Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Diabetes mellitus in pregnancy causes congenital malformations in the offspring. The aim of this work was to characterize biochemical and morphologic anomalies in the conceptus of an animal model of diabetic pregnancy. In addition, a preventive treatment against diabetes-induced dysmorphogenesis was developed. Congenital cataract was often found in the offspring of diabetic rats. The fetal lenses had increased water accumulation, sorbitol concentration and aldose reductase activity compared to control lenses. The results suggest that the cataracts form via osmotic attraction of water due to sorbitol accumulation in the fetal lens. Another set of malformations, with possible neural crest cell origin, occurred frequently in offspring of diabetic rats. These included low set ears, micrognathia, hypoplasia of the thymus, thyroid and parathyroid glands, as well as anomalies of the heart and great vessels. Furthermore, diabetes caused intrauterine death and resorptions more frequently in the late part of gestation. When the pregnant diabetic rats were treated with the antioxidants butylated hydroxytoluene, vitamin E or vitamin C, the occurrence of gross malformations was reduced from approximately 25% to less than 8%, and late resorptions from 17% to 7%. This suggests that an abnormal handling of reactive oxygen species (ROS) is involved in diabetes-induced dysmorphogenesis in vivo. Indeed, an increased concentration of lipid peroxides, indicating damage caused by ROS, was found in fetuses of diabetes rats. In addition, embryos of diabetic rats had low concentrations of the antioxidant vitamin E compared to control embryos. These biochemical alterations were normalized by vitamin E treatment of the pregnant diabetic rats. The antioxidants are likely to have prevented ROS injury in the embryos of the diabetic rats, in particular in the neural crest cells, thereby normalizing embryonic development. These results provide a rationale for developing new anti-teratogenic treatments for pregnant women with diabetes mellitus.
 ...
PMID:Congenital malformations in experimental diabetic pregnancy: aetiology and antioxidative treatment. Minireview based on a doctoral thesis. 939 31

The study compares an occurrence rate of congenital malformations in newborn infants of mothers with insulin dependent diabetes (IDDM) and newborns of healthy mothers and mothers with pregnancy diabetes (GDM). This paper evaluates the influence of stage of advancement (a class) of diabetes in the mother and its control during early pregnancy on a rate of congenital malformations in the fetus. We have taken a group of 170 neonates of mothers with IDDM. The control group was 56 newborn infants of mothers with GDM and 26,368 newborn infants of healthy women. We found 11.2% of congenital malformations in newborn infants of mothers with IDDM, compared to 1.8% of ones in the newborn infant population of mothers with GDM and 2.2% in the population of healthy mothers. The occurrence rate of congenital malformations in offspring of diabetic mothers with IDDM was 5-times higher than in the general population of newborn infants of healthy and also mothers with GDM. A risk of major birth defect occurrence in the fetus was directly proportional to the grade of the blood glucose level control in mothers during the I trimester of pregnancy, but the presence of diabetic angiopathy (classes D-H) had a significant influence on the occurrence rate of major birth defects in the fetus only in metabolic imbalance cases.
 ...
PMID:A class of diabetes in mother, glycemic control in early pregnancy and occurrence of congenital malformations in newborn infants. 947 16

Recently new definitions were agreed for the glucose tolerance test (GTT), for impaired glucose tolerance and for the classification of diabetes mellitus. The World Health Organization and the American Diabetes Association have been active on this point. The fasting glucose value has been lowered and been brought into line with the two hour value of the GTT. Fasting glucose values can now be used for the diagnosis of diabetes mellitus and of impaired glucose tolerance. The new classification is based on differences in cause of the diabetes. The classification includes diabetes mellitus types 1 and 2, pregnancy diabetes and 'other forms of diabetes'.
 ...
PMID:[Diabetes mellitus: current classification based on cause and sharpened blood glucose limits for diagnosis]. 955 34

Diabetes in pregnancy is unique because of the diversity of problems that can affect the embryo/fetus beginning with conception. Considerable effort has been devoted to understanding the basic developmental biology from observing young embryos in vitro or in vivo. Maternal glucose control has been identified as an important event. The preponderance of evidence indicates that rigid glucose control will minimize the incidence of anomalies incurred before 9 weeks of pregnancy. Later events are related to fetal hyperinsulinemia. These include fetal macrosomia, respiratory distress syndrome, neonatal hypoglycemia, neonatal hypocalcemia, and neonatal hypomagnesemia. Control of maternal metabolism can have a significant impact on each of the above. Finally, the long-term effects of maternal diabetes are as diverse as the pathogenetic events during pregnancy. Surprisingly, there is a significant transmission rate of 2% of type I diabetes if the mother has insulin-dependent diabetic mother, whereas the rate is 6% for the father. The Diabetes in Early Pregnancy Study showed that good maternal control was associated with normal neurodevelopmental outcome.
 ...
PMID:Effects of diabetic pregnancy on the fetus and newborn. 1080 68

