RESUMEN
OBJECTIVE: The objective of the study was to compare premixed insulin aspart 30 (BIAsp 30) vs premixed human insulin 30 (BHI 30) on efficacy, safety, fetal and perinatal outcomes in pregnancies associated with gestational diabetes mellitus [GDM]. This was the first randomized study to use pre mixed insulin analogue [BIAsp] in GDM. METHODS: The study population consisted of 76 GDM women assigned to BIAsp 30 (group A) and an equal number to BHI 30 (group B). RESULTS: There was no statistically significant difference between the age, BMI, gestational weeks and glycemic level at entry between the group A and group B women (p > 0.05). There was no statistical difference between the two groups in glycemic control or insulin dose (p > 0.05) before confinement. The frequency of birth weight of new born above 90 percentile was 6.8% in Group 1 and 9.2% in Group 2. The proportion of macrosomia was higher in Group 2 when compared to Group 1, however the difference was not statistically significant (P = 0.819). CONCLUSION: BIAsp was safe during pregnancy and pregnant women found it convenient due to meal time dosing. Fetal outcome using BIAsp was also comparable with BHI 30.
Asunto(s)
Diabetes Gestacional/tratamiento farmacológico , Hipoglucemiantes/uso terapéutico , Insulina/análogos & derivados , Insulina/uso terapéutico , Adulto , Insulinas Bifásicas , Peso al Nacer , Glucemia/metabolismo , Índice de Masa Corporal , Cromatografía Líquida de Alta Presión , Diabetes Gestacional/diagnóstico , Femenino , Hemoglobina Glucada/análisis , Humanos , Hipoglucemiantes/efectos adversos , Recién Nacido , Inyecciones Subcutáneas , Insulina/efectos adversos , Insulina Aspart , Insulina Isófana , Proyectos Piloto , Embarazo , Resultado del Embarazo , Resultado del Tratamiento , Adulto JovenRESUMEN
Universal screening for gestational diabetes mellitus (GDM), detects more cases and improves maternal and offspring prognosis. Of all the screening tests, World Health Organization (WHO) procedure is simple and cost effective; the only disadvantage is that the pregnant woman has to come in the fasting state to undergo oral glucose tolerance test (OGTT). Hence, we undertook a study to elucidate a test that is casual and reliable to diagnose GDM. A total of 800 pregnant women underwent 75-g glucose challenge test (GCT) irrespective of the time of the last meal and their 2-h plasma glucose (PG) was estimated. They also underwent a 2-h 75-g OGTT recommended by WHO after 72 h. There was no statistically significant difference in the glycemic profile between GCT and WHO OGTT in the diagnosis of GDM. In conclusion, GCT performed irrespective of the last meal timing is a patient-friendly approach and causes least disturbance in the pregnant woman's routine activities.
Asunto(s)
Diabetes Gestacional/diagnóstico , Adulto , Glucemia/metabolismo , Índice de Masa Corporal , Diabetes Gestacional/sangre , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , India , Recién Nacido , Anamnesis , Embarazo , Segundo Trimestre del Embarazo , Tercer Trimestre del Embarazo , Factores de RiesgoRESUMEN
The policy of screening for gestational diabetes mellitus (GDM) between 24 and 28 weeks of gestation and care has resulted in a few women delivering big babies despite good glycemic control. Hence we undertook a study to assess the merits of care given to women in whom GDM was diagnosed in different weeks of gestation and to find out the ideal period of screening in women with history of high-risk pregnancies. A total of 207 consecutive pregnant women irrespective of trimester referred to our referral clinic for diabetes in pregnancy, underwent a 75g oral glucose tolerance test (OGTT) and GDM was diagnosed if 2h plasma glucose (PG) >/=140mg/dl. A1c was estimated in all of them. Women who failed to respond to medical nutrition therapy were advised insulin and the dose titrated to maintain fasting PG (FPG) <90mg/dl and 2h PG <120mg/dl. The mean age of the population screened was 28.38+/-4.31 years and the mean gestational age of screening was 20.05+/-10.71 weeks. Among them, 87 were diagnosed as GDM. The gestational week at diagnosis was
Asunto(s)
Peso al Nacer , Diabetes Gestacional/fisiopatología , Edad Gestacional , Adulto , Glucemia/metabolismo , Diabetes Gestacional/diagnóstico , Diagnóstico Diferencial , Ayuno , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Recién Nacido , Anamnesis , Embarazo , Valores de ReferenciaRESUMEN
Anthra, an organization of women veterinary scientists working in the field of livestock production and development, has been involved since 1996 in a research project to document and validate local ethnoveterinary and animal management practices carried out by livestock-rearing communities in different parts of the states of Andhra Pradesh and Maharashtra in India. Communal knowledge and innovation are an integral part of the day-to-day healing and management practices of farmers in all areas and over 80% of farmers continue to use these because they are easily and quickly available, especially in remote villages. However, this knowledge is today rapidly being lost. Farmers, both men and women, have expressed a keen desire to increase their own knowledge of these systems. This paper outlines the validation framework evolved by Anthra, wherein farmers using these medicines are actively participating in an evaluation process. Major findings are that local practices are effective, participating farmers use them confidently and other farmers are keen to use and increase their knowledge of them.