Background: Gestational diabetes mellitus (GDM) is one of the commonly occurring high‑risk obstetric complications that accounts for 4%–9% of total pregnancies. The present study
was an attempt to assess the effect of GDM on composition of the neonatal oral microbiota.
Materials and Methods: In this study, oral samples from 155 full‑term vaginally delivered newborns were collected with sterile swabs. Seventy‑five mothers diagnosed with GDM group and 80 were nondiabetic mothers (control). The oral microbiota was evaluated and analyzed by SPSS software.
Results: The mean gestational age in Group I was 38.1 weeks and in Group II was 39.6 weeks. Firmicutes was present in 38.1% in Group I versus 77.6% in Group II patients, Actinobacteria was seen in 15.2% in Group I and 7.4% in Group II, Bacteroidetes in 27.6% in Group I and 7.9% in Group II, Proteobacteria in 9.5% in Group I and 3.8% in Group II, and Tenericutes in 9.6% in Group I and 3.3% in Group II. There was a significant difference in major genera Prevotella, Bacteroidetes, Bifidobacterium, Corynebacterium, Ureaplasma, and Weissella in both groups (P < 0.05).
Conclusion: There was increased bacterial microbiota in neonates born to mothers with GDM as compared to neonates born to nondiabetic mothers. Assessment of initial oral microbiota of neonates could help in assessing the early effect of GDM on neonatal oral microbial flora.
This document discusses gestational diabetes, including its causes, risk factors, diagnosis, treatment, complications, and prevention. Gestational diabetes is a form of diabetes that develops during pregnancy. It occurs when pregnancy hormones interfere with the body's ability to produce and use insulin, resulting in high blood sugar levels. Risk factors include obesity, family history, previous gestational diabetes or large baby, and age over 30. It is diagnosed through glucose tolerance tests. Treatment involves diet, exercise, blood sugar monitoring, and possibly insulin. Complications can affect both mother and baby's health. Maintaining a healthy lifestyle before and during pregnancy can help prevent gestational diabetes.
This document discusses diabetes in pregnancy. It provides information on the physiological changes in pregnancy that affect glucose metabolism and insulin resistance. It covers the classification, definition, and prevalence of gestational diabetes. Guidelines for screening and diagnosing gestational diabetes are presented. The document also discusses potential maternal and fetal/neonatal complications and provides recommendations for prepregnancy counseling, medical management including glycemic control targets, diet, exercise, and medication options, and obstetric management of diabetes in pregnancy.
Diabetes in pregnancy-overt diabetes: type I DM, type II DM,Gestational diabe...FarsanaM
This document discusses diabetes in pregnancy, including types, screening, diagnosis, management, and effects on mother and fetus. It covers gestational diabetes and pregestational diabetes types 1 and 2. Key points include increased risk of complications for both mother and baby if blood sugar is not well-controlled, and the importance of medical nutrition therapy, exercise, monitoring blood sugar levels, and insulin treatment if needed to maintain healthy blood glucose levels during pregnancy. The goals are to reduce risks and promote optimal outcomes for mother and child.
Hormonal &Metabolic Changes during Pregnancy
Patho-physiology of hyperglycemia in pregnancy
Risk factors, Clinical Features & Investigations
Complications of hyperglycemia in pregnancy
Medical management of hyperglycemia in pregnancy
Obstetric Management of hyperglycemia in pregnancy
A seminar was arranged as a part of integrated teaching at Enam Medical College, Savar, Dhaka, Bangladesh which was presented by the students.
A comprehensive guide to the management of hyperglycaemia in pregnancy aimed at the primary care physician and based on latest evidenced based criteria. Includes information from latest studies such as HAPO study and ACHOIS, and involves guidelines from the IADPSG, ADA, WHO and Malaysia.
This document provides an overview of diabetes in pregnancy. It defines diabetes mellitus and describes the main types: type 1, type 2, and gestational diabetes. Risk factors, screening, and diagnostic criteria for gestational diabetes are covered. The document also discusses complications of diabetes in pregnancy for both mother and baby, as well as management through medical nutrition therapy, exercise, medication and insulin. Postpartum care is also summarized.
This document discusses diabetes mellitus (DM) and new developments in its management. It begins by defining DM according to the WHO and describing its global prevalence and projected increase. It then classifies the main types of DM and discusses testing and diagnosis criteria. The document outlines recommendations for lifestyle modifications, medical nutrition therapy, physical activity, weight management, and smoking cessation. It also reviews oral medications and insulin therapy as well as recommendations for self-monitoring and A1C testing.
This document provides an overview of diabetes mellitus in pregnancy. It defines diabetes in pregnancy and gestational diabetes, and discusses their incidence rates. It describes the screening, diagnosis, and management of diabetes in pregnancy. The document outlines the maternal and fetal effects of diabetes during pregnancy and notes increased risks of complications. It emphasizes the importance of glucose monitoring and medical nutrition therapy in managing diabetes in pregnancy.
This document discusses gestational diabetes, including its causes, risk factors, diagnosis, treatment, complications, and prevention. Gestational diabetes is a form of diabetes that develops during pregnancy. It occurs when pregnancy hormones interfere with the body's ability to produce and use insulin, resulting in high blood sugar levels. Risk factors include obesity, family history, previous gestational diabetes or large baby, and age over 30. It is diagnosed through glucose tolerance tests. Treatment involves diet, exercise, blood sugar monitoring, and possibly insulin. Complications can affect both mother and baby's health. Maintaining a healthy lifestyle before and during pregnancy can help prevent gestational diabetes.
This document discusses diabetes in pregnancy. It provides information on the physiological changes in pregnancy that affect glucose metabolism and insulin resistance. It covers the classification, definition, and prevalence of gestational diabetes. Guidelines for screening and diagnosing gestational diabetes are presented. The document also discusses potential maternal and fetal/neonatal complications and provides recommendations for prepregnancy counseling, medical management including glycemic control targets, diet, exercise, and medication options, and obstetric management of diabetes in pregnancy.
Diabetes in pregnancy-overt diabetes: type I DM, type II DM,Gestational diabe...FarsanaM
This document discusses diabetes in pregnancy, including types, screening, diagnosis, management, and effects on mother and fetus. It covers gestational diabetes and pregestational diabetes types 1 and 2. Key points include increased risk of complications for both mother and baby if blood sugar is not well-controlled, and the importance of medical nutrition therapy, exercise, monitoring blood sugar levels, and insulin treatment if needed to maintain healthy blood glucose levels during pregnancy. The goals are to reduce risks and promote optimal outcomes for mother and child.
Hormonal &Metabolic Changes during Pregnancy
Patho-physiology of hyperglycemia in pregnancy
Risk factors, Clinical Features & Investigations
Complications of hyperglycemia in pregnancy
Medical management of hyperglycemia in pregnancy
Obstetric Management of hyperglycemia in pregnancy
A seminar was arranged as a part of integrated teaching at Enam Medical College, Savar, Dhaka, Bangladesh which was presented by the students.
A comprehensive guide to the management of hyperglycaemia in pregnancy aimed at the primary care physician and based on latest evidenced based criteria. Includes information from latest studies such as HAPO study and ACHOIS, and involves guidelines from the IADPSG, ADA, WHO and Malaysia.
This document provides an overview of diabetes in pregnancy. It defines diabetes mellitus and describes the main types: type 1, type 2, and gestational diabetes. Risk factors, screening, and diagnostic criteria for gestational diabetes are covered. The document also discusses complications of diabetes in pregnancy for both mother and baby, as well as management through medical nutrition therapy, exercise, medication and insulin. Postpartum care is also summarized.
This document discusses diabetes mellitus (DM) and new developments in its management. It begins by defining DM according to the WHO and describing its global prevalence and projected increase. It then classifies the main types of DM and discusses testing and diagnosis criteria. The document outlines recommendations for lifestyle modifications, medical nutrition therapy, physical activity, weight management, and smoking cessation. It also reviews oral medications and insulin therapy as well as recommendations for self-monitoring and A1C testing.
This document provides an overview of diabetes mellitus in pregnancy. It defines diabetes in pregnancy and gestational diabetes, and discusses their incidence rates. It describes the screening, diagnosis, and management of diabetes in pregnancy. The document outlines the maternal and fetal effects of diabetes during pregnancy and notes increased risks of complications. It emphasizes the importance of glucose monitoring and medical nutrition therapy in managing diabetes in pregnancy.
This document discusses diabetes in pregnancy. It defines pre-gestational diabetes as diabetes diagnosed prior to pregnancy, including type 1 and type 2 diabetes, while gestational diabetes is diabetes diagnosed during pregnancy. The document outlines the classification systems for diabetes and examines the effects of both pre-gestational and gestational diabetes on the mother and fetus, including increased risks of fetal anomalies, preterm birth, macrosomia, and hypoglycemia.
Diabetes Mellitus in pregnancy " Gestational diabetes mellitus''Nassr ALBarhi
This document discusses a case of gestational diabetes in a 24-year-old pregnant woman. It defines gestational diabetes as glucose intolerance that develops during pregnancy. Risk factors, diagnostic tests such as OGTT, management including diet, exercise and insulin therapy if needed, and maternal and fetal complications of gestational diabetes are described. The goals of antepartum care including fetal surveillance to minimize risks are also mentioned.
