The diversity of gestational diabetes: a therapeutic challenge

Qvigstad, Elisabeth

doi:10.1530/eje-18-0012

Cited by 5 publications

(7 citation statements)

References 41 publications

(39 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Metformin is increasingly used in the treatment of GDM, however its use in pregnancy is still controversial due to the lack of convincing long-term offspring safety data [31] and, therefore, insulin is the first-line agent in many countries, including the US also [7]. Even if the unresolved concerns with metformin use in pregnancy would have been cleared, it is important to recognize that 34.8% [32] to nearly half [33] of GDM patients who initiated their drug therapy with metformin eventually had to start AIT during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

The MTNR1B rs10830963 Variant in Interaction with Pre-Pregnancy BMI is a Pharmacogenetic Marker for the Initiation of Antenatal Insulin Therapy in Gestational Diabetes Mellitus

Firneisz

Rosta

Al-Aissa

et al. 2018

IJMS

View full text Add to dashboard Cite

The rs10830963 variant of the Melatonin Receptor 1B (MTNR1B) gene is associated with the development of gestational diabetes mellitus (GDM). We hypothesized that carrying the rs10830963/G risk allele had effect on antenatal insulin therapy (AIT) initiation in GDM in a body mass index (BMI)-dependent manner. Design: In this post hoc analysis the MTNR1B rs10830963 genotype and the clinical data of 211 Caucasian GDM patients were assessed. As a first step, a pre-pregnancy BMI threshold was determined where the effect of MTNR1B rs10830963/G allele carrying on AIT initiation was the most significant using logistic regression. Maternal age adjusted real-life odds ratios (OR) values were calculated. The chi-square test was also used to calculate the p value and 10.000 bootstrap simulations were performed in each case to re-assess the statistical power and the OR. Carrying the MTNR1B rs10830963/G allele increased the odds of AIT initiation (OR = 5.2, p = 0.02 [χ2 test], statistical power = 0.53) in GDM patients with pre-pregnancy BMI ≥ 29 kg/m2. The statistical power reached 0.77, when the pre-pregnancy BMI cutoff of 27 kg/m2 was used and the genetic effect on AIT initiation was still significant, but only using the logistic regression model. Carrying the MTNR1B rs10830963/G risk allele—in interaction with pre-pregnancy BMI—is likely be considered as a candidate pharmacogenetic marker of antenatal insulin therapy initiation and should be further assessed in precision medicine trials in GDM.

show abstract

Section: Discussionmentioning

confidence: 99%

The MTNR1B rs10830963 Variant in Interaction with Pre-Pregnancy BMI is a Pharmacogenetic Marker for the Initiation of Antenatal Insulin Therapy in Gestational Diabetes Mellitus

Firneisz

Rosta

Al-Aissa

et al. 2018

IJMS

View full text Add to dashboard Cite

show abstract

“…A metformina consiste em discussão controversa quanto ao seu uso na gravidez, entretanto, tem sido recomendada em países como o Reino Unido desde 2008 para o tratamento de síndrome do ovário policístico, cancro e obesidade, incluindo prevenção em populações prédiabéticas e no diabetes gestacional (GIVEN et al, 2018). Tem como principal ação a redução da gliconeogênese hepática, incluindo outros efeitos antidiabéticos associados a apetite, esteroidogênese, ativação de cinases e influência favorável na microbiota intestinal (QVIGSTAD, 2018). Desse modo, promove a diminuição de glicose no sangue, minimizando a chance de hipoglicemia e ganho de peso durante a gestação (PRIYA; KALRA, 2018).…”

Section: Resultsunclassified

O uso de metformina no controle do Diabetes Gestacional

Moreira

Rezende

Pereira

et al. 2020

BJHR

View full text Add to dashboard Cite

show abstract

“…GDM is a health problem with deleterious effects on maternal health not limited by delivery but may prolong and expose these women to long-term medical problems (8) as women with GDM are at increased risk of developing manifest T2-DM (9. 10) and had a significantly increased incidence of hypertension and ischemic heart diseases (10) .…”

mentioning

confidence: 99%

Reciprocal Relationship Between Insulin Resistance and Disturbed Adma/No Axis in Gestational Diabetes Mellitus.

MD¹,

MD²,

MD³

2018

IJAR

View full text Add to dashboard Cite

Objectives: To estimate serum nitric oxide (NO) and asymmetric dimethylarginine (ADMA) levels in pregnant women and correlate it with severity of gestational diabetes mellitus (GDM) judged by Oral Glucose Tolerance Test (OGTT). Patients & Methods: 225 pregnant women gave fasting blood samples to estimate baseline blood glucose (BG), and serum insulin, NO and ADMA, and to undergo OGTT. Insulin resistance (IR) was indicated by HOMA-IR score >2. At 24 th week, blood sample were re-evaluated using OGTT and women were categorized in Study (GDM) and Control (free of GDM) group. Results: At 24 th week, HOMA-IR scores were significantly higher than baseline scores and in study versus control women. Baseline serum ADMA levels were significantly higher, while serum NO levels were significantly lower in study versus control women and correlated with body mass index (BMI), GDM, BG and HOMA-IR score of all women. Serum ADMA and NO showed significant correlation with extent of serum insulin change, but low serum NO is significant predictor for development and severity of IR. Conclusion: IR induces endothelial dysfunction manifested as low serum NO and high serum ADMA. Baseline serum NO could predict the extent of serum insulin change.

show abstract

The diversity of gestational diabetes: a therapeutic challenge

Cited by 5 publications

References 41 publications

The MTNR1B rs10830963 Variant in Interaction with Pre-Pregnancy BMI is a Pharmacogenetic Marker for the Initiation of Antenatal Insulin Therapy in Gestational Diabetes Mellitus

The MTNR1B rs10830963 Variant in Interaction with Pre-Pregnancy BMI is a Pharmacogenetic Marker for the Initiation of Antenatal Insulin Therapy in Gestational Diabetes Mellitus

O uso de metformina no controle do Diabetes Gestacional

Reciprocal Relationship Between Insulin Resistance and Disturbed Adma/No Axis in Gestational Diabetes Mellitus.

Contact Info

Product

Resources

About