: A retrospective cohort of women who had singleton pregnancies in New South Wales, Australia, between 2002 and 2016 and identified using linked population health administrative databases. The primary exposure was new-onset HDP (pre-eclampsia/eclampsia and gestational hypertension), and the endpoint was hospitalisation or death due to ischaemic or hypertensive heart disease, or stroke. Kaplan-Meier analysis estimated risks among mothers following their first birth, and multivariable time-dependent Cox regression estimated the association between HDP and CVD.Results: Among 528 106 women, 10.3% experienced HDP in their first pregnancy. The 10-year estimated risk of CVD was 2.1 per 1000 if no HDP and 5.5 per 1000 following HDP. Adjusting for demographics, gestational diabetes, small for gestational age and preterm birth, we found that there was an interaction between smoking and HDP, and a larger effect of early-onset (<34 weeks) HDP, compared with late-onset HDP. The HR for women with early-onset HDP who did not smoke was 4.90 (95% CI 3.00 to 7.80) and the HR for those who did smoke was 23.5 (95% CI 13.5 to 40.5), each compared with women without HDP who did not smoke.Conclusion: In this nationally representative Australian cohort, HDP, especially early onset, conferred a clear increase in the risk of CVD, with amplification by smoking. Targeted preventive health, during and after pregnancy, could prevent a substantial burden of CVD among childbearing women. [ABSTRACT FROM AUTHOR]

Background The single nucleotide polymorphism in TCF7L2 rs7903146 is associated with an increased risk of type 2 diabetes mellitus and gestational diabetes mellitus. Mechanisms by which this mutation acts, and its impact on the clinical course of the diseases remain unclear. Here we investigated the clinical impact of the T risk allele in women with gestational diabetes mellitus. Methods We genotyped the C/T polymorphism in 164 Caucasian women with GDM (German n=114; Greek n=50). The impact of the T allele on the results of the 75g oral-glucose-tolerance-test, and on the required therapy (diet/lifestyle or insulin) was investigated. Results During oral-glucose-tolerance-test, women harboring the T allele displayed significantly higher glucose values at 60 min (p=0.034) and were more likely to require insulin therapy even after adjusting for confounders, such as BMI and age. Conclusion These results provide evidence that the T risk allele in TCF7L2 rs7903146 is associated with failure in early postprandial glycemic control and requirement of insulin therapy in women with gestational diabetes mellitus, even after adjusting for confounding factors such BMI and age. [ABSTRACT FROM AUTHOR]

Objective: Gestational diabetes mellitus is defined as "diabetes recognized in the second or third trimester that is not clearly overt diabetes". Evidence relating to women with hyperglycemia early in pregnancy is limited. We aimed to evaluate women diagnosed with hyperglycemia early in pregnancy (eGDM) and compared them to those with pregestational established type 2 diabetes mellitus (T2DM) and gestational diabetes diagnosed routinely at 24–28-week gestation (rtGDM) to determine if the length of exposure to hyperglycemia adversely affected outcomes. Methods: Forty consecutive women with eGDM who attended a multidisciplinary antenatal clinic were reviewed. Two separate BMI-matched control groups were identified, recognized pregestational T2DM (n = 80) and rtGDM (n = 80). Baseline demographics and outcomes were compared. Results: A higher proportion of women in the eGDM and T2DM group required insulin and the incidence of hypertensive disorders was similarly increased compared with the rtGDM group (88.6, 77.0 versus 8.1%, p <.001 and 42.5%, 37.5 versus 12.5% p <.001, respectively). The proportion of infants born small for gestational age varied (eGDM 11.1%, T2DM 13.0%, and rtGDM 2.5%, p=.049). Postpartum, 7.5% of eGDM women were diagnosed with T2DM versus 1.3% in the rtGDM group (p<.001). Conclusions: These novel data demonstrate that the length of exposure to glucose adversely affects materno-foetal outcomes independent of maternal adiposity. [ABSTRACT FROM AUTHOR]

