Pharmacotherapy and Associated Factors in Women with Gestational Diabetes

Introduction Pharmacotherapy is an indicator of severity of hyperglycemia in pregnancy that may reflect β-cell dysfunction in women with gestational diabetes mellitus. Methods and Results  Life after gestational diabetes Ahvaz Study (LAGAs) is a population-based prospective cohort study to investigate potential short and long-term metabolic outcomes of gestational diabetes in mothers and their offsprings. Pregnant women attending 25 urban public and private centers seeking prenatal care were recruited from March 2015. 19.3% (34/176) of women with gestational diabetes required pharmacotherapy in pregnancy (12.5% insulin and 6.8% metformin). The mean age of women who needed pharmacotherapy was 31.0 (SD, 4.6) years vs 29.3 (SD, 5.3) years in diet-treated women. Cesarean delivery, higher FPG at first visit of pregnancy and premature delivery were significantly associatiated  with need to pharmacotherapy in pregnancy (p<0.05).  Conclusions Although the use of oral anti-diabetic drugs in pregnancy is not recommended by the American diabetes Association (ADA), consumption of them in women exposed to gestational diabetes is considerable. Use of insulin or metformin for management of hyperglycemia in pregnancy strongly prognoses metabolic disturbance later in life.  Therefore postpartum prevention and screening program for cardiovascular risk factors is important for women with GDM who required pharmacotherapy for management of hyperglycemia in pregnancy

Incidence and Contributing Factors of Persistent Hyperglycemia at 6–12 Weeks Postpartum in Iranian Women with Gestational Diabetes: Results from LAGA Cohort Study

Background. A history of gestational diabetes is an important predictor of many metabolic disturbances later in life. Method. Life after gestational diabetes Ahvaz Study (LAGAs) is an ongoing population-based cohort study. Up to February 2016, 176 women with gestational diabetes underwent a 75 g oral glucose tolerance test (OGTT) at 6–12 weeks postpartum in Ahvaz (southwestern of Iran). Gestational diabetes was diagnosed according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria and the American Diabetes Association (ADA) criteria applied for diagnosis of postpartum prediabetes and diabetes. Univariate and multivariate regression analysis were done. Results. Overall incidence of early postpartum glucose intolerance was 22.2% (95% CI, 16.3–29.0), 17.6% prediabetes (95% CI, 12.3–24.1) and 4.5% diabetes (95% CI, 2.0–8.8%). Independent risk factors for glucose intolerance were FPG ≥ 100 at the time of OGTT (OR 3.86; 95% CI; 1.60–9.32), earlier diagnosis of GDM (OR 0.92; 95% CI; 0.88–0.97), systolic blood pressure (OR 1.02; 95% CI; 1.002–1.04), and insulin or metformin therapy (OR 3.14; 95% CI; 1.20–8.21). Conclusion. Results determined a relatively high rate of glucose intolerance at 6–12 weeks after GDM pregnancy. Early postpartum screening of type 2 diabetes is needed particularly in women at high risk of type 2 diabetes

Incidence and Contributing Factors of Persistent Hyperglycemia at 6–12 Weeks Postpartum in Iranian Women with Gestational Diabetes: Results from LAGA Cohort Study

Background. A history of gestational diabetes is an important predictor of many metabolic disturbances later in life. Method. Life after gestational diabetes Ahvaz Study (LAGAs) is an ongoing population-based cohort study. Up to February 2016, 176 women with gestational diabetes underwent a 75 g oral glucose tolerance test (OGTT) at 6–12 weeks postpartum in Ahvaz (southwestern of Iran). Gestational diabetes was diagnosed according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria and the American Diabetes Association (ADA) criteria applied for diagnosis of postpartum prediabetes and diabetes. Univariate and multivariate regression analysis were done. Results. Overall incidence of early postpartum glucose intolerance was 22.2% (95% CI, 16.3–29.0), 17.6% prediabetes (95% CI, 12.3–24.1) and 4.5% diabetes (95% CI, 2.0–8.8%). Independent risk factors for glucose intolerance were FPG ≥ 100 at the time of OGTT (OR 3.86; 95% CI; 1.60–9.32), earlier diagnosis of GDM (OR 0.92; 95% CI; 0.88–0.97), systolic blood pressure (OR 1.02; 95% CI; 1.002–1.04), and insulin or metformin therapy (OR 3.14; 95% CI; 1.20–8.21). Conclusion. Results determined a relatively high rate of glucose intolerance at 6–12 weeks after GDM pregnancy. Early postpartum screening of type 2 diabetes is needed particularly in women at high risk of type 2 diabetes