During late gestation, although maternal adipose tissue lipolytic activity becomes enhanced, lipolytic products cross the placenta with difficulty. Under fasting conditions, free fatty acids (FFA) are used for ketogenesis by the mother, and ketone bodies are used as fuels and lipogenic substrates by the fetus. Maternal glycerol is preferentially used for glucose synthesis, saving other gluconeogenic substrates, like amino acids, for fetal growth. Placental transfer of triglycerides is null, but essential fatty acids derived from maternal diet, which are transported as triglycerides in lipoproteins, become available to the fetus owing to the presence of both lipoprotein receptors and lipase activities in the placenta. Diabetes in pregnancy promotes lipid transfer to the fetus by increasing the maternal-fetal gradient, which may contribute to an increase in body fat mass in newborns of diabetic women. Deposition of fat stores in the fetus is very low in the rat but high in humans, where body fat accretion occurs essentially during the last trimester of intra-uterine life. This is sustained by the intense placental transfer of glucose and by its use as a lipogenic substrate, as well as by the placental transfer of fatty acids and to their low oxidation activity. During the perinatal period an active ketonemia develops, which is maintained in the suckling newborn by several factors: (i) the high-fat and low-carbohydrate content in milk, (ii) the enhanced lipolytic activity occurring during the first few hours of life, and (iii) both the uptake of circulating triglycerides by the liver due to the induction of lipoprotein lipase (LPL) activity in this organ, and the presence of ketogenic activity in the intestinal mucose. Changes in LPL activity, lipogenesis and lipolysis contribute to the sequential steps of adipocyte hyperplasia and hypertrophia occurring during the extra-uterine white adipose tissue development in rat, and this may be used as a model to extrapolate the intra-uterine adipose tissue development in other species, including humans.
Diabetes Metab Res Rev
PMID:Lipid metabolism in the fetus and the newborn. 1086 20

Diabetes in pregnancy, whether the woman had diabetes prior to becoming pregnant or developed gestational diabetes, is associated with many complications and risks. In the first trimester, organogenesis can be disrupted by complications due to poor control of the mother's diabetes, leading to fetal malformations or perinatal mortality. Problems with glucose control in the remainder of the pregnancy can also have consequences for the child. These include macrosomia, shoulder dystocia, pre-eclampsia, hypoglycemia and an increased risk for obesity and diabetes in the future. Therefore, aggressive and prompt treatment of the high blood sugar levels, which cause these complications, is necessary. This review looks at the current treatments for pregnancies complicated by diabetes and evaluates the place of new and possible future treatments including diet, exercise, insulin, insulin analogs and oral and inhaled agents.
 ...
PMID:New and future diabetes therapies: are they safe during pregnancy? 1268 46

There are two entities to differentiate: 1. Diabetes in pregnancy (pre-existent type 1 or type 2 diabetes with tendency of deterioration during pregnancy or first occurrence of a type 1 or type 2 diabetes with persistence after pregnancy. 2. Impaired Glucose Tolerance = IGT (Diagnosis of an impairment of glucose tolerance during pregnancy) Aims of the screening are the avoidance of complications for mother and child. There is no uniform consent regarding screening during pregnancy. With pregnant women without risk factors, the blood sugar is determined without eating and drinking in plasma between 24 and 28 weeks of gestation. If values are > 4.8 mmol/l, an oral 75 g glucose tolerance test is carried out. Alternatively, a 50 g oral glucose tolerance test can be made. With pregnant women with risk factors, we already carry out an oral 75 g glucose tolerance test in the first trimester. If the values are normal, we repeat the 75 g glucose tolerance test between 24 and 28 weeks of gestation. Main pillars of therapy are diet and movement. In gestational diabetes, an insulin therapy is indicated if blood sugars are too high, fetal growth is sonographically accelerated or a polyhydramnion is present. Oral antidiabetic medicaments are contraindicated during pregnancy. Pregnancies with diabetes in pregnancy or gestational diabetes are risk pregnancies, which are controlled more intensively. Delivery is ideally at term or with confirmed lung maturity. If an impaired glucose tolerance is diagnosed during pregnancy, an oral 75 g glucose tolerance test as well as annually blood sugar controls are carried out because of the augmented risk of developing a type 2 diabetes later in life.
 ...
PMID:[Diabetes mellitus and pregnancy: screening and therapy]. 1270 82

