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.
Background: Fifteen percent of small for gestational age are small as a result of fetal growth restriction, which could be due to maternal, placental or fetal factors. It is an important clinical problem associated with increase perinatal mortality and morbidity. Leptin is a protein that produced by many tissues including the placenta (syncytiotropholoast). Dysregulation of leptin metabolism may be implicated in preeclampsia and IUGR pathogenesis.
Aim of the study: To study the trend of leptin level alteration in maternal serum and cord blood in pregnancies complicated by fetal growth restriction and its relation with fetal outcome.
Methods: An Analytic, cross- sectional study conducted in Al-Elwyia Maternity Teaching Hospital and
Background: Improved glucose level control with insulin injections have allowed for the diabetic population to live longer and healthier lives. Unfortunately diabetes remains a worldwide epidemic disease with multiple health implications. Specifically, its effects upon fracture healing are compromised in diabetics with as high as 87% recovery delay relative to “healthy†counterparts. Current medical treatments for bone injuries have been largely focused on replacing the lost bone with allogenic or autogenous bone grafts, beta-tricalcium phosphate (β -TCP), a ceramic alloplast, has interconnected system of micropores, has been widely used as a biologically safe osteoconductive bone substitute. The aim of this study was histol
... Show MorePurpose: To explore whether baseline matrix metalloproteinase (MMP)-8 level in gingival crevicular fluid (GCF) (exposure) can predict the outcome (reduction in probing pocket depth (PPD) (outcome)) of nonsurgical periodontal therapy (NSPT) (manual or ultrasonic or both) in patients with periodontitis (population/problem) after 3 months. Methods: Six databases (PubMed, Cochrane library, ProQuest, Ovid, Scopus, EBSCO) were searched for relevant articles published until 30 July 2021. Retrieved articles were passed through a three-phase filtration process on the basis of the eligibility criteria. The primary outcome was the change in PPD after 3 months. Quality of the selected articles was assessed using Cochrane Risk of Bias tool (RoB2
... Show MoreThe current study includes (130) T2DM patients (group P) [51 males and 79 females with an ages range (35 to 55) and ages mean 49.89 years], they are sub-grouped into three categories according to their HbA1c value. patients with HbA1c less than 7 are considered as good controlled diabetic patients (30 patients) (group P1), while patients with HbA1c between 7 and 8 are considered as medium controlled diabetic patients (40 patients) (group P2), and the patient whom their HbA1c more than 8 are considered as uncontrolled diabetic patients (50 patients) (group P3). The patients group results are compared to control healthy subjects (35 subjects) (group C) [14 males and 21 Females with age range 45.51 years] matched for age, gender and BMI wer
... Show MoreGestational Diabetes Mellitus (GDM) is the most common metabolic disorder that found during gestation and is define as hyperglycemia of variable severity with onset or first recognition during gestation that does not clearly characterize any form of the preexisting diabetes (American Diabetes Association [1]). It affects approximately 16.5% of pregnancies worldwide (Plows, et al.[2]). The placenta is an organ that connects the mother and her fetus during pregnancy (Gul, et al.[3]). In the placenta, glucose can be transformed into glycogen for storage by either glycogen synthase or using glycogenin as a prime. However, the function of glycogen deposition stays a matter of debate, it may be the source of fuel for placenta itself or the storag
... Show MoreThe research aims at a statement Internal Debt options during shocks and the impact of this borrowing in the volume of the foreign reserve, using induction and deduction with available data analysis. During the period (2004-2013) did not require the use of borrowing across (financial institutions, discounted transfers, bonds); it was only sufficient by transfer with commercial banks that can finance of temporary budget deficits: rose and decline of volume of foreign reserve according to the changes of oil prices and the volume of purchases and sales of the Central Bank of Iraq. Central Bank of Iraq (CBI) has significantly contributed to Internal Debt through bond and discounted transfers in the secondary market; thus, funding the
... Show MoreThe current work aims to evaluate the association between genetic mutations in thymidylate synthetase (
Objective: is to determine the level of awareness concerning the reproductive health among adolescent girls in
Baghdad City.
Methodology: A cross sectional study was performed in order to assess the level of awareness regarding reproductive
health among 180 adolescent school girls in the age 12-18 years from five secondary schools in Al-Seder Sector in
Baghdad city, the data was collected by direct interview using constructed questionnaire to obtain socio-demographic
characteristics and level of awareness related to reproductive health. The study started from September 2012 to
January 2013.
Results: the results show that the highest percentage of girls (47.7%) was in age (17-18) year's age, (54.5%) at 4th class
se
Background The escalating global concern over increased body weight in adolescents, coupled with the rising rates of adolescent pregnancy worldwide, presents a significant challenge to healthcare systems. We plan to identify the maternal and neonatal consequences associated with pre-pregnancy overweight in adolescent women. Methods Throughout five years, all singleton adolescent pregnant women with pre-pregnancy self-reported body mass index (BMI) of 18.5– ≤ 29.9 were involved during the first-trimester visit. Two groups were generated: overweight and appropriate-weight (BMI 25–29.9 and 18.5–24.9, respectively). Obstetric and neonatal outcomes were observed prospectively and statistically adjusted for the confounding factors.
... Show MoreBackground The escalating global concern over increased body weight in adolescents, coupled with the rising rates of adolescent pregnancy worldwide, presents a significant challenge to healthcare systems. We plan to identify the maternal and neonatal consequences associated with pre-pregnancy overweight in adolescent women. Methods Throughout five years, all singleton adolescent pregnant women with pre-pregnancy self-reported body mass index (BMI) of 18.5– ≤ 29.9 were involved during the first-trimester visit. Two groups were generated: overweight and appropriate-weight (BMI 25–29.9 and 18.5–24.9, respectively). Obstetric and neonatal outcomes were observed prospectively and statistically adjusted for the confounding factors.
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