Gestational diabetes mellitus - A metabolic and reproductive disorder

Gestational diabetes education management interventions implemented across Arabic-speaking countries: A systematic scoping review

Background The prevalence of Gestational Diabetes Mellitus (GDM) in Arabic-speaking countries varies from 1.2 % (Jordan) to almost 40 % (Saudi Arabia). Untreated GDM increases the risk of poor maternal and neonatal health outcomes. Objective This systematic scoping review aims to examine the current literature to determine the effectiveness of interventions designed to manage and prevent GDM across Arabic-speaking countries. Design Systematic scoping review. Methods Employing the PRISMA-ScR and the AND-EAL for study quality and bias assessment, a comprehensive review of the literature was conducted using 12 databases and search terms relevant to GDM interventions conducted across the League of Arab states. The search period includes intervention studies published up to and including August 31st, 2024. Findings Eight studies met the inclusion criteria. Interventions conducted included those modeled on the Health Behavior Change model, Theory of Reasoned Action and the PRECEDE model, constructs of Social Cognitive Theory including self-efficacy, GDM self-management, lifestyle management and BASNEF model-based empowerment. The intervention studies had positive effect on GDM knowledge, self-efficacy, A1C levels, quality of life, maternal and neonatal outcomes. Conclusion Prevention and management of GDM is important in addressing maternal and neonatal health outcomes. Interventions designed with a theoretical framework and those that are culturally tailored are more likely to elicit behavior change.

Ultrasound-assisted green synthesis of functionalised xanthene derivatives: Advancing sustainable sonochemical strategies

Xanthenes are an important class of heterocycles in medicinal chemistry due to their diverse pharmacological properties. These tricyclic aromatic compounds, characterised by a dibenzo[b,e]pyran core with an oxygen atom at their central position, have gained significant attention for their extensive applications. Beyond pharmaceuticals, xanthenes are widely used in textiles, food industries, electro-optical devices, dyes, and bioimaging agents. Xanthene derivatives, particularly 9-substituted xanthenes, exhibit a wide range of biological activities, including antiparasitic, antibacterial, antileishmanial, cytotoxic, neuroprotective, and photophysical effects, making them valuable in drug discovery. The xanthene scaffold is present in various bioactive natural compounds such as mulgravanols A and B, hermannol, (+)-myrtucommulone D, homapanicones A and B, blumeaxanthene II, and acrotrione. Clinically relevant xanthene-based drugs include propantheline bromide (antimuscarinic), methantheline (antispasmodic), and phloxine B (photosensitiser in antimicrobial therapy). Thus, various synthetic approaches have been developed for the construction of xanthenes, with ultrasound-assisted green methodologies gaining prominence. Ultrasound technique offers advantages over conventional methods, including higher yields, faster reaction rates, and improved selectivity under milder conditions. This review comprehensively explores the ultrasound-assisted synthesis of functionalised xanthene derivatives as an eco-friendly alternative. To the best of our knowledge, this is the first in-depth review focusing on the green methodology under ultrasound irradiation.

Angiogenic Markers in Gestational Diabetes and their Association with Placental Dimensions

GDM is an increasing global concern, with its etiology not fully understood, though altered placental function is likely to play a role. Placental angiogenesis, essential for sufficient blood flow and nutrient exchange between mother and fetus, may be affected by GDM. However, the role of angiogenic markers in GDM remains unclear. This study aims to investigate angiogenic markers from early pregnancy till delivery and their relationship with placental dimensions. This study is a part of a longitudinal study, where a total of 1154 women were recruited, out of which 167 women developed GDM (15.2%). The current study includes a total of 130 women randomly selected (65 GDM and 65 Non-GDM women). Plasma and placental levels of angiogenic markers such as VEGF, PLGF and sFlt-1/Flt-1 were estimated. Placental dimensions and birth outcomes were recorded, and associations between angiogenic markers and these parameters were examined. sFlt-1 (p < 0.05) levels were higher at V1 (11-14 weeks) in GDM women as compared to Non-GDM women. Placental PLGF (p < 0.01) and Flt-1 (p < 0.05) levels were lower in the GDM group. PLGF and Flt-1 were negatively associated with placental dimensions such as major axis, minor axis and breadth of the placenta. This study reveals altered expression of placental angiogenic markers in women with GDM, potentially affecting placental development and function. Negative correlations between these markers and placental dimensions suggest their influence on pregnancy outcomes in GDM.

Nano-formulations in disease therapy: designs, advances, challenges, and future directions

Nano-formulations, as an innovative drug delivery system, offer distinct advantages in enhancing drug administration methods, improving bioavailability, promoting biodegradability, and enabling targeted delivery. By exploiting the unique size advantages of nano-formulations, therapeutic agents, including drugs, genes, and proteins, can be precisely reorganized at the microscale level. This modification not only facilitates the precise release of these agents but also significantly enhances their efficacy while minimizing adverse effects, thereby creating novel opportunities for treatment of a wide range of diseases. In this review, we discuss recent advancements, challenges, and future perspectives in nano-formulations for therapeutic applications. For this aim, we firstly introduce the development, design, synthesis, and action mechanisms of nano-formulations. Then, we summarize their applications in disease diagnosis and treatment, especially in fields of oncology, pulmonology, cardiology, endocrinology, dermatology, and ophthalmology. Furthermore, we address the challenges associated with the medical applications of nanomaterials, and provide an outlook on future directions based on these considerations. This review offers a comprehensive examination of the current applications and potential significance of nano-formulations in disease diagnosis and treatment, thereby contributing to the advancement of modern medical therapies.

Protective effect of preconception high dose vitamin D3 supplementation in gestational diabetes mellitus rats via modulation of placental LCPUFA metabolism, one carbon cycle components, inflammation, oxidative stress, and angiogenesis

Gestational diabetes mellitus (GDM), one of the most common pregnancy complications, adversely affects maternal and fetal health. This study investigated the impact of vitamin D3 (VD3) deficiency or supplementation on placental long chain polyunsaturated fatty acid (LCPUFA) metabolism, one-carbon cycle metabolites, inflammation, oxidative stress, angiogenesis, and birth outcomes in a GDM rat model. Wistar rats were divided into five groups: Control (1000 IU VD3/kg diet), Vitamin D Deficient (VDD, 0 IU VD3/kg diet), GDM (1000 IU VD3/kg diet + GDM), VD3 supplementation with 1500 IU (VDS-1500 +GDM), and VD3 supplementation with 10,000 IU (VDS-10,000 +GDM). GDM was induced using a high-fat, high-sugar diet and streptozotocin. Diets were provided from weaning through pregnancy. Only the VDS-10,000 +GDM group achieved sufficient serum 25(OH)D levels (>30 ng/ml). 10,000 IU/kg VD3 supplementation reduced gestational weight gain and improved fetal/placental weight ratios. It reduced the levels of FBS, fasting insulin, and HOMA-IR, while increased HOMA-IS. It regulated calcium homeostasis by decreasing parathyroid hormone and increasing phosphorous levels. It normalized one-carbon metabolites, reducing homocysteine and increasing folate levels. Both doses of VD3 supplementation mitigated oxidative stress, reducing malondialdehyde levels, which was higher in GDM and VDD groups. It restored LCPUFA profiles, increasing arachidonic acid and decreasing n-6 linoleic acid levels. High-dose VD3 reduced elevated plasma and placental TNF-α levels and downregulated IL-6 mRNA in the GDM group, while IL-6 protein levels remained comparable. The protein and mRNA levels of both VEGF and VEGF-R1 were higher in GDM group. 10,000 IU VD3 reduces VEGF levels whereas, 1500 IU VD3 reduces VEGF-R1 levels. High-dose VD3 supplementation (10,000 IU/kg) during pregnancy effectively improved vitamin D status and positively influenced placental metabolic pathways, oxidative stress, inflammation, and angiogenesis, thereby improving pregnancy outcomes in GDM.

DUSP9-mediated inhibition of IRS1/PI3K/AKT pathway contributes to insulin resistance and metabolic dysfunction in gestational diabetes mellitus

BACKGROUND

Gestational diabetes mellitus (GDM) is a common pregnancy complication associated with adverse maternal and fetal outcomes. Recent studies suggest a role for dual-specificity phosphatase 9 (DUSP9) in insulin resistance and metabolic dysregulation, though its specific contribution to GDM remains unclear. This study aims to investigate the function of DUSP9 in GDM pathophysiology and its underlying molecular mechanisms.

METHODS

We analyzed DUSP9 expression in umbilical cord blood and placental tissues from GDM patients (n = 16) and healthy controls (n = 14) using RT-qPCR and western blot assays. In vitro, functional assays were conducted on high glucose-induced HTR-8/SVneo trophoblast cells to evaluate the effects of DUSP9 knockdown on cell viability, apoptosis, and insulin signaling. In vivo, a GDM mouse model was constructed, and lentivirus-mediated shRNA was used to downregulate DUSP9 expression. Furthermore, metabolic parameters, including insulin resistance indices, lipid metabolism, and placental apoptosis were assessed, along with the phosphorylation status of key proteins in the IRS1/PI3K/AKT pathway.

RESULTS

We first observed that DUSP9 expression was significantly upregulated in the umbilical cord blood and placental tissues of GDM patients compared to healthy controls (p < 0.01). Using high glucose-induced HTR-8/SVneo trophoblast cells to mimic GDM conditions, we found that downregulation of DUSP9 increased cell viability and inhibited apoptosis (p < 0.01). Mechanistically, co-immunoprecipitation and pull-down assays demonstrated that DUSP9 directly interacts with insulin receptor substrate 1 (IRS1) and inhibits HG-mediated IRS1 phosphorylation at Tyr632, impairing downstream insulin signaling (p < 0.01). In vivo, a GDM mouse model revealed elevated DUSP9 expression, along with significant metabolic dysfunction, including insulin resistance and increased placental apoptosis (p < 0.01). Lentivirus-mediated knockdown of DUSP9 in these mice ameliorated insulin resistance, improved lipid metabolism, and reduced placental apoptosis by improving fasting glucose and insulin levels, lipid profiles, and decreased apoptotic markers (p < 0.01). Moreover, DUSP9 knockdown in these mice promoted activation of the IRS1/PI3K/AKT signaling pathway (p < 0.01).

