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Diabetes Mellitus: Type 2 and Gestational01:22

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Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
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α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
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Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
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Probiotics are live, non-pathogenic microorganisms that confer health benefits by modulating the gut microbiota. The human gastrointestinal tract harbors a complex microbial ecosystem, and the balance of this microbiota is crucial for digestive and systemic health. Among the most extensively studied and utilized probiotics are species formerly classified within the genera Lactobacillus and Bifidobacterium. These organisms not only naturally colonize the human gut but are also consumed through...
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Probiotic Studies in Neonatal Mice Using Gavage
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Probiotics for preventing gestational diabetes.

Helen L Barrett1, Marloes Dekker Nitert, Louise S Conwell

  • 1Internal Medicine, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Queensland, Australia, 4029.

The Cochrane Database of Systematic Reviews
|February 28, 2014
PubMed
Summary
This summary is machine-generated.

Probiotic supplementation may reduce gestational diabetes mellitus (GDM) rates in pregnant women. This intervention also reduced infant birthweight but requires further research due to limited data on other outcomes.

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Area of Science:

  • Obstetrics and Gynecology
  • Microbiology
  • Metabolic Disorders

Background:

  • Gestational diabetes mellitus (GDM) is linked to adverse maternal and infant outcomes, with lifestyle interventions proving challenging for prevention.
  • The gut microbiome influences inflammatory pathways and host metabolism, suggesting a role for microbial modulation in pregnancy.
  • Probiotics offer a method to alter the gut microbiome, but their impact on the metabolic state during pregnancy is not well understood.

Purpose of the Study:

  • To evaluate the efficacy of probiotic supplementation compared to other interventions for preventing GDM.
  • To assess the impact of probiotics on maternal and infant health outcomes during pregnancy.

Main Methods:

  • A systematic review of randomized and cluster-randomized trials was conducted.
  • Searches included the Cochrane Pregnancy and Childbirth Group's Trials Register and reference lists.
  • One trial with three arms (probiotic with diet, placebo with diet, diet alone) was included, assessed for risk of bias.

Main Results:

  • A single trial involving 256 women indicated a significant reduction in GDM rates with probiotic use (RR 0.38, 95% CI 0.20 to 0.70).
  • Probiotic supplementation was associated with a reduction in infant birthweight (MD -127.71 g, 95% CI -251.37 to -4.06).
  • No clear differences were observed in rates of miscarriage, stillbirth, preterm delivery, or caesarean section; however, data on macrosomia and other key outcomes were not reported.

Conclusions:

  • One trial suggests probiotics may reduce GDM rates in early pregnancy, but evidence regarding pregnancy loss is uncertain.
  • Insufficient data currently prevent a meta-analysis, and crucial outcomes like macrosomia remain unevaluated.
  • Further results from ongoing studies are necessary to confirm the benefits and safety of probiotics for GDM prevention.