The relationship between hot spots of air pollution and the incidence of gestational diabetes based on spatial analysis: A study on one of the most air-polluted metropolis of Iran

Background: Despite the serious impacts of air pollution on human health, few studies have focused on the adverse effects of air pollution on pregnancy outcomes based on the geographic information system (GIS) approach. Therefore, adopting the GIS approach, this study aimed to determine the extent to which of overlap of air pollution hotspots overlap with gestational diabetes density in Ahvaz, an airpolluted metropolis in Iran. Methods: Data from an ongoing population-based cohort study was used for gestational diabetes mapping. Three methods were used for air pollution assessment. The inverse distance weighting (IDW) technique was used for spatial interpolation. ArcGIS10.8 was used for preparing maps. Results: The lowest rate of gestational diabetes was estimated in District One (2.4%) while the highest rate was observed in Districts Six and Four (20.6% and 20.2%, respectively). As far as air pollution was concerned, 32.6% of mothers with gestational diabetes were residents in low-risk areas whereas 67.4% lived in high-risk areas. A higher density of gestational diabetes was estimated in high-risk air-polluted districts based on any method of air pollution assessment. Conclusion: The density of gestational diabetes incidence increased with residence in air-polluted areas. Residence in more polluted areas is a higher risk factor for developing gestational diabetes and its complications. Providing preventive services in these areas is a priority

The association between concentration of Uric Acid and metabolic syndrome among adolescents

Background: Metabolic syndromes are known as a set of risk factors for the development of cardio-vascular disease and diabetes in the individual. The association between concentration of uric acid and metabolic syndrome in adolescents has yet to be established thoroughly. The aim of this study was to investigate the relationship between uric acid and metabolic syndrome in a sample of adolescents. Methods: This cross-sectional study was conducted from September 23, 2009 to September 22, 2010 in Jundishapur University of Medical Sciences, Ahvaz, Iran. In this study, 240 individuals aged 10-19 years were randomly selected among participants of the Ahvaz MetS study (120 subjects normal and 120 subjects MetS). The serum levels of UA were measured by a colorimetric method. In the normal group, anyone with abdominal obesity, high systolic or diastolic blood pressure, High-density lipoprotein (HDL)&le;40 mg/dl, TG&le;110 mg/dl, fasting blood sugar (FBS)&le;100 mg/dl or diabetes was excluded from the study. History of Anticonvulsive drugs or steroids use was the criteria for exclusion for both groups. Results: Of the 240 subjects aged a mean of 14.95&plusmn;2.64 years, mean of uric acid in metabolic syndrome group was 4.8&plusmn;1.4 mg/dl and in the control group was 4.18&plusmn;1.01 mg/d (P=0.001). Participants were divided into three groups based on uric acid levels: &le;4.9 mg/dl, 4.9-5.7 mg/dl and >5.7 mg/dl. The risk of metabolic syndrome was significantly higher in third group of uric acid than the second and first group (odds ratio [OR], 3.7; 95% confidence interval [CI], 1.70 - 8.04) and (OR, 5.9; 95% CI, 2.42-14.35, P<0.001). In addition, uric acid level was inversely associated with hyperglycemia. The ORs of hypertriglyceridemia for the second and third group of uric acid were 4.36 (95% CI, 2.01- 9.47) 5.75 (95% CI, 2.43-13.61) respectively, compared with lowest group of UA. Conclusion: The results showed that hyperuricemia was significantly linked with increased risk for hypertriglyceridemia, low high-density lipoprotein cholesterol level, high blood pressure and waist circumference. Among Ahvaz adolescents, serum concentrations of uric acid strongly associated with the prevalence of metabolic syndrome and several of its components

Hypothalamic-pituitary-gonadal axis responses of the male rats to short and long time alternative magnetic fields (50 Hz) exposure

