Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The relationship between glucose and insulin levels was examined in a prospective study of 153 pregnant patients without diabetes who underwent a standard 50 gm glucose challenge test. One hundred eighteen women had normal screening results (glucose level less than 140 mg/dl) and 35 had abnormal screening values but a normal oral glucose tolerance test. Abnormal responders had greater insulin levels (149 vs 82 pmol/L, p less than 0.0001), and a higher insulin/glucose index (0.96 vs. 0.72, p less than 0.007). Patients with glucose levels less than 100 mg/dl had significantly lower insulin/glucose indices. Overall, obese patients had significantly greater glucose and insulin measurements than did nonobese women, but there was no difference within normal and abnormal groups. Glucose levels accounted for 52% of the insulin output and 29% of the insulin/glucose index variance. Neither age, parity, nor obesity contributed significantly to insulin levels in the multiple regression model. Therefore the accepted threshold for glucose screening reflects abnormal insulin output and this aberration may be indicative of the primary defect in gestational diabetes.
 ...
PMID:Relationships between glucose levels and insulin secretion during a glucose challenge test. 225 88

In a long-term longitudinal study of gestational diabetes mellitus in Black women, risk factors that were identified were age, obesity, a family history of diabetes, and the presence of hypertension. Poor predictors were a history of a previous large-for-date infant, parity, and age at first pregnancy. The prevalence of smooth muscle and nuclear autoantibodies was higher in gestational diabetic subjects. Gestational diabetic subjects who required insulin for glycemic control were more obese, had a lower frequency of the Bf-F phenotype and a higher frequency of the Bf-F1 phenotype, and had a lower frequency of the type 2 allele at the polymorphic locus adjacent to the insulin gene. Restriction-fragment-length polymorphisms flanking the insulin and apolipoprotein A-I and C-III genes, although not associated with gestational diabetes mellitus, may be associated with hyperlipidemia and subsequent atherosclerosis.
 ...
PMID:Risk factors for gestational diabetes in black population. 226 42

Glucose tolerance and insulin secretion were studied in 56 women 6-12 years following a pregnancy complicated by gestational diabetes, and in 23 matched controls. At recall 14 women were known to have diabetes and five were again pregnant with recurrent gestational diabetes. The early development of diabetes was associated with a fasting plasma glucose greater than 6 mmol/l during pregnancy and with a high plasma glucose response to oral glucose which persisted after delivery. Obesity was predictive of non-insulin-dependent diabetes whereas those that later required insulin were not obese. At recall, seven of the remaining 37 women were found to have unrecognized diabetes, 13 had impaired glucose tolerance (IGT) and 17 were normal by WHO criteria using a 75 g oral glucose tolerance test. In these 37 women, fasting plasma glucose and the glucose response to oral glucose in pregnancy were not predictive of subsequent diabetes or impaired glucose tolerance. Obesity in pregnancy and subsequent weight gain were associated with non-insulin-dependent diabetes and impaired glucose tolerance at recall. Insulin deficiency was observed during the oral glucose tolerance test in the diabetics (the mean +/- SEM ratio insulin area:glucose area 4.1 +/- 1.3 diabetics, 10.7 +/- 1.8 controls, p less than 0.05), whereas in the group with impaired glucose tolerance insulin levels were high and in proportion to their hyperglycaemia (insulin area:glucose area 10.9 +/- 1.4 IGT, 9.4 +/- 1.4 controls). Women with normal glucose tolerance and previous gestational diabetes had significantly lower insulin responses than their controls, despite mild hyperglycaemia (insulin area:glucose area 4.0 +/- 0.7 normal glucose tolerance, 7.6 +/- 1.1 controls, p less than 0.02). Abnormalities of glucose tolerance and insulin secretion are present following a gestational diabetic pregnancy. Gestational diabetes identifies women at risk for developing diabetes and impaired glucose tolerance, both of which are risk factors for premature vascular disease.
 ...
PMID:Abnormalities of glucose tolerance following gestational diabetes. 229 Sep 18