This document provides information on gestational diabetes mellitus (GDM), including its definition, pathophysiology, risk factors, diagnosis, complications, management, and postpartum follow up. GDM is defined as diabetes diagnosed during the second or third trimester of pregnancy that is not clearly type 1 or 2 diabetes. It results from the pancreas not being able to produce enough insulin to overcome insulin resistance during pregnancy. Management involves glucose monitoring, medical nutrition therapy, exercise if appropriate, and insulin treatment if needed to control blood glucose levels and prevent complications for both mother and baby. Women with GDM require testing after delivery and ongoing screening due to increased risk of developing diabetes.
<마더리스크라운드>Type 2 diabetes in pregnancymothersafe
This document discusses the risks and management of type 2 diabetes during pregnancy. Strict glycemic control is emphasized as key to improving outcomes for both mother and baby. Women with diabetes who want to become pregnant should receive preconception counseling and care to optimize health and control before and during pregnancy. Preconception screening for undiagnosed diabetes is also important given increasing rates of obesity and type 2 diabetes.
Gestational diabetes (GDM) accounts for 90% of diabetes in pregnancy and occurs when a woman without diabetes develops high blood glucose levels during pregnancy due to insufficient insulin production. Women with GDM are at risk of complications like macrosomia. GDM is managed through medical nutrition therapy, exercise, blood glucose monitoring, and sometimes insulin or oral medications. Strict glycemic control is important for reducing risks.
The document discusses gestational diabetes mellitus (GDM). It begins with physiological changes in pregnancy that increase insulin resistance and glucose intolerance. It then defines GDM, discusses prevalence, screening methods, diagnosis, medical and obstetric management, and controversies around screening. Key points include that GDM is associated with adverse maternal and neonatal outcomes. Screening methods include fasting blood glucose and glucose challenge tests. Treatment involves diet, exercise, and potentially insulin or oral hypoglycemic drugs. The goal of management is to maintain euglycemia and prevent macrosomia and other complications.
This document provides information about diabetes mellitus in pregnancy. It discusses the following key points:
- Gestational diabetes and pregestational diabetes are the most common medical complications of pregnancy. Excellent glycemic control is important to improve maternal and fetal outcomes.
- Screening methods for gestational diabetes typically involve a glucose challenge test between 24-28 weeks of gestation. A one-step or two-step approach can be used to diagnose gestational diabetes based on oral glucose tolerance test thresholds.
- Complications of uncontrolled diabetes in pregnancy for both mother and baby include congenital anomalies, macrosomia, preeclampsia, and stillbirth. Proper medical nutrition therapy, exercise, glucose monitoring
The document provides protocols and guidelines for the Department of Obstetrics including definitions, classifications, investigations, and management guidelines for various obstetric conditions. It covers protocols for pre-eclampsia and eclampsia, liver diseases in pregnancy, deep venous thrombosis in pregnancy, preterm labour, preterm PROM, breech presentation, APH, induction of labour, normal labour and delivery, PPH, umbilical cord prolapse, Rh prophylaxis, and GDM. The department aims to provide high quality, empathetic and research-based care through comprehensive training and by reviewing and creating protocols according to population needs.
1) Gestational diabetes occurs in 3-5% of pregnancies and 90% of women with abnormal glucose tolerance have gestational diabetes. Approximately 50% will later develop type 2 diabetes.
2) Gestational diabetes increases risks for both mother and fetus, including preeclampsia for the mother and fetal macrosomia, hypoglycemia and birth trauma for the fetus.
3) Gestational diabetes is managed primarily through diet and exercise, with insulin therapy if needed to control blood glucose levels and minimize complications. Women with gestational diabetes have increased monitoring during and after pregnancy.
This document summarizes diabetes mellitus (DM) and its management during pregnancy. It discusses the different types of DM, including pre-existing type 1 and type 2 DM as well as gestational DM. It outlines the physiological changes in pregnancy that can affect blood sugar levels. Diagnosis and treatment aims to achieve tight glycemic control before and during pregnancy to prevent complications such as fetal macrosomia and neonatal hypoglycemia. Management involves medical nutrition therapy, exercise, insulin therapy, and monitoring throughout pregnancy and the postpartum period. Complications of both maternal DM and infant outcomes are also summarized.
This talk was delivered for postgraduates and faculty of Dr. TMA Pai Hospital, Udupi on 07 March, 2017. This talk covered pathophysiology, screening, diagnosis, complications and management of diabetes mellitus in pregnancy.
This document provides an overview of gestational diabetes mellitus (GDM). It defines GDM as glucose intolerance that is diagnosed during pregnancy. The prevalence of GDM is increasing and it can lead to complications for both mother and fetus. The document discusses screening and diagnosis of GDM using the DIPSI criteria of a 75g oral glucose tolerance test. It outlines the management of GDM which includes lifestyle changes, medical nutrition therapy, glucose monitoring, and possible insulin treatment. Targets for glycemic control during pregnancy and delivery are presented. The risks of persistent diabetes after pregnancy are also summarized.
Diabetes in pregnancy Dr.Pasham Sharath ChandraPasham sharath
This document discusses diabetes in pregnancy. It provides information on different types of diabetes including type 1, type 2, and gestational diabetes. It notes the risks of diabetes in pregnancy for both the mother and fetus, including complications like miscarriage, pre-eclampsia, and congenital malformations. The document discusses management of pregestational or overt diabetes in pregnancy, including achieving good glycemic control before and during pregnancy through insulin therapy, medical nutrition therapy, glucose monitoring, and lifestyle modifications.
1. Gestational diabetes is characterized by carbohydrate intolerance that begins or is first recognized during pregnancy. It can increase risks for both mother and baby.
2. It is diagnosed through screening tests such as a glucose challenge test and confirmed with an oral glucose tolerance test. Treatment involves diet, exercise, blood sugar monitoring, and possibly insulin.
3. Complications for the mother include preeclampsia and infections. Complications for the baby include hypoglycemia, jaundice, and respiratory distress. Strict control of blood sugar levels can help reduce risks.
This document provides guidelines for the management of gestational diabetes mellitus (GDM). It defines GDM and discusses screening and diagnosis, including risk assessment and different screening criteria. It covers medical nutrition therapy, insulin therapy if needed, intrapartum management during labor, and postpartum follow up. Guidelines are provided for glycemic control targets, types of insulin therapy, and obstetric management during pregnancy. The document summarizes screening, diagnosis, treatment and management of GDM.
Hyperglycemia in pregnancy includes both gestational diabetes mellitus (GDM) and pre-existing type 1 or type 2 diabetes. The document estimates that one in six live births worldwide are affected by some form of hyperglycemia in pregnancy, with the majority (75-90%) being GDM. GDM results from inadequate insulin secretion in the face of insulin resistance during pregnancy and is associated with increased risks for both mother and baby if not well-managed. Screening for and diagnosis of GDM typically involves a 75-gram oral glucose tolerance test between 24-28 weeks of gestation.
1. There are four criteria for diagnosing diabetes: A1C ≥6.5%, FPG ≥126 mg/dL, 2-hr PG ≥200 mg/dL during OGTT, or random PG ≥200 mg/dL.
2. Lowering A1C below 7.0% can reduce microvascular complications and macrovascular disease.
3. Gestational diabetes is diagnosed using a one-step 75g OGTT or two-step 50g GLT and 100g OGTT, with defined plasma glucose thresholds.
This document discusses gestational diabetes and its management. It begins with an introduction noting the rising prevalence of diabetes in pregnancies. It then defines gestational diabetes and lists risk factors. Diagnostic criteria and classifications are provided. Potential complications for both mother and fetus are outlined. The document discusses management principles and goals, including glycemic control through various stages of pregnancy and potential insulin therapy. It also addresses delivery timing and indications for C-section. Dietary management and glucose monitoring protocols are described.
This document discusses intestinal flora in newborns and the use of probiotics to treat dysbiosis. It presents results from a study of 68 newborns divided into two groups: one treated with Subtil and the other with Eubioflor. Positive results were seen in 64% of Subtil patients by day 4 and 78% by day 10-30, while the Eubioflor group saw 82% improvement by day 4 and 89% by day 10-30. The study suggests Eubioflor may be more effective than Subtil at organizing intestinal flora and treating dysbiosis in newborns.
This document discusses the relationship between type 2 diabetes and the gut microbiome. It notes that the prevalence of metabolic syndrome is increasing rapidly globally, especially in developing countries where people are developing diabetes at younger ages. The gut microbiome can influence whole body metabolism and is impacted by factors like nutrition and lifestyle. Studies have found differences in the gut microbiome of people with obesity and type 2 diabetes, but more research is needed on populations in developing countries. The gut microbiome may impact metabolic health through effects on nutrient processing, gut permeability, inflammation, and signaling molecule production.
This document discusses diabetes in pregnancy. It defines pre-gestational diabetes as diabetes diagnosed prior to pregnancy, including type 1 and type 2 diabetes, while gestational diabetes is diabetes diagnosed during pregnancy. The document outlines the classification systems for diabetes and examines the effects of both pre-gestational and gestational diabetes on the mother and fetus, including increased risks of fetal anomalies, preterm birth, macrosomia, and hypoglycemia.
Diabetes Mellitus in pregnancy " Gestational diabetes mellitus''Nassr ALBarhi
This document discusses a case of gestational diabetes in a 24-year-old pregnant woman. It defines gestational diabetes as glucose intolerance that develops during pregnancy. Risk factors, diagnostic tests such as OGTT, management including diet, exercise and insulin therapy if needed, and maternal and fetal complications of gestational diabetes are described. The goals of antepartum care including fetal surveillance to minimize risks are also mentioned.
