Diabetes and Pregnancy

Forsbach-Sánchez, Gerardo; Tamez-Pérez, Héctor Eloy; Vázquez-Lara, Julia

doi:10.1016/j.arcmed.2005.03.001

Cited by 29 publications

(27 citation statements)

References 91 publications

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“…Increased placental IR directly impairs nutrient supply to the fetus and leads to fetal growth restriction (97,98). Hence, insulin-resistant women with PCOS appear to be predisposed to high-risk pregnancies.…”

Section: Metformin In Pcosmentioning

confidence: 99%

Metformin: an old medication of new fashion: evolving new molecular mechanisms and clinical implications in polycystic ovary syndrome

Diamanti-Kandarakis

Christakou

Kandaraki

et al. 2010

European Journal of Endocrinology

208

184

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Polycystic ovary syndrome (PCOS) is now recognized to be the most common endocrinopathy in women of reproductive age with a prevalence of 6.6-6.8%. PCOS, a syndrome of unknown etiology, was initially regarded as a reproductive disorder. However, in the last 15 years the role of insulin resistance (IR) has been identified as a significant contributor to the pathogenesis of PCOS, and the metabolic and cardiovascular sequelae of the syndrome have been increasingly appreciated. The coexistence and interaction of reproductive and cardiometabolic abnormalities in the context of PCOS have created a need for a modified therapeutic management of affected women. Insulin sensitizers, particularly metformin, have been introduced as a pharmaceutical option targeting not only IR, but several other aspects of the syndrome, including reproductive abnormalities. The landscape of the multifaceted actions of metformin evolves to broaden the therapeutic implications of this old drug in a new fashion for patients with PCOS. Most recently, the spectrum of metformin's targets has been expanded, and molecular studies have explored the tissue-specific mechanisms of metformin in the liver, the muscle, the endothelium, and the ovary. The use of metformin in pregnant women with PCOS comprises another scarcely explored, but promising area of research. This review attempts to cover the spectrum of metformin's cellular actions in different tissues and to summarize the current literature regarding the potential medical value of this medication in PCOS. Even if many of these actions are individually modest, they seem to be collectively sufficient to confer therapeutic benefits not only in cardiometabolic aspects but also in reproductive aspects of PCOS.

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Section: Metformin In Pcosmentioning

confidence: 99%

Metformin: an old medication of new fashion: evolving new molecular mechanisms and clinical implications in polycystic ovary syndrome

Diamanti-Kandarakis

Christakou

Kandaraki

et al. 2010

European Journal of Endocrinology

208

184

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“…1 GDM is associated with increased risk of adverse maternal and perinatal outcomes, including preeclampsia, preterm delivery, cesarean section, macrosomia, and respiratory distress syndrome, among other. 2 There is also an increased risk of complications after pregnancy such as the development of type 2 diabetes mellitus (T2DM) and cardiovascular disease in the mothers 3,4 and developing obesity, metabolic syndrome, and T2DM in the children during childhood and adolescence. 5 Although the precise mechanisms underlying GDM are still not completely understood, a close immune-metabolic relationship with inflammatory cytokines regulating metabolic homeostasis has been found.…”

Section: Introductionmentioning

confidence: 99%

Increased expression of immune-related genes in leukocytes of patients with diagnosed gestational diabetes mellitus (GDM)

Wójcik

Zieleniak

Źurawska-Kliś

et al. 2015

Exp Biol Med (Maywood)

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Compelling evidence indicates that the immune system is linked to metabolism in gestational diabetes mellitus (GDM), but factors participating in these processes still are awaiting identification. Inducible nitric oxide synthase, encoded by the NOS2 gene, and surfactant protein D, encoded by the SFTPD gene, have been implicated in diabetes. We investigated NOS2 and SFTPD mRNA levels in leukocytes obtained from 125 pregnant women with (n ¼ 87) or without (control group; n ¼ 38) GDM, and, in turn, correlated their expression with clinical parameters of subjects. Leukocytes were isolated from the blood of pregnant women and NOS2 and SFTPD expression in these cells was determined by quantitative real time PCR (qRT-PCR). Univariate correlation analyses were performed to assess an association between leukocyte NOS2 and SFTPD expression and clinical characteristics of patients. qRT-PCR experiments disclosed significantly increased leukocyte NOS2 and SFTPD mRNA levels in hyperglycemic GDM patients (P < 0.05). In the entire study group, there were significant positive associations of leukocyte NOS2 and SFTPD mRNAs with C-reactive protein. Additionally, transcript level of SFTPD also correlated positively with fasting glycemia and insulin resistance. This study demonstrates that an impaired glucose metabolism in GDM may be predominant predictor of leukocyte NOS2 and SFTPD overexpression in diabetic patients. Furthermore, alterations in the expression of these genes are associated with glucose metabolism dysfunction and/or inflammation during pregnancy. In addition, these findings support the utilization of leukocytes as good experimental model to study a relationship between immune-related genes and metabolic changes in women with GDM, as well as to assess the potential mechanisms underlying these alterations.