Objective: To estimate the incidence of major biological cardiovascular disease (CVD) risk factors in adults using non-exercise estimated cardiorespiratory fitness (eCRF).Methods: 200 039 healthy people (99 957 women), aged ≥18 years (38.5±12.1 years) from the Taiwan MJ Cohort. eCRF was estimated with validated algorithms. Biological CVD risk factors, including hypertension (HTN), hypercholesterolemia, atherogenic dyslipidaemia, type 2 diabetes mellitus (T2DM) and systemic inflammation, were assessed by standardised physical examinations and laboratory tests.Results: In a basic model, baseline eCRF was inversely associated with the incidence of each CVD risk factor in both men and women (HR per 1 metabolic equivalent (MET) increase in eCRF ranged from 0.53 for T2DM in women to 0.96 for hypercholesterolemia in women). In full adjusted models, the associations were attenuated but remained statistically significant, with the exception of hypercholesterolemia in women. In a subcohort of 116 313 individuals with two repeated exposure measurements, an increase in eCRF was associated in both sexes with a subsequent lower incidence of CVD risk factors (HR per 1-MET increase ranged from 0.58 to 0.91 in models adjusted for age, year of examination and baseline eCRF). Comparisons of predictive performance showed that the addition of eCRF to values of traditional CVD risk factors had relevant improvements in risk discrimination (C-index increased from 0.1% to 3.2%), mainly for HTN and T2DM risk prediction.Conclusions: eCRF and its changes predict the incidence of biological CVD risk factors, especially HTN and T2DM. Routine assessment of eCRF in clinical settings is technically feasible and might be useful for CVD prevention. [ABSTRACT FROM AUTHOR]

Objectives: The study was designed to find out the association of PCOS with insulin resistance and GLUT4. Study Design: Cross Sectional study. Setting: Outdoor Department of Sir Ganga Ram Hospital Lahore. Period: March 2016 to December 2016. Material & Methods: 37 PCOS women visited Outdoor Department of Sir Ganga Ram Hospital Lahore. Their age range was 25- 36 years. 20 ages matched medical staff of the Sir Ganga Ram Hospital, Lahore with no history of any disease were selected as control. Rotterdam's criteria were used to confirm PCOS. Levels of circulating insulin, GLUT 4 and fasting glucose were estimated. Results: Mean age of PCOS patients and of controls was 30.55 and 29.00 years respectively. Values of BMI were insignificantly raised in PCOS in comparison to controls. Levels of circulating GLUT-4, fasting glucose, insulin and resistance of insulin were increased significantly in women with PCOS in comparison to the controls. Decreased ratio of glucose to insulin was seen in PCOS women in comparison to their controls. Conclusion: A good association of PCOS was observed with insulin mediated release of glucose transporter GLUT 4 and insulin resistance. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) incidence is increasing among young adults below screening age, despite the effectiveness of screening in older populations. Individuals with diabetes mellitus are at increased risk of early-onset CRC. We aimed to determine how many years earlier than the general population patients with diabetes with/without family history of CRC reach the threshold risk at which CRC screening is recommended to the general population.Methods and Findings: A nationwide cohort study (follow-up:1964-2015) involving all Swedish residents born after 1931 and their parents was carried out using record linkage of Swedish Population Register, Cancer Registry, National Patient Register, and Multi-Generation Register. Of 12,614,256 individuals who were followed between 1964 and 2015 (51% men; age range at baseline 0-107 years), 162,226 developed CRC, and 559,375 developed diabetes. Age-specific 10-year cumulative risk curves were used to draw conclusions about how many years earlier patients with diabetes reach the 10-year cumulative risks of CRC in 50-year-old men and women (most common age of first screening), which were 0.44% and 0.41%, respectively. Diabetic patients attained the screening level of CRC risk earlier than the general Swedish population. Men with diabetes reached 0.44% risk at age 45 (5 years earlier than the recommended age of screening). In women with diabetes, the risk advancement was 4 years. Risk was more pronounced for those with additional family history of CRC (12-21 years earlier depending on sex and benchmark starting age of screening). The study limitations include lack of detailed information on diabetes type, lifestyle factors, and colonoscopy data.Conclusions: Using high-quality registers, this study is, to our knowledge, the first one that provides novel evidence-based information for risk-adapted starting ages of CRC screening for patients with diabetes, who are at higher risk of early-onset CRC than the general population. [ABSTRACT FROM AUTHOR]

Objectives: To determine association of iron deficiency anemia on hba1c level in diabetic patients. Study Design: Cross Sectional Analytical study. Setting: Department of Pathology PIMS Hospital. Period: From June 2018 to December 2018 (6 months duration). Material & Methods: A total of 117 diagnosed cases of diabetes mellitus were included in the study. Pregnant women, patients with end-stage renal disease, hypothyroidism, +hemoglobinopathies, hemolytic anemia, chronic liver disease and malignancy, participants with poorly controlled diabetes, and patient from the northern areas were excluded from the study. Patients were divided according to their fasting plasma glucose (FPG) level. FPG of 126mg/dl was used as a cut-off point for dividing the study population into two groups, i.e controlled sugar level (FPG between 100 and 126 mg/d L) and well controlled sugar level (FPG less than 100 mg/d L). Variables such as Hemoglobin, serum ferritin, serum Hba1c level etc. Results: Mean age of study population in the present study was 56.97±7.29 years. Out of 117 cases, about 45(38.5%) cases were female and 72 (38.5%) were male. Male to female ratio was 1: 1.6.Mean FPG level was 103.3±7.6 in our study population. The mean hba1c levels in the sample was 6.42±0.70%. Mean Hb levels were recorded as 11.5±2.7 and 10.9±3.03 g/dl, respectively in female and male. From a total of 117 cases, only 66 were identified as having iron deficiency anemia. Only 54 patients had plasma glucose greater than 100 mg/dl. Odds ratio for hba1c>6.5% in iron deficient was 3.90(p=0.001). Conclusion: Iron deficiency can cause elevated serum hba1c level. Health care providers, including physicians, must consider the iron status before prescribing diabetics treatment on the basis of serum hba1c level. [ABSTRACT FROM AUTHOR]

