Risk Factors and Management of Gestational Diabetes

Abstract

Gestational diabetes mellitus (GDM) is considered to be a typical condition of glucose intolerance in which a woman previously undiagnosed with diabetes exhibits high levels of blood glucose during the third trimester of pregnancy. It can hence be defined as any degree of intolerance to glucose with its first recognition only during the pregnancy. Approximately 7 % of all cases of pregnancy are found to be variedly complicated with GDM and this result in more than 200,000 cases annually. In US only, GDM has been found to complicate about 7-14 % cases annually, and the trend seems to have increased by 35-100 % in the recent years. A history of GDM can be considered to be one of the sturdiest risk factors concerning the development of type 2 diabetes. Among women who have a history of GDM, the risk of developing classical type 2 diabetes usually ranges from 20 to 50 %. Evidences collected from various efficacy trials suggest that lifestyle interventions like weight management can modulate and prevent type 2 diabetes in at-risk individuals. The cornerstone of GDM management is glycemic control, and hence, it is attributed to be the main focus of attention for the therapy. In this review, we have tried to highlight the various risk factors associated with GDM along with the available therapeutic options in the treatment and management of the disease.

Clinical Recommendations for the Use of Islet Cell Autoantibodies to Distinguish Autoimmune and Non-Autoimmune Gestational Diabetes

“…There is enormous literature on both main types of diabetes -T1D and T2D, including the role of microflora [107,108], inflammatory responses, including gestational influences [109][110][111][112], interventional studies in both humans and animal models [113][114][115][116][117], the role of vitamin D and other nutritional factors [118][119][120][121], and better definition of genetic control, autoantibodies, and the implications of offspring of the diabetic mother [122][123][124]. In this manuscript, we have focused on the research data that reflects the metabolic conditions of pregnancy and adiposity.…”

Structural Heterogeneity and Dynamics of the Unfolded Ensemble

“…Some examples of proteins that maintain various degrees of disorder in the bound state have been described in the last few years, [47] shedding light on the possibility of having a continuous structural spectrum of functional proteins. [45,48] Molecular dynamics simulations have proven to be a powerful tool for studying conformational heterogeneity of IDPs, [49,50] providing the spatial and temporal resolution necessary to understand, for example, the molecular mechanism by which these proteins couple folding to binding in a functional way. [36,51,52] Histone tails, which play a crucial role in DNA compaction, are an example of IDPs which exhibit mostly compact molten-globule like structures (Figure 1).…”

Coarse-grained residue-based models of disordered protein condensates: utility and limitations of simple charge pattern parameters

“…62 To assess the extent to which predictions from these models are affected by lattice artifacts and to broaden our effort to model biomolecular condensates in general, here we apply more realistic coarse-grained models wherein IDP chains are configured in the continuum. [80][81][82][83] Coarse-grained explicit-chain models are well-suited to address general physical principles. The rapidly expanding experimental efforts have provided an increasing rich set of data on overall physical properties of biomolecular condensates that awaits theoretical analysis.…”