CONCLUSIONS

DUSP9 contributes to GDM progression by inhibiting the IRS1/PI3K/AKT pathway, leading to insulin resistance and metabolic dysfunction. The knockdown of DUSP9 ameliorates key pathological features of GDM, including insulin resistance, impaired lipid metabolism, and placental apoptosis, suggesting that targeting DUSP9 may represent a potential therapeutic strategy for GDM.

Application of Proteomics in Maternal and Neonatal Health: Advancements and Future Directions

Maternal and neonatal health (women during pregnancy, childbirth, and the postnatal period) presents a spectrum of healthcare challenges, including preterm birth, preeclampsia, intrauterine growth restriction, polycystic ovarian syndrome, and gestational diabetes mellitus. While genomic investigations have shed light on many of these topics, protein biomarker discovery, a pivotal aspect of such research, holds promise in offering insights into disease diagnosis, progression, and prognosis. This review paper aims to explore the landscape of proteomics research pertaining to the aforementioned disorders. In the search for viable biomarkers, existing ones are either outdated or lack specificity and new ones being investigated do not commonly make it to the validation stage. In this review, the reasons for the gap between the biomarker discovery stage and the clinical validation stage are evaluated, in addition to what steps are being taken to mitigate the unexpectedly slow scientific and clinical progress. Notably, this paper also delves into the ethnic disparities found in maternal and neonatal health research, as well as how AI is currently being used to alleviate socioeconomic and ethnic disparities, as well as its advantages for the analysis of large "omics" datasets. We anticipate this investigation will provide critical, invaluable information for researchers, medical professionals, and policy decision-makers in this field to improve overall maternal and neonatal health outcomes.

miRNA-186-5p modulates placental inflammation via Inflammasome activation in gestational diabetes mellitus

Inflammasomes are multiprotein complexes that initiate inflammatory responses by activating pro-inflammatory cytokines, playing a crucial role in innate immunity. However, their dysregulation can lead to excessive inflammation, particularly in conditions like gestational diabetes mellitus (GDM), where placental inflammation may adversely affect fetal development and increase the risk of complications. NEK7 (NIMA-related kinase 7) has been identified as a key mediator in inflammasome activation, facilitating the complex assembly and amplifying inflammatory responses. This study aims to investigate the regulatory role of miRNA in inflammasome-mediated placental inflammation through its interaction with NEK7 in the pathophysiology of GDM. In-silico analysis identified that NEK7 is a direct target of miR-186-5p, while PCR analysis demonstrated a significant loss of miR-186-5p expression in GDM placental tissues. Further, the expressions of NEK7, NLRP1, NLRP3, Caspase 1 along with the inflammatory cytokines were significantly elevated in GDM placenta. Furthermore, the correlation analysis demonstrated a significant negative correlation between miR-186-5p and NEK7 expression levels, suggesting that the loss of miR-186-5p may contribute to inflammasome mediated placental inflammation in GDM. Additionally, the overexpression of miR-186-5p decreased the high glucose induced inflammation and the expressions of NEK7, NLRP1 and NLRP3 in BeWo cell line. Therefore, this study concludes that miR-186-5p may attenuate the activation of inflammasome and regulate inflammation via NEK7 in the progression of GDM. Understanding these molecular mechanisms offers valuable insights into potential therapeutic targets aimed at improving pregnancy outcomes in GDM.

Genetics and epigenetics in gestational diabetes contributing to type 2 diabetes

Gestational diabetes mellitus (GDM) is a common pregnancy complication and a risk factor for the subsequent development of type 2 diabetes (T2D) in mothers and of several metabolic diseases in offspring. However, the molecular underpinnings of these risks are not well understood. Genome-wide association studies (GWAS) and epigenetic studies may provide complementary insights into the causal relationships between GDM exposure and maternal/offspring metabolic outcomes. In this review we discuss the potential pathophysiological roles of specific genetic variants and commonly reported differentially methylated loci in GDM development, and their link to the progression to T2D in both the mother and the offspring in later life, pointing to the potential for tailored interventional strategies based on these genetic and epigenetic mechanisms.

Prediction of clinical risk factors in pregnancy using optimized neural network scheme

Women should be aware of prenancy related health issues. A user-friendly model is developed in which the patients can use as well as clinicians to determine the risks associated with foetal development inside the womb, birth weight, whose effects are typically linked to the mother through biological relationships. Recent advances in computer vision and artificial intelligence offer new techniques for automated evaluation of medical images across a variety of fields, including ultrasound (US) images. Enhancing the detection of the estimated foetal weight (EFW) and mother-foetal disease computations can aid obstetricians in making decisions and reduce perinatal issues. This study aims to build a birth weight classification and prediction of relevant parameters during delivery. In this data analysis suite, exploratory data analysis is performed as part of the data pre-processing to investigate the fundamental information and transformational properties. For feature extracting model, the Advanced Dynamic based Feature Selection (ADFS) algorithm has been used which is optimized using the enriched elephant herding optimization algorithm (EEHOA). The multiple feature estimation is classified using augmented recurrent neural network classifier (AURNN). The findings of analyses with graphical representations have been interpreted through the application of visual analytical techniques.

Lepidium Sativum Extract Alleviates Reproductive and Developmental Toxicity in Polycystic Ovary Syndrome Induced by Letrozole and High-Fat Diet in Rats

Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by irregular menstrual cycles, hyperandrogenism, and polycystic ovarian morphology, leading to infertility and an increased risk of metabolic dysfunction. This study investigated the protective effects of Lepidium sativum seed extract (LSSE) on fertility and pregnancy outcomes in a rat model of PCOS induced by letrozole and a high-fat diet (HFD) (68% regular rat food pellets, 6% maize oil, 20% milk powder, and 6% ghee). PCOS was induced by oral administration of letrozole, an aromatase inhibitor, (1 mg/kg in 2% DMSO) along with an HFD for four weeks and the results were compared to the metformin antidiabetic agent. Sixty rats were divided into five groups (n = 12): control, PCOS, PCOS + LSSE (250 mg/kg), PCOS + LSSE (500 mg/kg), and metformin (200 mg/kg). Half of the rats were euthanized after four weeks, while the remaining rats were housed with males (1 male: 2 females) for testing pregnancy outcomes. LSSE led to remarkable improvements in body weight, glucose, sex hormonal balance, liver and kidney functions, antioxidant and anti-inflammatory systems, mating and fertility indices, pregnancy outcomes, and fetal morphology. Histologically, LSSE treatment reduced ovarian cyst number and size, and enhanced the blood vessel, Graafian follicle, and endometrial morphologies. LSSE showed dose-dependent effects, with the high-dose demonstrating superior results in the biochemical parameters, while the low-dose showed the most promising pregnancy outcomes. LSSE exhibits potent protective effects against PCOS, surpassing metformin in several aspects. LSSE acts through multi-mechanistic action, including anti-inflammatory, antioxidant, metabolic, and hormone-balancing properties, along with its positive impact on fertility, suggesting that LSSE could be a promising natural alternative for PCOS management.

Impact of Maternal Education on Perinatal and Maternal Outcomes in Women With a History of Gestational Diabetes

INTRODUCTION

Gestational diabetes is a common complication of pregnancy and is linked to adverse health outcomes for both mothers and their children. Lower maternal educational levels and poor health literacy have also been associated with poor health outcomes. However, few studies have analyzed the magnitude of the association between maternal education and poor outcomes for both mother and child in the context of gestational diabetes. This study aimed to explore the potential relationship between maternal and paternal education levels and the risk of negative health outcomes in both mother and child in pregnant women with gestational diabetes in the United States.

METHODS

This project is a retrospective cohort study. National Vital Statistics System-Natality (NVSS-N) data from 2019 to 2020 was used, sampling women aged 18-34 with gestational diabetes who gave birth to a singleton. Outcomes were the presence of at least one congenital anomaly and maternal intensive care unit (ICU) admission. Multivariable logistic regression analysis via Stata V. 16 (StataCorp LLC, College Station, TX, US) estimated adjusted odds ratio (OR) and 95% confidence interval (CI).

RESULTS

Among 541,117 women, 38% had a high school diploma or less, 52% completed some college, and 11% held a master's degree or higher. The maternal ICU admission rate was 0.17%, and at least one congenital anomaly occurred in 0.21% of births. In adjusted models, compared to mothers with a high school diploma or less, those with a master's degree or some college had adjusted ORs of 1.14 (95% CI = 0.80, 1.61) and 1.11 (95% CI = 0.90, 1.36) for congenital anomalies, respectively. Paternal education was associated with reduced odds for both outcomes.

CONCLUSIONS

Maternal education was not associated with adverse outcomes in gestational diabetes. Findings suggest paternal education may impact patient outcomes and should be further explored. Potential alternative targets to improve the health of women with gestational diabetes and their offspring are warranted.

Global burden of polycystic ovary syndrome among women of childbearing age, 1990-2021: a systematic analysis using the global burden of disease study 2021

BACKGROUND

The escalating global incidence of polycystic ovary syndrome (PCOS) necessitates a thorough examination of its epidemiological trends and sociodemographic correlations. Our study bridges this gap by analyzing the global impact of PCOS among women of childbearing age (WCBA) from 1990 to 2021, aiming to inform strategies for enhanced prevention and management.

METHODS

We extracted data from the Global Burden of Disease Study 2021 (GBD 2021), focusing on the burden of PCOS among women aged 15-49 years. We assessed incidence, prevalence, and disability-adjusted life years (DALYs) trends using the estimated annual percentage change (EAPC) and explored the link between PCOS burden and sociodemographic index (SDI).

RESULTS

In 2021, the prevalence cases of PCOS worldwide were 65.77 million, the incidence cases were 1,175.07 thousand, and the DALYs cases were 576.05 thousand. Compared with 1990, the percentage changes were 89, 49, and 87%, respectively. The EAPCs indicated upward trends in prevalence and DALYs rates, with a less pronounced increase in incidence rates. The middle SDI region had the highest PCOS case numbers, and the 45-49 age group in this region experienced the most significant burden increase. A strong positive correlation existed between PCOS prevalent rates and SDI (r = 0.582, p < 0.001).