&lt;font face="TimesNewRoman,Bold" size="1"&gt;&lt;font face="TimesNewRoman,Bold" size="1"&gt;&lt;ul&gt;&lt;li&gt;&lt;div align="left"&gt;&lt;strong&gt;BACKGROUND&lt;/strong&gt;: &lt;font face="TimesNewRoman" size="2"&gt;&lt;font face="TimesNewRoman" size="2"&gt;Electromagnetic fields are associated with production, transmission and use of electricity. In this&amp;nbsp; tudy we have investigated the effects of short and long time alternative magnetic fields' (AMF, 50 Hz) exposure on the secretion of hypothalamic-pituitary-gonadal axis in the male rats.&lt;/font&gt;&lt;/font&gt;&lt;/div&gt;&lt;/li&gt;&lt;font face="TimesNewRoman,Bold" size="1"&gt;&lt;font face="TimesNewRoman,Bold" size="1"&gt;&lt;li&gt;&lt;div align="left"&gt;&lt;strong&gt;METHODS&lt;/strong&gt;: &lt;font face="TimesNewRoman" size="2"&gt;&lt;font face="TimesNewRoman" size="2"&gt;Forty eight Wistar male rats, same range of age and weight were divided into four groups and each group&lt;li&gt;&lt;div align="left"&gt;contained 12 rats. After one-week adaptation each&amp;nbsp; roup were exposed to AMF (0, 25, 50 and 100 &lt;font face="+TimesNewRoman" size="2"&gt;&lt;font face="+TimesNewRoman" size="2"&gt;4&lt;/font&gt;&lt;/font&gt;&lt;font face="TimesNewRoman" size="2"&gt;&lt;font face="TimesNewRoman" size="2"&gt;T&amp;nbsp; espectively) for 17 days, 5 hours a day. In the second protocol the time of exposure extended to 34 days. After experiments rats' blood serums were removed from their blood samples and kept frozen for usage. The results were analyzed by one way- ANOVA statistical method (p &lt; 0.05).&lt;/font&gt;&lt;/font&gt;&lt;/div&gt;&lt;/li&gt;&lt;/font&gt;&lt;/font&gt;&lt;/div&gt;&lt;/li&gt;&lt;/font&gt;&lt;/font&gt;&lt;font face="TimesNewRoman,Bold" size="1"&gt;&lt;font face="TimesNewRoman,Bold" size="1"&gt;&lt;li&gt;&lt;div align="left"&gt;&lt;strong&gt;RESULTS&lt;/strong&gt;: &lt;font face="TimesNewRoman" size="2"&gt;&lt;font face="TimesNewRoman" size="2"&gt;Chronic exposures (5h/day for 34 days) to AMFs had no effect on serum's testosterone and LH. But, AMF&amp;nbsp; t 100 &lt;/font&gt;&lt;/font&gt;&lt;font face="+TimesNewRoman" size="2"&gt;&lt;font face="+TimesNewRoman" size="2"&gt;4&lt;/font&gt;&lt;/font&gt;&lt;font face="TimesNewRoman" size="2"&gt;&lt;font face="TimesNewRoman" size="2"&gt;T induced an increase of serum's FSH level in&amp;nbsp; omparison with 25 &amp;mu;T, 50 &lt;/font&gt;&lt;/font&gt;&lt;font face="+TimesNewRoman" size="2"&gt;&lt;font face="+TimesNewRoman" size="2"&gt;4&lt;/font&gt;&lt;/font&gt;&lt;font face="TimesNewRoman" size="2"&gt;&lt;font face="TimesNewRoman" size="2"&gt;T and control groups. In contrast, subchronic AMFs (5 h/day for 17 days) induced a decrease of serum's testosterone in control group in&amp;nbsp; omparison with 25, 50 and 100 &lt;/font&gt;&lt;/font&gt;&lt;font face="+TimesNewRoman" size="2"&gt;&lt;font face="+TimesNewRoman" size="2"&gt;4&lt;/font&gt;&lt;/font&gt;&lt;font face="TimesNewRoman" size="2"&gt;&lt;font face="TimesNewRoman" size="2"&gt;T groups. But these AMFs had no effect on serum's LH and FSH levels.&lt;/font&gt;&lt;/font&gt;&lt;/div&gt;&lt;/li&gt;&lt;/font&gt;&lt;/font&gt;&lt;font face="TimesNewRoman,Bold" size="1"&gt;&lt;font face="TimesNewRoman,Bold" size="1"&gt;&lt;li&gt;&lt;div align="left"&gt;&lt;strong&gt;CONCLUSIONS&lt;/strong&gt;: &lt;font face="TimesNewRoman" size="2"&gt;&lt;font face="TimesNewRoman" size="2"&gt;Increased level of FSH suggests damage to the seminiferous tubules. Our results suggest that AMFs probably causes dysfunction in gonadal axis at the hypothalamic-pituitary level in male rats in different protocols.&lt;/font&gt;&lt;/font&gt;&lt;/div&gt;&lt;/li&gt;&lt;/font&gt;&lt;/font&gt;&lt;font face="TimesNewRoman,Bold" size="1"&gt;&lt;font face="TimesNewRoman,Bold" size="1"&gt;&lt;li&gt;&lt;div align="left"&gt;&lt;strong&gt;KEYWORDS&lt;/strong&gt;: &lt;font face="TimesNewRoman" size="2"&gt;&lt;font face="TimesNewRoman" size="2"&gt;Sex Hormones, Male Rats, Magnetic Field.&lt;/font&gt;&lt;/font&gt;&lt;/div&gt;&lt;/li&gt;&lt;/font&gt;&lt;/font&gt;&lt;/ul&gt;&lt;/font&gt;&lt;/font&gt

