The effect of myoinositol supplementation on insulin resistance in patients with gestational diabetes To test the hypothesis that myoinositol supplementation will improve insulin sensitivity as measured by markers of insulin resistance such as homeostasis model assessment of insulin resistance and adiponectin in women with gestational diabetes.The trial was carried out in diet-treated patients with gestational diabetes diagnosed in our department between April 2008 and September 2009. Subjects (...) . Fasting glucose and insulin, and consequently homeostasis model assessment of insulin resistance, decreased in both groups (50% in the study group vs. 29% in the control group), but the decline in the study group was significantly greater than that in the control group (P = 0.0001). Adiponectin increased in the myoinositol group while it decreased in the control group (P = 0.009).Myoinositol improves insulin resistance in patients with gestational diabetes.© 2011 The Authors. Diabetic Medicine © 2011

Accuracy of the random glucose test as screening test for gestational diabetes mellitus: a systematic review Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

Metformin should be considered in the treatment of gestational diabetes: a prospective randomised study To examine if oral metformin is as effective as insulin in the prevention of fetal macrosomy in pregnancies complicated with gestational diabetes mellitus (GDM).Open-label prospective randomised controlled study.Maternity outpatient clinics in a secondary and tertiary level hospital in Finland.One hundred women with GDM who did not attain euglycaemia with diet.Women were randomised to therapy (...) with insulin (n = 50) or oral metformin (n = 50).Incidence of large-for-gestational-age (LGA) infants and neonatal morbidity.There were no statistically significant differences in the incidence of LGA (8.5 versus 10.0%, P = 0.97), mean birthweight, mean cord artery pH or neonatal morbidity between the insulin and metformin groups. Fifteen (31.9%) of the 47 women randomised to metformin needed supplemental insulin. They were more obese (with a body mass index of 36 versus 30 kg/m(2), P = 0.002), had higher

Gestational Diabetes - Whom Do We Treat?

Diagnosis and Treatment of Gestational Diabetes Diagnosis and Treatment of Gestational Diabetes Scientific Impact Paper No. 23 January 2011Diagnosis and Treatment of Gestational Diabetes 1. Background Historically, there has been controversy over screening and diagnosis of gestational diabetes. The 2002 National Institute for Health and Clinical Excellence (NICE) Health Technology Assessment concluded that there was insufficient evidence to advocate universal screening in pregnancy while noting (...) women. The results of this large observational study formed the basis of a reconsideration of diagnosis and screening for diabetes in a consensus report published in 2010 4 under the auspices of the International Association of Diabetes and Pregnancy Study Groups (IADPSG). A further major trial examining the effect on pregnancy outcomes of management of gestational diabetes was reported in 2009, 5 while a randomised controlled trial in 2008 examined the efficacy of metformin, 6 adding to the older

Development of a model to assess the cost-effectiveness of gestational diabetes mellitus screening and lifestyle change for the prevention of type 2 diabetes mellitus Development of a model to assess the cost-effectiveness of gestational diabetes mellitus screening and lifestyle change for the prevention of type 2 diabetes mellitus Development of a model to assess the cost-effectiveness of gestational diabetes mellitus screening and lifestyle change for the prevention of type 2 diabetes (...) mellitus Lohse N, Marseille E, Kahn JG Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary The study examined the cost-effectiveness of gestational diabetes mellitus screening and management using a mathematical model (GDModel). The authors

Resistance exercise and glycemic control in women with gestational diabetes mellitus The objective of the study was to evaluate the effect of a resistance exercise program with an elastic band on insulin requirement and glycemic control in patients with gestational diabetes mellitus (GDM).Sixty-four patients with gestational diabetes mellitus were randomly assigned into 2 groups: an exercise group (EG; n = 32) and a control group not submitted to the exercise program (CG; n = 32).A significant

Oral hypoglycemic agents vs insulin in management of gestational diabetes: a systematic review and metaanalysis The objective of this review was to provide pooled estimates of randomized controlled trials comparing the effects of oral hypoglycemic agents with insulin in achieving glycemic control and to study the maternal and perinatal outcomes in gestational diabetes mellitus.A protocol for the study was developed. All metaanalyses were performed using Stats Direct statistical software (Stats (...) of caesarean section (OR, 0.91; 95% CI, -0.68 to 1.22), or incidence of large-for-gestational-age babies (OR, 1.01; 95% CI, 0.61-1.68).Our study demonstrates that there are no differences in glycemic control or pregnancy outcomes when OHAs were compared with insulin.Copyright © 2010 Mosby, Inc. All rights reserved.

