149 research outputs found
Comprehensive self-tracking of blood glucose and lifestyle with a mobile application in the management of gestational diabetes: a study protocol for a randomised controlled trial (eMOM GDM study)
No full textFunding Information: This work was supported by Business Finland grant number 860/31/2018 (eMOM GDM). Publisher Copyright: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.Introduction Gestational diabetes (GDM) causes various adverse short-term and long-term consequences for the mother and child, and its incidence is increasing globally. So far, the most promising digital health interventions for GDM management have involved healthcare professionals to provide guidance and feedback. The principal aim of this study is to evaluate the effects of comprehensive and real-time self-tracking with eMOM GDM mobile application (app) on glucose levels in women with GDM, and more broadly, on different other maternal and neonatal outcomes. Methods and analysis This randomised controlled trial is carried out in Helsinki metropolitan area. We randomise 200 pregnant women with GDM into the intervention and the control group at gestational week (GW) 24-28 (baseline, BL). The intervention group receives standard antenatal care and the eMOM GDM app, while the control group will receive only standard care. Participants in the intervention group use the eMOM GDM app with continuous glucose metre (CGM) and activity bracelet for 1 week every month until delivery and an electronic 3-day food record every month until delivery. The follow-up visit after intervention takes place 3 months post partum for both groups. Data are collected by laboratory blood tests, clinical measurements, capillary glucose measures, wearable sensors, air displacement plethysmography and digital questionnaires. The primary outcome is fasting plasma glucose change from BL to GW 35-37. Secondary outcomes include, for example, self-tracked capillary fasting and postprandial glucose measures, change in gestational weight gain, change in nutrition quality, change in physical activity, medication use due to GDM, birth weight and fat percentage of the child. Ethics and dissemination The study has been approved by Ethics Committee of the Helsinki and Uusimaa Hospital District. The results will be presented in peer-reviewed journals and at conferences. Trial registration number NCT04714762.Peer reviewe
Effects of intervention to mild GDM on outcomes
No full textObjective: To evaluate pregnancy outcomes in women with gestational diabetes mellitus (GDM) diagnosed by the IADPSG criteria at 24-28 weeks of gestation but with fasting plasma glucose (FPG) less than 4.4 mmol/L. Research design and methods: A retrospective study was conducted. Medical records of 25 674 pregnant women attending the Peking University First Hospital (PUFH) were analyzed. Women with FPG value <4.4 mmol/L were segregated into those with and without GDM based on the IADPSG criteria. Pregnancy outcomes in the form of birth weight, neonatal hypoglycemia and cesarean delivery were compared between the two groups. Results: The incidence of macrosomia between GDM 7.1% (treated 6.9%; untreated 7.2%) was not different from the non GDM group 6.3%, similarly neonatal hypoglycemia 1.9% (treated 2.0%; untreated 1.7%) was were not significantly different from the non GDM group 1.1%. Rate of cesarean delivery in the untreated GDM group 59.7% was significantly higher compared to both with treated GDM (48.4%) and the non GDM group (47.6%). Conclusions: There is no difference in the incidence of select adverse pregnancy outcomes amongst Chinese women with mild GDM (FPG<4.4 mmol/L) with or without intervention compared to women without GDM.World Diabetes Foundation [WDF10-517]SCI(E)[email protected]
Innovative Hydrophilic MPL for Cathode Gas Diffusion Media (GDM)