CONCLUSION

The global burden of PCOS among WCBA has significantly increased over the past three decades, particularly in the 45-49 age group in middle SDI regions. The correlation between PCOS prevalent rates and SDI highlights the role of socio-economic factors in PCOS epidemiology. Tailored prevention and management strategies are crucial for reducing the global burden of PCOS and improving female health outcomes.

Exploring the anti-diabetic potential of barnyard millet: insights from virtual screening, MD simulation and MM-PBSA

Barnyard millet (Echinochloa frumentacea) is a nutritionally superior grain and a rich source of dietary fiber, and protein. It helps in managing health and dietary issues such as malnutrition, diabetes, obesity, and celiac disease. Its low content of slowly digestible carbohydrates promotes a gradual release of glucose, helping to maintain stable blood glucose levels. The present study aims to identify and screen phytochemicals in the barnyard millet and explore its anti-diabetic activity through an in-silico study. Gas chromatography-mass spectrometry (GC-MS) analyses of the seed extract revealed the occurrence of 73 bioactive compounds that are known to possess a variety of pharmacological activities. Based on the virtual screening analysis, phytochemicals interacted with five different diabetic targets, with diosgenin demonstrating the lowest binding affinity across four receptors. Specifically, diosgenin showed a binding affinity of -9.2 kcal/mol with the Insulin receptor (PDB ID: 1IR3), -8.7 kcal/mol with Peroxisome proliferator-activated receptors (PDB ID: 3G9E), -7.5 kcal/mol with Tyrosine phosphatase 1-beta (2F70), and -6.5 kcal/mol with the Glucagon receptor (PDB ID: 5EE7). For Aldose reductase (PDB ID: 4XZH), Docosahexaenoic acid exhibited the lowest binding affinity of -9.9 kcal/mol. The dynamic behavior of 2F70-Diosgenin docked complexes throughout a 500 ns trajectory run was investigated further. The RMSD and RMSF analyses reveal that the complex remains structurally stable. The binding free energies were computed using the Molecular Mechanics/Poisson-Boltzmann Surface Area (MM/PBSA) methodology. The calculation results show that the predicted free energies of the complex are stable. These results suggest that the 2F70-Diosgenin complex is stable, highlighting its potential for further wet lab validation.

Exploring Saliva as a Sample for Non-Invasive Glycemic Monitoring in Diabetes: A Scoping Review

Background/Objectives: Diabetes mellitus is characterized by a dysregulated glucose metabolism, necessitating frequent and often invasive monitoring techniques for its effective management. Saliva, a non-invasive and readily accessible biofluid, has been proposed as a potential alternative for glycemic monitoring due to its biochemical correlation with blood glucose levels. This scoping review aims to evaluate the evidence regarding the use of salivary glucose as a biomarker to track glycemic changes in diabetic populations. Methods: This study adhered to the Joanna Briggs Institute guidelines and the PRISMA Extension for Scoping Reviews. A literature search was performed across the PubMed, Scopus, and Web of Science databases, supplemented by manual searches. Results: A total of fifty-seven studies were included, representing populations affected by type 1 diabetes (T1D), type 2 diabetes (T2D), and gestational diabetes (GD). The findings indicated consistent positive correlations between the salivary and blood glucose levels in most studies, although there were significant variations in the sensitivity, specificity, and methodological approaches. Salivary glucose showed promise as a complementary biomarker for glycemic monitoring, particularly due to its non-invasive nature. Conclusions: Challenges such as variability in salivary composition, the absence of standardized collection protocols, and the limited availability of portable devices were noted. This review highlights the potential of saliva as an adjunct sample for diabetes management while stressing the need for further research to bridge existing gaps.

Machine learning based model for the early detection of Gestational Diabetes Mellitus

BACKGROUND

Gestational Diabetes Mellitus (GDM) is one of the most common medical complications during pregnancy. In the Gulf region, the prevalence of GDM is higher than in other parts of the world. Thus, there is a need for the early detection of GDM to avoid critical health conditions in newborns and post-pregnancy complexities of mothers.

METHODS

In this article, we propose a machine learning (ML)-based techniques for early detection of GDM. For this purpose, we considered clinical measurements taken during the first trimester to predict the onset of GDM in the second trimester.

RESULTS

The proposed ensemble-based model achieved high accuracy in predicting the onset of GDM with around 89% accuracy using only the first trimester data. We confirmed biomarkers, i.e., a history of high glucose level/diabetes, insulin and cholesterol, which align with the previous studies. Moreover, we proposed potential novel biomarkers such as HbA1C %, Glucose, MCH, NT pro-BNP, HOMA-IR- (22.5 Scale), HOMA-IR- (405 Scale), Magnesium, Uric Acid. C-Peptide, Triglyceride, Urea, Chloride, Fibrinogen, MCHC, ALT, family history of Diabetes, Vit B12, TSH, Potassium, Alk Phos, FT4, Homocysteine Plasma LC-MSMS, Monocyte Auto.

CONCLUSION

We believe our findings will complement the current clinical practice of GDM diagnosis at an early stage of pregnancy, leading toward minimizing its burden on the healthcare system.Source code is available in GitHub at: https://github.com/H-Zaky/GD.git.

The Hidden Impact of Gestational Diabetes: Unveiling Offspring Complications and Long-Term Effects

BACKGROUND

Gestational diabetes mellitus (GDM), characterized by gestational hyperglycemia due to insufficient insulin response, poses significant risks to both maternal and offspring health. Fetal exposure to maternal hyperglycemia leads to short-term complications such as macrosomia and neonatal hypoglycemia and long-term risks including obesity, metabolic syndrome, cardiovascular dysfunction, and type 2 diabetes. The Developmental Origins of Health and Disease (DOHaD) theory explains how maternal hyperglycemia alters fetal programming, increasing susceptibility to metabolic disorders later in life.

OBJECTIVE

This review explores the intergenerational impact of GDM, linking maternal hyperglycemia to lifelong metabolic, cardiovascular, and neurodevelopmental risks via epigenetic and microbiome alterations. It integrates the most recent findings, contrasts diagnostic methods, and offers clinical strategies for early intervention and prevention.

METHODS

A comprehensive literature search was conducted in PubMed, Scopus, and ScienceDirect to identify relevant studies published between 1 January 2000 and 31 December 2024. The search included studies focusing on the metabolic and developmental consequences of GDM exposure in offspring, as well as potential mechanisms such as epigenetic alterations and gut microbiota dysbiosis. Studies examining preventive strategies and management approaches were also included.

KEY FINDINGS

Maternal hyperglycemia leads to long-term metabolic changes in offspring, with epigenetic modifications and gut microbiota alterations playing key roles. GDM-exposed children face increased risks of obesity, glucose intolerance, and cardiovascular diseases. Early screening and monitoring are crucial for risk reduction.

PRACTICAL IMPLICATIONS

Understanding the intergenerational effects of GDM has important clinical implications for prenatal and postnatal care. Early detection, lifestyle interventions, and targeted postnatal surveillance are essential for reducing long-term health risks in offspring. These findings emphasize the importance of comprehensive maternal healthcare strategies to improve long-term outcomes for both mothers and their children.

Genetic and epigenetic alterations associated with gestational diabetes mellitus and adverse neonatal outcomes

Gestational diabetes mellitus (GDM) is a metabolic disorder, recognised during 24-28 weeks of pregnancy. GDM is linked with adverse newborn outcomes such as macrosomia, premature delivery, metabolic disorder, cardiovascular, and neurological disorders. Recent investigations have focused on the correlation of genetic factors such as β-cell function and insulin secretary genes (transcription factor 7 like 2, potassium voltage-gated channel subfamily q member 1, adiponectin etc.) on maternal metabolism during gestation leading to GDM. Epigenetic alterations like DNA methylation, histone modification, and miRNA expression can influence gene expression and play a dominant role in feto-maternal metabolic pathways. Interactions between genes and environment, resulting in differential gene expression patterns may lead to GDM. Researchers suggested that GDM women are more susceptible to insulin resistance, which alters intrauterine surroundings, resulting hyperglycemia and hyperinsulinemia. Epigenetic modifications in genes affecting neuroendocrine activities, and metabolism, increase the risk of obesity and type 2 diabetes in offspring. There is currently no treatment or effective preventive method for GDM, since the molecular processes of insulin resistance are not well understood. The present review was undertaken to understand the pathophysiology of GDM and its effects on adverse neonatal outcomes. In addition, the study of genetic and epigenetic alterations will provide lead to researchers in the search for predictive molecular biomarkers.

Differential activation of p53-Lamin A/C and p16-RB mediated senescence pathways in trophoblast from pregnancies complicated by type A2 Gestational Diabetes Mellitus

Gestational diabetes mellitus (GDM) increases maternal risks such as hypertension and future type 2 diabetes while also contributing to fetal complications such as large-for-gestational-age infants and stillbirth. The placenta which is crucial for fetal development, exhibits structural and functional changes in GDM, but the impact of these alterations on placental trophoblast function remains unclear. During their differentiation villous cytotrophoblast display several characteristics of senescent cells however the role of senescence pathways in placental function remains unexplored in GDM. Here we investigate whether placental senescence pathways are altered in GDM, utilizing term villous tissue and primary trophoblasts to assess molecular changes, and determined fetal sex-based differences. Our data suggest that both p21 and p16 mediated senescence pathways are activated during trophoblast differentiation and are dysregulated in GDM placenta in a sexually dimorphic manner. We also provide evidence for increased activation of p53-Lamin A/C and p16-RB pathways in trophoblast from GDM placentas. Reduced expression of p21 and its downstream effects on GCM1 expression and βhCG secretion outline how altered physiological senescence can affect trophoblast differentiation and function. This is a seminal study highlighting how placental senescence pathways are altered in pregnancies complicated by GDM.