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“…O DMG é um bom exemplo para se analisar a pesquisa translacional visto que é uma das principais causas de morbidade e mortalidade perinatal, bem como da repercussão a longo prazo na vida da mulher (9)(10)(11)(12). A intrincada relação entre o que se observa na prática da atividade clínica e o que se obtém de resultados em pesquisa clínica e de investigação em ciência básica deve ser organizada e analisada dentro de um contexto único que, nos dias de hoje, é denominado "Pesquisa Translacional".…”

Section: Introductionunclassified

Pesquisa translacional em diabetes melito gestacional e hiperglicemia gestacional leve: conhecimento atual e nossa experiência

Rudge

Pículo

Marini

et al. 2013

Arq Bras Endocrinol Metab

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RESUMOO diabetes materno constitui um ambiente desfavorável para o desenvolvimento embrionário e feto--placentário. É uma repercussão de importância na obstetrícia moderna, visto que está associado a um risco aumentado de morbidade materna e neonatal e continua a ser um desafio médico significativo. O aumento mundial na incidência do diabetes, o aumento do diabetes tipo 2 em mulheres em idade reprodutiva e a geração cruzada da programação intrauterina do diabetes tipo 2 são as bases para o interesse crescente na utilização de modelos experimentais diabéticos, a fim de obter conhecimento sobre os mecanismos que induzem as alterações de desenvolvimento no diabetes gestacional. Vários estudos têm demonstrado os benefícios da prevenção do diabetes com intervenções no estilo de vida, melhora metabólica e controle de fator de risco cardiovascular para evitar substancialmente as complicações devastadores da doença. Apesar desses achados e a revolução recente no conhecimento científico e infinidade de novas terapias do diabetes, continua a haver uma grande lacuna entre o que foi aprendido por meio da pesquisa e o que é feito na prática da saúde pública, clínica e comunitária. O iminente impacto econômico negativo dessa complacência nos indivíduos, nas famílias e nas economias nacionais é alarmante. Espera-se que a pesquisa translacional no binômio diabetes-gravidez seja implementada em centros de excelência tanto de pesquisa básica como aplicada e complementada por estudos clínicos multicêntricos, conduzidos de forma pragmá-tica para aumentar o nível de evidência científica com recursos diagnósticos e propedêuticos mais confiáveis. Arq Bras Endocrinol Metab. 2013;57(7):497-508 Descritores Diabetes; gestação; modelos animais; pesquisa translacional; incontinência urinária ABSTRACT Maternal diabetes constitutes an unfavorable environment for fetal-placental and embryonic development. It is has important repercussion in modern obstetrics, since it is associated to an increased risk of neonatal and maternal morbidity, and it still is a significant medical challenge. The increased occurrence of diabetes worldwide, the increase in diabetes type 2 in women at reproductive age and the crossed generation of intrauterine programming for diabetes type 2 are the bases for the growing interest in utilization of diabetic experimental samples, with the aim to acquire knowledge about the mechanisms that induce development alterations in gestational diabetes. Several studies have shown the benefits of diabetes prevention, with interventions in lifestyle, metabolic improvement and control of cardiovascular risk factors to substantially prevent the complications of this devastating disease. Despite these findings, the recent revolution in the scientific knowledge, and the infinite number of new therapies for diabetes, there is still a large gap between what was learned through research and what is really done in public, clinical and community health. The negative economic impact of this complacency in people, families, and national econom...

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Diabetes and Pregnancy

Cited by 29 publications

References 91 publications

Metformin: an old medication of new fashion: evolving new molecular mechanisms and clinical implications in polycystic ovary syndrome

Metformin: an old medication of new fashion: evolving new molecular mechanisms and clinical implications in polycystic ovary syndrome

Increased expression of immune-related genes in leukocytes of patients with diagnosed gestational diabetes mellitus (GDM)

Pesquisa translacional em diabetes melito gestacional e hiperglicemia gestacional leve: conhecimento atual e nossa experiência

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