No full textIn a departure from the conventional design of hydrophobic MPLs, the author conceived the idea of hydrophilic double MPLs. The hydrophilic layers are composed of carbon fibers and a hydrophilic polymer. The ratio of hydrophilic polymer to carbon fiber is designed to be low in the first layer (catalyst side) and high in the second layer (GDM side), in order that the two layers should function differently. The first layer removes liquid water from the cathode catalyst layer and the second layer retains water, thus preventing the membrane from drying-out. The MEA, which uses a cathode GDM with hydrophilic double MPLs, exhibits excellent performance under both high and low humidity conditions. This work clearly indicates that applying hydrophobic MPLs to the cathode GDM is not a golden rule in the design of MEAs.</jats:p
Performance Evaluation of a Pilot-Scale Aerobic Granular Sludge Integrated with Gravity-Driven Membrane System Treating Domestic Wastewater
No full textThis study describes a novel integration of aerobic granular sludge (AGS) with a gravity-driven membrane (GDM) system at a pilot scale with a treatment capacity of approximately 150 L per day to treat raw domestic wastewater. The treatment performance and energy consumption of the AGS-GDM system were compared to the neighboring full-scale aerobic membrane bioreactor (AeMBR), treating the same wastewater at about 4000(±500) m3 per day. The AGS-GDM system demonstrated superior nutrient (nitrogen and phosphorus) removal as compared to the AeMBR. The GDM unit was continuously supplied with AGS-treated effluent. The GDM unit started with high [ >20 L per m2 per h (LMH) ] flux, which gradually declined. The flux remained quite stable after 15 days reaching 3 LMH after 35 days without any physical or chemical cleaning. Our results suggest that AGS-GDM is a viable technology for decentralized wastewater treatment and reuse in water-scarce regions. The AGS-GDM could easily replace conventional AeMBR technology in the wastewater treatment and reclamation market.Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.BT/Environmental Biotechnolog
Not like this! - On disappointed hopes, surging emotions and associations based on experience during a lecture at an annual conference of the GDM
No full textIch habe viele Vorträge auf GDM-Tagungen - natürlich auch auf anderen Tagungen - gehört. Es waren gute Vorträge dabei, einige sehr gute. Es waren aber auch viele - nun sagen wir - verbesserungswürdige Vorträge dabei. Sehr oft habe ich mich über Vortrag und Art der Präsentation geärgert. Oft habe ich verständnislos darüber den Kopf geschüttelt, dass Vortragende - gleich welchen Alters – nicht einmal elementare Präsentationsregeln kennen, dass sie offensichtlich nicht in der Lage sind, aus guten Vorträgen, die sie sicherlich schon gehört haben, zu lernen. Warum ist das so? Antworten suche ich seit Jahrzehnten, mögliche Lösungsstrategien auch. Dieser Artikel kumuliert und konzentriert vielfältige persönliche Erlebnisse und stellt sie im Stile von „Leutnant Gustl“ (1901) von Arthur Schnitzler https://www.projekt-gutenberg.org/schnitzl/gustl/gustl.html dar. Eine Stück, von dem der Autor immer wieder beeindruckt ist.I have heard many presentations at GDM conferences - and of course at other conferences too. There were some good presentations, some very good ones. But there were also many - let's say - presentations that could be improved. Very often I was annoyed by the lecture and the way it was presented. I often shook my head in astonishment at the fact that speakers - regardless of their age - don't even know the basic rules of presentation, that they are obviously unable to learn from good presentations that they have certainly already heard. Why is this the case? I have been looking for answers for decades, as well as possible solution strategies. This article accumulates and concentrates a wide range of personal experiences and presents them in the style of “Leutnant Gustl” (1901) by Arthur Schnitzler https://www.projekt-gutenberg.org/schnitzl/gustl/gustl.html. A play that has always impressed the author.