This document provides information on gestational diabetes mellitus (GDM), including its definition, pathophysiology, risk factors, diagnosis, complications, management, and postpartum follow up. GDM is defined as diabetes diagnosed during the second or third trimester of pregnancy that is not clearly type 1 or 2 diabetes. It results from the pancreas not being able to produce enough insulin to overcome insulin resistance during pregnancy. Management involves glucose monitoring, medical nutrition therapy, exercise if appropriate, and insulin treatment if needed to control blood glucose levels and prevent complications for both mother and baby. Women with GDM require testing after delivery and ongoing screening due to increased risk of developing diabetes.
<마더리스크라운드>Type 2 diabetes in pregnancymothersafe
This document discusses the risks and management of type 2 diabetes during pregnancy. Strict glycemic control is emphasized as key to improving outcomes for both mother and baby. Women with diabetes who want to become pregnant should receive preconception counseling and care to optimize health and control before and during pregnancy. Preconception screening for undiagnosed diabetes is also important given increasing rates of obesity and type 2 diabetes.
Gestational diabetes (GDM) accounts for 90% of diabetes in pregnancy and occurs when a woman without diabetes develops high blood glucose levels during pregnancy due to insufficient insulin production. Women with GDM are at risk of complications like macrosomia. GDM is managed through medical nutrition therapy, exercise, blood glucose monitoring, and sometimes insulin or oral medications. Strict glycemic control is important for reducing risks.
The document discusses gestational diabetes mellitus (GDM). It begins with physiological changes in pregnancy that increase insulin resistance and glucose intolerance. It then defines GDM, discusses prevalence, screening methods, diagnosis, medical and obstetric management, and controversies around screening. Key points include that GDM is associated with adverse maternal and neonatal outcomes. Screening methods include fasting blood glucose and glucose challenge tests. Treatment involves diet, exercise, and potentially insulin or oral hypoglycemic drugs. The goal of management is to maintain euglycemia and prevent macrosomia and other complications.
This document provides information about diabetes mellitus in pregnancy. It discusses the following key points:
- Gestational diabetes and pregestational diabetes are the most common medical complications of pregnancy. Excellent glycemic control is important to improve maternal and fetal outcomes.
- Screening methods for gestational diabetes typically involve a glucose challenge test between 24-28 weeks of gestation. A one-step or two-step approach can be used to diagnose gestational diabetes based on oral glucose tolerance test thresholds.
- Complications of uncontrolled diabetes in pregnancy for both mother and baby include congenital anomalies, macrosomia, preeclampsia, and stillbirth. Proper medical nutrition therapy, exercise, glucose monitoring
The document provides protocols and guidelines for the Department of Obstetrics including definitions, classifications, investigations, and management guidelines for various obstetric conditions. It covers protocols for pre-eclampsia and eclampsia, liver diseases in pregnancy, deep venous thrombosis in pregnancy, preterm labour, preterm PROM, breech presentation, APH, induction of labour, normal labour and delivery, PPH, umbilical cord prolapse, Rh prophylaxis, and GDM. The department aims to provide high quality, empathetic and research-based care through comprehensive training and by reviewing and creating protocols according to population needs.
1) Gestational diabetes occurs in 3-5% of pregnancies and 90% of women with abnormal glucose tolerance have gestational diabetes. Approximately 50% will later develop type 2 diabetes.
2) Gestational diabetes increases risks for both mother and fetus, including preeclampsia for the mother and fetal macrosomia, hypoglycemia and birth trauma for the fetus.
3) Gestational diabetes is managed primarily through diet and exercise, with insulin therapy if needed to control blood glucose levels and minimize complications. Women with gestational diabetes have increased monitoring during and after pregnancy.
This document summarizes diabetes mellitus (DM) and its management during pregnancy. It discusses the different types of DM, including pre-existing type 1 and type 2 DM as well as gestational DM. It outlines the physiological changes in pregnancy that can affect blood sugar levels. Diagnosis and treatment aims to achieve tight glycemic control before and during pregnancy to prevent complications such as fetal macrosomia and neonatal hypoglycemia. Management involves medical nutrition therapy, exercise, insulin therapy, and monitoring throughout pregnancy and the postpartum period. Complications of both maternal DM and infant outcomes are also summarized.
This talk was delivered for postgraduates and faculty of Dr. TMA Pai Hospital, Udupi on 07 March, 2017. This talk covered pathophysiology, screening, diagnosis, complications and management of diabetes mellitus in pregnancy.
This document provides an overview of gestational diabetes mellitus (GDM). It defines GDM as glucose intolerance that is diagnosed during pregnancy. The prevalence of GDM is increasing and it can lead to complications for both mother and fetus. The document discusses screening and diagnosis of GDM using the DIPSI criteria of a 75g oral glucose tolerance test. It outlines the management of GDM which includes lifestyle changes, medical nutrition therapy, glucose monitoring, and possible insulin treatment. Targets for glycemic control during pregnancy and delivery are presented. The risks of persistent diabetes after pregnancy are also summarized.
Diabetes in pregnancy Dr.Pasham Sharath ChandraPasham sharath
This document discusses diabetes in pregnancy. It provides information on different types of diabetes including type 1, type 2, and gestational diabetes. It notes the risks of diabetes in pregnancy for both the mother and fetus, including complications like miscarriage, pre-eclampsia, and congenital malformations. The document discusses management of pregestational or overt diabetes in pregnancy, including achieving good glycemic control before and during pregnancy through insulin therapy, medical nutrition therapy, glucose monitoring, and lifestyle modifications.
1. Gestational diabetes is characterized by carbohydrate intolerance that begins or is first recognized during pregnancy. It can increase risks for both mother and baby.
2. It is diagnosed through screening tests such as a glucose challenge test and confirmed with an oral glucose tolerance test. Treatment involves diet, exercise, blood sugar monitoring, and possibly insulin.
3. Complications for the mother include preeclampsia and infections. Complications for the baby include hypoglycemia, jaundice, and respiratory distress. Strict control of blood sugar levels can help reduce risks.
This document provides guidelines for the management of gestational diabetes mellitus (GDM). It defines GDM and discusses screening and diagnosis, including risk assessment and different screening criteria. It covers medical nutrition therapy, insulin therapy if needed, intrapartum management during labor, and postpartum follow up. Guidelines are provided for glycemic control targets, types of insulin therapy, and obstetric management during pregnancy. The document summarizes screening, diagnosis, treatment and management of GDM.
Hyperglycemia in pregnancy includes both gestational diabetes mellitus (GDM) and pre-existing type 1 or type 2 diabetes. The document estimates that one in six live births worldwide are affected by some form of hyperglycemia in pregnancy, with the majority (75-90%) being GDM. GDM results from inadequate insulin secretion in the face of insulin resistance during pregnancy and is associated with increased risks for both mother and baby if not well-managed. Screening for and diagnosis of GDM typically involves a 75-gram oral glucose tolerance test between 24-28 weeks of gestation.
1. There are four criteria for diagnosing diabetes: A1C ≥6.5%, FPG ≥126 mg/dL, 2-hr PG ≥200 mg/dL during OGTT, or random PG ≥200 mg/dL.
2. Lowering A1C below 7.0% can reduce microvascular complications and macrovascular disease.
3. Gestational diabetes is diagnosed using a one-step 75g OGTT or two-step 50g GLT and 100g OGTT, with defined plasma glucose thresholds.
This document discusses gestational diabetes and its management. It begins with an introduction noting the rising prevalence of diabetes in pregnancies. It then defines gestational diabetes and lists risk factors. Diagnostic criteria and classifications are provided. Potential complications for both mother and fetus are outlined. The document discusses management principles and goals, including glycemic control through various stages of pregnancy and potential insulin therapy. It also addresses delivery timing and indications for C-section. Dietary management and glucose monitoring protocols are described.
This document discusses intestinal flora in newborns and the use of probiotics to treat dysbiosis. It presents results from a study of 68 newborns divided into two groups: one treated with Subtil and the other with Eubioflor. Positive results were seen in 64% of Subtil patients by day 4 and 78% by day 10-30, while the Eubioflor group saw 82% improvement by day 4 and 89% by day 10-30. The study suggests Eubioflor may be more effective than Subtil at organizing intestinal flora and treating dysbiosis in newborns.
This document discusses the relationship between type 2 diabetes and the gut microbiome. It notes that the prevalence of metabolic syndrome is increasing rapidly globally, especially in developing countries where people are developing diabetes at younger ages. The gut microbiome can influence whole body metabolism and is impacted by factors like nutrition and lifestyle. Studies have found differences in the gut microbiome of people with obesity and type 2 diabetes, but more research is needed on populations in developing countries. The gut microbiome may impact metabolic health through effects on nutrient processing, gut permeability, inflammation, and signaling molecule production.
This document discusses gestational diabetes, including its challenges, diagnosis, treatment, and prevention. Some key points:
- Gestational diabetes requires a comprehensive multidisciplinary approach to improve maternal and neonatal outcomes.
- Screening guidelines and diagnostic criteria for gestational diabetes are controversial and lack consensus.
- Treatment involves lifestyle modifications like diet, exercise and glucose monitoring, and may require insulin or other medications if needed.
- Both mother and baby are at risk for short-term and long-term complications if gestational diabetes is not properly managed.
