Long-term cardio-metabolic effects after gestational diabetes: a review

Burlina, Silvia; Dalfrà, Maria Grazia; Lapolla, Annunziata

doi:10.1080/14767058.2021.1903863

Cited by 6 publications

(5 citation statements)

References 59 publications

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“…1 Today, the burden of GDM on healthcare system and economy is remarkable since the incidence of GDM is increasing together with obesity globally, 2 and it is associated with a range of adverse short-term and long-term consequences for both the mother and child. [3][4][5][6][7] The primary treatment for GDM and glycaemic control is through adjustments toward heathier lifestyle, especially changing the diet and increasing exercising. 8 9 It is critical that women with GDM are supported in this behaviour change.…”

Section: Introductionmentioning

confidence: 99%

Comprehensive self-tracking of blood glucose and lifestyle with a mobile application in the management of gestational diabetes: a study protocol for a randomised controlled trial (eMOM GDM study)

et al. 2022

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IntroductionGestational diabetes (GDM) causes various adverse short-term and long-term consequences for the mother and child, and its incidence is increasing globally. So far, the most promising digital health interventions for GDM management have involved healthcare professionals to provide guidance and feedback. The principal aim of this study is to evaluate the effects of comprehensive and real-time self-tracking with eMOM GDM mobile application (app) on glucose levels in women with GDM, and more broadly, on different other maternal and neonatal outcomes.Methods and analysisThis randomised controlled trial is carried out in Helsinki metropolitan area. We randomise 200 pregnant women with GDM into the intervention and the control group at gestational week (GW) 24–28 (baseline, BL). The intervention group receives standard antenatal care and the eMOM GDM app, while the control group will receive only standard care. Participants in the intervention group use the eMOM GDM app with continuous glucose metre (CGM) and activity bracelet for 1 week every month until delivery and an electronic 3-day food record every month until delivery. The follow-up visit after intervention takes place 3 months post partum for both groups. Data are collected by laboratory blood tests, clinical measurements, capillary glucose measures, wearable sensors, air displacement plethysmography and digital questionnaires. The primary outcome is fasting plasma glucose change from BL to GW 35–37. Secondary outcomes include, for example, self-tracked capillary fasting and postprandial glucose measures, change in gestational weight gain, change in nutrition quality, change in physical activity, medication use due to GDM, birth weight and fat percentage of the child.Ethics and disseminationThe study has been approved by Ethics Committee of the Helsinki and Uusimaa Hospital District. The results will be presented in peer-reviewed journals and at conferences.Trial registration numberNCT04714762.

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Section: Introductionmentioning

confidence: 99%

Comprehensive self-tracking of blood glucose and lifestyle with a mobile application in the management of gestational diabetes: a study protocol for a randomised controlled trial (eMOM GDM study)

et al. 2022

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“…These recent prevalence findings are consistent with the high prevalence of overall diabetes in these regions, and it has been suggested that the same lifestyle risk factors that underly the overall diabetes, such as obesity and metabolic syndrome, also contribute to an increased risk of GDM. GDM is associated with a range of adverse short-and long-term consequences for both mother and child [2][3][4]. Although GDM is a temporary condition that lasts until the birth of the child, GDM increases the later risk of type 2 diabetes [5].…”

Section: Introductionmentioning

confidence: 99%

Behavior Change App for Self-management of Gestational Diabetes: Design and Evaluation of Desirable Features