Background: Higher maternal plasma glucose (PG) concentrations, even below gestational diabetes mellitus (GDM) thresholds, are associated with adverse offspring outcomes, with DNA methylation proposed as a mediating mechanism. Here, we examined the relationships between maternal dysglycaemia at 24 to 28 weeks' gestation and DNA methylation in neonates and whether a dietary and physical activity intervention in pregnant women with obesity modified the methylation signatures associated with maternal dysglycaemia.Methods and Findings: We investigated 557 women, recruited between 2009 and 2014 from the UK Pregnancies Better Eating and Activity Trial (UPBEAT), a randomised controlled trial (RCT), of a lifestyle intervention (low glycaemic index (GI) diet plus physical activity) in pregnant women with obesity (294 contol, 263 intervention). Between 27 and 28 weeks of pregnancy, participants had an oral glucose (75 g) tolerance test (OGTT), and GDM diagnosis was based on diagnostic criteria recommended by the International Association of Diabetes and Pregnancy Study Groups (IADPSG), with 159 women having a diagnosis of GDM. Cord blood DNA samples from the infants were interrogated for genome-wide DNA methylation levels using the Infinium Human MethylationEPIC BeadChip array. Robust regression was carried out, adjusting for maternal age, smoking, parity, ethnicity, neonate sex, and predicted cell-type composition. Maternal GDM, fasting glucose, 1-h, and 2-h glucose concentrations following an OGTT were associated with 242, 1, 592, and 17 differentially methylated cytosine-phosphate-guanine (dmCpG) sites (false discovery rate (FDR) ≤ 0.05), respectively, in the infant's cord blood DNA. The most significantly GDM-associated CpG was cg03566881 located within the leucine-rich repeat-containing G-protein coupled receptor 6 (LGR6) (FDR = 0.0002). Moreover, we show that the GDM and 1-h glucose-associated methylation signatures in the cord blood of the infant appeared to be attenuated by the dietary and physical activity intervention during pregnancy; in the intervention arm, there were no GDM and two 1-h glucose-associated dmCpGs, whereas in the standard care arm, there were 41 GDM and 160 1-h glucose-associated dmCpGs. A total of 87% of the GDM and 77% of the 1-h glucose-associated dmCpGs had smaller effect sizes in the intervention compared to the standard care arm; the adjusted r2 for the association of LGR6 cg03566881 with GDM was 0.317 (95% confidence interval (CI) 0.012, 0.022) in the standard care and 0.240 (95% CI 0.001, 0.015) in the intervention arm. Limitations included measurement of DNA methylation in cord blood, where the functional significance of such changes are unclear, and because of the strong collinearity between treatment modality and severity of hyperglycaemia, we cannot exclude that treatment-related differences are potential confounders.Conclusions: Maternal dysglycaemia was associated with significant changes in the epigenome of the infants. Moreover, we found that the epigenetic impact of a dysglycaemic prenatal maternal environment appeared to be modified by a lifestyle intervention in pregnancy. Further research will be needed to investigate possible medical implications of the findings.Trial Registration: ISRCTN89971375. [ABSTRACT FROM AUTHOR]