Effects of probiotic yogurt consumption on inflammatory biomarkers in patients with type 2 diabetes

Introduction: The role of inflammatory cytokines in diabetes and its complications has been shown in some studies. The purpose of this study was to compare the effect of probiotic and conventional yogurt on inflammatory markers in patients with type 2 diabetes. Methods: Forty- four patients with type 2 diabetes were participated in this randomized, double – blind controlled clinical trial and were assigned to two intervention and control groups. The subjects in the intervention group consumed 300 g/d probiotic yogurt and subjects in the control group consumed 300g/d conventional yogurt for 8 weeks. Anthropometric indices, dietary intakes, and serum levels of glucose, HbA1c, IL-6, TNF-α and hs-CRP were evaluated at the beginning and end of the intervention.Results: For anthropometric indices and dietary intakes, no significant differences were seen within and between groups post intervention (p> 0.05). The consumption of probiotic yogurt caused significant decrease in HbA1c and TNF-α levels (p=0.032 and p= 0.040, respectively) in the intervention group. Conclusions: It is suggested that probiotic yogurt may be used as an alternative prevention approach and treatment method to control diabetic complications

Incidence and Risk Factors of Diabetic Foot Ulcer: A Population-Based Diabetic Foot Cohort (ADFC Study)—Two-Year Follow-Up Study

Aim/Introduction. This study was carried out to assess the incidence and risk factors of diabetic foot ulcer (DFU). Materials and Methods. In this prospective cohort study in a university hospital, all the participants were examined and followed up for new DFU as final outcome for two years. To analyze the data, the variables were first evaluated with a univariate analysis. Then variables with P value < 0.2 were tested with a multivariate analysis, using backward-elimination multiple logistic regression. Results. Among 605 patients, 39 cases had DFU, so we followed up the remaining 566 patients without any present or history of DFU. A two-year cumulative incidence of diabetic foot ulcer was 5.62% (95% CI 3.89–8.02). After analysis, previous history of DFU or amputation [OR = 9.65, 95% CI (2.13–43.78), P value = 0.003], insulin usage [OR = 5.78, 95% CI (2.37–14.07), P value < 0.01], gender [OR = 3.23, 95% CI (1.33–7.83), P value = 0.01], distal neuropathy [OR = 3.37, 95% CI (1.40–8.09), P value = 0.007], and foot deformity [OR = 3.02, 95% CI (1.10–8.29), P value = 0.032] had a statistically significant relationship with DFU incidence. Conclusion. Our data showed that the average annual DFU incidence is about 2.8%. Independent risk factors of DFU development were previous history of DFU or amputation, insulin consumption, gender, distal neuropathy, and foot deformity. These findings provide support for a multifactorial etiology for DFU