Comment on Scholtens et al. Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Glycemia and Childhood Glucose Metabolism. Diabetes Care 2019;42:381–392

Hulmán, Ádám

doi:10.2337/dc19-0650

Cited by 5 publications

(5 citation statements)

References 5 publications

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“…Model fit criteria ( 4 , 5 ) identified the reported quadratic model as the best fit, given those explored for the available HAPO data. We agree with Hulman ( 2 ) that four or more time points could facilitate more accurate polynomial or spline fits.…”

supporting

confidence: 90%

“…As described in our article ( 1 ), the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study and HAPO Follow-up Study (HAPO FUS) allowed examination of associations between maternal glucose levels during a 75-g oral glucose tolerance test (OGTT) at ∼28 weeks’ gestation, across the continuum, with child glucose metabolism at ages 10–14 years. The comment by Hulman ( 2 ) on our article ( 1 ) raises questions about exploratory trajectory analyses that complemented main regression analyses of these secondary predictors and outcomes.…”

mentioning

confidence: 99%

“…Second, regarding the reported quadratic models, the comment ( 2 ) and additional reports ( 3 ) describe a rise in glucose during a 2-h OGTT, followed by a decline. It is therefore surprising that reporting a quadratic fit, given the available data, would be considered problematic ( 2 ); certainly linearity would not suffice and cubic models did not converge. Model fit criteria ( 4 , 5 ) identified the reported quadratic model as the best fit, given those explored for the available HAPO data.…”

mentioning

confidence: 99%

“…Third, Hulman ( 2 ) states that further investigation of clinical relevance of glucose response patterns is required before changing current guidelines. Perhaps our conclusion was misunderstood; we are not advocating immediate change in current guidelines based on exploratory trajectory analyses using limited time points in HAPO data.…”

mentioning

confidence: 99%

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Response to Comment on Scholtens et al. Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Glycemia and Childhood Glucose Metabolism. Diabetes Care 2019;42:381–392

Scholtens

Metzger

2019

Diabetes Care

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supporting

confidence: 90%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Response to Comment on Scholtens et al. Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Glycemia and Childhood Glucose Metabolism. Diabetes Care 2019;42:381–392

Scholtens

Metzger

2019

Diabetes Care

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“…Therefore, the aim of glycemic management during birth is to optimize maternal and fetal outcomes. In a recent HAPO Follow-Up Study (HAPO FUS), it was observed that GDM was significantly and independently associated with childhood impaired glucose tolerance (32).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the relationship between placental stiffness measured by shear wave elastography and perinatal outcomes in women with gestational diabetes mellitus

et al. 2021

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Background Recently, studies on placental elastography in high-risk pregnancies continue to increase. The shear wave technique can contribute to the management of gestational diabetes mellitus (GDM) and improve perinatal outcomes by measuring placental stiffness. Purpose: To evaluate the relationship between placental stiffness measured by shear wave elastography (SWE) and perinatal outcomes in women with GDM. Material and Methods: This prospective cross-sectional study was conducted at our hospital between March and October 2020. The participants were divided into three groups: GDM-A1 group (regulated by dietary modifications); GDM-A2 group (needed pharmacologic treatment); and low-risk pregnancy (LRP) group. Both SWE and shear wave velocity (SWV) were measured in the placenta during pregnancy. Results In total, 111 women were included in the study. The mean SWE (kPa) values for the GDM-A1, GDM-A2, and LRP groups were 10.4 (range 3.1–23.3), 13 (range 4.3–29.6), and 8.3 (range 3.2–15.1), respectively. The mean HbA1c and fasting glucose values of diabetes groups showed strongly positive correlation with mean SWE and SWV values ( P < 0.001, r=0.875; P < 0.001, r=0.856; P < 0.001, r=0.791; P < 0.001, r=0.740), respectively. The SWE values of central maternal and fetal surfaces of the placenta ( P=0.01, r=0.242; P < 0.001, r=0.333) showed a moderately positive correlation with admission to the neonatal intensive care unit. Conclusion Placental stiffness has increased in the GDM-A2 group when compared to the GDM-A1 and LRP groups. We also observed a strong positive correlation between HbA1c, fasting glucose values, and increased elasticity values in diabetic patients with metabolic dysregulation that may have clinical value.

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Gestational Diabetes: A Review

Barbach,

Chenguiti,

Charrah

et al. 2023

Biomed. Pharmacol. J.

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Gestational diabetes (GD) is a disorder of glucose tolerance resulting in hyperglycemia first diagnosed during pregnancy. Its worldwide prevalence is estimated at 14% but varies regionally. In 2008, new diagnostic criteria were adopted, leading to an increase in diagnosed cases. Biomarkers could potentially serve as an alternative to the current diagnostic criteria in the future, enabling the realization of a universally applicable GD screening program. Risk factors associated with GD encompass a range of factors, including epigenetic factors, inadequate vitamin D levels, family history of diabetes, prediabetes, obesity, fetal death, polycystic ovary syndrome (PCOS), and advanced maternal age. GD can have consequences for maternal health, increasing the risk of hypertensive disorders, premature labor, cesarean delivery, metabolic disorders, and later type 2 diabetes. In children, it may be associated with macrosomia, shoulder dystocia, respiratory insufficiency, and hospitalization in the neonatal intensive care. Offspring born to mothers with GD face heightened susceptibility to childhood and adult obesity, alongside elevated cardiometabolic risk. The consequences and risk factors of GD are not fully understood to this day. Therefore, Additional research is warranted to gain a deeper comprehension of the pathophysiology underlying the disease and to ascertain efficacious preventive and therapeutic approaches. Nutritional therapy is often sufficient to achieve normoglycemia objectives. An individualized nutritional program is recommended, providing the necessary nutrients to promote maternal and infant health, attain optimal gestational weight gain and uphold glycemic regulation. However, in some cases, additional antidiabetic therapy is necessary. Insulin remains the most commonly used treatment, but metformin may be a safe and effective alternative. This still needs to be validated by in-depth studies leading to better evaluation of its long-term effects on offspring.

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Comment on Scholtens et al. Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Glycemia and Childhood Glucose Metabolism. Diabetes Care 2019;42:381–392

Cited by 5 publications

References 5 publications

Response to Comment on Scholtens et al. Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Glycemia and Childhood Glucose Metabolism. Diabetes Care 2019;42:381–392

Response to Comment on Scholtens et al. Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Glycemia and Childhood Glucose Metabolism. Diabetes Care 2019;42:381–392

Evaluation of the relationship between placental stiffness measured by shear wave elastography and perinatal outcomes in women with gestational diabetes mellitus

Gestational Diabetes: A Review

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