Background: Cardio-obstetrics refers to a team-based approach to maternal care that includes multidisciplinary collaboration among maternal fetal medicine, cardiology, and others.Objectives: This study sought to describe clinical characteristics, maternal and fetal outcomes, and cardiovascular readmissions in a cohort of pregnant women with underlying cardiovascular disease (CVD) followed by a cardio-obstetrics team.Methods: We identified patients evaluated by our cardio-obstetrics team from January 1, 2010, through December 31, 2019, at a quaternary care hospital in New York City. Information was collected regarding demographics, comorbidities, underlying CVD, medications, maternal and fetal outcomes, and cardiovascular readmissions. Each patient was assigned a Cardiac Disease in Pregnancy (CARPREG) II score based on her clinical characteristics and underlying CVD.Results: During the study period, 306 pregnant women (median age 29 years, 52.9% Hispanic or Latino) with CVD were seen. Most women (74.2%) were insured through Medicaid. The most common forms of CVD included arrhythmia (n = 88, 28.8%), congenital heart disease (n = 72, 23.5%), and cardiomyopathy (n = 72, 23.5%). The median CARPREG II score was 3; 130 patients (42.5%) had a CARPREG II score ≥4. Gestational diabetes occurred in 11.4%, gestational hypertension in 9.5%, and preeclampsia in 12.1% of women. Intensive care unit admission was required for 27 patients (8.8%) during delivery. Median gestational age for delivery was 38 weeks (interquartile range: 37 to 39). Live birth occurred in 98% of pregnancies. One maternal death occurred within a year of delivery in a woman with Eisenmenger syndrome. Following delivery, 30-day readmission rate was 2% and the rate of readmission from 30 to 90 days postpartum was 4.6%. Median follow-up was 2.6 years.Conclusions: In a population of primarily Medicaid-insured pregnant women managed by a cardio-obstetrics team, maternal outcomes were encouraging and readmission rates following delivery were low. Prospective studies are needed to evaluate the impact of cardio-obstetric models of care on maternal outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Modern strategies for the screening and diagnosis of Gestational Diabetes Mellitus (GDM) rely on universal Oral Glucose Tolerance Test (OGTT). However, they are unsustainable in low-income countries. In this study, we aimed at assessing the feasibility of a simplified diagnostic policy. Methods: The study took place in an urban referral hospital in Freetown, Sierra Leone. During an 11-month period, pregnant women were offered capillary blood test for glucose assessment. They could be screened at any time during pregnancy. GDM was diagnosed if fasting glucose was ≥ 92 mg/dl or if the OGTT was positive. The latter was prescribed only to women presenting after 24 weeks' gestation with at least one risk factor for GDM and fasting capillary glucose between 85 and 91 mg/dl. A definitive diagnosis required confirmation to this aim, women with values above the thresholds were invited to refer the next working day for repeating the test after fasting overnight. Results: Overall, 7827 women were referred for screening, of whom 6872 (87%) underwent at least one capillary glucose assessment. However, 895 of those who had a positive test did not return for confirmation. Overall, a definite assessment could be done in 5799 subjects corresponding to 76% (95% CI 75–77%) of those eligible. GDM was diagnosed in 128 women (1.9%, 95% CI 1.6–2.2%). Based on an expected confirmation rate of 22% (calculated from those who referred for confirmation) in the 895 women who did not come back, one could infer that GDM would have been diagnosed in additional 197 women, raising the prevalence to 4.7% (95% CI 4.2–5.3%). Conclusion: Three quarters of subjects could be assessed with our approach. Data also suggest that GDM is not rare even if identification of affected cases remains challenging. [ABSTRACT FROM AUTHOR]

Purpose: The aim was to follow-up two cohorts of women with GDM to investigate the incidence and time of diagnosis of manifest diabetes mellitus (DM) postpartum and identify the risk factors for diabetes in our population. Methods: A follow-up study on two independent cohorts having oral glucose tolerance test (OGTT) in 1991/1992 and 2011–2016: Cohort 1 consisted of 406 women including 54 with GDM and 352 with a non-GDM OGTT-test and cohort 2 had 433 women diagnosed with GDM. The first cohort had nearly 25 years of follow-up and gave information on magnitude, conversion rate and type of diabetes manifestation. The second cohort was started recently to evaluate whether newer diagnostic criteria and baseline information on the old cohort are still valid for prediction of diabetes risk. Results: The risk of manifest diabetes in cohort 1 at the end of follow-up was six times higher in women with previous GDM compared with non-GDM (RR = 6; 95% CI 4–11). We observed a 70% diabetes rate 25 years after pregnancy. Only family history of diabetes in cohort 2 was associated with conversion to manifest diabetes (p = 0.002), also after adjustment for age, BMI, non-Danish origin and smoking during pregnancy (p < 0.001) Conclusion: The incidence of diabetes after GDM is higher than that previously reported in Scandinavian populations and the rate of manifest diabetes rises steeply 15 years after pregnancy and after 40 years of age. The women of cohort 2 with recent GDM are at risk of DM at a higher rate. On this background our results are useful in identifying the time where GDM women may benefit from the effective implementation of evidence-based treatment to postpone and advert manifest DM. [ABSTRACT FROM AUTHOR]