 
Variations in Author Gender in Obstetrics Disease Prevalence Literature: A Systematic Review
No full textThis systematic review aims to evaluate gender differences in authorship of prevalence literature concerning intimate partner violence (IPV) during pregnancy and gestational diabetes mellitus (GDM). GDM studies were matched for publication year and study country as a gender-neutral obstetric disease with similar morbidity to IPV. Relevant studies were captured without language restrictions via online searches of PubMed, Scopus and Web of Science from database inception to January 2022. Proportion of female authors and gender of the first and corresponding author were outcome measures. Multivariable regression models were built to examine if female authors featured more or less often in IPV during pregnancy and GDM literature adjusting by the influence of type of study, country’s human development index (HDI), year of publication and journal’s impact factor. 137 IPV-GDM studies pairs were included. Female authors in IPV studies were slightly lower than in GDM [59.7%, 95% CI 54.7–64.7, vs. 54.9%, 95% CI 50.7–59.1, p = 0.204]. Studies published in high-income countries were more likely to be signed by a woman as first and corresponding author (Odds Ratio 2.22, 95% CI 1.20; 4.11, p = 0.011 and Odds Ratio 2.24, CI 1.22; 4.10, p = 0.009 respectively) and proportion of women as corresponding authors decreased as the journal impact factor increased (β = 0.62, 95% CI 0.37, 1.05, p = 0.075). There is a gender gap in the field of prevalence research in IPV during pregnancy with variations according to the level of development. International programs aimed at eradicating these inequalities are needed
A Walking Plan for Pregnant Women with Gestational Diabetes: A Feasibility Study
No full textabstract: Gestational diabetes mellitus (GDM) is a well-established predictor for the development of type II diabetes mellitus (T2DM) later in life. The incidence of GDM has been on the rise over the past 30 years and is the leading co-morbidity during pregnancy (Ferrara, 2007). Physical activity (PA) in combination with nutritional therapy has been shown to achieve glycemic control in women with GDM and is therefore first line therapy for management (American College of Obstetrics and Gynecology [ACOG], 2017; Center for Disease Control and Prevent [CDC], 2018). Recommendations for PA in pregnancy include 150 minutes of moderate intensity exercise most days of the week (ACOG 2015; U.S. Department of Health & Human Services, 2018). Because of this, an innovative project was created to determine the feasibility of adding a walking plan into GDM care. Participants in the project received verbal and written instruction on an unsupervised structured walking plan set up for a beginner to gradually increase PA to the recommended time of 150 minutes per week for a total of four weeks. Eight women were interested, recruited, and enrolled in the project. Results show that overall, participant PA increased. One hundred percent agreed that the walking plan was useful and increased their awareness about PA. The addition of a walking plan in GDM teaching is an effective strategy to lower serum blood glucose (SBG) levels and for meeting PA recommendations during pregnancy
The impact of educational attainment on the occurrence of gestational diabetes mellitus in two successive pregnancies of Finnish primiparous women : a population-based cohort study
No full textAims To assess the impact of educational attainment on the occurrence and recurrence of gestational diabetes mellitus (GDM) in two successive pregnancies in primiparous women. Methods This is a population-based observational cohort study including all 2347 Finnish women without previously diagnosed diabetes, aged >= 20 years from the city of Vantaa, Finland, who gave birth to their first and second child between 2009 and 2015. National registries provided data on study participants. We divided the population into four groups according to the presence of GDM in the two pregnancies (GDM-/-, n = 1820; GDM-/+, n = 223; GDM+/-, n = 113; GDM+/+, n = 191). Results The occurrence of GDM in the first pregnancy was 13.0% (n = 304) and 17.6% (n = 414) in the second. The recurrence rate of GDM was 62.8%. The four groups did not differ in relation to educational attainment (p = 0.11). In multinomial regression analysis, educational attainment protected from GDM in the second pregnancy [relative risk ratio 0.93 (95% confidence interval (CI) 0.86-0.99) per year of schooling for being GDM-/+ compared with GDM-/-]. In multivariate logistics models, prepregnancy body mass index at the first pregnancy [odds ratio (OR) 1.53 per 1-standard deviation (SD) (95% CI 1.22-1.91)], first-born birth weight z-score [OR 1.30 per 1-SD (95% CI 1.00-1.67)], and inter-pregnancy weight change [OR 1.66 per 1-SD (95% CI 1.27-2.16)], but not educational attainment, predicted recurrence of GDM. Conclusions The recurrence rate of GDM was high. Education protected from novel GDM in the second pregnancy, but was not associated with GDM recurrence.Peer reviewe