Gestational diabetes mellitus: simplifying the international association of diabetes and pregnancy diagnostic algorithm using fasting plasma glucose To determine the impact of the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria on 1) gestational diabetes mellitus (GDM) diagnosis compared with the American Diabetes Association (ADA) criteria and 2) the fasting plasma glucose (FPG) to predict GDM.In 10,283 pregnant women undergoing a 75-g oral glucose tolerance

Oral anti-diabetic agents for women with pre-existing diabetes mellitus/impaired glucose tolerance or previous gestational diabetes mellitus. While most guidelines recommend the use of insulin in women whose pregnancies are affected by pre-existing diabetes, oral agents have obvious benefits for patient acceptability and adherence. It is necessary, however, to assess the effects of these anti-diabetic agents on maternal and infant health outcomes. Additionally, women with previous gestational (...) diabetes mellitus are increasingly found to be predisposed to impaired glucose tolerance and, despite the potential need for intervention for these women, there has been little evidence about the use of oral anti-diabetic agents by these women pre-conceptionally or during a subsequent pregnancy.To investigate the effect of oral anti-diabetic agents in women with pre-existing diabetes mellitus, impaired glucose tolerance or previous gestational diabetes planning a pregnancy or pregnant women

Effects of treatment in women with gestational diabetes mellitus: systematic review and meta-analysis. To summarise the benefits and harms of treatments for women with gestational diabetes mellitus.Systematic review and meta-analysis of randomised controlled trials.Embase, Medline, AMED, BIOSIS, CCMed, CDMS, CDSR, CENTRAL, CINAHL, DARE, HTA, NHS EED, Heclinet, SciSearch, several publishers' databases, and reference lists of relevant secondary literature up to October 2009. Review methods (...) Included studies were randomised controlled trials of specific treatment for gestational diabetes compared with usual care or "intensified" compared with "less intensified" specific treatment.Five randomised controlled trials matched the inclusion criteria for specific versus usual treatment. All studies used a two step approach with a 50 g glucose challenge test or screening for risk factors, or both, and a subsequent 75 g or 100 g oral glucose tolerance test. Meta-analyses did not show significant

Gestational diabetes mellitus (GDM). Evidence-based nutrition practice guideline. Guidelines and Measures | Agency for Healthcare Research & Quality HHS.gov Search ahrq.gov Search ahrq.gov Menu Topics A - Z Healthcare Delivery Latest available findings on quality of and access to health care Searchable database of AHRQ Grants, Working Papers & HHS Recovery Act Projects AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund You are here Guidelines and Measures Funding

First-trimester follistatin-like-3 levels in pregnancies complicated by subsequent gestational diabetes mellitus OBJECTIVE To determine whether maternal levels of follistatin-like-3 (FSTL3), an inhibitor of activin and myostatin involved in glucose homeostasis, are altered in the first trimester of pregnancies complicated by subsequent gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS This was a nested case-control study of subjects enrolled in a prospective cohort of pregnant (...) women with and without GDM (> or =2 abnormal values on a 100-g glucose tolerance test at approximately 28 weeks of gestation). We measured FSTL3 levels in serum collected during the first trimester of pregnancy. Logistic regression analyses were used to determine the risk of GDM. RESULTS Women who developed GDM (n = 37) had lower first-trimester serum levels of FSTL3 compared with women who did not (n = 127) (median 10,789 [interquartile range 7,013-18,939] vs. 30,670 [18,370-55,484] pg/ml, P

Risk factors for gestational diabetes mellitus in Chinese women: a prospective study of 16,286 pregnant women in China To determine the incidence of gestational diabetes mellitus (GDM) in China and to further identify population specific risk factors for GDM.Following a universal GDM screening recommendation, 16,286 pregnant women who underwent a 50-g glucose challenge test from 18 cities in China were followed up through pregnancy. GDM was confirmed by oral glucose tolerance test according (...) to American Diabetes Association criteria.The incidence of GDM was 4.3%. Previously reported risk factors for GDM, including advanced maternal age, pre-pregnancy obesity and family history of diabetes, were strongly associated with an elevated GDM risk. Moreover, after the adjustment for the above-mentioned risk factors, a history of recurrent vulvovaginal candidiasis, residency in south China and a history of spontaneous abortion were significantly associated with an increased GDM risk; adjusted odds

What is known about options and approaches to intrapartum management of women with gestational diabetes mellitus (GDM)? KTA Evidence Summary: Intrapartum Management of Patients with Gestational Diabetes Mellitus (GDM) Page 1 of 19 May 2010 May 2010 – Knowledge to Action Evidence Summary What is known about options and approaches to fetal surveillance and intrapartum management of women with gestational diabetes mellitus (GDM)? This report aims to summarize the evidence around the intrapartum (...) management of women with gestational diabetes mellitus (GDM) to help inform evidence-based guidelines and advance practice in the province of Ontario. Key Messages ? Gestational Diabetes Mellitus (GDM) can cause serious complications in the intrapartum care of pregnant women and their fetuses. The impact and treatment differs somewhat from that of Type 1 and Type 2 diabetes. ? Fetal surveillance is a key aspect of the intrapartum care of the fetus. The most prominent methods appear to be: fetal movement