- Preventing and treating gestational diabetes can help reduce the future risk of diabetes for both mother and child.
This study examined the effects of maternal diabetes (pregestational and gestational) on biochemical parameters in their offspring. The study compared levels of glucose, calcium, and bilirubin in three groups of neonates: infants of mothers with pregestational diabetes, infants of mothers with gestational diabetes, and a control group of infants without diabetes exposure. Biochemical parameters were measured at admission to the NICU and before discharge. Results found that glucose and calcium levels improved before discharge in infants of mothers with pregestational diabetes compared to levels at admission. However, bilirubin levels remained elevated compared to controls. The study concludes that the reversibility of abnormalities in calcium and glucose is faster than for bilirubin
The gut microbiota refers to the complex community of bacteria in the intestine. Its composition is initially determined at birth by factors like delivery method and feeding, and later by medications, sanitation, diet, and environment. Animal models have shown that genetic, dietary, and environmental influences can alter the gut microbiota. Studies have linked the human gut microbiome to type 2 diabetes, finding that diet influences its composition and that certain bacterial signatures in the gut promote intestinal inflammation and systemic inflammation linked to type 2 diabetes. Gastric bypass surgery, which highly effectively treats obesity and type 2 diabetes, likely works through changes to diet and the gut microbiota.
Renée Wilson, Registered Dietitian and PhD Candidate at University of Otago, New Zealand. Presented at the 1st International Symposium on Kiwifruit and Health: http://www.kiwifruitsymposium.org/presentations/diet-microbiota-and-metabolic-health/
This cross-sectional pilot study aims to determine whether or not there are any differences between the gut microbiota of people with normal glucose tolerance, pre-diabetes and type 2 diabetes.
The document discusses recent research on diabetes and the gut microbiome. It describes a study that found mice with a protective gene against type 1 diabetes lost that protection if they received antibiotics or were raised in a sterile environment, showing the importance of gut bacteria. Another study found compounds in cocoa that improved insulin secretion in beta cells and helped delay type 2 diabetes in mice. The student argues this discovery could lead to new diabetes treatments using foods people enjoy. Overall, the document emphasizes the vital role of gut bacteria in protecting against diabetes and modulating genes.
Breastfeeding during pregnancy does not increase the risk of miscarriage or preterm birth according to a case-control study. The study compared 215 pregnant women who breastfed during pregnancy to 280 pregnant women who did not breastfeed. The frequency of miscarriage was significantly lower in those who breastfed, but there was no significant difference in rates of preterm birth or birth weight between the groups. The study concludes that breastfeeding during pregnancy does not pose additional risks for miscarriage, preterm birth, or neonatal birth weight.
The document summarizes 5 research articles related to diabetes. It discusses the purpose, background, methods, subjects, data collection and analysis, and conclusions of each study. The first study examined pregnant women's knowledge of gestational diabetes prevention. The second looked at factors influencing insulin initiation in UK adults with diabetes. The third evaluated the relationship between continuous glucose monitoring and type 1 diabetes management. The fourth assessed the link between vitamin D intake and risk of type 1 diabetes in infants. The fifth studied the association between erectile dysfunction and glycemic control in men with type 2 diabetes.
1) The study examined the effect of probiotics in preventing necrotizing enterocolitis (NEC) in preterm neonates compared to a control group.
2) 115 preterm infants weighing 750-1500g or less than 32 weeks gestation received probiotics or did not (control). The probiotic group had significantly lower incidence of NEC and fewer cases of elevated C-reactive protein.
3) However, there were no significant differences between the groups in duration of oxygen therapy, total parenteral nutrition, time to full feeding, or length of hospital stay. The study results suggest probiotics have a protective effect against NEC in preterm infants.
This study assessed oral microbiota in different trimesters of pregnancy. Samples were taken from 70 pregnant women divided into groups by trimester and 15 non-pregnant controls. The amount of colony forming units (CFU)/ml was highest in the first trimester, decreased in the second, and was higher again in the third trimester compared to non-pregnant women. Higher CFU/ml positively correlated with worse periodontal diagnoses. The study concluded that oral bacteria levels increase in the first and third trimesters of pregnancy, which can negatively impact oral and overall health of the mother and developing fetus.
Gdm rcog diagnosis and treatment of gestational diabetes 2011Diabetes for all
This document summarizes recent evidence on the diagnosis and treatment of gestational diabetes. It finds that:
1) Several large studies including HAPO have demonstrated a linear relationship between maternal glucose levels and fetal growth outcomes like birthweight.
2) Two major trials, ACHOIS and MFMU Network, showed treating gestational diabetes according to different diagnostic criteria significantly reduced adverse outcomes.
3) While lifestyle changes are usually effective, 7-20% of women require medication like metformin or insulin to control glucose.
This study analyzed data from 24,656 pregnant women screened for gestational diabetes in Uttar Pradesh, India. The prevalence of gestational diabetes was found to be 14.42%. Women with gestational diabetes had significantly higher rates of adverse maternal and fetal outcomes like stillbirth, perinatal mortality, neonatal mortality, congenital malformations, and low birthweight babies compared to women without gestational diabetes. Most cases of gestational diabetes occurred during first pregnancies. The study highlights the need for increased screening and awareness of gestational diabetes in India to help reduce poor maternal and infant health outcomes.
Diabetes Type 1 Sara MartinezChamberlain College of Nursing.docxlynettearnold46882
Diabetes Type 1
Sara Martinez
Chamberlain College of Nursing
NR 507 Advanced Pathophysiology
2018
1
1
What is Diabetes
Body Does not make or properly use insulin: (ADA,2005)
No insulin production
Insufficient insulin production
Resistance to insulin’s effects
No insulin to move glucose from blood into cells
High blood glucose means:
Fuel loss, cells starve
Short and long term complications
2
Diabetes is a chronic disease in which the body does not make or properly
use insulin, a hormone that is needed to convert sugar, starches, and other
food into energy by moving glucose from blood into the cells ( American Diabetes Association, 2005).
People with diabetes have increased blood glucose (sugar) levels for one or
more of the following three reasons: Either
No insulin is being produced,
Insulin production is insufficient, and/or
The body is resistant to the effects of insulin.
As a result, high levels of glucose build up in the blood, and spill into the
urine and out of the body. The body loses its main source of fuel and cells
are deprived of glucose, a needed source of energy. High blood glucose
levels may result in short and long term complications over time ( Centers for Disease Control and Prevention, 2017).
2
Understanding Diabetes Type 1
Auto immune disorder
Insulin – producing cells destroyed
Daily insulin replacement necessary
Age of onset: usually childhood, young adults
Most prevalent type of diabetes in children and adolescent’s
(CDC,2017)
3
Diabetes mellitus (DM) is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both (CDC,2017).
The term diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both.
The effects of diabetes mellitus include long–term damage, dysfunction and failure of various organs.
Diabetes is a condition where the body fails to utilize the ingested glucose properly. This could be due to lack of the hormone insulin or because the insulin that is available is not working effectively. Diabetes is the fastest growing long term disease that affects millions of people worldwide (CDC,2017). According to the charity Diabetes UK, more than two million people in the UK have the condition and up to 750,000 more are unaware of having the condition. In the United States 25.8 million people or 8.3% of the population have diabetes. Of these, 7.0 million have undiagnosed diabetes. In 2010, about 1.9 million new cases of diabetes were diagnosed in population over 20 years. It is said that if this trend continues, 1 in 3 Americans would be diabetic by 2050 (Mayo Clinic, 2017).
Type 1 diabetes is a disease of the immune system, which is the body’s system for fighting infection.
In people with type 1 diabetes, the .
Gestational diabetes mellitus by sushantSushant Yadav
This document discusses gestational diabetes mellitus (GDM). It defines GDM as carbohydrate intolerance that is recognized or begins during pregnancy. The document discusses the types, risk factors, pathophysiology, screening recommendations, and classifications of diabetes in pregnancy according to White's groups. It notes that GDM occurs in about 7% of pregnancies globally and prevalence varies between racial/ethnic groups and countries. Screening is recommended between 24-28 weeks of gestation using a 75g oral glucose tolerance test.
This document discusses gestational diabetes mellitus (GDM) and its diagnosis and management according to national guidelines in India. It begins with an agenda for a GDM training workshop covering diabetes as a public health crisis, the impacts of diabetes and GDM on maternal and fetal health, and national guidelines for GDM diagnosis and treatment. It then reviews globally recognized GDM risk factors and screening protocols. The document emphasizes that universal GDM screening is recommended given its high prevalence and associated maternal and fetal risks. National guidelines advise testing all pregnant women twice, with management for those testing positive.
This document discusses the natural history of disease and fetal origins of adult disease. It provides background on how diseases progress over time without treatment and the importance of understanding this progression. It then discusses the theory that nutritional deprivation of the fetus during critical periods of development can force adaptations that become maladaptive when faced with different postnatal nutritional circumstances, potentially leading to adult health disorders. Factors like low birth weight, infant growth, and prenatal exposures are associated with increased risk of adult obesity, cardiovascular disease, and other issues. The document emphasizes that fetal development can permanently affect body structure and function in ways that manifest as disease later in life.