Gut microbiome-derived metabolites and their impact on gene regulatory networks in gestational diabetes

This study explored the therapeutic potential of gut microbiota metabolites in managing Gestational Diabetes Mellitus (GDM). Using network pharmacology, molecular docking, and dynamics simulations, we identified key targets and pathways involved in GDM. We screened 135 gut-derived metabolites, with 8 meeting drug-likeness and pharmacokinetic criteria. Analysis revealed significant overlap with GDM-related targets, including AKT1, IL6, TNF, and STAT3. Functional enrichment analysis highlighted the AGE-RAGE signaling and inflammatory pathways as crucial in GDM pathogenesis. Molecular docking and dynamics simulations showed strong binding affinities and stable interactions between two metabolites, luteolin and naringenin chalcone, and the target protein AKT1. These findings suggest that gut microbiota-derived metabolites, particularly luteolin and naringenin chalcone, may effectively modulate key pathways in GDM, offering promising avenues for novel treatment strategies.

Computational analysis of potential drug-like compounds from Solanum torvum - A promising phytotherapeutics approach for the treatment of diabetes

Diabetes mellitus (DM) is a global pandemic that is characterized by high blood glucose levels. Conventional treatments have limitations, leading to the search for natural alternatives. This study focused on Solanum torvum (STV), a medicinal plant, to identify potential anti-diabetic compounds using molecular docking and molecular dynamics simulations. We focused on identifying natural inhibitors of two key enzymes involved in glucose metabolism: α-amylase (1HNY) and α-glucosidase (4J5T). In our preliminary docking study, rutin showed the highest binding affinity (-11.58 kcal/mol) to α-amylase, followed by chlorogenin (-7.58 kcal/mol) and myricetin (-5.82 kcal/mol). For α-glucosidase, rutin had the highest binding affinity (-11.78 kcal/mol), followed by chlorogenin (-7.11 kcal/mol) and fisetin (-6.44 kcal/mol). Hence, chlorogenin and rutin were selected for further analysis and compared with acarbose, an FDA-approved antidiabetic drug. Comparative docking revealed that chlorogenin had the highest binding affinity of (-9.9 kcal/mol) > rutin (-8.7 kcal/mol) and > acarbose (-7.7 kcal/mol) for α-amylase. While docking with α-glucosidase, chlorogenin again had the highest binding affinity of (-9.8 kcal/mol) > compared to rutin (-9.5 kcal/mol) and acarbose (-7.9 kcal/mol). Molecular dynamics (MD) simulations were conducted to assess their stability. We simulated 100 nanoseconds (ns) trajectories to analyze their stability on various parameters, including RMSD, RMSF, RG, SASA, H-bond analysis, PCA, FEL, and MM-PBSA on the six docked proteins. In conclusion, our study suggests that chlorogenin and rutin derived from STV may be effective natural therapeutic agents for diabetes management because of their strong binding affinities for the α-amylase and α-glucosidase enzymes.Communicated by Ramaswamy H. Sarma.

Association Between Neighborhood Deprivation and Gestational Diabetes: A Systematic Review and Meta-Analysis

Gestational diabetes mellitus (GDM) is a major global health concern, affecting maternal and child health. Although genetic predispositions and individual medical histories are well-recognized risk factors, emerging research suggests a significant impact of external factors like neighborhood socioeconomic characteristics. This study systematically reviews and meta-analyzes the association between neighborhood deprivation and GDM incidence. We searched multiple databases up to January 10, 2024, for studies linking neighborhood deprivation with GDM. Eligible studies were selected based on predefined criteria, with the Nested Knowledge software assisting in screening and data extraction. Quality assessment utilized the Newcastle-Ottawa Scale, and a random-effects model computed the pooled relative risk (RR) using R software, version 4.3. The review included six studies varying significantly in design, sample sizes, and deprivation assessment methods. The meta-analysis combined data from five studies totaling 15 827 participants from the least deprived and 18 147 from the most deprived neighborhoods, yielding an RR of 0.909, indicating a non-significant lower risk of GDM in more deprived groups. A substantial heterogeneity (I2 = 70%) was observed, and sensitivity analysis confirmed the robustness of these findings. This analysis suggests that living in a deprived neighborhood does not significantly alter GDM risk, underscoring the necessity for further research to refine public health strategies and interventions. The variability in neighborhood deprivation definitions and potential unaccounted confounding factors highlight the need for comprehensive studies, especially from low-income and middle-income countries, to elucidate the intricate links between socioeconomic factors and GDM.

Investigating factors affecting the quality of life of women with gestational diabetes: a systematic review and meta-analysis

BACKGROUND

Gestational diabetes mellitus (GDM) affects a significant proportion of pregnant women, impacting both physical and psychological well-being. This study aimed to investigate the factors influencing quality of life (QoL) in women with GDM.

METHODS

This systematic review followed PRISMA guidelines and was registered in PROSPERO (ID: CRD42024612587). A comprehensive search was conducted in PubMed, Scopus, ProQuest, Web of Science, and CINAHL, using MeSH terms related to gestational diabetes and quality of life. Eligible studies included adult women with gestational diabetes and assessed factors influencing their quality of life. The included studies were related to various stages including antenatal, during pregnancy or postpartum. Data extraction was performed independently by two authors, and study quality was evaluated using the Newcastle-Ottawa Scale (NOS). Statistical analyses were conducted in STATA, including meta-analysis with a random-effects model.

FINDINGS

The findings reveal that women with GDM experience significantly lower QoL compared to healthy pregnant women, with sexual dysfunction being a notable contributor. Women with GDM reported lower sexual desire, satisfaction, and higher pain levels, which were significantly associated with poorer QoL, particularly in mental health and pain domains. Socio-demographic factors such as age, education, income, and marital status were significantly linked to QoL, with younger women and those with lower education or income reporting poorer outcomes. Psychological factors, including stress, depression, and anxiety, negatively impacted QoL, while social support, self-efficacy, and illness acceptance were positively correlated with better QoL outcomes. Additionally, stress was found to be the main predictor of QoL for women over 30, while social relationships were more important for younger women. Treatment with insulin or a combination of insulin and oral hypoglycemic agents was associated with lower QoL compared to dietary management alone.

CONCLUSION

This systematic review identified key psychosocial and medical factors influencing the quality of life in women with gestational diabetes. The findings emphasize the importance of addressing psychological well-being, social support, and treatment approaches to enhance QoL in these women. Further research is needed to explore interventions targeting mental health and stress management to improve outcomes for women with gestational diabetes.

Homozygous AA Genotype of IL-17A and 14-bp Insertion Polymorphism in HLA-G 3'UTR Are Associated with Increased Risk of Gestational Diabetes Mellitus

Gestational diabetes mellitus (GDM) is a common pregnancy complication characterized by hyperglycemia and insulin resistance, with unclear genetic mechanisms. The specific involvement of proinflammatory cytokines, including IL-17A, and the immuno-tolerogenic HLA-G remains poorly understood in GDM. We aimed to explore the associations of three polymorphisms, IL-17A -197G>A (rs2275913), IL-17RA -947A>G (rs4819554), and HLA-G 14-bp insertion/deletion (indel), with GDM risk in a Brazilian population. We conducted a case-control study (79 GDM cases and 79 controls). Genetic polymorphisms were analyzed using PCR-RFLP, with DNA extracted using the Salting-out procedure. Significant associations were identified between -197G>A rs2275913 and HLA-G 14-bp indel polymorphisms in both codominant and recessive models. The IL-17A rs2275913 AA genotype was associated with a nearly ten-fold increased risk of GDM in both the codominant (p = 0.021, OR 9.89, 95% CI: 1.63-59.92) and recessive models (p = 0.006, OR 9.33, 95% CI: 1.57-55.38). Similarly, the HLA-G 14-bp Ins/Ins genotype was associated with an increased risk in both the codominant (p = 0.026, OR 3.34, 95% CI: 0.98-11.41) and recessive models (p = 0.010, OR 4.20, 95% CI: 1.36-12.96). IL-17RA polymorphism showed no significant associations. The study findings highlight the potential genetic and immune factors associated with GDM, particularly the -197G>A rs2275913 and HLA-G 14-bp indel polymorphisms. Further functional characterization is warranted to uncover the mechanism of genotype-phenotype association.

Dietary fat intake with risk of gestational diabetes mellitus and preeclampsia: a systematic review and meta-analysis of prospective cohort studies

CONTEXT

Gestational diabetes mellitus (GDM) and preeclampsia (PE) are commonly observed medical complications in pregnancy. Dietary total fat and fatty acids associated with GDM and PE risk have been examined in several epidemiological studies. In some instances, systematic reviews and meta-analyses might provide more accurate dietary recommendations.

OBJECTIVES

This systematic review and dose-response meta-analysis was conducted to investigate the association between dietary total fat and fatty acids and the risk of GDM and PE.

DATA SOURCES

Research on dietary fat intake and the risk of GDM and PE was conducted through systematic searches of the PubMed, Scopus, and Web of Science databases for articles published up to August 19, 2023. An investigation of associations between dietary intake of total fat and fatty acids and the risk of GDM and PE was performed using prospective cohort study designs.

RESULTS

Twenty-one prospective cohort studies were considered eligible. Findings indicated that higher intakes of total fat (relative risk [RR], 1.08; 95% confidence interval [CI], 1.02-1.14), animal fat (RR, 1.56; 95%CI, 1.34-1.89), vegetable fat (RR, 1.23; 95%CI, 1.05-1.45), dietary cholesterol (RR, 1.48; 95%CI, 1.10-2.00), and omega-3 fatty acid (RR, 1.11; 95%CI, 1.02-1.20) are associated with a greater risk of GDM. However, no significant association was found between dietary total fat and fatty acids and the risk of PE. Dose-response meta-analyses suggested every 10% increment in total energy intake from total fat, 5% from animal fat, 5% from vegetable fat, and 100 mg from cholesterol was related to 15%, 12%, 7%, 14%, and 20% higher GDM risk, respectively.

CONCLUSIONS

Overall, total fat, animal fat, vegetable fat, dietary cholesterol, and omega-3 fatty acid consumption are associated with a small but statistically significant increase in GDM risk.

PROTOCOL REGISTRATION

PROSPERO (CRD42023466844).