Kytö¹,

Koivusalo²,

Ruonala³

et al. 2022

JMIR Hum Factors

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Background Gestational diabetes (GDM) has considerable and increasing health effects as it raises both the mother’s and the offspring’s risk for short- and long-term health problems. GDM can usually be treated with a healthier lifestyle, such as appropriate dietary modifications and sufficient physical activity. Although telemedicine interventions providing weekly or more frequent feedback from health care professionals have shown the potential to improve glycemic control among women with GDM, apps without extensive input from health care professionals are limited and have not been shown to be effective. Different features in personalization and support have been proposed to increase the efficacy of GDM apps, but the knowledge of how these features should be designed is lacking. Objective The aim of this study is to investigate how GDM apps should be designed, considering the desirable features based on the previous literature. Methods We designed an interactive GDM prototype app that provided example implementations of desirable features, such as providing automatic and personalized suggestions and social support through the app. Women with GDM explored the prototype and provided feedback in semistructured interviews. Results We identified that (1) self-tracking data in GDM apps should be extended with written feedback, (2) habits and goals should be highly customizable to be useful, (3) the app should have different functions to provide social support, and (4) health care professionals should be notified through the app if something unusual occurs. In addition, we found 2 additional themes. First, basic functionalities that are fast to learn by women with GDM who have recently received the diagnosis should be provided, but there should also be deeper features to maintain interest for women with GDM at a later stage of pregnancy. Second, as women with GDM may have feelings of guilt, the app should have a tolerance for and a supporting approach to unfavorable behavior. Conclusions The feedback on the GDM prototype app supported the need for desirable features and provided new insights into how these features should be incorporated into GDM apps. We expect that following the proposed designs and feedback will increase the efficacy of GDM self-management apps. Trial Registration ClinicalTrials.gov NCT03941652; https://clinicaltrials.gov/ct2/show/NCT03941652

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“…It accounts for 12–18% of all pregnancies and is due mainly to the increased frequency of obesity [ 2 , 3 ]. This condition, if not properly diagnosed and treated, determines a series of short- and long-term maternal and fetal complications such as preeclampsia, cesarean delivery, birth trauma, macrosomia, neonatal hypoglycemia and hyperbilirubinemia [ 3 , 4 , 5 ]. Furthermore, women affected by GDM and their children are at high risk of developing cardiometabolic diseases (including type 2 diabetes, obesity, hyperlipemia, metabolic syndrome, hypertension, and cardiovascular disease) later in life [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…This condition, if not properly diagnosed and treated, determines a series of short- and long-term maternal and fetal complications such as preeclampsia, cesarean delivery, birth trauma, macrosomia, neonatal hypoglycemia and hyperbilirubinemia [ 3 , 4 , 5 ]. Furthermore, women affected by GDM and their children are at high risk of developing cardiometabolic diseases (including type 2 diabetes, obesity, hyperlipemia, metabolic syndrome, hypertension, and cardiovascular disease) later in life [ 4 , 5 ]. GDM develops when beta cell insulin secretion is unable to compensate for the physiological pregnancy-induced insulin resistance, and/or in conjunction with an impaired beta cell function [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Proteomic Approaches in the Study of Placenta of Pregnancy Complicated by Gestational Diabetes Mellitus

Lapolla

Traldi

2022

Biomedicines

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Gestational diabetes mellitus (GDM), a glucose intolerance developing or first recognized during pregnancy, leads to a series of short- and long-term maternal and fetal complications, somehow related to placenta structural and functional changes. The focus and the objective of the present review are to discuss the results which can be obtained by different mass spectrometric approaches in the study of placenta protein profile. Thus, matrix-assisted laser desorption/ionization mass spectrometry (MALDI) has been applied on placenta omogenates before and after one-dimensional electrophoretic separation, followed by tryptic digestion. MALDI imaging was used for direct investigation on the placenta tissue (both maternal and fetal sides). The results showed that some differences among the absolute abundances of some proteins are present for placenta samples from GDM patients. The majority of investigations were carried out by two-dimensional electrophoresis (2DE) followed by LC-MS/MS or, directly by the label-free LC-MSE approach. It should be emphasized that all these techniques were showed differences in the protein expression between the placenta samples from healthy or GDM subjects. 2DE was also employed to separate and compare placental protein levels from GDM and the control groups: differentially expressed proteins between the two groups were identified by MALDI-TOF/TOF mass spectrometry and were further confirmed by Western blotting. The physiopathological significance of the obtained results are reported and discussed in this narrative review. The experimental data obtained until now show that the newest, mass spectrometric approaches can be considered a valid tool to investigate the possible changes of placenta in the presence of GDM.

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Long-term cardio-metabolic effects after gestational diabetes: a review

Cited by 6 publications

References 59 publications

Comprehensive self-tracking of blood glucose and lifestyle with a mobile application in the management of gestational diabetes: a study protocol for a randomised controlled trial (eMOM GDM study)

Comprehensive self-tracking of blood glucose and lifestyle with a mobile application in the management of gestational diabetes: a study protocol for a randomised controlled trial (eMOM GDM study)

Behavior Change App for Self-management of Gestational Diabetes: Design and Evaluation of Desirable Features

Proteomic Approaches in the Study of Placenta of Pregnancy Complicated by Gestational Diabetes Mellitus

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