Vascular Complications in the Diabetic Pregnancy

Leguizamón, Gustavo; Trigubo, Denise; Pereira, J.I.; Vera, María Fernanda; Fernandez, Jessica

doi:10.1007/s11892-015-0586-5

Cited by 76 publications

(21 citation statements)

References 86 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Appropriate blood glucose levels are then maintained through homeostatic mechanisms such as hypertrophy and hyperplasia of pancreatic β-cells (10). However, in GDM pregnancies, normal metabolic adaptions fail to adequately control glycemic levels, resulting in hyperglycemia and secondary complications such as vasculopathy and birthing complications (11). GDM outcomes have been linked to issues upstream of dietary glucose absorption, such as impaired insulin sensitivity caused by β-cell dysfunction (12).…”

Section: Introductionmentioning

confidence: 99%

Mechanisms of Endothelial Dysfunction in Pre-eclampsia and Gestational Diabetes Mellitus: Windows Into Future Cardiometabolic Health?

et al. 2020

View full text Add to dashboard Cite

Placental insufficiency and adipose tissue dysregulation are postulated to play key roles in the pathophysiology of both pre-eclampsia (PE) and gestational diabetes mellitus (GDM). A dysfunctional release of deleterious signaling motifs can offset an increase in circulating oxidative stressors, pro-inflammatory factors and various cytokines. It has been previously postulated that endothelial dysfunction, instigated by signaling from endocrine organs such as the placenta and adipose tissue, may be a key mediator of the vasculopathy that is evident in both adverse obstetric complications. These signaling pathways also have significant effects on long term maternal cardiometabolic health outcomes, specifically cardiovascular disease, hypertension, and type II diabetes. Recent studies have noted that both PE and GDM are strongly associated with lower maternal flow-mediated dilation, however the exact pathways which link endothelial dysfunction to clinical outcomes in these complications remains in question. The current diagnostic regimen for both PE and GDM lacks specificity and consistency in relation to clinical guidelines. Furthermore, current therapeutic options rely largely on clinical symptom control such as antihypertensives and insulin therapy, rather than that of early intervention or prophylaxis. A better understanding of the pathogenic origin of these obstetric complications will allow for more targeted therapeutic interventions. In this review we will explore the complex signaling relationship between the placenta and adipose tissue in PE and GDM and investigate how these intricate pathways affect maternal endothelial function and, hence, play a role in acute pathophysiology and the development of future chronic maternal health outcomes.

show abstract

Section: Introductionmentioning

confidence: 99%

Mechanisms of Endothelial Dysfunction in Pre-eclampsia and Gestational Diabetes Mellitus: Windows Into Future Cardiometabolic Health?

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Offspring of diabetic mothers show a higher rate of diabetes and characteristics of the metabolic syndrome, both strongly associated with premature death [2]. Indeed, in many clinical and experimental studies, it has been found that diabetes during pregnancy is an important risk factor for fetal growth restriction, and for the development of obesity and diabetes in adult offspring [3,4]. During pregnancy, diabetes leads to reproductive abnormalities that enhance spontaneous abortion, congenital anomalies, and neonatal morbidity and mortality [5].…”

Section: Introductionmentioning

confidence: 99%

Trigonelline Inhibits Inflammation and Protects β Cells to Prevent Fetal Growth Restriction during Pregnancy in a Mouse Model of Diabetes

Zhou

Du²,

Zuo³

et al. 2017

Pharmacology

View full text Add to dashboard Cite

Background: As an active component from traditional Chinese medicine, trigonelline has a protective effect on diabetes. This study evaluated the protective effects of trigonelline on diabetic mice during pregnancy. Methods: Diabetes was induced in female mice by intraperitoneal injection for continuous 5-day of 40 mg/kg/day streptozotocin. Female mice were divided into 4 groups after they were allowed to mate with normal male mice: nondiabetic, nondiabetic treated with trigonelline (70 mg/kg) for 18 days, diabetic, and diabetic treated with trigonelline (70 mg/kg). Results: Diabetic pregnant mice had significantly higher levels of blood glucose, serum total cholesterol, triglyceride, insulin, and leptin but lower serum omentin-1 level and insulin sensitivity index than the nondiabetic ones. Trigonelline improved the hyperglycemia, dyslipidemia, insulin resistance, and adipocytokine of diabetic pregnant mice. Diabetic pregnant mice had significantly reduced fetus numbers, fetal weight, and fetal/placental ratio, which were reversed by trigonelline. Trigonelline prevented the increase in proinflammatory cytokines and reduced interleukin-10 level in placenta of diabetic pregnant mice. Trigonelline increased β-cell replication and the decreased β-cell mass, and decreased the β-cell apoptosis of diabetic pregnant mice. Conclusion: These findings suggest that trigonelline protects diabetic pregnancy partly by suppressing inflammation, regulating the secretion of adipocytokines, increasing β-cell mass, replication, and decreasing β-cell apoptosis.

show abstract

“…The more complicated course of pregnancy itself and perinatal outcomes are expected more in diabetic women with vasculopathy than in those without vasculopathy (18). Women with advanced diabetic microvascular complications (White class D, F and R) often delivered SGA infants.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy and neonatal outcomes in women with type 1 diabetes mellitus

Durackova¹,

Krištúfková²,

Korbeľ³

2017

BLL

View full text Add to dashboard Cite

AIM: The aim of study was to compare some perinatal outcomes in mothers with type 1 diabetes mellitus (T1DM). MATERIAL AND METHODS: All patients with T1DM delivered at the 1st Department of Obstetrics & Gynaecology of Faculty of Medicine, Comenius University in Bratislava from January 1st 2009 to December 31th 2015 were included to the study. RESULTS: Out of 118 diabetic mothers, 46.6 % had vasculopathy and 53. 4 % were without microvascular complications. In the vasculopathy group, signifi cantly higher incidence rates of preeclampsia (49. 1 versus 19.1 %; p = 0.002) and caesarean section (89.1 versus 68.3 %; p = 0.017) were found. Neonatal morbidity and mortality rates were higher in vasculopathy group (but not statistically signifi cantly). Preparation for pregnancy improves perinatal and neonatal results. Nevertheless, this preparation in our study group was received only in 9.3 %. Perinatal mortality was 25.4 per 1,000 total births. CONCLUSION: For pregnancy of diabetic women to become possible a qualifi ed management must be provided. Good outcomes for both women and newborns are real when preparation for pregnancy and metabolic control before and during whole pregnancy are at adequate level (Tab. 3, Ref. 28). Text in PDF www.elis.sk.

show abstract

Vascular Complications in the Diabetic Pregnancy

Cited by 76 publications

References 86 publications

Mechanisms of Endothelial Dysfunction in Pre-eclampsia and Gestational Diabetes Mellitus: Windows Into Future Cardiometabolic Health?

Mechanisms of Endothelial Dysfunction in Pre-eclampsia and Gestational Diabetes Mellitus: Windows Into Future Cardiometabolic Health?

Trigonelline Inhibits Inflammation and Protects β Cells to Prevent Fetal Growth Restriction during Pregnancy in a Mouse Model of Diabetes

Pregnancy and neonatal outcomes in women with type 1 diabetes mellitus

Contact Info

Product

Resources

About