Relationship of BMI and rs12255372 TCF7L2 Polymorphism on the Conversion to Type 2 Diabetes Mellitus in Lactating Women with Previous Gestational Diabetes | Chapter 2 | Medical Science: Trends and Innovations Vol. 13

Women with previous gestational diabetes mellitus (pGDM) have a high risk of developing postpartum type 2 diabetes mellitus (T2DM). Several reports have shown that approximately 50% of women with GDM will develop diabetes within 5 years. There are other risk factors for postpartum diabetes as a family history of diabetes, pre-pregnancy and postpartum body mass index, dietary patterns, physical activity, and breastfeeding. This study aimed to analyse the relationship between BMI and rs12255372 TCF7L2 polymorphisms in the conversion to T2DM in lactating women with pGDM. One hundred and fifty-three women con pGDM were recruited from public hospitals of León, Guanajuato, México. Three groups: normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and T2DM after the oral glucose tolerance test were formed. All women were interviewed and asked about their glycemic control and the time since their last glucose test. Serum glucose concentrations and lipid profiles were measured using enzymatic methods with an analyser. Metabolic and hormone variables were measured, and genotyping was performed. The questionnaire included data on lactation (yes/no), duration of lactation, and full lactation. After 35 (21–49) months from the last partum, 54% of women had an NGT, 30.7% IGT, and 15% T2DM. BMI and rs12255372 are associated with the risk of conversion to IGT and T2DM [OR = 1.07 (95% IC 1.0–1.14, p = 0 .041, OR = 2.14, 95% IC 1.01–4.55, p = 0 .04 respectively), while the lactation shows a strong protective effects OR = 0.15 (95% IC 0.062–0.39, p = 0.00007), and an apparent interaction with rs12255372T decreasing the risk in carriers (OR = 2.15, 95% IC 0.97–4.7, p = 0 .05). BMI is an independent risk factor of IGT/T2DM development. Both sporadic and long-term breastfeeding are associated with a lower risk of T2DM and a better metabolic profile in women with a history of GDM. The multivariate analysis revealed that both BMI and the rs12255372 predicted the conversion to IGT and T2DM in women with pGDM.  The lactation shows a strong protective effect and a possible interaction with rs12255372 polymorphism. In conclusion, it means that lactation and polymorphism share variability by means of an interaction of an unidentified nature. Further studies are necessary to confirm a possible interaction of rs12255372 TCF7L2 with full breastfeeding and lactation duration.

 

Author (s) Details

 

Ruth Reyes-López
Department of Medical Sciences, Health Sciences Division, University of Guanajuato, Leon Campus, Mexico.

 

Elva Perez-Luque
Department of Medical Sciences, Health Sciences Division, University of Guanajuato, Leon Campus, Mexico.

 

Juan Manuel Malacara
Department of Medical Sciences, Health Sciences Division, University of Guanajuato, Leon Campus, Mexico.

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v13/5153

Vitamin D Efficiency in Pregnancy: Reporting an Updated Viewpoint in Indian Scenario | Chapter 10 | Current Topics in Medicine and Medical Research Vol. 13

 Vitamin D was once thought to be a bone-building mineral that improved calcium absorption; however, recent research shows that it has potential in a wide range of diseases, including diabetes, hypertension, and cancer, as well as in special populations such as pregnancy and lactation. Vitamin D deficiency is currently regarded as the world's most untreated nutritional deficiency. Vitamin D status becomes critical for optimal maternal and foetal outcomes as calcium demands rise during pregnancy. Low Vitamin D levels during pregnancy and infancy have been related to negative health effects such as preeclampsia, low birth weight, neonatal hypocalcemia, bone fragility, and an increased rate of autoimmune diseases. Despite widespread use of prenatal vitamins, Vitamin D deficiency is common during pregnancy and lactation since these are insufficient to maintain normal Vitamin D levels. The widespread deficiency of Vitamin D in pregnant women and lactating mothers necessitates a study to determine the optimum level of Vitamin D and the appropriate amount of Vitamin D intake needed to sustain optimum levels in these populations. Vitamin D supplementation as recommended by the IOM (US) and the ICMR (India) is insufficient to maintain the optimal levels of serum 25(OH) D above 30 ng/ml needed during pregnancy. As a result, it might be prudent to provide Vitamin D testing as part of routine antenatal treatment for all pregnant women, and supplementation should be suggested if deficiency continues. Interventional studies in special populations have shown that vitamin D supplementation during pregnancy and lactation is both safe and effective for optimal maternal and foetal outcomes. Most experts agree that up to 2000 IU/day of Vitamin D is healthy when Vitamin D deficiency is discovered during pregnancy. This analysis discusses Vitamin D deficiency in India and the need for supplementation, as well as the facts for implementing Vitamin D supplementation while preparing a pregnancy, existing guidelines, and the consequences of Vitamin D deficiency during pregnancy and lactation.

Author (s) Details

Manish Maladkar
Aristo Pharmaceuticals Pvt. Ltd., Mumbai, India

Srividya Sankar
Aristo Pharmaceuticals Pvt. Ltd., Mumbai, India

Chitra Tekchandani
Aristo Pharmaceuticals Pvt. Ltd., Mumbai, India

View Book :- https://stm.bookpi.org/CTMMR-V13/article/view/741