Free-radical peroxidation of cholesterol results in, among others, another products of its oxidation, called oxysterols. Scientists are still more and more interested in oxysterols, because, like the products of polyunsaturated fatty acids, show a strong biological activity, which effects physiology, pathology and pharmacology. The aim of the work was to investigate whether pre-pregnancy diabetes effects cholesterol oxidation process studied on the basis of the concentration of the chosen oxysterols. The chosen oxysterols were determined in 45 patients suffering from diabetes for various time period before pregnancy (diabetes type according to White from B to R) and in a control group (n = 27). Oxysterols (7-ketocholesterol, 7 alpha and 7 alpha-hydroxycholesterols and the sum of 5 alpha, 6 alpha and 5 beta, 6 beta-epoxycholesterols) were determined by thin-layer chromatography with densitometric detection according to the methodology which had been developed in the Chemical Department, the Silesian Medical Academy. The analysis scheme included plasma sample hydrolysis and lipid extraction, oxysterol fraction isolation by solid phase extraction (SPE), separation and identification of individual sterols by TLC technique, and densitometric quantitative analysis of the cholesterol oxidized derivatives mentioned above. We found statistically considerable differences between the concentrations of epoxycholesterol sum and 7-ketocholesterol in both groups, and the concentration was higher in the control group. While analysing the concentrations of the investigated parameters in diabetic pregnant women in II and III trimester we found a statistically considerable increase in oxysterol concentration in III trimester, compared to II trimester. The authors suggest that during complicated diabetic pregnancy the cholesterol oxidation process becomes more intensive, particularly in III trimester, compared to II trimester, both in normal pregnant women and in type I diabetic pregnant women as well.
 ...
PMID:[Concentration of the oxygenated derivates of cholesterol in pregnant women suffering from diabetes type I]. 1500 18

The prevalence of diabetes is two- to threefold higher in American Indians in Montana compared with the non-Indian population. High rates of diabetes have also been described in Canadian aboriginal populations closely related to the tribes in Montana. Diabetes in pregnancy has increased among Indian mothers and high-birth-weight babies are increasingly likely to be born to Indian mothers with diabetes in pregnancy. Over 70% of the incident cases of diabetes in youth less than 20 years of age on the reservations have the clinical characteristics of type 2 diabetes. Cardiovascular disease mortality rates are high among Indians in Montana, and the prevalence of smoking in the Indian populations of Montana and the neighboring tribes in Canada is remarkably high. Indians in Montana are more likely than non-Indians of similar age to believe that diabetes is preventable and to recall advice about diabetes risk.
 ...
PMID:Diabetes in Montana's Indians: the epidemiology of diabetes in the Indians of the Northern Plains and Canada. 1513 90

In pregnancy, the growth hormone axis is shifted from pituitary growth hormone (GH) to placental growth hormone (PGH). Their common binding protein, GH binding protein (GHBP), displays peak serum levels at mid-gestation in normal individuals. In the non-pregnant state, diabetes is known to be associated with elevated levels of GH and decreased levels of insulin-like growth factors (IGFs) and GHBP. Diabetes in pregnancy may therefore as well be associated with disturbances in the growth hormone axis. In the present study, we aimed at investigating the impact of GHBP and maternal body mass index (BMI) on levels of PGH, thereby enabling estimation of any association between free PGH and weight adjusted insulin requirements. In 51 type 1 diabetic women, blood samples were collected in gestational week 10+, 16+, 22+, 28+ and 34+, and analysed for their serum content of GHBP, PGH, and GH. Serum GHBP increased from the first weeks of pregnancy to median 2.07 nmol/l (range 1.17-4.26) in week 22+, then declined to median 1.29 nmol/l (range 0.77-2.35) in week 34+ (ANOVA P < 0.001). Serum PGH levels were highest in week 34+ at median 21.3 microg/l (range 5.1-165.4) (P < 0.001), whereas a steady decrease in GH values was observed throughout pregnancy to a median 0.17 microg/l (range 0-5.53). The fraction of calculated free PGH to total PGH increased from mid-gestation onwards to 55.2% (37.0-87.1) in week 34+ at a median level of free PGH of 10.4 microg/l (range 1.9-144.0) (P < 0.001). Similarly, the molar ratio of total PGH to GHBP increased to a maximum of 0.68 (0.12-6.62) in week 34+. As in normal pregnancies, the correlation between BMI and GHBP was lost in late pregnancy. The newborns birth weight z-score correlated with total PGH and derivatives here-of in week 34+. Neither total nor weight adjusted insulin requirements correlated to total PGH, calculated free PGH, nor GHBP. In conclusion, PGH and GHBP display a similar course during pregnancy in type 1 diabetic women as described in normal women. The well-known association between GHBP and BMI was lost in late pregnancy. Calculated levels of free PGH were positively associated to fetal growth, but not to maternal insulin requirements.
 ...
PMID:Growth hormone binding protein and maternal body mass index in relation to placental growth hormone and insulin requirements during pregnancy in type 1 diabetic women. 1592 43


<< Previous 1 2 3 4 5 6 7 8 9 Next >>