Post Partum Care for Gestational Diabetes Mellitus KTA Evidence Summary: Postpartum Intervention for Women with History of GDM Page 1 of 19 March 2010 March 2010 – Knowledge to Action Evidence Summary What is known about postpartum intervention for women with history of GDM? Gestational diabetes mellitus (GDM) is a sentinel event in the life of a woman of reproductive age that confers risk to both mother and baby for future development of type 2 diabetes mellitus (T2D) and a host of other (...) to provide some context; these statements are not meant to address all of the evidence in existence on the subject, rather, that which is featured in this document. KTA Evidence Summary: Postpartum Intervention for Women with History of GDM Page 2 of 19 March 2010 Background According to the 2008 Canadian Diabetes Association Clinical Practice Guidelines, the prevalence of gestational diabetes mellitus (GDM) in Canada varies around 3.7% for non-Aboriginals and ranges from 8-18% in the Aboriginal

[Medtronic-Minimed Continuous Glucose Monitoring System for patients with type 1 diabetes mellitus and gestational diabetes: efficacy and safety] Sistemes de monitoratge continu de glucosa de Medtronic-Minimed a pacients amb diabetis mellitus de tipus 1 i gestacional: eficacia i seguretat [Medtronic-Minimed Continuous Glucose Monitoring System for patients with type 1 diabetes mellitus and gestational diabetes: efficacy and safety] Sistemes de monitoratge continu de glucosa de Medtronic-Minimed (...) a pacients amb diabetis mellitus de tipus 1 i gestacional: eficacia i seguretat [Medtronic-Minimed Continuous Glucose Monitoring System for patients with type 1 diabetes mellitus and gestational diabetes: efficacy and safety] Solans M, Kotzeva A, Almazan C Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Solans M, Kotzeva A, Almazan C. Sistemes de

Oral hypoglycemic agents vs insulin in management of gestational diabetes: a systematic review and metaanalysis Oral hypoglycemic agents vs insulin in management of gestational diabetes: a systematic review and metaanalysis Oral hypoglycemic agents vs insulin in management of gestational diabetes: a systematic review and metaanalysis Dhulkotia JS, Ola B, Fraser R, Farrell T CRD summary This review found no significant differences between oral hypoglycaemic agents and insulin in glycaemic (...) control or pregnancy outcomes in women with gestational diabetes. Patient satisfaction was higher with the oral agents because of ease of administration. The small numbers of included studies mostly with small sample sizes and of poor quality should be considered when interpreting the results Authors' objectives To compare the effects of oral hypoglycaemic agents (OHA) to insulin treatment in pregnant women with gestational diabetes Searching MEDLINE, EMBASE, National Health Service Library

Effects of treatment in women with gestational diabetes mellitus: systematic review and meta-analysis Effects of treatment in women with gestational diabetes mellitus: systematic review and meta-analysis Effects of treatment in women with gestational diabetes mellitus: systematic review and meta-analysis Horvath K, Koch K, Jeitler K, Matyas E, Bender R, Bastian H, Lange S, Siebenhofer A CRD summary This well-conducted systematic review aimed to determine the benefits and harms of specific (...) treatments for women with gestational diabetes mellitus. The authors concluded that treatment appeared to lower the risk of some perinatal or neonatal complications, but that insufficient data were available to draw conclusions on possible long-term effects of treatment. These conclusions are likely to be reliable. Authors' objectives To determine the benefits and harms of specific treatments for women with gestational diabetes mellitus. Searching MEDLINE, EMBASE, AMED, BIOSIS Previews, CCMed (Current

Gestational diabetes: fasting capillary glucose as a screening test in a multi-ethnic, high-risk population In populations at high risk of gestational diabetes mellitus (GDM), screening every pregnant woman by an oral glucose tolerance test (OGTT) is very demanding. The aim of this study was to determine the value of the fasting capillary glucose (FCG) as a screening test for GDM.FCG was measured by a plasma-correlated glucometer in 1465 pregnant women who underwent a one-step diagnostic 75-g (...) OGTT for universal screening of GDM.One hundred and ninety-six (13.4%) women had GDM as defined by the criteria of the American Diabetes Association. The area under the receiver operating characteristic curve (AUC) of the FCG was 0.83 (95% confidence interval 0.80-0.86). A FCG threshold of 4.7 mmol/l (at an acceptable sensitivity of 86.0%) independently could rule-out GDM in 731 (49.9%) women, while the FCG could rule-in GDM (100% specificity) in 16 (1.1%) additional women; therefore, approximately