Aims/Introduction: A low level of urine pH (U‐pH) has been reported to be associated with metabolic disorders. However, the relationship between the incidence of diabetes mellitus and U‐pH has not yet been fully addressed. Materials and Methods: We investigated the relationship between U‐pH and the development of diabetes mellitus during a 10‐year period in a general population of individuals who received annual health examinations in 2006 (n = 28,990). After exclusion of individuals with missing data, and those with diabetes mellitus and/or chronic kidney disease at baseline, a total of 12,476 individuals (men/women: 8,027/4,449) who received health examinations at least once during the period from 2007 to 2016 were recruited. The recruited individuals were divided into four groups according to their U‐pH levels: groups of U‐pH ≤5.0, 5.5, 6.0 and ≥6.5. Results: During a 10‐year period, 521 men (6.5%) and 132 women (3.0%) had new onset of diabetes mellitus. The cumulative incidence of diabetes mellitus was 7.5% (men/women: 9.3%/4.4%) per 100 person‐years. The hazard ratios (HRs) in the U‐pH ≤5.0 (HR 1.93) and U‐pH 5.5 groups (HR 1.46) were significantly higher than that in the U‐pH ≥6.5 group as a reference for men, but not for women. After adjustment of age, obesity, fasting glucose, smoking and alcohol drinking habits, family history of diabetes mellitus, and use of drugs for hypertension and dyslipidemia, HR in the U‐pH ≤5.0 group (HR 1.39) was significantly higher than that in the U‐pH ≥6.5 group for men, but not for women. Conclusions: Low U‐pH predicts new onset of diabetes mellitus in a general population of men. [ABSTRACT FROM AUTHOR]

Aims/Introduction: To evaluate gestational weight gain (GWG) in the first and second trimester as a risk factor for gestational diabetes mellitus (GDM) among women pregnant with singletons. Materials and Methods: This was a cohort study of women with singleton pregnancies who delivered between 1 January 2013 and 31 October 2014 in a Chinese hospital. We collected data from medical records from the first antenatal visit to delivery. All pregnant women were subjected to an oral glucose tolerance test for diagnosis of GDM during the second trimester. GWG in the first and second trimester was calculated by subtracting the prepregnancy weight from weight within 4 weeks of the oral glucose tolerance test. We categorized GWG into insufficient, appropriate and excessive according to the Institute of Medicine guidelines and population quantiles. Univariable and multivariable analyses were used to determine the association between GWG and GDM risk. Results: Of 10,422 pregnant women, we identified 8,356 eligible women with 1,622 (19.4%) diagnosed with GDM. Univariable analysis showed that GWG that exceeded the Institute of Medicine recommendation might be associated with risk of GDM (P < 0.05), but this association was not observed by multivariable analysis (adjusted odds ratio 1.07, [95% confidence interval 0.94–1.21]). Univariable and multivariable analyses both showed that GWG exceeding the 90th and 95th quantiles of included women, respectively, were at increased risk for GDM (adjusted odds ratio >P90 vs P10–P90 adjusted odds ratio 1.31, [95% confidence interval 1.12–1.52]; >P95 vs P5‐P95 adjusted odds ratio 1.45 [95% confidence interval 1.16–1.81]). Conclusions: Excessive GWG in the first and second trimester might be a risk factor for GDM, which highlights the importance of appropriate weight gain during pregnancy. [ABSTRACT FROM AUTHOR]

Objective: To examine whether proinflammatory and hyperinsulinemic diets are associated with increased risk of type 2 diabetes.Research Design and Methods: We prospectively followed 74,767 women from the Nurses' Health Study (1984-2016), 90,786 women from the Nurses' Health Study II (1989-2017), and 39,442 men from the Health Professionals Follow-up Study (1986-2016). Using repeated measures of food-frequency questionnaires, we calculated empirical dietary inflammatory pattern (EDIP) and empirical dietary index for hyperinsulinemia (EDIH) scores, which are food-based indices that characterize dietary inflammatory or insulinemic potential based on circulating biomarkers of inflammation or C-peptide. Diagnoses of type 2 diabetes were confirmed by validated supplementary questionnaires.Results: We documented 19,666 incident type 2 diabetes cases over 4.9 million person-years of follow-up. In the pooled multivariable-adjusted analyses, individuals in the highest EDIP or EDIH quintile had 3.11 times (95% CI 2.96-3.27) and 3.40 times (95% CI 3.23-3.58) higher type 2 diabetes risk, respectively, compared with those in the lowest quintile. Additional adjustment for BMI attenuated the associations (hazard ratio 1.95 [95% CI 1.85-2.05] for EDIP and hazard ratio 1.87 [95% CI 1.78-1.98] for EDIH), suggesting adiposity partly mediates the observed associations. Moreover, individuals in both highest EDIP and EDIH quintiles had 2.34 times higher type 2 diabetes risk (95% CI 2.17-2.52), compared with those in both lowest quintiles, after adjustment for BMI.Conclusions: Higher dietary inflammatory and insulinemic potential were associated with increased type 2 diabetes incidence. Findings suggest that inflammation and hyperinsulinemia are potential mechanisms linking dietary patterns and type 2 diabetes development. [ABSTRACT FROM AUTHOR]

