Objectives: Teenage pregnancy with gestational diabetes mellitus (GDM) offers a real challenge to the health system and needs a special care. We aimed to evaluate possible obstetrical and neonatal adverse events of different treatment protocols in adolescent GDM including lifestyle, metformin (MTF), and insulin. Methods: All teen pregnant women ≤ 19 years old visiting Baghdad Teaching Hospital throughout four years (from June 1, 2016 till May 31, 2020) diagnosed with GDM were included in this cohort study and followed-up closely throughout pregnancy and after delivery. Included adolescents were put on lifestyle alone during the first week of presentation. Adolescents who reached target glucose measurements were categorized into lifestyle group, while other adolescents were randomly allocated into MTF and insulin groups. Also, adolescent pregnant women without GDM were recruited as control group using computer randomization. Results: The GDM (110 cases) and control (121 individuals) groups had matched general features at recruitment except for diabetes family history. Also, GDM treatment groups had matched features. Glycemic readings (fasting and random) was significantly (p< 0.05) higher in insulin group having odds ratio (OR) of 1.41, and 1.57, respectively. In MTF group, significant protective OR was found in preeclampsia (OR=0.76, p< 0.05). MTF showed non-significant protective OR regarding prematurity and five minutes Apgar score>7 [(OR=0.83, p=0.24), and (OR=0.94, p=0.73), respectively], and significant protective association with large for gestational age and admission to neonatal intensive unit. Insulin had significantly higher prematurity, small for gestational age, and hypoglycemia [OR=1.89, 2.53, and 2.84, respectively]. Conclusion: Metformin (MTF) showed less pregnancy and neonatal complications in adolescent GDM than insulin and lifestyle. doi: https://doi.org/10.12669/pjms.37.4.3966 How to cite this:Jasim SK, Al-Momen H, Wahbi MA. Treatment options of Adolescent Gestational Diabetes: Effect on Outcome. Pak J Med Sci. 2021;37(4):1139-1144. doi: https://doi.org/10.12669/pjms.37.4.3966 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Diabetic nephropathy (DN) is a prevalent chronic microvascular diabetic complication. As inflammation plays a vital role in the development and progress of DN the macrophages migration inhibitory factor (MIF), a proinflammatory multifunctional cytokine approved to play a critical function in inflammatory responses in various pathologic situations like DN. This study aimed To assess serum levels of MIF in a sample of Iraqi diabetic patients with nephropathy supporting its validity as a marker for predicting nephropathy in T2DM patients. In addition, to evaluate the nephroprotective effect of angiotensin-converting enzyme (ACE) inhibitors in terms of their influence on MIF levels. This is a case-control study involving ninety
... Show MoreThe aim of the study was comparative between oxidative stress in diabetes mellitus using the measurement of some biophysical and biochemical parameters on two groups of diabetic patients, were conducted in the Al-Yarmuk Teaching Hospital,30 patients insulin dependent diabetes mellitus (IDDM) or type 1 ,their ages ranged between (15-45) and30 patients non- insulin dependent diabetes mellitus (NIDDM) or type 2,their ages ranged between (42-65).This study has been compared with 30 healthy subjects. The present study was demonstrated to evaluate the alteration in oxidative stress as measured by plasma and red blood cells Malondialdehyde (MDA) andchanges in antioxidant mechanism as measured by plasma and red blood cells Glutathione (GSH)
... Show MoreOne of the most common metabolic illnesses in the world is diabetes mellitus. This metabolic disease is responsible for a large percentage of the burden of kidney damage and dysfunction. The goal of this study was to look into the renal function of diabetic patients using metformin monotherapy who came to Mosul's Al-Wafaa diabetes care and research facility. During the period 1 January 2021 to 30 April 2021, 47 patients with T2DM (age 50.48 7.74 years) were enrolled in this case-control study. These patients' results were compared to a control group of 47 seemingly healthy people (age 45.89 9.06 years). All participants' demographic and medical histories were acquired through the delivery of a questionnaire. Blood samples were collected
... Show MoreThe purpose of this paper is to identify the statistical indicators of the searched variables and identify the relationship between the cognitive learning outcome and the performance of the two mastering skills by parallel spherical standing and equilibrium on the balance beam. And the identification of the percentage of the cognitive learning outcome contribution to the performance of the two mastering skills by parallel spherical standing and the equilibrium on the balance beam. The two researchers used the descriptive approach in the survey method and the correlational relations, being the most appropriate to the nature of the research problem. The research community for the second stage students in the College of Physical Education and
... Show MoreThe objective of this paper is to study the stability of SIS epidemic model involving treatment. Two types of such eco-epidemiological models are introduced and analyzed. Boundedness of the system is established. The local and global dynamical behaviors are performed. The conditions of persistence of the models are derived.
The research aimed to demonstrate the possibility of benefiting from the coordination between real estate and income tax as the independent variable on the tax outcome as the dependent variable as the dependent variable. Which were practiced within rented buildings, as information was obtained from real estate owners, and the annual controls for the year 2021 were relied upon in the process of calculating the tax amounts expected to be obtained. used in the tax inventory process lacks seriousness and continuous updating
Background: Extracorporeal Shock wave lithotripsy (ESWL) is widely used in treating patients with ureteralstones because it is effective, safe, and noninvasive. Based on factors such as size and the location of stones,there is a significant variation in the overall stone-free rate (SFR).Aim of the study: To evaluate the effect of ureteral wall thickness (UWT), stone attenuation, the time fromfirst attack of pain till first session of ESWL and stone/ rib density on the outcome of SWL in the treatmentof upper ureteral stones (UUS).Patient and methods: A prospective study when 127 patients with radio-opaque UUS ranging from 7 to 20mm and treated by ESWL were included in this study. The effect of (stone/ 12th rib) density by KUB, ureter
... Show MoreBackground/Aim: Knee osteoarthritis is a frequently crippling chronic condition. Numerous pharmacological medications have been successfully utilised to treat knee osteoarthritis. This research aimed to compare the efficiency of metformin and serratiopeptidase in treating and preventing osteoarthritis development via distinct mechanisms. Methods: Between 1 January and 30 May 2019, a randomised-clinical-trial was done at Al-Kindy Hospital on 80 osteoarthritis patients, divided in two groups. Group I was given metformin 850 mg orally, whereas Group II was given serratiopeptidase 20 mg and metformin 850 mg orally. Parameters in these groups were compared with forty healthy normal controls. Results: Following treatment, patients in Grou
... Show MoreThe aim of the present study is to investigate and compare the efficacy of L-carnitine, multivitamins and their combination therapies on semen characteristics in idiopathic male infertility. Idiophathic infertile patients were randomly divided into three groups who had received three different treatment regimens for three months: group A (45 patients) has received 2 grams daily of L-carnitine alone; group B (55 patients) had received the combination of L-carnitine (2 grams daily) plus one tablet daily of multivitamins (Stresstabs®); and group C (29 patients) had received one tablet daily of multivitamins alone. The study was started on 1/11/2009 and completed on 31/3/2010 and performed at Rizgari Teaching Hospital in
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