Histopathological placental lesions in mild gestational hyperglycemic and diabetic women

Objective: To investigate and compare the incidence of histopathological placental lesions in mild gestational hyperglycemia, gestational diabetes and overt diabetes at term and preterm gestation.Research design and methods: One-hundred-and-thirty-one placental samples were collected from Diabetes mellitus (DM) positive screened patients. Two diagnostic tests, glycemic profile and 100 g oral glucose tolerance test (OGTT) in parallel identified 4 groups normoglycemic, mild gestational hyperglycemia (MGH), gestational DM (GDM) or overt DM (DM). Placental tissue specimens and sections from 4 groups were obtained by uniform random sampling and stained with hematoxylin-eosin.Results: Placentas from MGH group presented 17 types of histopathological change and higher rates of syncytial nodes and endarteritis. GDM placentas presented only nine types of histopathological change, high rates of dysmaturity, low rates of calcification and no syncytial nodes. Overt DM placentas showed 22 types of histopathological change, 21 of which were present in the preterm period. There were histopathological similarities between MGH and DM placentas, but the former exhibited a higher incidence of endarteritis, which has been described as a post-mortem phenomenon.Conclusion: Our results confirmed that the distinct placental changes associated with DM and MGH depend on gestational period during which the diabetic insult occurs. It may reasonably be inferred that subclinical maternal hyperglycemia during pregnancy, as showed in MGH group, is responsible for increased placental endarteritis, a postmortem lesion in the live fetus

Diabète gestationnel en France en 2012 :dépistage, prévalence et modalités de prise en charge pendant la grossesse

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Screening, diagnosis and medical care for gestational diabetes mellitus in France in 2012

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Screening, diagnosis and medical care for gestational diabetes mellitus in France in 2012

info:eu-repo/semantics/nonPublishe

Treatment of diabetes mellitus using an external insulin pump: the state of the art.

International audienceThe aim of diabetes treatment is to achieve tight glucose control to avoid the development of chronic diabetic complications while reducing the frequency of hypoglycaemic episodes. Continuous subcutaneous insulin infusion (CSII) using an external pump is an intensive diabetes therapy recognized to improve metabolic control and glycaemic instability, and to reduce the frequency of severe hypoglycaemia. For years, the theoretical advantages of the insulin pump (constancy of basal delivery, adjustable basal rates, and low insulin depots allowing the reduction of glycaemic variability) have contributed to its reported superiority compared with multiple daily injections (MDI). However, insulin pump therapy is now challenged by new MDI regimens based on long-acting insulin analogues that could replace the use of CSII. As a consequence, health professionals now have to determine which patients are likely to benefit the most from CSII. Recently, several studies reported that children and adolescents, and patients whose blood glucose imbalance was initially the most pronounced with basal-bolus regimens, would particularly benefit from CSII. Other indications were also proposed in marginal clinical situations with highly selected patients in whom a significant improvement of blood glucose was demonstrated. Finally, the use of CSII in type 2 diabetic patients now appears to be a good alternative to the ineffective MDI regimens observed in some of these patients. However, past experience with CSII indicates that candidates for insulin pump therapy must be carefully selected and strongly motivated to improve their glucose control. Use of CSII also requires strict medical supervision by physicians and a regular programme of patient education by paramedical teams, to ensure optimal responsible use of this technique by healthcare professionals

Vivre avec un diabète de type 1 : L’impact de la préparation de sa consultation diabétologique sur son sentiment d’auto-efficacité personnelle

International audienceContexte et objectif : Le patient DT1 a besoin d’avoir confiance en ses capacités d’analyse glycémique pourintervenir sur ses doses insuliniques. L’objectif de cette étude était de voir en quoi la préparation de laconsultation diabétologique pour le DT1 permet de développer son sentiment d’auto-efficacité personnellegénéralisé (GSE) ? Matériel et méthodes : Après avoir élaboré un outil d’aide à la préparation de laconsultation, une étude de terrain a été réalisée afin de mesurer cet outil par deux questionnaires : un premieravant la consultation puis un second à 1 mois de la consultation. Au total, 277 guides de préparation à laconsultation ont été distribués à T0 et 223 personnes sollicitées à T1. Résultats : La moyenne auquestionnaire GSE est de : 33,16/40 à T0 et de 35,18/40 à T1 (p<0,001). La satisfaction du guide mesurée àT1 mois montre un développement du GSE ; un rassemblement des documents utiles à la consultation ; uneamélioration des échanges avec le médecin ; une meilleure obtention des réponses à leurs attentes ; unemeilleure analyse de leur diabète. La satisfaction globale du guide est évaluée à 7,81/10. En revanche,81,03% des personnes ont trouvé que le guide n’avait pas changé le regard de leur médecin sur la prise encharge de leur diabète. Seuls 55,9% ont vu un intérêt informatif sur le suivi du diabète en termes desurveillance des complications. L’ETP ou le centre n’ont pas eu d’influence sur les résultats. 85% desparticipants avaient participé à des séances d’éducation thérapeutique. Conclusion : Bien que notre étude ades limites, elle nous permet de poursuivre notre recherche vers des axes complémentaires tels que laposture éducative du soignant en vue d’améliore l’alliance thérapeutique avec le DT1

Nutritional and health benefits of essential oils in dairy cows

International audienceScientific data supporting the efficacy of Essential oils (EOs) in livestock as anti-inflammatory, antibacterial and antioxidant molecules accumulate over time; however, the cumulative evidence is not always sufficient. Still, so far, the MILKQUA project is the first to evaluate, by a combined OMICS approach, the possible use of selected EOs in the nutrition sector and forthe treatment of mastitis in dairy cows. Given the importance of the DOHaD concept (Developmental Origin of Health and Diseases), we emphasized EOs’ impact, when included in calves’ diet, on food efficiency and animal growth. We also tested EOs direct curative effects on inflamed mammary gland and isolated Blood Mononuclear Peripheral cells (PBMC). We also assessed the in vitro ruminal fermentation and change in the microbiome content in the presence of both natural and synthetic EOs compounds and decrypted, using several in vitro models, the EOs mechanism of action on the NfKB inflammatory pathway. We present in this communication the results of our interdisciplinary approach

Nutritional and health benefits of essential oils in dairy cows

Trabajo presentado al: 73rd Annual Meeting of the European Federation of Animal Science (EAAP). Oporto (Portugal), 5-9 de septiembre