Objective: Pregnancy is reported to exacerbate manifestations in women with Gaucher Disease (GD). The objective of our study was to examine the outcome of pregnancies of Caucasian women with GD in a Greek Center of Excellence on GD.Study Design: Fifteen GD women were enrolled. All data were collected by questionnaire: fertility, normal pregnancies, spontaneous-elective-therapeutic abortions, maternal -neonatal status, birth weight and chromosomal abnormalities.Results: Forty-one pregnancies were reported among 15 women: mean conception age (±SD) 27.7 ± 5.8years (range 17-42years). Thirty-seven conceptions were spontaneous, 4 were after in vitro fertilization (IVF). Twenty three out of the 41 (56.1 %) pregnancies were normal. Eleven out of the 41 (26.8 %) pregnancies resulted in spontaneous abortions, 3 out of 41 (7.3 %) in elective and 3 out of 41 (7.3 %) in therapeutic abortions. Therapeutic abortions were due to worsening of GD manifestations, fetal chromosomal abnormalities and GD type 2 embryo. Nine out of 15 women had maternal complications: gestational diabetes, splenomegaly, hepatomegaly, thrombocytopenia, osteoporosis and postpartum hemorrhage. Twenty three out of the 41 pregnancies resulted in live births. Nine out of the 23 (39.1 %) deliveries were caesarian sections and 14 out of 23 (60.9 %) were vaginal. The total number of neonates was 24 (14 females / 10 males). Mean gestational age on delivery (± SD) was 35.9 ± 3.1 weeks (range 26-38 w). Average female birth weight (±SD) was 2671.4 ± 851.6 g (range 900-4100 grams) and male was 3333 ± 996.4 g (range 1930-4700 grams). Nine out of 24 (37.5 %) neonates had low birth weight. Average low birth weight (±SD) was 1931.1 ± 420.52 g (range 900-2300 grams). Twenty out of the 24 (83.3 %) neonates were healthy. Four out of 24 neonates had neonatal complications: two neonates had GD type 1, one had GD type 3 and one neonate died two days after delivery (it was born at 26 weeks). Four neonates were hospitalized in incubators at the intensive neonatal care unit due to low birth weight. Thirty-nine women did not receive enzyme replacement therapy for GD during pregnancy, while, in two pregnancies, treatment was discontinued during the first trimester and re-administered after that. Mean first menarche age (±SD) was 13.6 ± 0.7 years. Thirteen out of 15 women were menopausal, mean menopausal age (± SD) 466 ± 2.6 years.Conclusion: Most of GD women experience uncomplicated pregnancies and deliver normal, healthy infants, although the rate of complications and the rate of abortions is high in this population. [ABSTRACT FROM AUTHOR]

Background: It is suggested that combining a healthy diet with physical activity during and before pregnancy have a significant effect on insulin sensitivity. This study aimed to investigate the relationship between physical activity and diet before and during pregnancy with the risk of gestational diabetes mellitus (GDM).Methods: A case-control study was conducted on 173 women with GDM diagnosed during the pregnancy as the case group and 168 women with a negative test for GDM as controls. Weight and height were measured and BMI was calculated. Dietary intake and physical activity data during pregnancy were collected using 24-hour food recall questionnaire and international physical activity questionnaire (IPAQ).Results: Body mass index and the intake of refined sugars, high fat dairy products, and fried foods were significantly higher and the intake of fruit and animal oil intake were significantly lower in the case group compared to the control group (All p < .05). However, there was not any significant association between the level of physical activity, vegetable intake, and total energy intake with the risk of GDM.Conclusions: According to the results of this study, dietary intake before and during the pregnancy have a critical effect on the risk of GDM. Appropriate dietary planning for pregnant women can reduce the risk of GDM. [ABSTRACT FROM AUTHOR]