Gestational diabetes mellitus and polycystic ovary syndrome, a position statement from EGOI-PCOS

Gestational diabetes mellitus is a worldwide health issue in pregnancy, posing a threat to both mother and child. One of the major risk factors for the development of gestational diabetes mellitus is polycystic ovary syndrome, primarily due to the biochemical hyperandrogenism and metabolic issues, commonly observed in these patients. In recent years, the Expert Group on Inositol in Basic and Clinical Research and on PCOS (EGOI-PCOS) has sought to better understand the pathogenesis behind polycystic ovary syndrome, in order to accurately diagnose and treat patients according to their individual needs. Through the scope of polycystic ovary syndrome, this position paper examines the characteristics of both conditions, and underlying biological mechanisms, before moving on to common treatment strategies to avoid or treat gestational diabetes mellitus in women with polycystic ovary syndrome.

Prevalence and Risk Factors of Gestational Diabetes Mellitus in Romania: Maternal and Fetal Outcomes

Background and Objectives: Gestational diabetes mellitus (GDM) is a prevalent condition associated with maternal and fetal complications, including preeclampsia, preterm birth, and neonatal risks. This study investigates the prevalence, risk factors, and socio-demographic and medical determinants of GDM in a Romanian cohort. Materials and Methods: This retrospective study analyzed 200 pregnant women aged 22-43, grouped by demographic and health factors. Data included glucose tolerance tests, hypertension, obesity, and socio-demographic evaluations. Statistical analysis, performed in SPSS with p < 0.05, used logistic regression to assess variable associations. Results: GDM prevalence was 10%, with higher rates in women with obesity (25%, p = 0.03) and hypertension (12%, p = 0.01). Urban living was significantly linked to obesity and hypertension (p = 0.02). Cesarean deliveries occurred in 30% of cases (p = 0.02), and term births accounted for 85% (p = 0.01). Factor analysis identified two key patterns, with urban-related health risks (obesity and hypertension) and socio-demographic vulnerabilities (marital status and rural residence) increasing GDM risk. Conclusions: GDM prevalence underscores the impact of medical and socio-demographic factors, stressing the need for tailored interventions like weight management, glycemic control, and equitable healthcare access to reduce risks and improve outcomes for mothers and infants.

The effect of training intervention based on health belief model on self-care behaviors of women with gestational diabetes mellitus

Background

Gestational diabetes mellitus (GDM) is currently the most common complication of pregnancy, and the prevalence of undiagnosed hyperglycemia and overt diabetes in young women is increasing. In this regard, the present study aimed to investigate the effect of training intervention based on the health belief model of self-care behaviors in women with gestational diabetes.

Methods

The present study was an interventional study, which was conducted on 160 women with gestational diabetes (80 in the interventional group and 80 in the control group), who were under treatment in healthcare centers in the city of Fasa in Fars Province, Iran, in 2022-2023. The method was simple random sampling. The collecting data tools were demographic characteristics questionnaire (age, education, occupation, monthly income of the family, gestational age (in the week), and rank of pregnancy, a knowledge assessment questionnaire, a questionnaire based on the health belief model (perceived sensitivity, perceived severity, perceived advantages, and disadvantages, self-efficiency), and the self-care behaviors questionnaire. The questionnaires were completed before the intervention and 6 weeks after the intervention. The women in the intervention group received six sessions of 50-55 min. Fasting blood sugar level and blood sugar level 2 h after the meal, A1C hemoglobin, and the need for taking insulin and the required dosage were recorded. The data were analyzed using SPSS 24, Kolmogorov-Smirnov tests (for normal distribution of data), independent t-test, paired t-test, chi-2 test, and descriptive statistics (P < 0.05).

Results

The mean age of the participants in the intervention group and control group was 32.45 ± 4.82 and 33.16 ± 4.69, respectively. The results showed that the mean scores of all structures of the health belief model in the intervention group were significantly different from those obtained after the intervention in this group (p < 0.001). Also, the comparison of averages of blood sugar levels after the intervention in the two groups indicated that fasting blood sugar level, A1C hemoglobin, and blood sugar levels measured 2 h after the meal significantly decreased in the intervention group (p < 0.001). The need to increase the dosage of insulin in the intervention group was lower than in the control group.

Conclusions

according to the results, the health belief model was effective in improving clinical results of self-care behaviors in women with gestational diabetes. HBM played an important role in understanding what care and support the women need. Therefore, the incidence of various diseases can be prevented and mothers with GDM can experience such vulnerability less than before. It can also be used as a model to design, implement, and monitor health programs for women with gestational diabetes.

Health literacy assessment and analysis of influencing factors in pregnant women with gestational diabetes mellitus in Southwest China

Objective

The main objectives of our study are evaluating the health literacy level among women with gestational diabetes mellitus (GDM) in Southwest China and explore the influencing factors, using a multidimensional health literacy assessment scale (Chinese version of the HLS-14). Given that the HLS-14 has not been used in GDM previously, its reliability and validity testing was included as a secondary objective.

Method

It was a cross-sectional survey with 565 GDM pregnancies. The Maternal and child health information access questionnaire, Chinese version of the HLS-14, Perceived Social Support Scale (PSSS) and General Self-efficacy Scale (GSES) was used to collect health information access behaviors, health literacy, social support and self-efficacy levels, respectively. SPSS 21.0 was used for descriptive statistical, multiple stepwise linear regression analysis and exploratory factor analysis (EFA). Amos 26.0 was used for confirmatory factor analysis (CFA).

Results

The Chinese version of HLS-14 has good reliability and validity in GDM pregnancies. The Cronbach's α are 0.849, 0.866, 0.859, and 0.883, respectively. The exploratory factor analysis extracted three common factors with a cumulative variance contribution rate of 68.405%. The confirmatory factor analysis model fit was good (χ2/df = 2.595, RMSEA = 0.055, IFI = 0.970, TLI = 0.963, CFI = 0.970). The HL level in pregnancies with GDM was moderate with a mean score of 3.26 ± 0.41, of which 24.10% had limited HL, 41.87% had moderate HL, and 34.03% had adequate HL. Regression analysis showed that the women with higher family support (β = 0.298, p < 0.001), recording pregnancy management diary (β = 0.199, p < 0.001), higher the family income (β = 0.140, p < 0.001), lower pre-pregnancy BMI (β = -0.116, p = 0.004), longer time spent searching for health information (β = 0.111, p = 0.006), and searching for health information through a medical health information website (β = 0.093, p = 0.019) had higher HL levels. These variables explained 23.1% of the variance in HL.

Conclusion

The Chinese version of the HLS-14 has good applicability in the GDM pregnancies. The HL level of them is moderate, needs to be improved. Healthcare professionals should focus on the GDM population with low family income and high pre-pregnancy BMI, fully mobilize their social support system, provide reliable access to information, encourage all GDM pregnancies to use pregnancy management diaries to record their self-management behaviors, and ensure the effectiveness of health education.

Blood Cells Parameters in Second Trimester of Pregnancy and Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis

OBJECTIVE

Gestational diabetes mellitus (GDM) is one of the most common complications during pregnancy. There is inconsistency between previous studies regarding the blood and inflammatory parameters levels among pregnant women and its association with GDM. This study aimed to investigate the relationship between blood parameters in relation to GDM.

METHODS

Systematic literature searches were carried out through databases like PubMed, Web of Science, Epistemonikos, Scopus, Scientific Information Database and Magiran till May 2024. The effect size of serum blood parameters levels was determined by using standard mean deviations (SMDs) and 95% confidence intervals (CIs).

RESULTS

Thirty articles were included in this study. Meta-analysis showed that compared with the control group, women with GDM had significantly higher levels of haemoglobin (0.343 [95% CI 0.134-0.553] p = 0.01, sensitivity analysis: 0.174 [95% CI 0.0343-0.315] p = 0.01), red blood cell (0.387 [95% CI 0.224-0.550] p < 0.001), mean platelet volume (0.498 [95% CI 0.165-0.831] p = 0.003), white blood cell count (0.351 [95% CI 0.0882-0.615] p = 0.009) and neutrophil-lymphocyte ratio (0.534 [95% CI 0.127-0.941] p = 0.01). However, women with GDM had lower levels of mean corpuscular haemoglobin concentration (-0.249 [95% CI -0.386--0.112] p < 0.001). Pooled results from MPV showed no association between adjusted MPV and GDM (adjusted OR 1.33 [95% CI 0.8-1.86] I2 = 57.2%).

CONCLUSIONS

Finding supports higher levels of blood parameters (Hb, RBC, WBC, NLR and MPV) among women with GDM in the second trimester of pregnancy. Future studies should investigate the potential role of these haematological markers as predictive tools for adverse pregnancy outcomes and evaluate therapeutic interventions targeting these parameters to enhance maternal and fetal health.

Practical Considerations for Using Continuous Glucose Monitoring in Patients with Gestational Diabetes Mellitus

Gestational diabetes mellitus (GDM) is the most prevalent metabolic complication during pregnancy. GDM is associated with adverse perinatal, neonatal, and long-term health consequences. Studies have demonstrated that the use of continuous glucose monitoring (CGM) reduces the incidence of maternal and neonatal complications in pregnant women with type 1 diabetes. Although the use of CGM in GDM has not been well studied, a growing body of evidence is showing potential benefits in the GDM population. This article discusses the advantages and challenges of CGM and provides practical guidelines for using this technology in the GDM population.

Probiotic Supplementation during Pregnancy: Evaluating the Current Clinical Evidence against Gestational Diabetes Mellitus

BACKGROUND

Gestational diabetes mellitus (GDM) constitutes a common metabolic disorder that could lead to deleterious short- and long-term complications in both the mother and her infant. Probiotic supplementation seems to exert diverse, healthy effects by acting as a preventive agent against various human diseases, including GDM.

OBJECTIVE

The purpose of the current narrative review was to critically summarize and scrutinize the available clinical studies during the last 15 years (2008-2023) concerning the use of probiotic supplementation during pregnancy as a protecting agent against GDM.

METHODS

A thorough and in-depth search was performed in the most accurate scientific databases, e.g., PubMed., Scopus, Web of Science, and Google Scholar applying effective, and relevant keywords.

