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: Cardiovascular disease (CVD) is an important complication of type 2 diabetes mellitus (T2DM). Oxidative stress plays a major role in the development of CVD. Saliva has a diagnostic properties aiding in the detection of systemic diseases. This study aimed to assess the association between salivary oxidative stress markers and the risk of vascular disease (VD) in T2DM patients. Materials and Methods: One hundred T2DM patients and fifty apparently healthy males were enrolled in this study. Saliva sample was collected for assessment of oxidative stress markers including: lipid peroxidation plasma thiobarbituric acid-reactive substances (TBARS), uric acid (UA) and total antioxidant capacity (TAC) levels. Arterial stiffness index (ASI
... Show MoreGlutathione S-transferases (GSTs) are enzymes that included, in a more range of detoxifying reactions by conjugation of glutathione, to electrophilic material. Polymorphisms n the genes that responsible of GSTs affect, the function of the GSTs. GSTs play an active role in protection of cell against oxidative stress mechanism. Polymorphisms of GSTP1 at codon 105 amino acids forms GSTP1 important site for bind of hydrophobic electrophiles and the substitution of Ile/Val affect substrate specially catalytic activity of the enzyme and may correlate with reach to different diseases in human like diabetes mellitus type2 disease. Correlation between these polymorphisms and changes in the parameters file of diabetic patients has also bee
... Show MoreBackground:Measurement of hemoglobin A1c (A1C) is a renowned tactic for gauging long-term glycemic control, and exemplifies an outstanding influence to the quality of care in diabetic patients.The concept of targets is open to criticism; they may be unattainable, or limit what could be attained, and in addition they may be economically difficult to attain. However, without some form of targeted control of an asymptomatic condition it becomes difficult to promote care at allObjectives: The present article aims to address the most recent evidence-based global guidelines of A1C targets intended for glycemic control in Type 2 Diabetes Mellitus (T2D).Key messages:Rationale for Treatment Targets of A1C includesevidence for microvascular and ma
... Show MoreBackground: Osteoporosis (OP) is a systemic disease characterized by low bone mass and micro architectural deterioration of bone tissue, resulting in an increased risk of fractures and has touched rampant proportions. Osteocalcin, one of the osteoblast-specific proteins, showed that its functions as a hormone improves glucose metabolism and reduces fat mass ratio. This study is aimed to estimate the osteocalcin and glucose level in blood serum of osteoporotic postmenopausal Women with and without Type 2 Diabetes.Materials and methods: 60 postmenopausal women with osteoporosis divided into two groups depending on with or without T2DM, 30 patients for each. Serum samples of 30 healthy postmenopausal women were collected as control group. Ost
... Show MoreThis study included 50 blood samples collected from children with mean age 8-12 years. Thirty five blood samples were collected from children with Type 1 Diabetes Mellitus (T1D) with mean age 9.4±0.34 years, and 15 blood samples collected from healthy children as a control sample with mean age 10.9±0.38 years. Immunogenetic study was done on collected blood samples. Concentrations of IFN-γ were estimated from T1D patient and control samples by using Elisa instrument. The concentration of this interferon was 1.575 pg/ml in T1D patient sample in comparison with 0.921 pg/ml in control sample. Significant differences of this interferon concentration were found between T1D patient and control samples when Mann-Whitney U test was used
... Show MoreDiabetes mellitus (T2DM) is a multifactorial syndrome that israpidly rising in all the continents ofthe globe, causing elevated blood sugar levels in affected people. A sample of 81 Iraqi T2DM patients was investigated based on several parameters. Glycemic control parameters includedlevels of fasting blood glucose (FBG),
glycated hemoglobin (HbA1C), and insulin, along with insulin resistance (IR) and insulin sensitivity (IS). Renal function tests includedmeasuring the blood levels of urea and creatinine. Oxidative stress parameters included total antioxidant capacity (TAC) and thelevel of reactive oxygen species (ROS). The results of the present
study showed a highly significant (P˂0.01) increase in FBG, HbA1c, insulin and IR leve
Background: Glycemic control and prevention of secondary complications are the most important aims of using pharmacological treatments in diabetes mellitus. Due to the high incidence of inadequate response to insulin and, we try to evaluate the effects of adjunct use of silymarin with insulin on glycemic control, lipid profile and renal function in type 1 diabetes mellitus patients.
Patients and Methods: Placebo-controlled, doubled blinded clinical trial method is utilized through which 60 type 1 DM patients allocated into two groups, 30 patients treated with insulin and silymarin 400 mg/day in two divided doses, while the other 30 patients treated with insulin and placebo for 60 days. Fasting serum gluco
The importance of the research from a practical point of view lies in the fact that it presents a set of statistics and data that give a clear picture of how the Iraqi newspapers (the subject of the study) deal with the visit of "Pope Francis" to Iraq ، and what are the most prominent indicators and manifestations of that visit in promoting societal peace among the Iraqi public. From a scientific point of view، the research provides another scientific addition to the media library، especially with regard to journalistic treatments and methods of framing the Arab international press for the subject of the visit، which could be a starting point for other researchers to complete qualitative research in this field. The research prob
... Show MoreIn order to investigate the levels of reduced glutathione GSH and α1-antitrypsine in the sera of 20 type 2 diabetic patients and 10 healthy subjects, were enrolled in this study. A significant reduction in GSH level was found in the patient group compared with control. On the other hand a significant elevation in α1-antitrypsine in patient compared with control was observed. Correlation between α1-antitrypsine and reduced glutathion was found to be positive (+Ve) for diabetes mellitus type2 patients and negative (-Ve) for healthy control with r values 0.257 and – 0.339 respectively. In conclusion the depletion of GSH as antioxidant defense insured higher free radical generation in diabetic patients
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