Type 2 diabetes mellitus (T2DM) in postmenopausal women is associated with a high incidence of urogenital infections, which negatively impact the quality of life and increase morbidity, mortality, and health-care costs. Glucosuria is a known risk factor for these infections; therefore, it is of interest to determine if increased glucosuria secondary to sodium-glucose cotransporter-2 inhibitors (SGLT2in) impacts the incidence and severity of urogenital infections in postmenopausal women with T2DM. The study was conducted at Gaffrée Guinle University Hospital on two groups of postmenopausal women with T2DM: with and without SGLT2in therapy (n = 80 in each group). Medical records and laboratory parameters (urinary dipstick test and culture; blood glucose, glycosylated hemoglobin, and creatinine; cervical cytologic study) of all subjects were carefully assessed at baseline and thrice during the 12-month study period. We observed a significant incidence of vulvovaginitis (relative risk [RR], 2.37; 95% confidence interval [CI], 1.10–5.10; P = 0.03) and asymptomatic bacteriuria (RR, 2.47; 95% CI, 1.09–5.60; P = 0.03), but not of urinary tract infections (RR, 2.08; 95% CI, 0.74–5.81; P = 0.16), secondary to SGLT2in therapy. Genital infection was severe enough to warrant treatment discontinuation in 57.89% of patients in group 1. All urinary tract infections were of mild intensity with a good response to antibiotic therapy. Glucosuria induced by SGLT2in therapy may lead to a high incidence of urogenital infections in postmenopausal women with T2DM and can be considered a risk factor for these infections. [ABSTRACT FROM AUTHOR]

Objective: Abnormal pro-inflammatory regulation of the immune system might contribute to the pathogenesis of hyperglycemia during pregnancy. We examined the correlations of neutrophil–lymphocyte ratio (NLR) and monocyte–lymphocyte ratio (MLR) with disease severity and assessed their predictive values. Methods: This retrospective case–control study included 311 cases of hyperglycemia first detected during pregnancy (HFDP) [153 with gestational diabetes mellitus (GDM) and 158 with diabetes in pregnancy (DIP)] and, as a control group, 172 pregnant women with normal glucose tolerance. The NLRs and MLRs were calculated from the blood test data. Results: The absolute leukocyte, neutrophil, monocyte, and lymphocyte counts as well as the NLR and MLR values of HFDP patients significantly differed from control values, but no significant differences were detected in the leukocyte, neutrophil, and monocyte counts of the GDM and DIP groups. Significantly different metrics were selected, binary analysis performed, and odds ratios calculated to identify risk factors. Age, BMI, NLR, and MLR were found to be risk factors for HFDP, and high systolic blood pressure (SBP) at triage and MLR related to the occurrence of DIP. Receiver operating characteristics curve analysis showed that NLR and MLR had better diagnostic accuracy in distinguishing HFDP from controls [NLR area under the curve (AUC) = 0.78; MLR AUC = 0.72] than age and BMI. Values for NLR > 4.394 or MLR > 0.309 correlated with the severity of maternal clinical symptoms and perinatal infant outcomes. MLR was the best predictor of DIP (AUC = 0.72) and MLR values > 0.299 could identify patients at risk for developing DIP and having poor fetal outcomes. Conclusion: Metrics derived from peripheral blood neutrophil, monocyte, and lymphocyte counts are thought to reflect systemic immune-inflammation. Elevated MLR and NLR may be unfavorable prognostic factors for clinical outcomes in patients with hyperglycemia during pregnancy. [ABSTRACT FROM AUTHOR]

Objectives: An increasing percentage of the US population is obese. Cardiometabolic risk in the population increases with body mass index (BMI), but whether this correlation changes over time is unknown. We analysed the National Health and Nutrition Examination Survey (NHANES) database from 1999 to 2016 to determine if the prevalence of cardiometabolic disease and cardiovascular events within each BMI category is changing over time as the BMI of the population is increasing.Study Design: For each of the nine survey cycles covering this period, we divided the population by BMI category (normal, overweight, class 1 obesity, class ≥2 obesity) and subsequently by the presence of cardiovascular events or cardiometabolic disease. NHANES participants are a group of 5000 individuals/cycle selected to be representative of the US population. We used the weighted data sets to perform trend analyses for each risk/BMI group adjusted for relevant confounders.Results: The distribution of the highest risk category (cardiovascular event) has not changed over time within any BMI category. The distribution of the lowest risk category (cardiometabolically healthy) increased significantly over time in all BMI categories. This was noted in the 18- to 45-year subgroup but not in the group aged >45 years.Conclusions: The increase in the prevalence of overweight and obese individuals might be associated with a 'healthy obesity' phenotype in those <45 years; however, individuals >45 years showed a proportional increase in associated cardiometabolic risk. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the performance of first trimester maternal serum glycosylated (Sambucus nigra lectin-reactive) fibronectin in prediction of gestational diabetes mellitus (GDM). Methods: In this case–control study, first trimester maternal serum glycosylated fibronectin and fibronectin were measured in 19 women who consequently developed GDM and in 59 control women with normal pregnancy outcomes. Adiponectin was used as a reference protein to evaluate relation of glycoprotein to SNA-lectin-reactive assay format. Samples were taken during gestational weeks 9+6–11+6. Data concerning GDM was obtained from the National Institute for Health and Welfare, which records the pregnancy outcomes of all women in Finland. Results: There was no difference in maternal serum glycosylated fibronectin concentrations between women with consequent GDM [447.5 μg/mL, interquartile range (IQR) 254.4–540.9 μg/mL] and control women (437.6 μg/mL, IQR 357.1–569.1 μg/mL). Maternal serum fibronectin levels were significantly lower in GDM group (224.2 μg/mL, IQR 156.8–270.6 μg/mL), compared to the control group (264.8 μg/mL, IQR 224.6–330.6 μg/mL, p < 0.01). There was no difference in assay formats for adiponectin. Conclusion: There was no association between first trimester maternal serum glycosylated (SNA-reactive) fibronectin and GDM. [ABSTRACT FROM AUTHOR]

