We found several maternal glycaemic and neonatal adiposity benefits in the metformin group. Along with reduced maternal weight gain and insulin dosage and improved glycaemic control, the lower adiposity and infant size measurements resulted in fewer large infants but a higher proportion of small-for-gestational-age infants (The Lancet Diabetes & Endocrinology)
Diabetes News
Category: Gestational
Metformin in women with type 2 diabetes in pregnancy (MiTy): a multicentre, international, randomised, placebo-controlled trial
We found several maternal glycaemic and neonatal adiposity benefits in the metformin group. Along with reduced maternal weight gain and insulin dosage and improved glycaemic control, the lower adiposity and infant size measurements resulted in fewer large infants but a higher proportion of small-for-gestational-age infants (The Lancet Diabetes & Endocrinology)
DTN-UK launch Best Practice Guide for Diabetes Technology in Pregnancy
Written by the leading experts in pregnancy in type 1 diabetes in the UK, the guide has useful tips, guidance and details about the use of insulin pumps, flash glucose monitoring and continuous glucose monitoring in pregnancy (ABCD)
Longitudinal changes in glucose metabolism in women with gestational diabetes, from late pregnancy to the postpartum period
In women with GDM, delivery was associated with improvement in both insulin sensitivity and insulin production within the first few days. Improvement in insulin production persisted for 6–12 weeks, but insulin sensitivity deteriorated slightly (Diabtologia)
The Utility of Lower Glycemic Targets for Treating Gestational Diabetes: A Retrospective Study
Lower glycemic targets did not produce large reductions in fetal overgrowth, but they were associated with a higher rate of inductions. As there were no observed differences in maternal or neonatal outcomes otherwise, aiming for lower glycemic targets in GDM is likely not cost-effective (Journal of Diabetes Research)
The Gut Microbiota in Women Suffering from Gestational Diabetes Mellitus with the Failure of Glycemic Control by Lifestyle Modification
Blautia, Faecalibacterium, and Eubacterium_hallii_group had important characteristic changes in the gut microbiota of women with GDM2. The relative abundance of Faecalibacterium, Blautia, and Eubacterium_hallii_group can discriminate GDM2 from GDM. Gut bacteria may participate in the pathological development of GDM2 through the PPAR signaling pathway, which should be conducted for further study in the future (Journal of Diabetes Research)
Screening for monogenic diabetes in primary care
The benefits and implications of life altering treatment such as termination of insulin administration are significant but little can be done without appropriate identification and referral (Primary Care Diabetes)
Modelling potential cost savings from use of real‐time continuous glucose monitoring in pregnant women with Type 1 diabetes
Routine use of RT‐CGM by pregnant women with type 1 diabetes, would result in substantial cost savings, mainly through reductions in NICU admissions and shorter duration of NICU care (Diabetes Medicine)
Impaired awareness of hypoglycemia: a new risk factor for adverse pregnancy outcomes in type 1 diabetes
Impaired awareness of hypoglycemia: a new risk factor for adverse pregnancy outcomes in type 1 diabetes (Diabetes Research and Clinical Practice)
Testing for type 1 diabetes autoantibodies in gestational diabetes mellitus (GDM): is it clinically useful?
From several epidemiological studies it appears that diabetes-related autoimmunity is not a main factor in the aetiology of GDM, accounting for less than 10% of all cases (BMC Endocrine Disorders)
Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Gestational Diabetes Mellitus and Childhood Glucose Metabolism
Offspring exposed to untreated GDM in utero are insulin resistant with limited β-cell compensation compared with offspring of mothers without GDM. GDM is significantly and independently associated with childhood IGT (Diabetes Care)
Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Glycemia and Childhood Glucose Metabolism
Across the maternal glucose spectrum, exposure to higher levels in utero is significantly associated with childhood glucose and insulin resistance independent of maternal and childhood BMI and family history of diabetes (Diabetes Care)
The association between Gestational Diabetes and Postpartum Depression: A Systematic Review and Meta-analysis
The association between Gestational Diabetes and Postpartum Depression: A Systematic Review and Meta-analysis (Diabetes Research and Clinical Practice)
Experiences of women, hospital clinicians and general practitioners with gestational diabetes mellitus postnatal follow-up: A mixed methods approach
This research informs seven practical recommendations to help promote completion of recommended postnatal GDM follow-up (Diabetes Research and Clinical Practice)
A systematic review on costs and cost-effectiveness of screening and prevention of type 2 diabetes in women with prior gestational diabetes: exploring uncharted territory
An oral glucose tolerance test per three years leads to the lowest cost per case detected, and prevention is potentially cost-effective or cost-saving. More health economic evaluations are needed that compare all relevant alternatives, including ‘doing nothing’ (Diabetes Research and Clinical Practice)
Effect of metformin in addition to dietary and lifestyle advice for pregnant women who are overweight or obese: the GRoW randomised, double-blind, placebo-controlled trial
For pregnant women who are overweight or obese, metformin given in addition to dietary and lifestyle advice initiated at 10–20 weeks’ gestation does not improve pregnancy and birth outcomes (The Lancet Diabetes & Endocrinology)
Treatments for women with gestational diabetes mellitus: an overview of Cochrane systematic reviews
Currently there is insufficient high‐quality evidence about the effects on health outcomes of relevance for women with GDM and their babies for many of the comparisons in this overview comparing treatment interventions for women with GDM (Cochrane Library)
Pumps or Multiple Daily Injections in Pregnancy Involving Type 1 Diabetes: A Prespecified Analysis of the CONCEPTT Randomized Trial
In CONCEPTT, MDI users were more likely to have better glycemic outcomes and less likely to have gestational hypertension, neonatal hypoglycemia, and NICU admissions than pump users. These data suggest that implementation of insulin pump therapy is potentially suboptimal during pregnancy (Diabetes Care)
Implementation of national screening guidelines for gestational diabetes: a national survey of maternity units in England
Additional resources are required for NHS Trusts to fully implement and sustain risk-factor screening, especially for women with previous GDM, BMI≥30kg/m2 and ethnic minority groups (Diabetes Research and Clinical Practice)
Midlife development of type 2 diabetes and hypertension in women by history of hypertensive disorders of pregnancy
Women with history of HDP are not only at higher risk of cardiometabolic disease during their reproductive years, but HDP is also associated with midlife T2D development above and beyond established risk factors (Cardiovascular Diabetology)
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