RESULTS

There are currently some clinical studies suggesting the potential beneficial impact of probiotic supplementation in the prevention and/or co-treatment of GDM. Nevertheless, there is a high heterogeneity amongst the available clinical studies concerning the dosage, the administration duration, the probiotic species types, the method designs and protocols, and the study populations.

CONCLUSION

Probiotic supplementation at conventional dosages and in combination with a balanced healthy diet, and lifestyle seems to reduce the the risk of developing GDM, while ameliorating the severity of its symptoms. Further clinical studies taking into account the above considerations should be performed to establish conclusive results, while the future meta-analyses should include studies with the feasibly lowest heterogeneity.

Green synthesis and characterization of iron nanoparticles synthesized from bioflocculant for wastewater treatment: A review

Nanotechnology is a rapidly expanding field with diverse healthcare, agriculture, and industry applications. Central to this discipline is manipulating materials at the nanoscale, particularly nanoparticles (NPs) ranging from 1 to 100 nm. These NPs can be synthesized through various methods, including chemical, physical, and biological processes. Among these, biological synthesis has gained significant attention due to its eco-friendly nature, utilizing natural resources such as microbes and plants as reducing and capping agents. However, information is scarce regarding the production of iron nanoparticles (FeNPs) using biological approaches, and even less is available on the synthesis of FeNPs employing microbial bioflocculants. This review aims to provide a comprehensive examination of the synthesis of FeNPs using microbial bioflocculants, highlighting the methodologies involved and their implications for environmental applications. Recent findings indicate that microbial bioflocculants enhance the stability and efficiency of FeNP synthesis while promoting environmentally friendly production methods. The synthesized FeNPs demonstrated effective removal of contaminants from wastewater, achieving removal rates of up to 93 % for specific dyes and significant reductions in chemical oxygen demand (COD) and biological oxygen demand (BOD). Additionally, these FeNPs exhibited notable antimicrobial properties against both Gram-positive and Gram-negative bacteria. This review encompasses studies conducted between January 2015 and December 2023, providing detailed characterization of the synthesized FeNPs and underscoring their potential applications in wastewater treatment and environmental remediation.

LncRNAs Involved in Antioxidant Response Regulation as Biomarkers of Gestational Diabetes: A Study on H19, MALAT1 and MEG3

Recent findings highlighted the potential of long non-coding RNAs (lncRNAs) as novel indicators of gestational diabetes mellitus (GDM), as they demonstrate altered expression in metabolic disorders, oxidative stress (OS) and inflammation (IFM). The aim of this study was to evaluate the diagnostic potential and prognostic significance of the OS/IFM-related lncRNAs H19, MALAT1 and MEG3 in GDM and their correlations with redox status-related parameters. The relative quantification of selected lncRNAs from peripheral blood mononuclear cells (PBMCs) of GDM patients and controls (n = 50 each) was performed by qPCR. The expression levels were tested for correlations with metal ion concentrations, NRF2 expression, activities of glutathione reductase (GR), superoxide dismutase (SOD), catalase (CAT), serum thiol content, protein carbonyl level and thiobarbituric acid reactive substances. MALAT1 and H19 were significantly downregulated in GDM patients (p = 0.0095 and p = 0.012, respectively). A correlation was observed between H19 expression and zinc levels in both GDM patients and controls. MALAT1 expression positively correlated with NFE2L2 levels in GDM patients (p = 0.026), while H19 exhibited a positive correlation with GR activity in controls (p = 0.018) and an inverse correlation with SOD activity (p = 0.048). Our data show the disturbance of OS/IFM-lncRNAs in GDM pathogenesis and illustrate the biomarker potential of the analyzed lncRNAs, as well as of certain redox status parameters.

Metabolic profiles in early pregnancy associated with metabolic pregnancy complications in women with obesity

INTRODUCTION

Higher maternal body mass index (BMI) is associated with metabolic disturbances and pregnancy complications. We aimed to examine whether metabolic profiles in early pregnancy were associated with metabolic pregnancy complications in women with obesity (BMI ≥ 30 kg/m2).

MATERIAL AND METHODS

Nested cohort study from a prospective longitudinal cohort (n = 1031) of women who were healthy prior to pregnancy and gave birth at Oslo University Hospital from 2002-2008. The sample comprised 81 women with obesity. Metabolic pregnancy complications included gestational diabetes mellitus, gestational hypertension and preeclampsia. In plasma samples from gestational weeks 14-16, 91 metabolites were analyzed by nuclear magnetic resonance spectroscopy. We performed a principal component analysis to reduce the metabolic dimensions. Logistic regression models were fitted to estimate crude and adjusted odds ratios (ORs) of metabolic pregnancy complications.

RESULTS

Twenty-four out of 81 women developed metabolic pregnancy complications (gestational hypertension, preeclampsia, and/or gestational diabetes). Two of five principal components (80 % explained variance) were significantly associated with metabolic pregnancy complications. The ratio of monounsaturated to total fatty acids increased the risk of metabolic pregnancy complications (OR 2.09, 95 % confidence interval [CI] 1.25-3.75), while the ratio of polyunsaturated to monounsaturated fatty acids decreased the risk (OR 0.54, 95 % CI 0.30-0.89). The ratio of omega-3 to total fatty acids (OR 0.59, 95 % CI 0.34-0.98) and the ratio of docosahexaenoic acid to total fatty acids (OR 0.57, 95 % CI 0.31-0.97) also decreased the risk of metabolic pregnancy complications.

CONCLUSION

Metabolic profile in early pregnancy was associated with risk of metabolic pregnancy complications in women with obesity. We observed the strongest associations between fatty acid composition and metabolic pregnancy complications.

Monocyte-to-lymphocyte ratio in the early second trimester is a predictor of gestational diabetes mellitus

OBJECTIVE

To evaluate neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), neutrophil-to-monocyte ratio (NMR), and other hemogram-derived inflammatory parameters measured in the early second trimester and their association with the risk of gestational diabetes mellitus (GDM).

METHODS

This case-control study was conducted with 105 women with GDM and 205 healthy pregnant women, matched for maternal age at a 1:2 ratio with the cases at two regional maternity hospitals between January 2021 and August 2022. The inflammatory blood cell indices were tested in the early second trimester, and the patient's characteristics and the course of the pregnancy were analyzed. Logistic regression was used to determine the association between hematological parameters and the risk of GDM. Data were analyzed using SPSS, version 25.0 (SPSS, Chicago, IL).

RESULTS

The final analysis included 310 pregnant women. The GDM group showed a higher pre-pregnancy BMI compared to the healthy controls (p < .01). There was no difference in NMR, PLR, and NLR between the groups (p = .63, .54, and .39, respectively). GDM was only positively associated with MLR (p = .02). After adjusting for potential confounding risk factors including maternal age, parity, and BMI, the multivariate regression analysis showed a higher level of MLR, with a cutoff point of 0.312, was independently associated with the risk of GDM (OR = 2.15, 95%CI 1.51-4.31, p = .03). However, ROC analysis showed that the AUC value of MLR was poor (0.670).

CONCLUSIONS

We found that MLR, an inflammatory combined index derived from whole blood counts, may potentially serve as a predictor of GDM in the early second trimester.

Triglyceride-glycaemic index: Insights into predicting fetal macrosomia and its interaction with gestational diabetes mellitus: A cohort study of Chinese pregnant women

OBJECTIVE

This study investigates the association between a new insulin resistance indicator, the triglyceride-glucose (TyG) index, and the risk of macrosomia.

DESIGN

This is a prospective cohort study.

METHODS

This study included 1332 women who delivered at Peking University International Hospital between October 2017 and August 2019. Participants were divided equally into three groups based on the TyG index. Logistic regression and restricted cubic spline (RCS) analyses were used to evaluate the relationship between the TyG index and macrosomia and conducted subgroup analyses. The TyG index's ability to predict macrosomia was assessed using the receiver operating characteristic (ROC) curve.

RESULTS

Multivariable logistic regression analysis revealed that the TyG index is an independent risk factor for macrosomia (Odds ratio [OR] 1.84, 95% confidence interval [CI] 1.02-3.30, p < .05). RCS analysis indicates that the risk of macrosomia increases with the rise of the TyG index (p for nonlinearity <.001) when the TyG index is >6.53. Subgroup analysis showed a synergistic additive interaction between the TyG index and gestational diabetes mellitus (GDM) of macrosomia. The area under the ROC curve for the predictive model was 0.733 (95% CI 0.684, 0.781), with a sensitivity of 76.4% and specificity of 66.9%. Incorporating the TyG index alongside traditional risk factors notably enhances macrosomia prediction (p < .05).

CONCLUSIONS

The TyG index independently predicts macrosomia, and exhibits an additive interaction with GDM in its occurrence. Integrating the TyG index with traditional risk factors improves the prediction of macrosomia.

TRIAL REGISTRY

Clinical trials. gov [NCT02966405].

Diabetes and the associated complications: The role of antioxidants in diabetes therapy and care

Diabetes mellitus (DM) is a chronic metabolic disorder characterized by high blood sugar levels (hyperglycemia). Poorly managed diabetes can lead to complications affecting multiple organ systems. Antioxidants play a crucial role in reducing oxidative stress caused by reactive oxygen species (ROS), primarily triggered by uncontrolled high blood sugar levels in diabetes. Antioxidants like vitamin C, E, selenium, and alpha-lipoic acid, when used as supplements, have shown promise in reducing oxidative stress markers and improving antioxidant status in laboratory and animal studies and diabetic patients. Antioxidant supplementation may help reduce the risk of diabetic complications such as neuropathy, nephropathy, retinopathy, and cardiovascular disease. Additionally, antioxidants also have anti-inflammatory properties, which could be beneficial in reducing inflammation associated with diabetes. Antioxidant supplementation has been shown to enhance endothelial function, insulin sensitivity, and glucose metabolism, thereby aiding in glycemic control and overall diabetic management. Combining antioxidants with certain medications may have therapeutic benefits, such as effectively neutralizing free radicals and enhancing the regulation of antioxidant defense systems. This review presents an update on diabetes, the sources of free radical generation, the body's natural defense mechanisms, the clinical evidence regarding using antioxidants in managing diabetic complications, and the potential new therapeutic approaches. Overall, antioxidant supplementation may offer some benefits in managing diabetic complications. However, further studies are needed to understand the mechanisms of action, determine the optimal supplementation, explore potential interactions with other medications, and conduct long-term studies to establish the possible use of antioxidants for optimal benefits in diabetes care.

iTRAQ proteomics analysis of placental tissue with gestational diabetes mellitus

BACKGROUND

Gestational diabetes mellitus is an endocrine and metabolic disorder that appears for the first time during pregnancy and causes varying degrees of short- and/or long-term effects on the mother and child. The etiology of the disease is currently unknown and isobaric tags for relative and absolute quantitation proteomics approach, the present study attempted to identify potential proteins in placental tissues that may be involved in the pathogenesis of GDM and adverse foetal pregnancy outcomes.

