• Title/Summary/Keyword: Neonatal diabetes mellitus

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Effects of an Integrated Self-Management Program on Self-Management, Glycemic Control, and Maternal Identity in Women with Gestational Diabetes Mellitus (통합 자가관리 프로그램이 임신성 당뇨병 임부의 자가관리, 혈당 및 모성 정체성에 미치는 효과)

  • Kim, HeeSook;Kim, Sue
    • Journal of Korean Academy of Nursing
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    • v.43 no.1
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    • pp.69-80
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    • 2013
  • Purpose: The purpose of the study was to investigate the effects of an integrated self-management program on self-management, glycemic control, and maternal identity in women with gestational diabetes mellitus (GDM). Methods: A non-equivalent control group non-synchronized quasi-experimental design was used. A total of 55 women with GDM were recruited from Cheil General Hospital, Seoul, Korea and were assigned to an experimental (n=28) or control group (n=27). The participants were 24-30 weeks pregnant women who had been diagnosed with GDM as of July 30, 2010. The program was conducted as a 1 hour small group meeting 3 out of 5 times and by telephone-counseling 2 out of 5 times. The integrated self-management program was verified by an expert panel. Results: Although there was no significant reduction in HbA1c (U= -1.17, p=.238), there were statistically significant increases in self-management (U= -3.80, p<.001) and maternal identity (U= -4.48, p<.001), and decreased 2-h postprandial glucose levels (U= -2.43, p<.015) in the experimental group compared to the control group. Conclusion: These findings suggest that an integrated self-management program for women with GDM improves self-management, maternal identity, and glycemic control. Further studies are needed to identify the effects of an integrated self-management program on pregnancy and neonatal outcomes.

Viability and Functions of Alginate-microencapsulated Islets Isolated from Neonatal Pigs

  • Lin, Yi-Juain;Wang, Jui-Ping;Chung, Yu-Tung;Sun, Yu-Ling;Chou, Yu-Chi
    • Asian-Australasian Journal of Animal Sciences
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    • v.20 no.5
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    • pp.795-801
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    • 2007
  • Patients with Type I diabetes mellitus have been treated with porcine insulin for several decades and pigs have recently been deemed an ideal source of microencapsulated islet cells for clinical xenotransplantation. In this study, neonatal pigs were anesthetized and sacrificed prior to a pancreatectomy. Islet cells were isolated from pancreas via collagenase digestion. Islet cells were separated and collected by hand under microscopic guidance. These cells were suspended in 1.4% sodium alginate solution and encapsulated by dropping them into 1.1% calcium chloride solution and in which the round gel in size was 250-400 ${\mu}m$ in diameter. Viability of the microencapsulated islet cells cultured in medium at $37^{\circ}C$ was assessed by MTT assay. Furthermore, insulin released in response to glucose challenge was investigated using an enzyme-linked immunosorbent assay. Secretion of insulin was low in response to the basal glucose solution (4.4 mM) in medium and was significantly higher in response to the high glucose solution (16.7 mM). The viability of microencapsulated islet cells did not differ significantly over a period of 7 days; that is, the increasing pattern of insulin concentration in the culture medium after glucose stimulation interval day was similar throughout the 7 days cultivation. In summary, experimental evidences indicated that the effects of alginate-microencapsulation prolonged survival of the neonatal porcine islets in vitro cultures and the insulin response to glucose of the islets was maintained.

Effect of Undaria pinnatifida Extract on Insulin Secretion from the Pancreas of Diabetic Rats

  • Nam, Jeong-Su;Lee, Won-Joon;Choi, Hyun-Ju
    • Biomedical Science Letters
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    • v.15 no.4
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    • pp.281-286
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    • 2009
  • We found previously that Undaria pinnatifida extract has an effect of lowering blood glucose levels in diabetic rats. Therefore, an effect of Undaria pinnatifida extract on the insulin secretion directly from the pancreas was examined in this study. Neonatal diabetes were induced by intraperitoneal injection of Streptozotocin (100 mg/kg body weight) at age of day 1. Rats were fed a rodent pellet diet until they were grown to adults (age of 7 weeks). Rats having a fasting serum glucose level over 250 mg/dL were used in this feeding study and they were divided into two diet groups as follows; a diet with Undaria pinnatifida extract (5%) and a diet without this extract (control group). Fasting (12 hr) blood glucose and serum insulin levels were measured before and after feeding a diet with Undaria pinnatifida extract for 4 weeks. At the last day of feeding, in vitro pancreas perfusion was performed. Pancreas was stimulated with a perfusate without glucose during a period of 0~10 minutes and with a perfusate containing 200 mg/dL glucose during a period of 11~40 minutes. Insulin amount was measured using a radioimmuno assay. In results, amount of the insulin secreted from the pancreas in the diabetic rats fed Undaria pinnatifida extract was significantly greater than that in the diabetic control group during the periods of the equilibration period (0~10 min) and the first phase (11~20 min) of the insulin secretion (P<0.05). It is concluded that Undaria pinnatifida extract increases insulin secretion from the pancreas in the neonatal diabetic rats. Therefore, the blood glucose lowering effect of the Undaria pinnatifida extract may be elucidated by mechanisms with promoted insulin secretion from the pancreas in diabetic rats.