The document discusses factors that influence the development of the infant microbiome and its potential link to obesity risk later in life. It states that the microbiome develops both before and after birth, and is shaped by factors like birth mode, initial feeding method, antibiotic use, and diet. Diet plays the most significant role after infancy, with high fiber diets cultivating more diverse microbiomes. The composition of the infant microbiome may impact obesity risk through the microbiome's role in energy regulation and inflammation. Alterations in the microbiome could increase obesity risk through mechanisms like increased energy harvest from food, raised inflammatory responses, and changes in lipid metabolism.
REGULAR YOGURT CONSUMPTION MAY HELP PREVENT CARDIOMETABOLIC DISEASES - Andre ...Yogurt in Nutrition #YINI
Growing evidence for the benefits of yogurt consumption in preventing type 2 diabetes and other cardiometabolic risk factors. The importance of dairy as part of a balanced and healthy diet is widely recognised by health authorities and scientific experts worldwide. Now, evidence is mounting that consuming yogurt in particular as part of a healthy diet helps to prevent type 2 diabetes and other cardiometabolic risk factors, with one of the most recent studies suggesting that people who regularly eat yogurt are almost 30% less likely to develop type 2 diabetes than those who do not (1). Speaking to public health officials at the III World Congress of Public Health Nutrition in Spain, Dr André Marette from the Heart and Lung Institute of Laval Hospital in Quebec, Canada, said it was time to recognize the all-round health benefits of yogurt and encourage more people to eat yogurt on a daily basis.
Similar to Evaluation of effect of gestational diabetes mellitus on composition of the initial oral microbiota of neonates (20)
Comparative Evaluation of Serum Tumor Necrosis Factor a in Health and Chronic...Dr. Anuj S Parihar
Background: Tumor necrosis factor‑alpha (TNF‑α), a “major inflammatory cytokine,” not only plays an important role in periodontal destruction but also is extremely toxic to the host. Till date, there are not many studies comparing the levels of TNF‑α in serum and its relationship to periodontal disease.
Aim: Our study aimed to compare the serum TNF‑α among the two study groups, namely, healthy controls and chronic periodontitis patients and establish a correlation between serum TNF‑α and various clinical parameters. Hence, an attempt is made to estimate the level of TNF‑α in serum, its relationship to periodontal disease and to explore the possibility of using the level of TNF‑α in serum as a biochemical “marker” of periodontal disease. Materials and Methods: Forty individuals
participated in the study and were grouped into two subgroups. Group A – 20 systemically and periodontally healthy controls. Group B – twenty patients with generalized chronic periodontitis.
The serum samples were assayed for TNF‑α levels by enzyme‑linked immunosorbent assay method.
Results: The mean serum TNF‑α cytokines for Group B Generalized chronic periodontitis (GCP) was 2.977 ± 1.011, and Group A (healthy) was 0.867 ± 0.865. The range of serum TNF‑α was from (0.867 to 2.977). Serum TNF‑α cytokines had highly significant correlation with all clinical parameters (plaque index, probing pocket depth, clinical attachment loss, and gingival index) among all study participants (P = 0.001). Conclusion: These observations suggest a positive association
between periodontal disease and increased levels of TNF‑α in serum. It can be concluded that there is a prospect of using the estimation of TNF‑α in serum as a “marker” of periodontal disease in future. However, it remains a possibility that the absence or low levels of TNF‑α in serum might indicate a stable lesion and elevated levels might indicate an active site but only longitudinal studies taking into account, the disease “activity” and “inactivity” could suggest the possibility of using
TNF‑α in serum as an “Indicator” of periodontal disease.
This document provides an overview of the nervous system and several cranial nerves. It begins with an introduction to the nervous system and its organization into the central and peripheral nervous systems. Key terms like neuron, nucleus, tract, nerve, and plexus are defined. The 12 pairs of cranial nerves are then introduced, and five specific cranial nerves - V (trigeminal), VII (facial), IX (glossopharyngeal), X (vagus), and XII (hypoglossal) are examined in more detail, including their nuclear connections, functional components, course through the body, and branches. Clinical testing and applied anatomy are also discussed for each nerve.
Oral Health–Related Quality of Life in Children and Adolescents of Indian pop...Dr. Anuj S Parihar
Background: Kids and teenagers are more prone to oral diseases. Poor oral health has a significant impact on oral well-being–associated quality of life. Thus, we performed an investigation to examine the outcome of oral health status on
the quality of life of children and adolescents in Indian population, by using the Oral Health Impact Profile-14 (OHIP-14).
Materials and Methods: A total of 100 children, ranging between 1 and 19 years of age who attended Indian hospitals from November 2016 to October 2019, were included in the study. The DMFT Index (Decayed, Missing, and Filled Teeth) and OHIP-14 were used as data collection tools. Association of the total OHIP-14 score and seven subscales associated with it was evaluated using Spearman’s correlations.
Results: The results showed statistically noteworthy association between the toothbrushing regularity, number of dental appointments, history of oral trauma, smoking, and subdomains of OHIP-14 (P < 0.05)
Conclusion: Dental and oral health of an individual has a great impact on their quality of life.
Evaluation of Microleakage and Microgap of Two Different Internal Implant–Abu...Dr. Anuj S Parihar
Aim: The higher success rate (>90%) of dental implants over 5 years has made this treatment option favorable for dental surgeons as well as for patients. The present in vitro study was conducted to assess microleakage and microgap of two dissimilar internal implant–abutment associations.
Materials and methods: Forty dental implants were divided into two groups: trilobe internal connection fixtures in group I and internal hexagonal geometry fixtures in group II. For the immersion of implant abutment assemblies, sterilized tubes containing 4 mL of Staphylococcus aureus broth culture were incubated at 37°C for 2 weeks. Gram’s stain and biochemical reactions were used for identification of colonies.
Results: The mean log10 colony-forming unit (CFU) in group I was 8.6 and was 9.3 in group II. The disparity among two groups was found to be significant (p < 0.05). The mean microgap in group I was 7.2 μm and was 10.4 μm in group II. The disparity among the two groups was found
to be significant (p < 0.05).
Conclusion: Authors found that microscopic space between implant and abutment may be the site of penetration of bacteria. There was significant higher log10 CFU in dental implant fixtures with an internal hexagonal geometry compared to the dental implant fixtures with a trilobe internal connection.
A must read seminar on Dental Implants for Under-Graduates and Post-Graduates.
If you have any doubts regarding Dental Implants or any topic if you are unable to understand then do feel free to contact me on my Email address: Dr.anujparihar@gmail.com
Periodontally accelerated osteogenic orthodontics: A perio-ortho ambidextrous...Dr. Anuj S Parihar
The interdisciplinary collaboration of periodontics and orthodontics has allowed teeth to be moved 2–3 times faster, reducing the time required for traditional orthodontic therapy considerably. Periodontally accelerated osteogenic orthodontics (PAOO), also known as Wilckodontics, is a combination of a selective decortication facilitated orthodontics and alveolar augmentation. With this technique, there is no dependence on the pre‑existing alveolar volume. This case report describes the treatment of permanent mandibular molar protraction in a 14‑year‑old patient undergoing orthodontic therapy using PAOO with piezosurgery.
A 10 years retrospective study of assessment of prevalence and risk factors o...Dr. Anuj S Parihar
Aim: The present study was conducted to determine the prevalence rate of dental implants failure and risk factors affecting dental implant outcome.
Materials and Methods: The present retrospective study was conducted on 826 patients who received 1420 dental implants in
both genders. Length of implant, diameter of implant, location of implant, and bone quality were recorded. Risk factors such as habit of smoking, history of diabetes, hypertension, etc., were recorded.
Results: In 516 males, 832 dental implants and in 310 females, 588 dental implants were placed. Maximum dental implant failure was seen with length <10 mm (16%), with diameter <3.75 mm, and with type IV bone (20.6%). The difference found to be significant (P < 0.05). Maximum dental implant failures were seen with smoking (37%) followed by
hypertension (20.8%), diabetes (20.3%), and CVDs (18.7%). Healthy patients had the lowest failure rate (4.37%).
Conclusion: Dental implant failure was high in type IV bone, dental implant with <3.75 mm diameter, dental implant with length <10.0 mm, and among smokers..
Assessment of correlation of periodontitis in teeth adjacent to implant and p...Dr. Anuj S Parihar
Aims: The present study was conducted to determine correlation between peri‑implantitis and periodontitis in adjacent teeth. Materials and Methods: The present study was conducted on 58 patients with 84 dental implants. They were divided into two groups, group I (50) was with peri‑implantitis and group II (34) was without it. In all patients, probing depth (PD), gingival recession (GR), and clinical attachment loss (CAL) was calculated around implant, adjacent to implant and on contralateral side. Obtained data were statistically analyzed using statistical software IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp with one‑way analysis of variance. Results: Males were 30 with 52 dental implants and females were 28 with 32 dental implants. CAL was 5.82 ± 0.52 in group I and 3.62 ± 0.63 in group II (P = 0.001) around implants. PD was 4.28 ± 1.26 in group I and 2.20 ± 0.52
in group II around adjacent teeth (P = 0.002). PD around contralateral teeth was significant (P = 0.05) in group I (3.18 ± 1.01) and group II (2.71 ± 0.73). Conclusion: Periodontitis has negative effect on implant success. Teeth adjacent to dental implant plays an important role in deciding the success or failure of implant. Maintenance of periodontal health is of paramount importance for successful implant therapy.