METHODS

Pregnant women with GDM hospitalised were selected as the experimental group, and pregnant women with normal glucose metabolism as the control group. The iTRAQ protein quantification technology was used to screen the differentially expressed proteins between the GDM group and the normal control group, and the differentially expressed proteins were analysed by GO, KEGG, PPI, etc., and the key proteins were subsequently verified by western blot.

RESULTS

Based on the proteomics of iTRAQ, we experimented with three different samples of placental tissues from GDM and normal pregnant women, and the total number of identified proteins were 5906, 5959, and 6017, respectively, which were similar in the three different samples, indicating that the results were reliable. Through the Wayne diagram, we found that the total number of proteins coexisting in the three groups was 4475, and 91 differential proteins that could meet the quantification criteria were strictly screened, of which 32 proteins were up-regulated and 59 proteins were down-regulated. By GO enrichment analysis, these differential proteins are widely distributed in extracellular membrane-bounded organelle, mainly in extracellular exosome, followed by intracellular vesicle, extracellular organelle. It not only undertakes protein binding, protein complex binding, macromolecular complex binding, but also involves molecular biological functions such as neutrophil degranulation, multicellular organismal process, developmental process, cellular component organization, secretion, regulated exocytosis. Through the analysis of the KEGG signaling pathway, it is found that these differential proteins are mainly involved in HIF-1 signaling pathway, Glycolysis/Gluconeogenesis, Central carbon metabolism in cancer, AMPK signaling pathway, Proteoglycans in cancer, Protein processing in endoplasmic reticulum, Thyroid cancer, Alcoholism, Glucagon signaling pathway.

DISCUSSION

This preliminary study helps us to understand the changes in the placental proteome of GDM patients, and provides new insights into the pathophysiology of GDM.

Synthesis of arylated tetrahydrobenzo[H]quinoline-3-carbonitrile derivatives as potential hits for treatment of diabetes

Aim: Quinoline scaffolds are serving as the core structure for numerous antifungal, analgesic, antipyretic, anti-inflammatory drugs as well as have also been investigated for their potential antidiabetic properties. Though further exploration is required in this area as the current antidiabetic agents, such as acarbose, miglitol and voglibose, are associated with several adverse side effects. In this context, arylated tetrahydrobenzo[H]quinoline-3-carbonitrile derivatives were designed and evaluated as potential antidiabetic agents.Materials & methods: A one-pot multicomponent reaction of 6-methoxy-1-tetralone with ethyl cyanoacetate, ammonium acetate and varying aldehydes yielded a range of new arylated tetrahydrobenzo[h]quinoline-3-carbonitrile molecules 1-36.Results: Compounds 2-5, 12, 13, 19 and 32-34 showed excellent inhibition against α-amylase (IC50 = 3.42-15.14 μM) and α-glucosidase (IC50 = 0.65-9.23 μM) enzymes in comparison to the standard acarbose (IC50 = 14.35 μM). In addition, all compounds revealed significant to moderate DPPH radical scavenging activity (SC50 = 21.30-138.30 μM) compared with BHT (SC50 = 64.40 μM). Kinetic studies confirmed competitive inhibition mode, while molecular docking studies comprehend ligands' interaction with enzyme's active sites and absorption, distribution, metabolism, and excretion analysis confirms that all synthetic derivatives are nontoxic.Conclusion: This research offers a range of lead candidates to become antidiabetic agents after further advanced study.

The Effect of Oxidative Stress and Antioxidants Treatment on Gestational Diabetes Mellitus Outcome: A Scoping Review

Diagnosing a pregnant woman's glucose intolerance is referred to as gestational diabetes mellitus (GDM). Diabetes has been linked to enhanced oxidative stress. In this condition, oxidative stress may damage nucleic acids, fats, and proteins, which in turn affects cell and tissue functions. The present study highlights the relationship between oxidative stress and GDM, with a particular focus on the role of hyperglycemia-induced processes during reactive oxygen species (ROS) oversupply, followed by it discusses the oxidative stress biomarkers and assesses the effects of antioxidant supplements on glycemic control, inflammatory processes, and oxidative stress among individuals with GDM. Two reviewers conducted a comprehensive literature search utilizing the PubMed®, Web of Science™, and Scopus® databases. Only items published in the English language up until June 2024 were taken into account. We conducted a thorough search of research databases to identify articles that had the terms "oxidative stress" or "antioxidant" and "GDM". From this search, we selected 55 relevant papers to be included in this narrative review. Pregnancy-induced hypertension, postpartum bleeding, lower birth weight, a higher risk of hyperbilirubinemia in their neonates, fetal growth retardation, and birth asphyxia were revealed to be outcomes of women enduring major oxidative stress during pregnancy. Furthermore, tight glycemic control both before and throughout pregnancy as well as oxidative stress treatment may help women highly prone to GDM.

Metformin administration during pregnancy tends to reduce the risk of gestational diabetes mellitus and improve pregnancy outcomes in previously infertile women with polycystic ovary syndrome who become pregnant

OBJECTIVE

Metformin reduces incidences of miscarriage and preterm delivery in polycystic ovary syndrome (PCOS) women, but its impact on gestational diabetes mellitus (GDM) is conflicting. Hence, this study set up selection criteria to include previously infertile women with PCOS but without pre-existing DM who became pregnant, aiming to minimize confounders and investigate the influence of metformin on GDM, miscarriage, and preterm delivery.

METHODS

This study included 195 previously infertile women with PCOS who became pregnant. They were divided into metformin (receiving metformin during pregnancy) and control (not receiving metformin) groups without intervention.

RESULTS

Metformin group tended to have a lower incidence of GDM versus control group (13.3% versus 23.3%, P = 0.070). A logistic regression model adjusted for all baseline characteristics (demographics, infertile duration, and diabetes mellitus-related features) showed that metformin was associated with a decreased probability of GDM (odds ratio (OR): 0.426, P = 0.037). Metformin group showed a similar incidence of miscarriage (6.7% versus 11.1%, P = 0.273), but decreased incidences of preterm delivery (not statistically significant) (6.7% versus 13.3%, P = 0.091) and miscarriage or preterm delivery (13.3% versus 24.4%, P = 0.046) versus control group. A logistic regression model adjusted for all the aforementioned features revealed that metformin was related to a lower risk of miscarriage or preterm delivery (OR: 0.417, P = 0.040). Fetal outcomes, including birth weight (P = 0.245) and the incidence of 5 min-Apgar score ≤ 7 (P = 0.702), were similar between groups.

CONCLUSION

Metformin administration during pregnancy may reduce GDM, miscarriage, and preterm delivery risks without adverse effects on fetal outcomes in previously infertile women with PCOS.

The Impact of Maternal Gestational Diabetes Mellitus on Minipuberty in Boys

BACKGROUND/OBJECTIVES

Minipuberty is thought to play an important role in the sexual maturation of infants. Maternal disorders during pregnancy were found to have an impact on the activity of the reproductive axis in the first year of life. This prospective, matched, cohort study was aimed at investigating whether the course of minipuberty in boys is affected by maternal gestational diabetes mellitus (GDM).

METHODS

The study population consisted of three matched groups of boys: infants born to women with poorly controlled GDM, sons of women with adequately controlled GDM, and infants of healthy women with normal carbohydrate tolerance during pregnancy (control group). Salivary levels of testosterone, androstenedione, DHEA-S and estradiol, and urinary concentrations of FSH and LH were repeatedly measured over the first 12 months of life. Hormone levels were correlated with the size of genital organs (testicular volume and penile length), which were measured at each visit.

RESULTS

Compared with the remaining groups, the male offspring of women with poorly controlled GDM were characterized by higher concentrations of both gonadotropins, higher salivary testosterone levels, lower salivary DHEA-S concentrations, and longer periods of detection for LH and testosterone. Levels of gonadotropin, testosterone and DHEA-S in sons of mothers with poorly controlled GDM correlated with mean levels of glycated hemoglobin during pregnancy. Moreover, the infant boys assigned to this group were characterized by larger sizes of the testes and penis. Over the entire study period, there were no differences in hormone levels, testicular volume and penile length between sons of adequately treated women with GDM and sons of healthy women.

CONCLUSIONS

The obtained results indicate that GDM, if poorly controlled, may affect the activity of the reproductive axis and postnatal growth of male genital organs in the offspring.

Impact of gestational diabetes mellitus on women's sexual function: a systematic review and meta-analysis

BACKGROUND

Gestational diabetes mellitus (GDM) is a prevalent pregnancy complication with well-established adverse effects on maternal and fetal health. However, research on its impact on sexual health is inconsistent. Currently, there is no comprehensive review on sexual function in pregnant women with GDM. The purpose of this study is to systematically gather and synthesize the available evidence, addressing this important research gap.

METHODS

This systematic review and meta-analysis utilized a comprehensive literature search strategy and incorporated the following databases: the Cochrane Library, Scopus, PubMed, Web of Science, SID, and Google Scholar. The search was conducted until February 21, 2024. The quality of the cross-sectional and case‒control studies included in the current study was evaluated via the modified and standard Newcastle‒Ottawa scale. The certainty of the evidence was evaluated via the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework. A meta-regression was conducted to examine the variables that influence total sexual function. Additionally, sequential analysis was performed to determine the required information size for the meta-analysis.