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Glucocorticoid treatment independently affects expansion and transdifferentiation of porcine neonatal pancreas cell clusters

  • Kim, Ji-Won;Sun, Cheng-Lin;Jeon, Sung-Yoon;You, Young-Hye;Shin, Ju-Young;Lee, Seung-Hwan;Cho, Jae-Hyoung;Park, Chung-Gyu;Yoon, Kun-Ho
    • BMB Reports
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    • v.45 no.1
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    • pp.51-56
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    • 2012
  • The purpose of this study was to determine the effects of duration and timing of glucocorticoid treatment on the expansion and differentiation of porcine neonatal pancreas cell clusters (NPCCs) into ${\beta}$-cells. After transplantation of NPCCs, the ductal cyst area and ${\beta}$-cell mass in the grafts both showed positive and negative correlations with duration of dexamethasone (Dx) treatment. Pdx-1 and HNF-3${\beta}$ gene expression was significantly downregulated following Dx treatment, whereas PGC-1${\alpha}$ expression increased. Pancreatic duct cell apoptosis significantly increased following Dx treatment, whereas proliferation did not change. Altogether, transdifferentiation of porcine NPCCs into ${\beta}$-cells was influenced by the duration of Dx treatment, which might have been due to the suppression of key pancreatic transcription factors. PGC-1${\alpha}$ plays an important role in the expansion and transdifferentiation of porcine NPCCs, and the initial 2 weeks following transplantation of porcine NPCCs is a critical period in determining the final ${\beta}$-cell mass in grafts.

Effects of nursing intervention programs for women with gestational diabetes: a systematic review of randomized controlled trials (임신성 당뇨병을 가진 임산부를 위한 간호중재 프로그램의 효과: 무작위 대조군 실험연구의 체계적 문헌고찰)

  • Kim, JooHee;Chung, ChaeWeon
    • Women's Health Nursing
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    • v.27 no.1
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    • pp.14-26
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    • 2021
  • Purpose: This study aimed to identify the effects of nursing intervention programs for women with gestational diabetes mellitus (GDM) through a critical review of recent studies. Methods: Studies related to effects of nursing intervention programs for women with GDM published in English or Korean between 2000 and 2019 were extracted from 10 electronic databases. The quality of the studies was evaluated and double-checked for accuracy by two reviewers using the Revised Cochrane Risk-of-Bias tool for randomized controlled trials. Results: Twenty studies were selected, of which 19 had a low risk of bias and one had a high risk of bias. Interventions fell into six main groups: (1) integrated interventions, (2) self-monitoring of blood glucose levels, (3) dietary interventions, (4) exercise, (5) psychotherapy, and (6) complementary therapy. This review found that nursing interventions for GDM were of many types, and integrated interventions were the most common. However, low-carbohydrate diets and blood glucose monitoring interventions did not show statistically significant results. Evidence shows that various nursing intervention programs applied to GDM improved diverse aspects of maternal, fetal, and neonatal health, including both physical and psychological aspects. Conclusion: The composition and delivery of integrated interventions continue to evolve, and these interventions affect physical and psychological indicators. Although interventions affecting physical health indicators (e.g., blood glucose levels, diet, and exercise) are important, many studies have shown that programs including psycho-emotional nursing interventions related to anxiety, depression, stress, self- efficacy, and self-management are also highly useful.

Cord Blood Adiponectin and Insulin-like Growth Factor-I in Term Neonates of Gestational Diabetes Mellitus Mothers: Relationship to Fetal Growth

