Active clinical trials for "Diabetes, Gestational"

Insulin resistance plays a key role in the development of gestational diabetes mellitus(GDM). As the largest endocrine organ and the transport intermediary of maternal-fetal nutrient and a large of hormone and enzymes, placenta not only plays an important role in insulin resistance, but also have a profound effect on fetal growth and development. Insulin receptor substrate(IRS)-1, as a key signaling protein, plays vital role in the downstream of insulin receptor signaling pathway. Many studies have suggested that the central part of insulin resistance may be the insulin receptor substrate defect and the abnormal expression of the gene or protein of IRS-1 is one of the molecular mechanisms of the dysfunction of the insulin signaling pathway. The expression of IRS-1 and its tyrosine phosphorylated protein decreased abnormally in placenta, skeletal muscle and adipose tissue of GDM patients, which might be a significant cause to insulin resistance in GDM. Besides, glucose transporter-1(GLUT-1), which may play a major role in the glucose transporter in the placenta. The increase of blood glucose in patients with GDM has apparent up-regulating effect on the expression of GLUT-1 in the placenta, which is associated the development of offspring. The investigators' previous study showed that FGF19 in serum, placenta and musculus rectus abdominis was significantly decreased in patients with GDM, and was related to insulin resistance. Thus, the investigators speculate that the abnormal expression of FGF19 may be involved in the development of insulin resistance in GDM patients and disorder of carbohydrate and lipid metabolism. In the present study, the investigators will further investigate the effect of FGF19 on the expression of IRS-1/GLUT-1 in cultured trophoblast cells of high glucose, and probe into the effect of FGF19 on the insulin resistance and glucose transport.

Serum amyloid A and Interleukin-1 (IL-1) receptor antagonist (A-SAA and IL-1Ra) values; Comparison of pregnant women with and without GDM diagnosis Comparison of insulin therapy and diet-regulated GDM patients Comparison of pregnant women with and without LGA (large gestational age) Comparison of pregnant women with and without polyhydroamnios Investigation of its effect on pregnancy prognosis In the prediction of GDM diagnosis, it is aimed to study the sensitivity and specificity of both parameters and cut off values. (In GDM patients, liver and kidney function parameters will also be evaluated with A-SAA and IL-1Ra levels).

Research hypothesis: pregnant women with gestational diabetes have elevated serum CRP values and homocysteine compared to pregnant women with normal glucose metabolism Elevated CRP and homocysteine values are associated with poorer perinatal outcome. reduced concentrations of folic acid and vitamin B 12 are associated with higher homocitein values Carriers of the MTHFR gene mutation have higher homocysteine concentrations

Evaluation of 25- Hydroxyvitamin D levels in pregnant women in Austria and potential related disorders Hypothesis: Austrian pregnant women are Vitamin D deficient Present vitamin D supplementation in pregnancy is insufficient Vitamin D deficiency is associated with pregnancy related disorders like preeclampsia

Obesity is an ongoing public health problem that is difficult to treat. There is evidence that obesity has fetal origins. Body composition, including visceral, subcutaneous, brown, and hepatic fat have been found to be important predictors in obesity and metabolic syndrome. Magnetic resonance imaging (MRI) can quantify body composition that does not require radiation but is motion limited. The investigators have developed a motion-compensated MRI sequence, also known as "free breathing" MRI. In this study, the investigators plan to obtain free-breathing MRIs of pregnant women in the third trimester of pregnancy. MRIs will be obtained from healthy mothers, mothers with growth-restricted fetuses, and mothers with gestational diabetes. The different types of adipose tissue will be measured and compared between groups and correlated to birth growth parameters. The goal is this study is to assess if motion-compensated MRI can help predict early growth patterns in infancy.

The investigators seek to examine the metabolic changes that occur amongst obese and lean pregnant women with normal glycemic control as well as pregnant women with diabetes mellitus (gestational diabetes and pre-existing type 2 diabetes mellitus) compared to non-pregnant age matched controls. Given the adaptive tendency of the maternal body to use alternative energy sources such as ketones and free fatty acids rather than glucose and to shunt glucose and amino acids to the fetus, the investigators hypothesize that the amino acid and fatty acid profile will be reflective of this adaptive change and that maternal insulin resistance will result in alterations in this pattern in both the plasma and CSF. Furthermore, the investigators also hypothesize that maternal degrees of insulin resistance will also be reflected in CSF hormonal changes.

A total of 1,180 women diagnosed with Gestational Diabetes Mellitus (GDM) from 2005 to 2009 and their children have and continues to be randomly assigned to either the intervention group or the control group. A total of 83 women with prior GDM and newly diagnosed diabetes at baseline survey have the nine-month lifestyle intervention program. GDM women in the intervention group will have five consulting sessions with a dietician during the first year and two sessions during the second year. The intervention group are given detailed advice about how to achieve the five goals of the intervention. The primary aim will test whether lifestyle intervention can reduce incident Type 2 Diabetes (T2D) in women with prior GDM. The second aim will test gene-intervention interactions through fine-mapping established genes for glucose, IR, lipids, obesity and T2D in relation to metabolic traits for T2D in GDM women. The third aim will evaluate the effects of the nine-month lifestyle intervention program on cardiovascular risk factors in women with prior GDM and newly diagnosed diabetes. The forth aim will assess if a lifestyle intervention targeting both GDM mothers and their offspring can greatly improve offspring's cardimetablic risk (body weight, glucose and lipid metabolism).

The object of this study is to evaluate patients with a diagnosis of GD who are included in a program of RE carried out with rubber tubes, comparing the frequency of women who will use insulin in the group who will participate in the program with the group that won't do the exercises, and to verify the impact of the program on the adequacy of capillary glycemic control of the pregnant women.

To evaluate the impact of induction of labour at 38 weeks with the induction of labour at 40 weeks in women with insulin dependent gestational diabetes mellitus on maternal and fetal outcome.

The purpose of this research study is to compare 3 methods of measuring blood glucose (blood sugar) levels to see if the finger-stick method or the continuous glucose monitoring system is better than or as good as the 3 hour glucose tolerance test (GTT) for the diagnosis of gestational diabetes.