Evaluation of role of periodontal pathogens in endodontic periodontal diseasesDr. Anuj S Parihar
Aim: This study aimed to correlate periodontal pathogens in endodontic periodontal diseases. Methodology: This study was conducted on 40 patients of both genders. All the participants were obtained from department of endodontics and periodontology with history of endo‑perio lesion in same teeth. Polymerase chain reaction was performed and correlation was established. Results: This study included 18 males and 22 females. The mean age of male was 42.5 years and female was 41.3 years. Specimens of Tannerella forsythia were isolated from 94% endodontium and 92% periodontium, Porphyromonas gingivalis from 71% endodontium and 55% periodontium,
Aggregatibacter actinomycetemcomitans from 12% endodontium and 58% periodontium. The difference was significant (P < 0.05). Bacteria in endodontic‑periodontal infection confirmed statistically significant correlation between absolute quantitation of T. forsythia and P. gingivalis (r = 0.412, P < 0.05), P. gingivalis and A. actinomycetemcomitans (r = 0.524, P < 0.05), and T. forsythia and A. actinomycetemcomitans (r = 0.427, P < 0.05). Conclusion: There was correlation between targeted bacterial species levels from concurrent endodontic‑periodontal diseases. Thus, it can be suggested that dentinal tubules may be the pathway for spread of bacteria.
Crestal bone loss around dental implants after implantation of Tricalcium pho...Dr. Anuj S Parihar
Background and Aims: Bone loss around dental implants is generally measured by monitoring changes in marginal bone level using radiographs. After the first year of implantation, an implant should have <0.2 mm annual loss of marginal bone level to satisfy the criteria of success. However, the success rate of dental implants depends on the amount of the crestal bone around the implants. The main aim of this study was to evaluate and compare the crestal bone loss around implants placed with particulate β‑Tricalcium Phosphate Bone Graft and platelet concentrates. Methods: 50 individuals received hundred dental implants. Each individual received one dental implant in the edentulous site filled with β‑Tricalcium Phosphate Bone Graft along (β‑TCP) with Platelet‑ Rich Plasma (PRP)
(Group A) and another in edentulous site filled only with β‑Tricalcium Phosphate Bone Graft (Group B) in the posterior edentulous region. All the 100 implants were prosthetically loaded after a healing period of three months. Crestal bone loss was measured on mesial, distal, buccal and lingual side of each implant using periapical radiographs 3 months, 6 months and 9 months after implant placement. Results: The average crestal bone loss 9 months after the implants placement in Group A and Group B was 2.75 mm and 2.23 mm respectively, the value being statistically significant (P < 0.05). In both Group A and Group B, the average crestal bone loss was maximum on the lingual side followed by buccal, distal and mesial sides. Conclusion: β‑TCP is a promising biomaterial for clinical
situations requiring bone augmentation. However, the addition of PRP results in decreased bone loss around the dental implants.
Assessment of Lingual Concavities in Submandibular Fossa Region in Patients r...Dr. Anuj S Parihar
Aim: The present study was aimed at assessing the lingual concavities in the submandibular fossa region in patients requiring dental implants with the help of cone beam computed tomography (CBCT). Materials and methods: The present study included 140 patients who visited the department with the missing mandibular posterior teeth. CBCT images were obtained using planmeca machine. Cross sections of 1 mm of submandibular fossa in the region of 1st and 2nd molar were studied and Type I to III lingual concavities were analyzed by a radiologist. Results: Type I lingual concavity (< 2 mm) was seen in 23%, type II (2-3 mm) in 62% and Type III (> 3 mm) in 15% of patients. The difference was significant (p < 0.05). Males had slightly higher mean ± S.D value at 1st molar (2.6 mm ± 0.94) and 2nd molar (2.8 mm ± 0.90) on the left side and (2.7 mm ± 0.92) at 1st molar and (2.9 mm ± 0.93) at 2nd molar on the right side. The difference was nonsignificant (p > 0.05). Females had mean ± S.D value at 1st molar (2.3 mm ± 0.90) and (2.5 mm ± 0.92) at 2nd molar on the left side and (2.4 mm ± 0.91) at 1st molar and (2.8 mm ± 0.93) at 2nd molar. The difference was nonsignificant (p > 0.05. The difference between both genders was statistically nonsignifi-cant (p > 0.05). Conclusion: Type I bone is the best for placing an implant. The chances of complications are more in type II and III bone. CBCT provides necessary information before planning implant in the edentulous area. Clinical significance: Cone beam computed tomography (CBCT) is the best radiographic aid which is effective in delin-eating different types of bone in the mandibular posterior region.
Correlation of Clinical Attachment Level (CAL) and C - Reactive Protein (CRP)...Dr. Anuj S Parihar
Periodontal disease, caused mainly by bacteria, is characterized by inflammation and destruction of the attachment apparatus of the teeth. Periodontitis is a multi-factorial disease with microbial dental plaque as the initiator of periodontal disease. Studies indicate that the periodontal lesion is not strictly a localized process but may lead to systemic alterations in the immune function. The present study intends to evaluate the correlation of clinical attachment level and C-reactive protein levels in
smoker and non-smoker patients with chronic generalized periodontitis. A total of fifty patients were included in the study, and they were divided into two group. Group A consisting of 25 patients who are smokers and they are having chronic generalized periodontitis, while Group B consist of 25 patients who are nonsmokers and having chronic generalized periodontitis. In the study clinical parameters we checked were Oral hygiene index – Simplified (OHI-S), Gingival Index (GI), Probing pocket depth (PPD) and Clinical Attachment level (CAL). Furthermore, CRP was evaluated as well between
Group-A (Smokers with chronic generalized periodontitis) and Group-B (Nonsmokers with chronic generalized periodontitis). The results showed higher OHI – S, PPD, CAL and CRP levels in Group - A (Smokers having chronic generalized periodontitis) than Group - B (Nonsmokers having chronic generalized periodontitis). GI score was higher in Group - B as compared to Group - A. Increased levels of clinical attachment level
(CAL) were seen in smokers suffering from chronic periodontitis. Significantly an increased level of C - reactive protein (CRP) was seen in smokers suffering from chronic periodontitis. Correlation between Clinical attachment level (CAL) and Creactive protein levels (CRP) was very strongly positive and significant. Suggesting, as value of CAL increases, CRP also increases.
Healing Effects of Hydroalcoholic Extract of Guava (Psidium guajava) Leaf on ...Dr. Anuj S Parihar
Oral mucositis (OM) is a common inflammatory complication among cancerous patients as an adverse effect of chemotherapy and radiotherapy. The aim of this study is to evaluate the healing effects of hydroalcoholic extract of Psidium
Guajava leaf on oral induced mucositis induced by 5-fluorouracil using histopathologic and tissue antioxidative markers assessment in male dark brown rats. In a prospective randomized double blind animal study, OM was induced in 64 male dark brown rats that allocated in 4 groups by 5-FU (60 mg/kg) on days 0, 5, and 10 of the study. The cheek pouch was scratched with a sterile needle on once daily on days 3 and 4. Starting from day 12, gel base, topical form and 600 mg/kg dietry form of hydroalcoholic extract of Psidium Guajava leaf were administered per day. Pouch histopathology score, superoxide dismutase, glutathione peroxidase, total antioxidant capacity were evaluated on day 14 and 18. DPPH scavenging activity and total phenolic content also were measured. Histopathology scores of mucositis were lower in the systemic and topical treatment groups than the gel base and control groups (P<0.05). Higher activities of SOD, GPX and TAC were detected in the topical and systemic treatment groups in comparison to the others (P<0.05). The extract was rich in total phenolic content as antioxidant. The use of extract of Psidium Guajava leave may be associated with reduced intensity of OM, increased concentration of SOD, GPX and TAC on induced
OM in dark brown rats undergoing 5-FU consumption.
Assessment of Survival Rate of Dental Implants in Patients with Bruxism: A 5-...Dr. Anuj S Parihar
Background: Dental implants are associated with failure such as early or late failure. Systemic conditions such as diabetes, hypertension, and bruxism affect the success rate. The
present study was conducted to assess complications in dental implants in bruxism patients.
Materials and Methods: This 5‑year retrospective study was conducted on 450 patients (640 dental implants) who received implants during the period and followed up for 5 years from June 2010 to June 2015. Among these patients, 124 had bruxism habit. Dental radiographs or patients’ recalled records were evaluated for the presence of complications such as fracture of implant, fracture of ceramic, screw loosening, screw fracture, and decementation of unit. Results: In 240 males
and 210 females, 380 implants and 260 implants were inserted, respectively. The difference was statistically nonsignificant (P = 0.1). A total of 145 screw‑type and 130 cemented‑type fixations
had complications. The difference was statistically nonsignificant (P = 0.5). Complications were seen in single crown (45), partial prostheses (125), and complete prostheses (105). The difference was statistically significant (P = 0.012). The common complication was fracture of ceramic (70) in cemented‑type fixation and fracture of ceramic (85) in screw‑type fixation. The difference was statistically significant (P = 0.01). Forty‑two single crowns showed decementation, 85 partial prostheses had fracture of ceramic/porcelain, and 50 complete prostheses showed fracture of ceramic/porcelain. The failure rate was 42.9%. Survival rate of dental implants in males with bruxism habit was 90% after 1 year, 87% after 2 years, 85% after 3 years, 75% after 4 years, and 72% after 5 years. Survival rate of dental implants in females with bruxism habit was 92% after 1 year, 90% after 2 years, 85% after 3 years, 75% after 4 years, and 70% after 5 years. The difference among
genders was statistically nonsignificant (P = 0.21).
