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Latest & greatest articles for gestational diabetes
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Probiotic treatment for women with gestationaldiabetes to improve maternal and infant health and well-being. Gestationaldiabetes mellitus (GDM) is carbohydrate intolerance first recognised during pregnancy and associated with complications for mothers and babies. Probiotics are naturally occurring micro-organisms, which when ingested in adequate amounts, may confer health benefits. Evidence of the role of probiotics as treatment for GDM is limited.To evaluate the safety and effectiveness (...) possible benefit and possible harm. No trials reported primary outcomes of: mode of birth as vaginal/assisted and subsequent development of type 2 diabetes. We are uncertain if probiotics have any effect compared with placebo on induction of labour (RR 1.33, 95% CI 0.74 to 2.37; participants = 127; studies = 1; very low-certainty evidence). For other secondary maternal outcomes, we are uncertain if there are differences between probiotics and placebo for: postpartum haemorrhage; weight gain during
Interventions to prevent women from developing gestationaldiabetes mellitus: an overview of Cochrane Reviews. The prevalence of gestationaldiabetes mellitus (GDM) is increasing, with approximately 15% of pregnant women affected worldwide, varying by country, ethnicity and diagnostic thresholds. There are associated short- and long-term health risks for women and their babies.We aimed to summarise the evidence from Cochrane systematic reviews on the effects of interventions for preventing (...) GDM.We searched the Cochrane Database of Systematic Reviews (6 August 2019) with key words 'gestationaldiabetes' OR 'GDM' to identify reviews pre-specifying GDM as an outcome. We included reviews of interventions in women who were pregnant or planning a pregnancy, irrespective of their GDM risk status. Two overview authors independently assessed eligibility, extracted data and assessed quality of evidence using ROBIS and GRADE tools. We assigned interventions to categories with graphic icons
Progression to type 2 diabetes in women with a known history of gestationaldiabetes: systematic review and meta-analysis. To estimate and compare progression rates to type 2 diabetes mellitus (T2DM) in women with gestationaldiabetes mellitus (GDM) and healthy controls.Systematic review and meta-analysis.Medline and Embase between January 2000 and December 2019, studies published in English and conducted on humans.Observational studies investigating progression to T2DM. Inclusion criteria were (...) postpartum follow-up for at least 12 months, incident physician based diagnosis of diabetes, T2DM reported as a separate outcome rather than combined with impaired fasting glucose or impaired glucose tolerance, and studies with both a group of patients with GDM and a control group.This meta-analysis of 20 studies assessed a total of 1 332 373 individuals (67 956 women with GDM and 1 264 417 controls). Data were pooled by random effects meta-analysis models, and heterogeneity was assessed by use of the I2
Effects of MTNR1B Genetic Variants on Individual Susceptibility to GestationalDiabetes Mellitus: A Meta-Analysis. Whether melatonin receptor 1B (MTNR1B) variants are implicated in gestationaldiabetes mellitus (GDM) remains unclear. Therefore, we performed this meta-analysis to obtain a more conclusive result on associations between MTNR1B variants and GDM. Literature research was performed in PubMed, Web of Science, Embase, and China National Knowledge Infrastructure. Odds ratios (ORs
Relationship between Maternal Central Obesity and the Risk of GestationalDiabetes Mellitus: A Systematic Review and Meta-Analysis of Cohort Studies. Nowadays, body mass index (BMI) is used to evaluate the risk stratification of obesity-related pregnancy complications in clinics. However, BMI cannot reflect fat distribution or the proportion of adipose to nonadipose tissue. The objective of this study is to evaluate the association of maternal first or second trimester central obesity