RESULTS

The systematic search process yielded a total of 370 studies. The final analysis included six studies. The meta-analysis findings revealed that compared with controls, women with GDM had significantly lower total scores for sexual function (SMD - 1.80, 95% CI -3.44 to -0.15, p = 0.03), sexual desire (SMD - 5.14, 95% CI -8.14 to -2.14, p < 0.001), arousal (SMD - 0.58, 95% CI -0.95 to -0.21, p = 0.002), lubrication (MD -0.41, 95% CI -0.59 to -0.22, p < 0.001) and satisfaction (SMD - 3.82, 95% CI -6.08 to -1.57, p < 0.001). However, the analysis did not reveal statistically significant differences in sexual pain, or orgasm between the GDM and control groups. The meta-regression analysis revealed that older age in the control group was associated with poorer sexual function.

CONCLUSION

Compared with control women, pregnant women diagnosed with GDM have lower sexual function. Further research with larger sample sizes is necessary to enhance the robustness of the evidence, given the low level of certainty. Healthcare providers should focus on the sexual well-being of women with GDM and create tailored interventions to address their specific needs.

Chromium supplementation and type 2 diabetes mellitus: an extensive systematic review

Diabetes is a global public health concern with increasing prevalence worldwide. Chromium (Cr), a trace element found in soil, water, and food, has been proposed to have a possible positive effect in glucose metabolism and diabetes mellitus prevention. However, the relationship between trivalent chromium [Cr(III)] exposure, mainly through the consumption of diet supplements, and type 2 diabetes mellitus (T2DM) remains controversial. An extensive systematic review of the current literature on randomized controlled studies (RCTs) was conducted from 1 January 2000, to January 2024 using the databases PubMed, Scopus, ScienceDirect, and Cochrane, with specific keywords and inclusion as well as exclusion criteria. After close screening of the research studies retrieved from the mentioned websites was conducted, the most related studies were included in the final systematic review. The studies were evaluated for the degree of relevance, quality, and risk bias, using appropriate quality assessment tools. Several of the included RCT studies reported possible benefits of Cr(III) supplementation, mainly in the form of chromium picolinate (CrPic), chromium yeast (CY), chromium chloride (CrCl3), and chromium nicotinate (CrN). The dosage of chromium was between 50 and 1000 μg/day and it was consumed from 2 to 6 months. Glycemic control markers, including FPG, insulin, HbA1C, and HOMA-IR levels, significantly decrease following chromium supplementation, mainly in studies with a longer intervention period. Supplementing with chromium (Cr) indicated that could significantly improve lipid profile by raising high-density lipoprotein and lowering triglyceride and total cholesterol while having little effect on low-density lipoprotein. However, most research findings include significant limitations, such as inconsistent dosage and type of chromium, formulation of supplements, and study duration. Further well-designed and high-quality research is needed to fully understand the role of chromium dietary supplementation and the potential risks related to its mechanisms of action, type, and dose, in the prevention and treatment of type 2 diabetes mellitus.

The modulatory effects of tyrosol and nano-tyrosol on anxiety-like behavior and emotional memory in streptozotocin-induced diabetic rats

The effects of tyrosol and nano-tyrosol on the modulation of anxiety-like behavior and memory processes were evaluated in streptozotocin-induced diabetic rats. Male diabetic rats were orally treated with 1 ml of saline, nano-niosome, tyrosol, and nano-tyrosol (20 mg/dl) for 30 days. Anxiety-like behavior and memory process were evaluated by an elevated plus-maze (EPM) test-retest paradigm. The results showed that a single intraperitoneal (i.p.) administration of streptozotocin (50 mg/kg) raised blood glucose. While daily intragastric administration of tyrosol and nano-tyrosol reduced blood glucose. Induction of type II diabetes produced a distorted cellular arrangement whereas treatment with tyrosol and nano-tyrosol showed a typical cellular arrangement in the liver. Furthermore, induction of type II diabetes decreased %OAT (%open-arm time) but daily intragastric application of tyrosol (20 mg/dl) and nano-tyrosol (20 mg/dl) enhanced %OAT and %OAE (%open-arm entry) in the EPM when compared to the saline groups, showing anxiogenic- and anxiolytic-like effects, respectively. Also, induction of type II diabetes increased %OAT while daily intragastric administration of tyrosol (20 mg/dl) and nano-tyrosol (20 mg/dl) decreased %OAT and %OAE in the EPM in comparison to the saline groups, displaying impairment and improvement of emotional memory, respectively. Interestingly, nano-tyrosol exhibited the highest significant effect rather than tyrosol. Upon these results, we proposed the beneficial effects of tyrosol and nano-tyrosol on the modulation of anxiety-like behavior and memory processes in streptozotocin-induced diabetic rats.

The Impact of Gestational Diabetes Mellitus on Minipuberty in Girls

Minipuberty is the second phase of physiological activation of the reproductive axis, playing a role in the postnatal development of sexual organs. The course of female minipuberty was found to be affected by low maternal vitamin D status and hypothyroidism during pregnancy. The aim of the current study was to assess the hormonal profile and the size of sexual organs in daughters of mothers with gestational diabetes mellitus. The study included three matched groups of infant girls: daughters of healthy women without metabolic disorders during pregnancy (group 1), daughters of women with poorly controlled gestational diabetes mellitus (group 2), and daughters of women with gestational diabetes mellitus adequately controlled during pregnancy (group 3). Urinary levels of gonadotropins, salivary levels of estradiol, testosterone, DHEA-S and progesterone, ovarian volume, uterine length and breast diameter were measured from postnatal month 1 to postnatal month 18. Concentrations of FSH, LH and estradiol were higher, while concentration of progesterone was lower in group 2 than in the remaining groups. There were no between-group differences in concentrations of testosterone and DHEA-S. Levels of LH, FSH, estradiol and progesterone correlated with maternal whole-blood levels of glycated hemoglobin. Group 2 was also characterized by the longest detection periods for LH and estradiol. Ovarian volume, uterine length and breast diameter were greater in group 1 than in the remaining two groups. Over the entire observation period, there were no differences in hormone levels and sizes of the sexual organs between groups 1 and 3. The obtained results suggest that poorly controlled, but not well controlled, gestational diabetes mellitus affects the course of female minipuberty.

Ethnic differences in the effects of lifestyle interventions on adverse pregnancy outcomes among women with gestational diabetes mellitus: A systematic review and meta-analysis

AIMS

Lifestyle interventions are widely used among women with gestational diabetes mellitus (GDM). This study aimed to assess the ethnic disparities in the effectiveness of lifestyle interventions on reducing adverse pregnancy outcomes, particularly macrosomia and neonatal hypoglycemia among women with GDM.

METHODS

We systematically searched the PubMed/MEDLINE, Web of Science, and Cochrane Library databases from January 1, 2000, up to March 31, 2024, to identify randomized controlled trials (RCTs) examining the effects of lifestyle interventions in GDM patients. Subgroup analysis was performed to investigate heterogeneity across different ethnic groups (including Asians, Whites/Caucasians, Hispanics/ Latinos, and Unknown ethnicity). The random effects model was used to calculate the relative risk (RR) and 95% confidence interval (CI).

RESULTS

After applying inclusion and exclusion criteria, twenty-one studies comprising 4567 participants were included. Lifestyle interventions significantly reduced the incidence of macrosomia ((RR = 0.54; 95 % CI: 0.42-0.70, P < 0.001), with consistent effects observed across racial groups. Conversely, lifestyle interventions were associated with a significant reduction in the risk of neonatal hypoglycemia only among Asians (RR = 0.56; 95 % CI: 0.38-0.84, P = 0.004), while no significant effects were observed in Whites/Caucasians or Hispanics/Latinos (all P > 0.05). Sensitivity analyses confirmed the robustness of the findings.

CONCLUSIONS

Regardless of ethnic background, this study emphasizes the significant benefits of lifestyle interventions in reducing the risk of macrosomia among women with GDM. However, lifestyle interventions seem to reduce the risk of neonatal hypoglycemia only among Asians, which warrants further studies.

Gestational diabetes mellitus, not obesity, triggers postpartum brain inflammation and premature aging in Sprague-Dawley rats

Previous studies showed that women with gestational diabetes mellitus (GDM) are susceptible to cognitive dysfunction. We investigated the effects of GDM on brain pathologies and premature brain aging in rats. Seven-week-old female Sprague-Dawley rats were fed a normal diet (ND) or a high-fat diet (HFD) after two weeks of acclimatization. On pregnancy day 0, HFD-treated rats received streptozotocin (GDM group) or vehicle (Obese mothers). ND-treated rats received vehicle (ND-control mothers). On postpartum day 21, brains and blood were collected. The GDM group showed increased inflammatory and premature aging markers, mitochondrial changes, and compensatory increases in the blood-brain barrier and synaptic proteins in the prefrontal cortex and hippocampus. GDM triggers maternal brain inflammation and premature aging, suggesting compensatory mechanisms may protect against these effects.

Probiotic therapy as a promising strategy for gestational diabetes mellitus management

INTRODUCTION

Gestational diabetes mellitus (GDM) has become the most common pregnancy medical complication, and its prevalence has increased in recent years. The GDM treatment primarily relies on adopting healthy eating habits, physical exercise, and insulin therapy. However, using probiotics to modulate the gut microbiota has been the subject of clinical trials as a promising therapeutic strategy for GDM management.

AREAS COVERED

Due to the adverse effects of gut dysbiosis in women with GDM, strategies targeting the gut microbiota to mitigate hyperglycemia, low-grade inflammation, and adverse pregnancy outcomes have been explored. Probiotic supplementation may improve glucose metabolism, lipid profile, oxidative stress, inflammation, and blood pressure in women with GDM. Furthermore, decreased fasting blood glucose, insulin resistance, and inflammatory markers, such as TNF-α and CRP, as well as increased total antioxidant capacity, lipid profile modulation, and improved blood pressure in women with GDM, are some of the important results reported in the available literature.

EXPERT OPINION

To fill the knowledge gap, further studies are needed focusing on modulating gut microbiota composition and metabolic activity and their systemic repercussions in GDM.