Conclusion: Bruxism is a parafunctional habit which affects the survival rate of dental implants. There is requirement to follow certain specific protocols in bruxism patients to prevent the developing complications.
Prevalence,riskfactors and treatment needs of traumatic dental injuries to an...Dr. Anuj S Parihar
The document summarizes a study that assessed the prevalence of traumatic dental injuries (TDIs) to permanent anterior teeth among 6-15 year old schoolchildren in Bhopal, India. The study found an overall TDI prevalence of 8.6%. Boys had a higher prevalence than girls at a ratio of 2.22:1. Falls at home were the most common cause, and overjet greater than 5.5 mm and inadequate lip coverage were significant risk factors. Most fractured cases occurred with Class I malocclusion. While TDIs were common, many injuries went untreated.
Gingival crevicular fluid turnover markers in premenopausal vs postmenopausal...Dr. Anuj S Parihar
1) The study evaluated levels of bone biomarkers RANKL and OPN in the gingival crevicular fluid of 50 women undergoing orthodontic treatment, dividing them into premenopausal (n=25) and postmenopausal (n=25) groups.
2) Baseline levels of RANKL and OPN were significantly different between the two groups but increased similarly with treatment in both.
3) Within each group, biomarker levels increased significantly from baseline to 24 hours after orthodontic force activation.
4) However, the changes in biomarker levels with treatment were not significantly different between the premenopausal and postmenopausal groups.
Local Drug Delivery Modalities in Treatment of Periodontitis: A ReviewDr. Anuj S Parihar
Periodontitis is an inflammatory disease that causes destruction of
tooth supporting tissues, characterized by multifactorial etiology
with pathogenic bacteria being the primary etiologic agents that
dwells the subgingival area. Local drug delivery system consists of
antimicrobial dosages that produces more constant and prolonged
concentration profiles within the subgingival tissue and provides
better access into the periodontal pockets. It addresses the critical
distress of exposing the patient to adverse effects of systemic
administration. This article reviews the literature and presents
novel trends such as osteoblast activators, growth factors, and
herbal products in the local drug delivery system.
This document discusses different types of bone grafts used in periodontics. It describes autografts, which are transplanted from one site to another within the same individual, as the gold standard due to their osteoinductive properties. Autografts can be obtained from both extraoral sites like the hip or iliac crest, as well as intraoral sites like the tuberosity, tori, or osseous coagulum collected from the surgical site. The document outlines the advantages and disadvantages of various graft materials and their properties like osteoinduction, osteoconduction, and osteogenesis that facilitate bone regeneration.
Dental Plaque
Soft deposits that form the biofilm adhering to the tooth surface or other hard surfaces in the oral cavity, including removable & fixed restorations”
Bowen , 1976
Bacterial aggregations on the teeth or other solid oral structures
Lindhe, 2003
Relationship between Severity of Periodontal Disease and Control of Diabetes ...Dr. Anuj S Parihar
Background: Both diabetes mellitus (DM) and periodontitis
are chronic diseases affecting large number of the population
worldwide. Changes in human behavior and lifestyle over the
last century have resulted in a dramatic increase in the incidence
of diabetes in the world. This study was designed to evaluate the
relationship between severity of periodontal disease and control of
diabetes (glycated hemoglobin [HBA1c]) in patients with Type 1
DM in a hospital based study.
Materials and Methods: Fifty patients (n = 50) with Type 1
diabetes were enrolled in the study. They were divided into three
groups based on the degree of glycemic control by measuring
HbA1c levels as: “Good” (HBA1c ≤7) Group A, fair (HBA1c = 7-8)
Group B and poor (HBA1c >8) Group C. All enrolled patients
underwent detailed history and dental checkup. Evaluation for
periodontal disease was done by measuring dental plaque (plaque
index), inflammation of gums (gingival index), probing pocket
depth (PPD), and clinical attachment level.
Results: Type 1 diabetics with poor glycemic control had
increased gingival inflammation (P < 0.05), more dental plaque
(P < 0.05), increased PPDs (P < 0.05) and attachment loss
(P < 0.05) as compared to those with fair and good glycemic
control, respectively.
Conclusion: Severity of periodontal disease increases with poor
glycemic control in patients with Type 1 DM.
Key Words: Glycated hemoglobin levels, periodontal disease,
Type 1 diabetes mellitus
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
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Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
2. Singh, et al.: Gestational diabetes and neonates’ oral microbiota
2 Advanced Biomedical Research | 2020
established that various factors including endogenous
and mother status affect composition of the neonatal oral
microbiome.[7]
The aim of the present study was to analyze
the effect of GDM on the composition of the neonatal oral
microbiota.
Materials and Methods
In the present study, enrollment of 155 term neonates,
which were delivered vaginally was done. Inclusion
criteria were infants with gestational age 37–42 weeks,
infants with birth weight > 2500 g, and infants without
any significant congenital and fetal chromosomal
abnormalities. The exclusion criteria were mothers
without preeclampsia, eclampsia, pregnancy‑induced
hypertension (PIH), maternal obesity and infections, and
patients with a negative history of any antibiotic therapy
in the past 1 month.[8]
All patients were well informed
regarding the study and their consent was taken. Data
such as name, age of mother, gestational age, birth
weight (grams), prepregnancy body mass index (BMI),
and antepartum BMI were recorded. The diagnosis of
GDM was based on the findings such as fasting plasma
glucose ≥5.1 mmol/L or 1 h postoral glucose tolerance
test (OGTT) glycemia ≥10 mmol/L or 2 h postglucose
tolerance test (OGTT) glycemia ≥8.5 mmol/L. Twenty‑five
mothers found to be have GDM and forty were nondiabetic
mothers, so we divided them in Group I (GDM) and Group
II (Control). Mothers were managed with exercise (a
30‑min daily moderate exercise) and diet control. All
samples from mothers were taken. For collection of
neonatal samples, sterile swabs were collected 1 min after
birth. After collection of sample, the entire sample was
transferred to the laboratory (two laboratories were used:
Omega Microbiology and Diagnostic Lab, Patna and Dr.
Jain’s Microbiology and Pathology lab, Ludhiana) and
was used for identification and isolation of aerobic and
anaerobic bacteria. All different colonies should be isolate
and plated on an anaerobic and aerobic blood agar plate
and chocolate agar plate. These plates are incubated for
1–6 days at 37°C. Using a strong magnifying glass and
employing Gram staining, an initial examination of
the colonies was done. Furthermore, identification of
anaerobes was done using organism‑specific anaerobic
agar media (Rogosa agar/Lactobacillus selection agar,
Columbia anaerobic agar, Bacteroides Bile Esculin,
cooked meat broth, Thioglycollate, brain–heart infusion
agar, MacConkey agar, and Tellurite blood agar).
Further analysis was assisted by conducting a series of
biochemical tests (indole, catalase, nitrate, and urease test)
with different sugar and variable substrates. Incubation
was done for 1–6 days, depending on the growth rate
of the isolate. Anaerobic condition was maintained by
chemical and anaerobic gas pack jar. Bacterial isolates
were subcultured on agar plates at regular intervals to
maintain viability and metabolic activities [Figure 1].
All the agar plates were stored at a temperature of 4°C
preservation and maintenance. Results were entered in MS
Excel sheet for statistical analysis using SPSS software
version 20.0 (IBM, Armonk, New York). Unpaired t‑tests
and Fisher’s exact tests were used to study differences
between GDM and Non diabetic mellitus group (NDM)
groups. The level of significance was set at 0.05.
Results
Table 1 shows that Group I comprised GDM (75) and
Group II nondiabetic group (80) (Control). Table 2 shows
that mean gestational age in Group I was 38.1 weeks and
in Group II was 39.6 weeks and birth weight was 3059.1
g in Group I and 3255.3 g in Group II. The difference
was significant (P < 0.05). There were 43 males and
32 females in Group I and 45 males and 35 females in
Group II. The difference was nonsignificant (P > 0.05).
Table 3 shows that the mean value of Shannon index
for the assessment of oral phyla in Group I was 3.38
and in Group II was 2.91. The difference found to be
significant (P < 0.05).
Firmicutes was present in 38.1% in Group I versus 77.6%
in Group II patients, Actinobacteria was seen in 15.2% in
Group I and 7.4% in Group II, Bacteroidetes in 27.6%
in Group I and 7.9% in Group II, Proteobacteria in 9.5%
in Group I and 3.8% in Group II, and Tenericutes in 9.6%
in Group I and 3.3% in Group II [Graph 1]. The difference
was found to be significant (P < 0.05).
