GESTATIONAL DIABETES MELLITUS

Abstract: GDM is a form of hyperglycemia. Gestational diabetes (GDM) is a glucose tolerance disorder that occurs or is diagnosed during pregnancy . GDM is a transient type of diabetes that occurs during pregnancy. Most women with GDM will return to normal glucose levels after delivery of the baby. If a woman does not return to normal glucose levels she will be re-diagnosed with type 2 diabetes and will no longer be considered to have GDM. It represents the most common metabolic complication of pregnancy. GDM is associated with maternal and fetal morbidities.Early recognition of GDM is very mandatory to prevent maternal morbidity and mortality. GDM may complicate during the pregnancy, intra-partum or post-partum. Birth trauma and poor fetal outcome are important complications. GDM doubles the risk of serious in jury at birth, triples the likelihood of cesarean delivery and quadruples the incidence of newborn intensive care unit admission . Approximately 7% of all pregnancies are complicated by GDM, resulting in more than 200,000 cases annually. The prevalence may range from 1 to 14% of all pregnancies, depending on the population studied and the diagnostic tests employed

MIPOMERSEN: A NOVEL THERAPEUTIC DRUG FOR THE TREATMENT OF FAMILIAL HYPERCHOLESTEROLEMIA, HYPERLIPIDAEMIA, AND HYPERCHOLESTEROLEMIA

Familial Hypercholesterolemia (FH) is one of the most common autosomal dominant disorders which exist in either heterozygous form or a homozygous form. These two forms are prevalent in1 in500 and1 ina million population respectively. FH results in premature atherosclerosis; as early as childhood in case of homozygous (HoFH) form and in adults in case of heterozygous (HeFH) form. In case of HoFH both the alleles forLDL-receptor are defective, whereas the mutation in the single allele is the cause for HeFH. Both the forms of the disease are associated with high levels ofLDL-C and lipoprotein (a) in plasma, with high morbidity and mortality rate caused by cardiovascular disease. In several past years, different lipid-lowering drugs like Statins (HMG-coenzyme-A reductase inhibitor), MTTP inhibitor, CETP inhibitors, PCSK9 inhibitor, thyroid mimetics, niacin, bile acid sequestrants and lipid apheresis were administered to patients with FH, to achieve the goal of reducing plasmaLDL-C and lipoprotein (a). However, such drugs proved inefficient to achieve the goals because of several reasons. Mipomersen is a 20 nucleotide antisense oligonucleotide; a novel lipid-lowering therapeutic drug currently enrolled in the treatment of patients with HoFH, HeFH and other forms of hypercholesterolemia. It arrests the synthesis of Apo B100 by targeting Apo B100 mRNA and thus inhibiting the synthesis and release of all Apo B-containing lipoproteins, such as very low-density lipoprotein (VLDL), intermediate density lipoprotein (IDL), low-density lipoprotein (LDL), and non-high-density lipoprotein. It also lowers lipoprotein (a), and ultimately reduces the severity of coronary artery disease and cardiovascular disease.Keywords: Hypercholesterolemia, Low-density lipoprotein, Mipomersen, Cholesterol, Lipoprotein, Antisense oligonucleotideÂ