  • Sohn, Jin-A;Park, Eun-Ae;Cho, Su-Jin;Kim, Young-Ju;Park, Hye-Sook
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.49-58
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    • 2011
  • Purpose: The purpose of this study was to evaluate the relationship between cord blood adiponectin and insulin-like growth factor (IGF)-I and their effect on fetal growth and insulin resistance in mothers with gestational diabetes mellitus (GDM). Methods: Cord blood adiponectin and IGF-I were compared between mothers with GDM (GDM group, N=53) and controls (non-GDM group, N=101). Neonates were classified into three groups of small for gestational age (SGA, N=26), appropriate for gestational age (AGA, N=97), and large for gestational age (LGA, N=31) by birth weight. The association between cord adiponectin and IGF-I levels was evaluated in relation to maternal and neonatal clinical data. Results: Cord adiponectin was lower in the GDM group than in the non-GDM group (P<0.001). There was no significant difference in cord adiponectin among the SGA, AGA, and LGA groups in the GDM group (P=0.228). The cord adiponectin of AGA in the GDM group was significantly lower than that in the non-GDM group (P<0.001). The most powerful predictor affecting cord adiponectin was the result of maternal 75 g oral glucose tolerance test. The cord IGF-I values between the GDM group and the non-GDM group were not different (P=0.834). Neonates with the heavier birth weight had the higher cord IGF-I levels. The most powerful predictor affecting cord IGF-I was birth weight and the next was maternal parity. Conclusion: Both cord blood adiponectin and IGF-I were associated with fetal growth, but IGF-I was a more general and direct factor affecting fetal body size, and adiponectin seemed to have more association with insulin sensitivity than growth.

cDNA Cloning, Tissue Expression and Association of Porcine Pleiomorphic Adenoma Gene-like 1 (PLAGL1) Gene with Carcass Traits

  • Zhang, F.W.;Cheng, H.C.;Deng, C.Y.;Xiong, Y.Z.;Li, F.E.;Lei, M.G.
    • Asian-Australasian Journal of Animal Sciences
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    • v.19 no.9
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    • pp.1257-1261
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    • 2006
  • Pleiomorphic adenoma gene-like1 (PLAGL1) encodes a zinc-finger (ZF) protein with seven ZFs of the C2H2-type which is a regulator of apoptosis and cell cycle arrest, and also regulates the secretion of insulin. In both human and mouse, PLAGL1 is a candidate gene for tumor suppressor and transient neonatal diabetes mellitus (TNDM). In this study, a 2,238 bp fragment covering the complete coding region was obtained and deposited to GenBank (accession number: DQ288899). The reverse transcriptase-polymerase chain reaction (RT-PCR) indicated that PLAGL1 was expressed almost equally in heart, liver, spleen, lung, kidney, stomach, small intestine, skeletal muscle, fat, uterus and ovary. Comparing the sequences of Large White and Meishan pigs, a C-T transition in exon 6 was found. The polymorphism could be detected by TaqI and was genotyped in five purebreds (Large White, Landrace, Meishan, Tongcheng and Bamei). Association analysis was performed between the polymorphism and carcass traits in 276 pigs of a "Large White${\times}$Meishan" F2 resource population. As a consequence, significant associations of the genotypes with shoulder backfat thickness (SFT) and internal fat rate (IFR) were observed. Pigs with TT genotype had low SFT and high IFR compared with TC or CC genotypes.

Comparative antidiabetic activity of different fractions of Enicostemma littorale Blume in streptozotocin induced NIDDM rats

  • Vishwakarma, Santosh L.;Rajani, M.;Goyal, Ramesh K.
    • Advances in Traditional Medicine
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    • v.3 no.4
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    • pp.196-204
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    • 2003
  • Aqueous extract of Enicostemma littorale is reported to have antidiabetic activity. In the present investigation, we studied the effect of aqueous extract of E. littorale and its different fractions i.e., toluene, chloroform, ethyl acetate, n-butanol fractions and remaining residual fraction in streptozotocin (STZ)-induced neonatal type 2 diabetic rats. Fasting glucose and insulin levels in NIDDM were significantly (P<0.05) higher than control rats and they were significantly decreased by treatment with aqueous extract of E. littorale and its n-butanol and ethyl acetate fractions. Results of oral glucose tolerance test (OGTT) showed that aqueous extract and its n-butanol and ethyl acetate fractions significantly (P<0.05) decrease both $AUC_{glucose}$ and $AUC_{insulin}$ values in NIDDM treated groups. Insulin sensitivity $(K_{ITT})$ index of NIDDM control was significantly lower as compared to normal control and this was significantly (P<0.05) increased after treatment with aqueous extract, its n-butanol and ethyl acetate fractions. Treatment with aqueous extract of E. littorale and its n-butanol and ethyl acetate fractions lowered the elevated cholesterol and triglyceride levels observed in NIDDM rats. Treatment with aqueous extract of E. littorale and its n-butanol fraction showed significant decrease in creatinine, urea, SGPT and SGOT levels as compared to NIDDM control rats. However ethyl acetate fraction showed significant changes only in creatinine and SGOT levels, and not in the levels of urea, and SGPT as compared to NIDDM control rats. Treatment with toluene, chloroform and residual fractions of E. littorale did not produce any effect on glucose, insulin, triglyceride, cholesterol, creatinine, urea, SGPT or SGOT levels as compared to NIDDM control rats. Our data suggest that n-butanol and ethyl acetate fractions contain the active compounds which may be responsible for the above activity and associated complications in NIDDM diabetes mellitus.