Graph 2 shows that major genera were Prevotella seen 16.5% in
Group I and 6.7% in Group II, Bacteroidetes 7.8% in Group
I and 3.02% in Group II, Bifidobacterium 5.62% in Group I
and 2.64% in Group II, Corynebacterium 7.02% in Group I
and 2.84% in Group II, Ureaplasma seen 6.78% in Group I
and 0.25% in Group II, and Weissella seen 8.45% in Group
Table 1: Distribution of patients
Groups Group I Group II
Status Gestational diabetes mellitus Nondiabetic group (control)
Number 75 80
Table 2: Assessment of neonatal parameters in both
groups
Parameters Group I Group II P
Gestational age (weeks) 38.1 39.6 0.04
Birth weight (g) 3059.1 3255.3 0.01
Male 43 45 0.31
Female 32 35
Table 3: Assessment of oral microbial diversity (Phyla)
with Shannon index in both groups
Shannon index Group I Group II P
Mean±SD 3.38±1.21 2.91±0.91 0.02
SD: Standard deviation
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3. 16.5
7.8
5.62
7.02 6.78
8.45
6.7
3.02 2.64 2.84
0.25 0.05
0
2
4
6
8
10
12
14
16
18
Prevotella
Bacteroids
Bifidobacterium
Corynebacterium
Ureaplasma
Weisella
Group I
Group II
Graph 2: Assessment of major genera in both groups
38.1
15.2
27.6
9.5 9.6
77.6
7.4 7.9
3.8 3.3
0
10
20
30
40
50
60
70
80
90
Firmicutes
Actinobacteria
Bacteroidetes
Proteobacteria
Tenericutes
Group I
Group II
Graph 1: Assessment of oral microbiota in both groups
Singh, et al.: Gestational diabetes and neonates’ oral microbiota
3Advanced Biomedical Research | 2020
I and 0.05% in Group II. The difference was found to be
significant (P < 0.05).
Table 4 shows that positive Pearson’s correlation of
gestational age was found with Firmicutes (r = 0.319,
P < 0.05) in Group II and Bacteroidetes (r = 0.683,
P < 0.05) and Prevotella (r = 217, P < 0.05) in Group I.
Discussion
In the present study, we included 155 term neonates
delivered vaginally. Seventy‑five mothers were found to
have GDM and eighty were nondiabetic mothers, so we
divided them into Group I (GDM) and Group II (Control).
It was observed that nondiabetic mothers had significantly
higher birth weight, gestational age, and gestational
weight gain. In neonates, oral microbiome consisted of
Actinobacteria, Firmicutes, Proteobacteria, Bacteroidetes,
and Tenericutes in neonatal oral microbiome. While
analyzing statistically, it was seen that, in the GDM
group, there was a significantly higher incidence of
Genus Alistipes, Streptococcus, and Faecalibacterium.
Furthermore, the mean Shannon index (oral phyla) in
Group I and Group II was 3.36 and 2.95, respectively. Our
results were in concordance with the results obtained by
previous authors who also reported similar findings in their
respective studies. Su et al.[9]
extracted meconium DNA
from 34 full‑term newborns. They reported a significant
difference in relation to gut microbiota among GDM
newborns and controls. In GDM group, they observed
an increase in Proteobacteria and Actinobacteria phyla
and a decline in Bacteroidetes. However, there was a
significant reduction in the Prevotella and Lactobacillus in
GDM neonates. They also observed a significant positive
correlation in between phylum Actinobacteria and genus
Acinetobacter with maternal fasting glucose levels and
negatively correlation between fasting blood glucose with
phylum Bacteroidetes and genus Prevotella. In the present
study, Firmicutes was found to be in higher amount among
controls (Group II), while the incidence of Actinobacteria,
Bacteroidetes, Proteobacteria, and Tenericutes was
significantly higher in GDM group. Our results were in
Figure 1: (a) Indole test is negative for Lactobacillus and Acinetobacter, (b) sugar fermentation test for Lactobacillus, (c) magnetic resonance test is
negative and Voges–Proskauer test is positive for Bifidobacterium, (d) Potassium tellurite agar for Corynebacterium, and (e) growth of Acinetobacter on
MacConkey agar
d
cba
e
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4. Singh, et al.: Gestational diabetes and neonates’ oral microbiota
4 Advanced Biomedical Research | 2020
concordance with the results obtained by He et al., who
also reported similar findings.[8]
In the present research, while comparing the major genera
in between the two study groups, significant results
were obtained. Incidence of Prevotella, Bacteroidetes,
Bifidobacterium, Corynebacterium, Ureaplasma, and
Weissella was significantly higher among GDM groups.
In a previous study conducted by Wang et al., authors
collected oral, intestinal, and vaginal samples from 581
GDM mothers and oral, pharyngeal, meconium, and
amniotic fluid samples from 248 neonates. Their results
also demonstrated altered microbiota of neonates and
GDM pregnant women. They observed that microbes with
variations in the maternal and neonatal microbiota showed
the intergenerational concordance of microbial variation
associated with GDM.[10]
We also observed a positive correlation of gestational
age with Firmicutes in Group I and Bacteroidetes and
Prevotella in Group I. Factors such as maternal status,
type of feeding, and environment greatly affect neonatal
oral microbiota. Under physiologic conditions, the
gastrointestinal tract of the fetus is said to be sterile
with the initial acquaintance of the immune system to
commensals happening during the way through the
birth canal. These primordial alterations on a long‑term
basis are considered the settling phase for mucosal
and systemic immune system. The procedure by which
neonate organ systems acclimatize to the intimidating
environment of microbial colonization remains partly
understood. However, parameters contained in maternal
milk are said to define some of these early responses to
commensals.[11‑13]
GDM is a significant risk factor for
general health of both neonatal and maternal health.[11]
Women are more prone to develop preeclampsia, PIH,
and in neonates, there can be respiratory distress
syndrome, fetal macrosomia, and Type II DM in
offspring. There are chances of microbiota dysbiosis
in the meconium of newborns due to maternal diabetes
status.[12‑14]
In GDM patients, carbohydrate deficiency can affect the
postprandial glycemic response. Lipopolysaccharides are
a significant component of cell wall of Gram‑negative
bacteria, and it plays a substantial pathogenetic role of
certain bacterial infections.[8]
Its enhancement in GDM
patients may have significant effects on the health of
neonates, and hence further exploration of results with
higher parameters is necessary.
Conclusion
Authors found that there was increased bacterial microbiota
in neonates born to mothers with GDM as compared to
neonates born to nondiabetic mothers. However, large‑scale
studies are necessary to substantiate the result obtained in
our study.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
1. American Diabetes Association. Diagnosis and classification of
diabetes mellitus. Diabetes Care 2012;35(Suppl 1):64‑71.
2. Sacks DA, Hadden DR, Maresh M, Deerochanawong C,
Dyer AR, Metzger BE, et al. Frequency of gestational
diabetes mellitus at collaborating centers based on IADPSG
consensus panel‑recommended criteria: The Hyperglycemia and
Adverse Pregnancy Outcome (HAPO) Study. Diabetes Care
2012;35:526‑8.
3. Mitanchez D. Foetal and neonatal complications in gestational
diabetes: Perinatal mortality, congenital malformations,
macrosomia, shoulder dystocia, birth injuries, neonatal
complications. Diabetes Metab 2010;36:617‑27.
4. Johns EC, Denison FC, Norman JE, Reynolds RM. Gestational
diabetes mellitus: Mechanisms, treatment, and complications.
Trends Endocrinol Metab 2018;29:743‑54.
5. Cheng YW, Caughey AB. Gestational diabetes: Diagnosis and
management. J Perinatol 2008;28:657‑64.
6. Catalano PM, Mclntyre HD, Cruickshank JK, McCance DR,
Dyer AR, Metzger BE, et al. The hyperglycemia and adverse
pregnancy outcome study: Association of GDM and obesity with
pregnancy outcomes. Diabetes Care 2012;35:780‑6.
7. Cheng YW, Chung JH, Kurbisch‑Block I, Inturrisi M,
Shafer S, Caughey AB. Gestational weight gain and gestational
diabetes mellitus: Perinatal outcomes. Obstet Gynecol
2008;112:1015‑22.
8. He Z, Wu J, Xiao B, Xiao S, Li H, Wu K. The initial oral
microbiota of neonates among subjects with gestational diabetes
mellitus. Front Pediatr 2019;7:513.
9. Su M, Nie Y, Shao R, Duan S, Jiang Y, Wang M, et al.
Diversified gut microbiota in newborns of mothers with
gestational diabetes mellitus. PLoS One 2018;13:e0205695.
10. Wang J, Zheng J, Shi W, Du N, Xu X, Zhang Y, et al. Dysbiosis
of maternal and neonatal microbiota associated with gestational
diabetes mellitus. Gut 2018;67:1614‑25.
11. Gillman MW, Rifas‑Shiman S, Berkey CS, Field AE,
Colditz GA. Maternal gestational diabetes, birth weight, and
adolescent obesity. Pediatrics 2003;111:e221‑6.
12. Blod C, Schlichting N, Schülin S, Suttkus A, Peukert N,
Table 4: Pearson’s correlation of gestational age with microbiota
Microbiota Group I Group II
Pearson correlation (r) Significant (two‑tailed) Pearson correlation (r) Significant (two‑tailed)
Firmicutes 0.319 0.612 0.241 0.016
Bacteroidetes 0.683 0.002 0.115 0.256
Prevotella 0.217 0.018 0.124 0.238
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5. Singh, et al.: Gestational diabetes and neonates’ oral microbiota
5Advanced Biomedical Research | 2020
Stingu CS, et al. The oral microbiome – The relevant
reservoir for acute pediatric appendicitis? Int J Colorectal Dis
2018;33:209‑18.
13. Reddy RM, Weir WB, Barnett S, Heiden BT, Orringer MB,
Lin J, et al. Increased variance in oral and gastric microbiome
correlates with esophagectomy anastomotic leak. Ann Thorac
Surg 2018;105:865‑70.
14. Gao L, Xu T, Huang G, Jiang S, Gu Y, Chen F. Oral
microbiomes: more and more importance in oral cavity and
whole body. Protein Cell 2018;9:488‑500.
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