Gestational diabetes mellitus (GDM) is a frequent complication in pregnancy and occurs with an incidence of about 1.5%. The condition is related to an increased perinatal morbidity and mortality, which can be reduced by treatment. Therefore screening is indicated. The potential diabetics were examined twice with fasting plasma glucose (F-PG) and when F-Pg was greater than or equal to 4.1 mmol/l one or several 75 g's oral glucose tolerance tests (OGTT) were performed. Going through 3421 case reports we found 8% potential diabetics. Four % were examined with F-PG and OGTT whereby we found 1.2% women with GDM. Previous GDM, obesity, positive family history for diabetes and glucosuria were important risk factors, whereas actual or earlier birth of a heavy baby seemed to be a little importance. We propose, that the F-PG cut-off point to carry out the OGTT can be raised to 4.6 mmol/l. If one only uses F-PG, then it should be measured after 31th, week of gestation, as most cases of abnormal OGTT occurs at that time.
 ...
PMID:[Screening of potential diabetic patients with fasting plasma glucose and oral glucose tolerance test]. 229 71

Early diagnosis of glucose intolerance by glucosuria testing is unreliable and should be replaced by blood sugar screening in the 24th to 28th week of gestation. If screening results are pathological (blood sugar in capillary whole blood over 140 mg% one hour after oral ingestion of 50 g glucose), a standardized glucose tolerance test should be performed. This screening test will reveal a glucose intolerance in approx. 3% of pregnant women. High-risk patients for gestational diabetes (previous pregnancies, complicated by gestational diabetes, family history of diabetes mellitus (first degree relatives), obesity (greater than 120% of ideal body weight), maternal age greater than 30 years, unexplained stillbirths) should have their glucose tolerance checked in early pregnancy, possibly before conception, but also in the 32nd to 36th week, if blood sugar screening is normal in weeks 24 to 28. If the glucose tolerance test is abnormal, blood sugar values must be controlled by diet on levels below 5 mmol (90 mg%) and postprandial below 7 mmol (126 mg%), measured in capillary whole blood. If these values are higher, an insulin treatment has to be discussed, since high blood glucose values result in an increased risk of infant morbidity and mortality. During insulin treatment, it might be possible that higher doses become necessary in order to avoid fetal hyperinsulinism with consecutive macrosomy. Although after childbirth often a normal glucose tolerance is noted, a manifestation of diabetes within the next 20 years will occur in one third of all gestational diabetics. Regular control of the glucose tolerance, e.g. in yearly intervals, as well as preventive measures (regulation of body weight) are indicated.
 ...
PMID:[Clinical significance, diagnosis and treatment of diabetes in pregnancy (gestational diabetes)]. 240 84

Gestational diabetes mellitus (GDM) is defined as glucose intolerance with onset or first recognition during pregnancy. We have examined restriction fragment length polymorphisms (RFLPs) near "candidate diabetogenic genes" as one approach to identify molecular markers for GDM genes. Genotypes for insulin hypervariable region (HVR), insulin-like growth factor II (IGF2), insulin receptor (INSR), and glucose transporter (GLUT1) RFLPs were studied in 96 GDM and 164 control subjects, matched to GDM for race, age, and gravidity. Logistic regression analysis was used to explore the relationship between genotypes at these candidate gene loci and GDM, while adjusting for the effects of potential confounding variables. Among black subjects, the INSR allele 1 (P = 0.001) and interactions between INSR allele 1 with body mass index (BMI) (P = 0.002) and history of DM in subject's mother (P = 0.004) contributed significantly to GDM risk. Among Caucasian subjects, a similar relationship between the INSR allele 1 (P = 0.007) and INSR allele 1-BMI interactions (P = 0.011) on GDM risk were observed. In Caucasians, an additional significant risk factor was determined by an INSR allele 1-IGF2 allele 2 interaction (P = 0.018). No risk factors were identified in Hispanic subjects. These data continue to support the hypothesis that GDM is a heterogeneous disorder with respect to phenotypic and genotypic features. Furthermore, our data suggest that risk for GDM in black and Caucasian subjects is not due to obesity perse but to interactions between obesity and INSR alleles. In Caucasian women, INSR and IGF2 alleles interact to confer additional risk for GDM. Thus genes underlying susceptibility to GDM in some women may be similar to genes conferring risk to NIDDM, while in others novel genes may contribute to GDM risk.
 ...
PMID:Increased risk for gestational diabetes mellitus associated with insulin receptor and insulin-like growth factor II restriction fragment length polymorphisms. 257 27