Physical activity patterns and gestational diabetes outcomes – The wings project
No full textAbstractObjectiveTo compare physical activity (PA) patterns in pregnant woman with and without gestational diabetes (GDM) and to assess the effects of an exercise intervention on change in PA patterns, blood glucose levels and pregnancy outcomes in GDM women.MethodsFor the first objective, PA patterns were studied in 795 pregnant women with and without GDM. For the second objective, the Women in India with Gestational Diabetes Strategy-Model of Care (WINGS-MOC) intervention were evaluated in 151 women out of 189 with GDM. PA was assessed using a validated questionnaire and a pedometer. Changes in PA patterns, glycemic parameters and neonatal outcomes were evaluated.ResultsOverall, only 10% of pregnant women performed recommended levels of PA. Women with GDM were significantly more sedentary compared to those without GDM (86.2 vs. 61.2%, p<0.001). After the MOC was implemented in women with GDM, there was a significant improvement in PA and a decrease in sedentary behaviour amongst women (before MOC, moderate activity: 15.2%, sedentary: 84.8% vs. after MOC-moderate: 26.5%, sedentary: 73.5%; p<0.001), and an increase in their daily step count from 2206/day to 2476/day (p<0.001). Fasting 1 and 2-h postprandial glucose values significantly decreased (p<0.001 for all). Sedentary behaviour was associated with a fourfold higher risk (p=0.02), and recreational walking with 70% decreased risk, of adverse neonatal outcomes (p=0.04) after adjusting for potential confounders.ConclusionsPA levels are inadequate amongst this group of pregnant women studied i.e. those with and without GDM. However, a low-cost, culturally appropriate MOC can bring about significant improvements in PA in women with GDM. These changes are associated with improved glycemic control and reduction in adverse neonatal outcomes
Taste and endocrine factors in women with gestational diabetes mellitus
No full textGestational diabetes mellitus (GDM) is hyperglycemia first identified during pregnancy. Many metabolic parameters increase across normal gestation, but may exceed those levels in pregnancies where GDM develops. Studies on the time course and pattern of metabolic factors in GDM are conflicting. Additionally, past research suggests changes in cravings and dietary intake during normal pregnancy and taste alterations in diabetes and pregnancy. Such parameters have been studied only on a limited basis in women with GDM. In this dissertation, we examined metabolic, taste and dietary measures across pregnancy.
The temporal profile of insulin, cortisol and leptin was determined in women who developed GDM and those who remained normal glucose tolerant (NGT). Fasting insulin levels were higher at 24-28 weeks gestation than during postpartum in women with GDM, however it was not until 34-38 weeks that insulin differed from postpartum in NGT women. Both pregnant groups showed similar increases in cortisol levels across gestation. From 16-20 weeks to 24-28 weeks, leptin rose rapidly in women with GDM and was marginally higher in GDM women relative to NGT women at 24-28 weeks. By 34-38 weeks, leptin values did not differ between pregnant groups.
We also studied pregnancy and GDM effects on sweet taste perception and preference, and examined relationships of taste parameters with circulating hormones. Women with GDM exhibited higher preference for sucrose-sweetened milk as well as positive relationships between liking of glucose solutions and sucrose-sweetened milk and insulin and leptin, respectively. Women with NGT reported higher intake of all sweet food and beverage at 24-28 weeks, primarily as fruit and fruit juice, while women with GDM reported higher frequency of sweet cravings at 34-38 weeks gestation.
These results suggest that women challenged with concurrent pregnancy and diabetes exhibit early rises in insulin and leptin during gestation and such endocrine changes may be related to elements of sweet taste. Additionally, during late gestation, although women with GDM report following a carbohydrate controlled diet, they show a higher preference and craving for sweet taste. In GDM, alterations in sweet taste and differences in sweet cravings and food intake may be metabolically or psychologically based.Ph.D.Includes bibliographical references
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