Background: The study was performed to evaluate the association between socio-demographic factors on the one hand, and quality of life and illness acceptance on the other, in pregnant women with hyperglycemia.Methods: The study was performed in the years 2016-2017 in south-eastern Poland. The study included 676 women: 339 pregnant women with hyperglycemia in the case group, and 337 healthy pregnant women in the control group. The research instruments applied included the WHOQOL-BREF quality of life questionnaire, the Acceptance of Illness Scale (AIS), and a general questionnaire.Results: Factors associated with quality of life in women with hyperglycemia include: relationship status, residence, professional activity, living conditions, number of pregnancies, self-reported knowledge of diabetes treatment and lifestyle and also of the potential pregnancy complications and fetal health impact associated with the disease, as well as the type of diabetes treatment (p < 0.05).The mean illness acceptance score among the patients is near the lower boundary of "moderate", 31.37 points. Factors associated with illness acceptance in women with hyperglycemia include: professional activity, living conditions, and self-reported knowledge of diabetes treatment and lifestyle and of the potential pregnancy complications and fetal health impact associated with the disease (p < 0.05).Conclusion: Better overall quality of life, general perceived health, and quality of life in all specific domains was found among healthy pregnant women compared to those with hyperglycemia. A higher level of illness acceptance has a positive effect on overall quality of life, general perceived health, and quality of life in all specific domains. General Quality of Life is positively correlated with reported living conditions and self-reported knowledge on glucose tolerance disorder treatment and lifestyle recommendations. AIS is positively correlated with living conditions, self-reported knowledge on glucose tolerance disorder treatment and lifestyle recommendations, and self-reported knowledge on possible pregnancy complications and infant health impact associated with glucose tolerance disorders. [ABSTRACT FROM AUTHOR]

Infantile colic is a functional gastrointestinal disease of the infancy that its cause has not yet been properly identified. It leads to severe discomfort in the infants and anxiety in their mothers. Probiotics have recently been recommended as an effective treatment for the improvement of infantile colic. The objective of this study is to determine the role of prenatal administration of Lactobacillus reuteri (L. reuteri) LR92 DSM 26866 on the occurrence of infantile colic. This double-blinded, placebo-controlled, randomized trial was conducted with healthy pregnant women from December 2017 to December 2018 in Isfahan, Iran. A total of 145 patients was included in this study. The case group consisted of 87 pregnant women, who received daily doses of 1 × 108 colony-forming units of live L. reuteri LR92 DSM 26866, and the control group with 88 pregnant women received the placebo (containing 9% glucose solutions) for the last 4 weeks of pregnancy. Mothers and their infants in both groups did not have significant differences in anthropometric indices, and the infants' feeding pattern. Infants born to both groups of mothers followed for 5 months on signs and symptoms of colic with the repetitive examination by a blinded pediatrics assistant to record the occurrence of colic and its grading. Mothers who received placebo were 2.36 times more likely to have infants exhibiting infantile colic than mothers in the L. reuteri LR92 DSM 26866 group (CI 95%, 1.18–4.73). Using Mann-Whitney U test, the Mean (SD) of colic severity was significantly lower in the intervention group (p = 0.01). The frequency of colic and its higher grades were significantly lower in the intervention group (p = 0.03 for the presence of colic and p = 0.01 for high grades of colic). The frequency of colic presence and its different grades according to mothers' delivery mode and infant feeding patterns were not different between the two groups (p > 0.05). Conclusion: Maternal prenatal supplementation with probiotic L. reuteri LR92 DSM 26866 during the last 4 weeks of pregnancy can prevent the occurrence and reduce the severity of infantile colic. What is Known • Lactobacillus reuteri LR92 DSM 26866 is effective in improving the symptoms of infantile colic. What is New • Prenatal administration of Lactobacillus Reuteri LR92 DSM 26866 can prevent the occurrence of infantile colic or reduce its severity. [ABSTRACT FROM AUTHOR]