Gestational diabetes survey

Article Abstract:

Many aspects of diagnosis and management of gestational diabetes being taught similarly in U.S. obstetric residency programs. A questionnaire was mailed to all program directors of accredited obstetrics and gynecology residency and maternal-fetal medicine fellowship programs. Seventy-four percent were returned. Seventy-seven percent or more of the programs were in agreement on many of the aspects of diagnosis and treatment of gestational diabetes. Of note, 97% agreed that all pregnant women should be screened, which is contrary to the guidelines of the American College of Obstetricians and Gynecologists. Lesser degrees of agreement were found on more controversial points of diagnosis and management, such as management of women with borderline blood sugar values or what constitutes optimal control of blood sugar.

Diagnosis, Training, Residents (Medicine), Obstetricians

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Insulin and glucose modulate glucose transporter messenger ribonucleic acid expression and glucose uptake in trophoblasts isolated from first-trimester chorionic villi

Article Abstract:

Maternal insulin may increase glucose consumption and the amount of a glucose transporting protein in the first-trimester placenta. Changes in maternal glucose and insulin caused by diabetes affect fetal health. Researchers studied the effect of insulin on cells from first-trimester human placenta. Exposure of the placental cells to insulin caused increased transport of 2(3H)deoxy-D-glucose. Decreasing the level of D-glucose caused more 2(3H)deoxy-D-glucose to be transported. D-glucose had a similar effect on the GLUT1 glucose transporter messenger ribonucleic acid (mRNA) levels. The placenta may control glucose and insulin transport from the mother to the fetus. Abnormal glucose levels in mothers may harm fetal growth during the first trimester, which is when the placenta has the highest levels of GLUT1 mRNA.

Complications and side effects, Insulin

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Ketoacids attenuate glucose uptake in human trophoblasts isolated from first-trimester chorionic villi

Article Abstract:

Ketoacids may interfere with glucose transport across the placenta into the fetal circulation. Ketoacids are the metabolic byproducts of overly low blood sugar. Researchers cultured placental tissue samples obtained during chorionic villi sampling procedures done early in pregnancy. Glucose uptake was inhibited when ketoacids were added to the culture medium. Increasing the concentration of ketoacids increased the inhibiting effect. This could be a potential mechanism for the known damaging effect of poorly controlled insulin-dependent diabetes in pregnancy.

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