The relationship between optimal levels of glycemic control and perinatal outcome was assessed in a prospective study of 334 gestational diabetic women and 334 subjects matched for control of obesity, race, and parity. All women with gestational diabetes mellitus were instructed in the use of a memory-based reflectance meter. They were treated with the same metabolic goal according to a predetermined protocol. Three groups were identified on the basis of mean blood glucose level throughout pregnancy (low, less than or equal to 86 mg/dl; mid, 87 to 104 mg/dl; and high, greater than or equal to 105 mg/dl). The low group had a significantly higher incidence of small-for-gestational-age infants (20%). In contrast, the incidence of large-for-gestational-age infants was 21-fold higher in the mean blood glucose category than in the low mean blood glucose category (24% vs. 1.4%, p less than 0.0001). An overall incidence of 11% small-for-gestational-age and 12% large-for-gestational-age infants was calculated for the control group. A significantly higher incidence of small-for-gestational-age infants (20% vs. 11%, p less than 0.001) was found between the control and the low category. In the high mean blood glucose category an approximate twofold increase was found in the incidence of large-for-gestational-age infants when compared with the control group (p less than 0.03). No significant difference was found between the control and mean blood glucose categories (87 to 104 mg/dl). Our data suggest that a relationship exists between level of glycemic control and neonatal weight. This information is helpful in targeting the level of glycemic control while optimizing pregnancy outcome in gestational diabetes comparable to the general population.
 ...
PMID:Glycemic control in gestational diabetes mellitus--how tight is tight enough: small for gestational age versus large for gestational age? 225 20

A prospective population-based study of gestational diabetes mellitus was done with 2272 patients to determine perinatal and maternal outcomes. A large data base was collected on all patients. Patients with gestational diabetes mellitus were older, shorter, heavier, and had more children than did the control group. The higher cesarean section rate in the patients with gestational diabetes mellitus was explained by their increased rate of repeat cesarean section compared with control patients. This was associated with increased infectious complications. Other maternal complication rates were similar in the two groups. Acceptable glucose control did not normalize birth weight percentiles in patients with gestational diabetes mellitus. Maternal weight at delivery was the only significant predictor of birth weight percentile in the group with gestational diabetes mellitus. Plasma glucose levels were a poor predictor of birth weight percentile. Factors associated with maternal obesity in well-controlled gestational diabetes mellitus may be more significant than glucose control in the development of large-for-gestational-age infants.
 ...
PMID:A population-based study of maternal and perinatal outcome in patients with gestational diabetes. 280 49

In this prospective study 246 women with gestational diabetes were followed up to determine the characteristics of metabolic control associated with large-for-gestational-age infants. Memory-based reflectance meters were used for self-monitoring blood glucose. Ambulatory glucose profiles were produced to characterize glycemic control levels throughout pregnancy. With these novel approaches to the collection and representation of glucose data, the severity of glucose intolerance (hyperglycemia) was found to be associated with both maternal and neonatal morbidity in terms of infant size and cesarean section rate. By use of hierarchical cluster analysis to identify three groups on the basis of control levels (low less than 87 mg/dl, mid 87 to 105 mg/dl, high greater than 105 mg/dl) we were able to show a positive outcome in the low group with reduced rates of large-for-gestational-age (2%) and macrosomatic (0%) infants. Furthermore, we showed that as mean blood glucose levels and instability in glycemic control increased from group to group, incidence of large-for-gestational-age and macrosomatic infants increased. Whereas obesity increased the relative risk of adverse neonatal outcome, type of treatment (insulin versus diet) did not appear to be significant. Appropriately monitored toward stability within a narrow range to achieve tight metabolic control, ambulatory glycemia in pregnancy is associated with a decreased risk of maternal and fetal complications.
 ...
PMID:The relationship between large-for-gestational-age infants and glycemic control in women with gestational diabetes. 320 26

Gestational diabetes is an asymptomatic disease of pregnant women, which results in significant morbidity and mortality. However, prompt diagnosis and treatment of this disorder have been found to be effective in decreasing complications. The increased risk for eventual diabetes in the patient and obesity or glucose intolerance in her off-spring suggests that long-term weight control and medical follow-up for both are important.
 ...
PMID:Gestational diabetes mellitus. 329 Sep 25


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>