Effect of maternal weight, adipokines, glucose intolerance and lipids on infant birth weight among women without gestational diabetes mellitus

Vitamin D and Parathyroid Hormone Status in Pregnancy: Effect on Insulin Sensitivity, β-cell Function, and Gestational Diabetes Mellitus

“…The study population consisted of 524 women participating in an ongoing prospective observational cohort in which pregnant women are recruited at the time of antepartum screening for GDM (17)(18). The exclusion criteria were pre-existing diabetes, major medical comorbidities, or major organ dysfunction (such as renal or liver failure).…”

“…Regardless of the GCT result (ie, whether normal or abnormal), all study participants underwent a 3-hour 100-g OGTT for determination of gestational glucose tolerance status (19). Recruitment of women following an abnormal GCT served to enrich the study population for those likely to have GDM, as previously described (17). The protocol has been approved by the Mount Sinai Hospital Research Ethics Board and all women provided written informed consent for their participation.…”

“…All OGTTs were performed in the morning with venous blood samples drawn for the measurement of glucose and specific insulin at fasting and at 30, 60, 120, and 180 minutes following the ingestion of the glucose load as previously described (17)(18). Glycemia was assessed by glucose tolerance status (categorical measure) and area under the glucose curve (AUC gluc ) during the OGTT (continuous measure).…”

Diagnostic criteria for gestational diabetes: Who decides?

“…7,8 In the report by Retnakaran and colleagues, among the additional women who would be identified as having gestational diabetes if the lower diagnostic thresholds were used, maternal BMI before pregnancy, weight gain during pregnancy and leptin levelsnot the mother's glucose level -were independently predictive of birth weight. 2 A recent analysis of the new criteria indicates that they are cost-effective only if the diagnosis of gestational diabetes can be linked to a future reduction of type 2 diabetes. 9 In the United States, the American Diabetes Association has endorsed the new criteria, 10 but the American College of Obstetrics and Gynecology has deferred a decision of whether to update its diagnostic criteria until after a National Institutes of Health consensus conference on the topic, to be held in October 2012.…”

“…1 In a related article in CMAJ, Retnakaran and colleagues report that, among women who did not have gestational diabetes according to current diagnostic criteria, im paired glucose tolerance was not a significant independent pre dictor of having a large-for-gestational-age infant. 2 Given that many of these women would be la belled as having gestational diabetes using the proposed diagnostic criteria, 1 this should give us pause before accepting such changes to the criteria.…”