Important User Information: Remote access to EBSCO's databases is permitted to patrons of subscribing institutions accessing from remote locations for personal, non-commercial use. However, remote access to EBSCO's databases from non-subscribing institutions is not allowed if the purpose of the use is for commercial gain through cost reduction or avoidance for a non-subscribing institution. Abstract: Gestational diabetes GDM is a glucose tolerance disorder which begins during pregnancy or diagnosed during pregnancy for the first time. Its prevalence increases day by day. The major reasons are the obesity incidence increasing globally and reducing threshold values in the diagnostic tests.
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Gestational diabetes mellitus GDM is defined as glucose intolerance with onset or first recognition during pregnancy 1,2. Women with known diabetes mellitus before conception are not classified as having GDM 3. The prevalence of GDM has increased over the past decades in parallel with the increase in the rates of obesity and type 2 diabetes mellitus T2D , and this trend is expected to continue. Women with GDM are at increased risk for urinary tract infections, pyelonephritis, asymptomatic bacteriuria, preeclampsia 2 , and cesarean delivery 5.
Fetal risks of poor glucose control include stillbirths, macrosomia 2 , birth trauma and neonatal hypoglycemia 5. Of having both high prevalence and important complications, GDM is one of the major metabolic disorders during pregnancy. GDM usually resolve postpartum, but commonly recur in subsequent pregnancies 4 and causes an increased risk for T2D later in life 5. In the pathogenesis of GDM and T2D, beta cells responsible for insulin secretion are destroyed, thus, insulin secretion diminishes, glucagon secretion increases and insulin resistance occurs.
GLP-1 is an incretin hormone that is released rapidly into the circulation after oral nutrient ingestion 6. GLP-1 stimulates insulin secretion, inhibits glucagon secretion and gastric emptying 7.
It induces weight loss by reducing food intake 8,9. Some studies have indicated that GLP-1 might inhibit beta cell apoptosis and stimulate beta cell proliferation In our study, we have evaluated GLP-1 secretion in response to oral glucose load in pregnant women at a high risk for GDM. Thirty-one patients having one of these risk factors were randomly selected. Patients having T2D or impaired glucose intolerance before pregnancy were excluded from the study.
All of them were evaluated in fasting blood samples. Besides, glucose, insulin, c-peptide, and GLP-1 levels during OGTT were also evaluated in blood samples collected at 60 and minutes. The patients were informed verbally about the study and written informed consent was obtained from all participants. Data analysis was performed by SPSS Continuous variables were presented as mean, median and standard deviation, and minimum-maximum values.
The Mann-Whitney U test was used to evaluate the statistical significance between two different medians. A p value of less than 0. The median level of A1C was 5. Lencioni et al. Kosinski et al. Bonde et al. The levels of GLP-1 during pregnancy were lower than the levels after pregnancy Insulin and c-peptide levels should be parallel to each other. However, in our study, while fasting insulin levels were statistically higher in women with GDM, fasting c-peptide levels were not higher than in those without GDM.
In addition, c-peptide levels at minutes during OGTT were higher in women with GDM, but there was no statistically significant difference in insulin levels. This may be due to searching on a small sample size because huge differences from median level may affect the p value. Peer-review: Internally peer-reviewed. Metzger BE. Diabetes ;40 Suppl 2 Gardner D, Shoback D. Goldman L, Ausiello D. Cecil Textbook of Internal Medicine. In: Bennerr JC, 21st ed. Philadelphia; Saunders; Screening and diagnosing gestational diabetes mellitus.
Gestational diabetes mellitus. J Clin Invest ; Glucagon-like peptide-1 and glucose-dependent insulin-releasing polypeptide plasma levels in response to nutrients. Digestion ; Glucagon-like peptide 1 promotes satiety and suppresses energy intake in humans. Glucagon-like peptide a potent regulator of food intake in humans.
Gut ; Am J Clin Nutr ; Drucker DJ. Glucagon-like peptide-1 and the islet beta-cell: augmentation of cell proliferation and inhibition of apoptosis. Endocrinology ; Gerich JE. The genetic basis of type 2 diabetes mellitus: Impaired insulin secretion versus impaired insulin sensitivity. Endocr Rev ; Reduced incretin effect in type 2 non-insulin-dependent diabetes. Diabetologia ; Impaired circulating glucagon-like peptide-1 response to oral glucose in women with previous gestational diabetes.
Clin Endocrinol ; Glucagon-like peptide-1 secretion in women with gestational diabetes mellitus during and after pregnancy. J Endocrinol Invest ; Postpartum reversibility of impaired incretin effect in gestational diabetes mellitus. Regul Pept ; Normal secretion of the incretin hormones glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 during gestational diabetes mellitus. Gynecol Endocrinol ; Reduced postprandial GLP-1 responses in women with gestational diabetes mellitus.
Diabetes Obes Metab ; Use of glycosylated hemoglobin as a screen for macrosomia in gestational diabetes. Obstet Gynecol ; Lipid profile and glycosylated hemoglobin status of gestational diabetic patients and healthy pregnant women. Indian J Med Sci ; Epidemiology of gestational diabetes mellitus and its association with Type 2 diabetes.
Diabetic Medicine ; Impact of gestational diabetes on lipid profiling and indices of oxidative stress in maternal and cord plasma. Saudi Med J ;
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Year , Volume 11 , Issue 1, Pages 0 - 0 Zotero Mendeley EndNote. References - Butte NF. Carbohydrate and lipid metabolism in pregnancy: normal compared with gestational diabetes mellitus. Fuel metabolism during pregnancy. The roles of placental growth hormone and placental lactogen in the regulation of human fetal growth and development. J Pediatr Endocrinol Metab.
Gestational diabetes mellitus GDM is defined as glucose intolerance with onset or first recognition during pregnancy 1,2. Women with known diabetes mellitus before conception are not classified as having GDM 3. The prevalence of GDM has increased over the past decades in parallel with the increase in the rates of obesity and type 2 diabetes mellitus T2D , and this trend is expected to continue. Women with GDM are at increased risk for urinary tract infections, pyelonephritis, asymptomatic bacteriuria, preeclampsia 2 , and cesarean delivery 5. Fetal risks of poor glucose control include stillbirths, macrosomia 2 , birth trauma and neonatal hypoglycemia 5. Of having both high prevalence and important complications, GDM is one of the major metabolic disorders during pregnancy.