[Translational research in gestational diabetes mellitus and mild gestational hyperglycemia: current knowledge and our experience]

Betatrophin for diagnosis and prognosis of mothers with gestational diabetes mellitus

Objectives

Betatrophin is a widely used diagnostic marker for type 2 diabetes mellitus (DM), but its clinical utility in diagnosing gestational DM (GDM) is unclear. We evaluated the relationship between betatrophin and the risk of GDM as well as the ability of betatrophin to predict postpartum type 2 DM (PDM).

Methods

In total, 386 patients were categorized into those with and without PDM. All underwent the oral glucose tolerance test while pregnant. Betatrophin was assessed to examine the diagnostic characteristics of GDM.

Results

The betatrophin concentration was remarkably higher in patients with than without GDM. The patients were categorized into three groups; those with a betatrophin concentration of 300 to 600 pg/mL and >600 pg/mL had a higher risk of GDM after adjusting for body mass index, age, homeostatic model assessment–insulin resistance (HOMA-IR) concentration, and betatrophin concentration than those with a betatrophin concentration of <300 pg/mL. The HOMA-IR concentration tended to increase as the betatrophin concentration increased, and betatrophin was independently associated with GDM after adjusting for confounders. The betatrophin concentration was higher among pregnant patients with than without PDM.

Conclusions

Betatrophin has high sensitivity but low specificity for diagnosing GDM and may be a promising predictor of PDM.

Possible Protective Role of Parsley Extract on the Diabetic Pregnant Rats and Their Fetuses

BACKGROUND AND OBJECTIVE

Gestational diabetes mellitus (GDM) is one form of diabetes. It causes obstetrical complications and affects between 5-18% of all pregnancies and leads to congenital malformations and long-term postnatal disorders. Supportive therapy in treatment of diabetes during pregnancy takes place by anti-diabetic plants such as parsley. The current study has been undertaken to investigate the possible anti-diabetic and antioxidant role of aqueous parsley extract on streptozotocin (STZ) induced gestational diabetes mellitus in rats.

MATERIALS AND METHODS

Fifty pregnant albino rats were categorized after mating into five groups: group C (control group), group D1 (pregnant rats injected with interperitoneally single dose of STZ (40 mg kg-1 b.wt.) in the 1st day of gestation, group D1+P: Pregnant rats were treated with parsley extract (1 m/150 g b.wt.) from the 1st to the 19th day of gestation post injection with STZ (40 mg kg-1 b.wt.), group D7: Pregnant rats were injected with STZ (40 mg kg-1 b.wt.) on day 7of gestation, group D7+P: Pregnant rats were treated with parsley extract (1 m/150 g b.wt.) from the 7th to the 19th day of gestation post injection with STZ (40 mg kg-1 b.wt.). The pregnant rats were dissected on the 19th day of pregnancy and the uterine horns were removed freshly and then photographed. Abnormalities or any morphological changes were recorded, weight of fetuses and placenta and placental index were determined. Blood samples were collected to estimate the glucose and biochemical parameters of the main kidney functions. Also, kidney samples of fetuses were taken for the histopathological study.

RESULTS

Fetuses of the diabetic mothers showed some developmental changes such as very thin skin, very thin muscle layer under the skin, absence of eyelid and ear pinna, exencephaly and kyphosis. On the other hand, fetuses of the diabetic mothers which were treated with parsley leaves extract showed somewhat normal morphological development. According to the biochemical histopathological observations, the parsley leaf extract succeeded to minimize the drastic changes, which were observed in the diabetic rats and their fetuses.

CONCLUSION

Administration of the parsley leaf extract has the ability to minimize the damage of hyperglycemia.

Streptozotocin-induced diabetes models: pathophysiological mechanisms and fetal outcomes

Glucose homeostasis is controlled by endocrine pancreatic cells, and any pancreatic disturbance can result in diabetes. Because 8% to 12% of diabetic pregnant women present with malformed fetuses, there is great interest in understanding the etiology, pathophysiological mechanisms, and treatment of gestational diabetes. Hyperglycemia enhances the production of reactive oxygen species, leading to oxidative stress, which is involved in diabetic teratogenesis. It has also been suggested that maternal diabetes alters embryonic gene expression, which might cause malformations. Due to ethical issues involving human studies that sometimes have invasive aspects and the multiplicity of uncontrolled variables that can alter the uterine environment during clinical studies, it is necessary to use animal models to better understand diabetic pathophysiology. This review aimed to gather information about pathophysiological mechanisms and fetal outcomes in streptozotocin-induced diabetic rats. To understand the pathophysiological mechanisms and factors involved in diabetes, the use of pancreatic regeneration studies is increasing in an attempt to understand the behavior of pancreatic beta cells. In addition, these studies suggest a new preventive concept as a treatment basis for diabetes, introducing therapeutic efforts to minimize or prevent diabetes-induced oxidative stress, DNA damage, and teratogenesis.