Continuous glucose monitor use in type 2 diabetes mellitus in pregnancy and perinatal outcomes: a systematic review and meta-analysis

OBJECTIVE

This study aimed to assess whether continuous glucose monitor use in type 2 diabetes mellitus in pregnancy is associated with improved perinatal outcomes.

DATA SOURCES

We searched Ovid MEDLINE, Scopus, ClinicalTrials.gov, and Cochrane library from inception through May 9, 2022.

STUDY ELIGIBILITY CRITERIA

We included all studies that compared continuous glucose monitor use with fingerstick glucose monitoring in women with type 2 diabetes mellitus.

METHODS

The initial search yielded 2463 unique citations that were screened in Covidence by 2 independent reviewers. Study types included randomized controlled trials, cohort studies, and cross-sectional studies. Our outcomes of interest were macrosomia or large-for-gestational-age infants, hemoglobin A1c, cesarean delivery, hypertensive disorders of pregnancy including preeclampsia, gestational age at delivery, and neonatal hypoglycemia.

RESULTS

Three randomized controlled trials met the inclusion criteria. We performed random-effects meta-analyses of estimates from 2 studies without risk of significant bias and reported summary adjusted odds ratios and 95% confidence intervals. Meta-analysis of 56 women with continuous glucose monitor use and 53 control women without continuous glucose monitor use showed that there was no difference in the incidence of large-for-gestational-age infants between continuous glucose monitor users and standard-of-care controls (odds ratio, 0.78; 95% confidence interval, 0.34-1.78) with an I2 of 0%. In addition, there was no difference in the development of preeclampsia between continuous glucose monitor users and standard-of-care controls (odds ratio, 1.63; 95% confidence interval, 0.34-7.22) with an I2 of 0%.

CONCLUSION

Continuous glucose monitor use was not associated with improved perinatal outcomes as assessed by large-for-gestational-age infants and preeclampsia. This review is limited by the small amount of data available for this population, and further research is needed.

8-Channel acquisition system for Time-Correlated Single-Photon Counting

Nowadays, an increasing number of applications require high-performance analytical instruments capable to detect the temporal trend of weak and fast light signals with picosecond time resolution. The Time-Correlated Single-Photon Counting (TCSPC) technique is currently one of the preferable solutions when such critical optical signals have to be analyzed and it is fully exploited in biomedical and chemical research fields, as well as in security and space applications. Recent progress in the field of single-photon detector arrays is pushing research towards the development of high performance multichannel TCSPC systems, opening the way to modern time-resolved multi-dimensional optical analysis. In this paper we describe a new 8-channel high-performance TCSPC acquisition system, designed to be compact and versatile, to be used in modern TCSPC measurement setups. We designed a novel integrated circuit including a multichannel Time-to-Amplitude Converter with variable full-scale range, a D∕A converter, and a parallel adder stage. The latter is used to adapt each converter output to the input dynamic range of a commercial 8-channel Analog-to-Digital Converter, while the integrated DAC implements the dithering technique with as small as possible area occupation. The use of this monolithic circuit made the design of a scalable system of very small dimensions (95 × 40 mm) and low power consumption (6 W) possible. Data acquired from the TCSPC measurement are digitally processed and stored inside an FPGA (Field-Programmable Gate Array), while a USB transceiver allows real-time transmission of up to eight TCSPC histograms to a remote PC. Eventually, the experimental results demonstrate that the acquisition system performs TCSPC measurements with high conversion rate (up to 5 MHz/channel), extremely low differential nonlinearity (<0.04 peak-to-peak of the time bin width), high time resolution (down to 20 ps Full-Width Half-Maximum), and very low crosstalk between channels.

Immunocytochemical analyses of annexin V (CaBP33) in a human-derived glioma cell line. Expression of annexin V depends on cellular growth state

The subcellular distribution of annexin V, a calcium-dependent phospholipid- and membrane-binding protein, in a human-derived cell line, GL15, was investigated by immunocytochemistry at light and electron microscope levels. Annexin V was found diffusely in the cytoplasm and associated with plasma membranes, membranes delimiting cytoplasmic vacuoles, membranes of the endoplasmic reticulum, and filamentous structures the identity of which remains to be established. By immunocytochemistry at the light microscope level and immunochemistry, the expression of annexin V in these cells was found to depend on cellular growth stage, being maximal soon after plating and progressively declining thereafter. However, re-expression of annexin V was observed whenever cell proliferation slowed down or arrested. These findings suggest that annexin V in glioma cells is mostly expressed in connection with cell differentiation. Also, the present ultrastructural data suggest that plasma membranes, membranes of the endoplasmic reticulum and the cytoskeleton are prominent sites of action of annexin V in vivo, thus lending support to the possibility that this protein might have a role in the regulation of cytoskeleton elements and/or of the structural organization of membranes.

'Neuron-specific' protein gene product 9.5 (PGP 9.5) is also expressed in glioma cell lines and its expression depends on cellular growth state

Protein gene product 9.5 (PGP 9.5), which in the normal nervous system is restricted to certain neurons, has been detected in two glioma cell lines, rat C6 and human GL15, by immunoblotting and immunocytochemistry. Its expression in these cells depends on the cellular growth state, being maximal between the first and second post-plating day. Only a faint PGP 9.5 immunoreactivity can be observed in glioma cells after the eleventh post-plating day, i.e. about one week after confluency has been reached. The present results suggest that PGP 9.5 in cultured glial cells is maximally expressed during the growth phase and that the protein could play a role during brain development in glial cells, in reactive gliosis, or in tumorigenesis of the glial lineage.