Placental histopathology in late preterm infants: clinical implications

  • Ericksen, Kristina;Fogel, Joshua;Verma, Rita P.
    • Clinical and Experimental Pediatrics
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    • v.63 no.2
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    • pp.48-51
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    • 2020
  • Background: The etiopathogenesis of late preterm (LPT) birth is undetermined. Placental histopathology, which reflects an adverse intrauterine environment and is reportedly associated with preterm labor and neonatal morbidities, has not been studied in LPT infants. Purpose: We investigated placental pathological lesion as markers of an adverse intrauterine environment during LPT labor. Methods: This retrospective case-control study compared placental histopathological and clinical variables between LPT and term neonates. Placental variables included chorioamnionitis, funisitis, hemorrhage, abruption, infarction, calcification, and syncytial knots. Maternal variables included age, substance abuse, pregnancyassociated diabetes mellitus and hypertension, duration of rupture of membrane, antibiotic use, and magnesium sulfate, whereas, those of neonates included gestational age, birth weight, race, sex, and Apgar scores. Standard statistical proedures were applied to analyze the data. Results: Chorioamnionitis (50% vs. 17.8%, P<0.001) and funisitis (20% vs. 4.4%, P=0.002) were more common in term infants. Placental infarction rate was insignificantly higher in LPT infants (25.6% vs. 14.3%, P=0.08). The mothers in the LPT group were older (30.4 years vs. 28.1 years, P=0.05; odds ratio [OR], 1.06; 95% confidence interval [CI], 0.998-1.12, P=0.056) and more often suffered from hypertension (28.9 vs. 12.9 %, P=0.02), and received magnesium sulfate (48.9 vs. 20%, P< 0.001; OR, 2.86; 95% CI, 1.12-7.29, P<0.05). Duration of rupture of membrane was higher in term infants (13.6 hours vs. 9.1 hours, P<0.001). Chorioamnionitis (OR, 0.33; 95% CI, 0.13-0.79; P<0.05) was associated with a lower risk of LPT delivery. Conclusion: Placental infection is not a risk factor for LPT births. There is a nonsignificant predominance of vascular anomalies in LPT placentas. Higher maternal age, magnesium sulfate therapy, and maternal hypertension are clinical risk factors for LPT labor.

Comparative antidiabetic activity of different fractions of methanolic extract of Zingiber officinale Roscoe in streptozotocin induced NIDDM rats

  • Kadnur, Sanjay V.;Goyal, Ramesh K.
    • Advances in Traditional Medicine
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    • v.5 no.3
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    • pp.201-208
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    • 2005
  • Earlier we have reported the antidiabetic activity of fresh juice of rhizomes of Zingiber officinale (Z. officinale) and its correlation with 5-HT receptor antagonism. Since 6-gingerol the marker compound of Z. officinale is reported to posses 5-HT anatgonistic activity, the present investigation, was undertaken to find out the concentration of 6-gingerol present in methanolic extract of Z. officinale and its different fractions (petroleum ether, toluene and chloroform). We also evaluated these fractions for antidiabetic activity in streptozotocin (STZ)-induced neonatal type 2 diabetic rats. Fasting glucose and insulin levels in non insulin dependent diabetes mellitus (NIDDM) rats were found to be significantly (P < 0.05) higher than control rats and these were significantly decreased by treatment with methanolic extract of Z. officinale and its fractions. The results of oral glucose tolerance test (OGTT) showed that methanolic extract and its fractions significantly (P < 0.05) decreased both STZ-induced increase in $AUC_{glucose}$ and $AUC_{insulin}$ values in NIDDM groups. Treatment with petroleum ether fraction produced a greater reduction in elevated glucose and $AUC_{glucose}$ levels as compared to treatment with other fractions. Treatment with methanolic extract of Z. officinale and its fractions also produced significant reduction in the elevated lipid, serum glutamate oxaloacetate transaminase (SGOT) and serum glutamate pyruvate transaminase (SGPT) levels in NIDDM rats. The effect of petroleum ether fraction on elevated lipid, SGOT and SGPT levels was significantly greater as compared to treatment with other fractions. The concentration of 6-gingerol was found to be maximum in petroleum ether fraction (11.430%) and minimum in chloroform fraction (0.973%). The methanolic extract and toluene fraction was found to contain 3.080% and 2.191 %, 6-gingerol respectively. In conclusion, our data suggest that methonolic extract and its fractions possess significant antidiabetic activity in NIDDM rats. The extent of activity appears to be dependent on the concentration of 6-gingerol present in the extract or its fractions.