Comparative Efficacy and Safety of Metformin, Glyburide, and Insulin in Treating GestationalDiabetes Mellitus: A Meta-Analysis. To compare the efficacy and safety of metformin, glyburide, and insulin in treating gestationaldiabetes mellitus (GDM), a meta-analysis of randomized controlled trials (RCTs) was conducted. PubMed, Embase, CINAHL, Web of Science, and Cochrane Library to November 13, 2018, were searched for RCT adjusted estimates of the efficacy and safety of metformin, glyburide (...) to 0.86; P < 0.05). To the outcomes of birth weight and gestational age at delivery, insulin had a significant increase when compared with metformin (MD, 114.48; 95% CI, 37.32 to 191.64; P < 0.01; MD, 0.23; 95% CI, 0.12 to 0.34; P < 0.001; respectively). Of the two groups between glyburide and metformin, metformin had lower gestational weight gain compared with glyburide (MD, 1.67; 95% CI, 0.26 to 3.07; P < 0.05). Glyburide had a higher risk of neonatal hypoglycemia compared with insulin (RR, 1.76; 95
Maternal age and the risk of gestationaldiabetes mellitus: A systematic review and meta-analysis of over 120 million participants. The objective of the present analysis was to evaluate and quantify the risk for gestationaldiabetes mellitus (GDM) according to maternal age.Three electronic databases were searched for publications from inception to July 2018. Odds ratio (OR) and 95% confidence interval (95% CI) were calculated. A dose-response analsis was performed using generalised least
Association between intrahepatic cholestasis of pregnancy and risk of gestationaldiabetes and preeclampsia: a systematic review and meta-analysis. Objective: To investigate the association between intrahepatic cholestasis of pregnancy (ICP) and the risk of gestationaldiabetes mellitus (GDM) and preeclampsia via meta-analysis.Methods: Pooled odds ratio (OR) and confidence interval (CI) of GDM and preeclampsia for women with ICP were calculated using the fixed- or random-effects model.Results
Polyphenol-rich foods and risk of gestationaldiabetes: a systematic review and meta-analysis. Animal studies have demonstrated anti-diabetic properties of several food-derived polyphenols, but data in humans remains unclear. This study aimed to review and meta-analyse evidence concerning the effect of the intake of several polyphenol-rich foods on gestationaldiabetes (GDM) risk. A systematic literature search was conducted in PubMed, Web of Science and Embase databases for observational
Metformin in pregnancy to avert gestationaldiabetes in women at high risk: Meta-analysis of randomized controlled trials. Previous randomized and observational studies on the efficacy of metformin in pregnancy to reduce incident gestationaldiabetes mellitus (GDM) in women at high risk (obesity, polycystic ovary syndrome [PCOS], or pregestational insulin resistance) have been conflicting and several groups are planning further randomized controlled trials (RCTs) to answer this question (...) conclusively. This work assesses the efficacy of metformin in pregnancy to avert one outcome-incident GDM in women at high risk. We included RCTs comparing metformin with usual care or placebo controls in terms of incident GDM and recruiting women at high risk during early pregnancy. Eleven eligible trials enrolled 2370 adult women whose intervention arm consisted of metformin started at conception or before 20 weeks of gestation. Risk of GDM was similar in intervention compared with controls (risk ratio
Role of C-reactive Protein(CRP) or high-sensitivity CRP in predicting gestationaldiabetes Mellitus:Systematic review. GestationalDiabetes Mellitus (GDM) is the most common disorder during pregnancy in 8-18% of pregnancies. Due to maternal and neonatal morbidity and mortality, early diagnosis and appropriate treatment have always been of interest to researchers. One of the recent cases for early diagnosis of GDM is the size of the C-reactive protein (CRP). The purpose of this review study (...) was to investigate the role of CRP or its high sensitivity type in predicting GDM.Systematic searching of MEDLINE, ISI Web of Science, PubMed, Scopus, Google Scholar, and ProQuest databases between 2009 and 2019 using keywords 'GestationalDiabetes Mellitus','Screening', 'C-reactive protein',' High sensitivity CRP'was performed. The quality of articles was also assessed using the STROBE checklist.After a thorough search of the mentioned databases, 31 articles with the desired quality were finally selected. Most
Burden, risk factors and maternal and offspring outcomes of gestationaldiabetes mellitus (GDM) in sub-Saharan Africa (SSA): a systematic review and meta-analysis. The burden, determinants and outcomes of gestationaldiabetes mellitus (GDM) in sub-Saharan Africa are not known. We summarized existing evidence on the prevalence, risk factors and complications of GDM in the region.PubMed was searched from inception to January 31st 2019. Studies were included if carried out in any of the sub (...) and previous history of GDM, macrosomia, stillbirth and abortion were important risk factors of GDM. In addition, being overweight or obese, over 25 years of age or hypertensive increased the risk of GDM. In terms of complications, GDM more than doubles the risk macrosomia (RR; 95%CI: 2.2; 1.1-4.4).There is a high burden of gestationaldiabetes mellitus in sub-Saharan Africa, but more studies are needed to document locally important risk factors as well as maternal and offspring outcomes. Interventions
Metabolic effects of breastfeed in women with prior gestationaldiabetes mellitus: A systematic review and meta-analysis. This study was undertaken to provide comprehensive analyses of current research developments in the field of breastfeed (BF) and metabolic-related outcomes among women with prior gestationaldiabetes mellitus (GDM). Database PubMed, Embase, BIOSIS Previews, Web of Science, and Cochrane Library were searched through December 3, 2017. Odds ratio (OR) and weighted mean (...) difference (WMD) with 95% confidence interval (CI) were pooled by random-effects model using Stata version 12.0. Twenty-three observational studies were included in quantitative synthesis. Reduced possibility of progression to type 2 diabetes mellitus (T2DM; OR = 0.79; 95% CI, 0.68-0.92) and pre-DM (OR = 0.66; 95% CI, 0.51-0.86) were found among women with longer BF of any intensity after GDM pregnancy. The positive effect of longer BF on progression to T2DM gradually became prominent with the extension
Effectiveness of telemedicine for pregnant women with gestationaldiabetes mellitus: an updated meta-analysis of 32 randomized controlled trials with trial sequential analysis. Gestationaldiabetes mellitus (GDM) is now a global health problem. Poor blood glucose control during pregnancy may lead to maternal and neonatal/foetal complications. Recently, the development of information and communication technology has resulted in new technical support for the clinical care of GDM. Telemedicine
Author response: cardiovascular risk factors in offspring exposed to gestationaldiabetes mellitus in utero: systematic review and meta-analysis. This commentary is an author response to Lu and Wang, regarding the manuscript entitled 'Cardiovascular risk factors in offspring exposed to gestationaldiabetes mellitus in utero: Systematic review and meta-analysis'. We address their concern regarding duplication of studies in the meta-analysis and the quality of included studies.
Can glyburide be advocated over subcutaneous insulin for perinatal outcomes of women with gestationaldiabetes? A systematic review and meta-analysis. To obtain precise findings from published studies about the efficacy and safety of glyburide versus subcutaneous insulin in patients with gestationaldiabetes mellitus (GDM).We searched PubMed, Cochrane Library, Web of Science, and Scopus, up to January 2019, for relevant studies that compared glyburide with subcutaneous insulin for patients (...) (OR = 1.14, 95% CI [0.92, 1.41], p = 0.25) and large for gestational age (LGA) (OR = 1.38, 95% CI [0.99, 1.92], p = 0.06). While subgroup analysis of RCTs showed that maternal hypoglycemia and LGA rates were significantly higher in glyburide than insulin and cesarean section rates were comparable between both compared groups.Our study suggests that glyburide is an effective and well-tolerated drug compared to insulin in the management of women with GDM, provided neonates are monitored for hypoglycemia
Early GestationalDiabetes Mellitus Screening With Glycated Hemoglobin: A Systematic Review. This review sought to examine the association of HbA1c levels <6.5% in early pregnancy with the subsequent development of gestationaldiabetes mellitus (GDM) and adverse pregnancy outcomes.A search of Medline and EMBASE was conducted for the period of January 1, 2000 to July 9, 2019 and the terms: "gestationaldiabetes or pregnancy diabetes mellitus" and "glycosylated hemoglobin or glycated hemoglobin (...) A" and "pregnancy trimester, first, or first-trimester pregnancy," "screening or prenatal screening," "prenatal diagnosis or early diagnosis or prediction," "retrospective studies or prospective studies." Quality of evidence was assessed using the Newcastle-Ottawa scale. Inclusion criteria were: measurement of HbA1c <20 weeks gestation, the absence of pre-gestationaldiabetes mellitus, and analysis of HbA1c levels below 6.5%. The primary outcome evaluated was the development of GDM. Secondary outcomes were