Iranian Journal of

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There are controversies on the effects of diabetes and lifestyle of affected patients on their bone mineral densities (BMDs). This study has investigated the effects of lifestyle of type 2 diabetics on BMD at the lumbar spine and proximal femur in pre and postmenopausal women.
Methods: In a historical cohort study, 20 pre-menopausal type 2 diabetics and 57 non-diabetics and 126 type 2 Diabetics and 315 non-diabetics postmenopausal women, were recruited. BMD measurements were also made to the spine and proximal femur (Neck, Wards, and Shaft) by dual energy X-ray absorptiometry (DXA) technique. Exclusion criteria were endocrine, rheumatologic or chronic diseases. Type 2 diabetic cases and non-diabetics were matched for age and body mass index (BMI) in both pre menopausal or postmenopausal groups.
Results: A total of 146 type 2 Diabetic patients without any other endocrine disorder and 372 non-diabetic women, aged 40-81 years were enrolled. No significant differences were found between diabetics and healthy controls in terms of BMD values of spine and femur regions in the pre‌menopausal women. Postmenopausal diabetics, however, had higher BMD at the lumbar spine compared with the healthy postmenopausal controls. An age-related decrease in BMD values (lumbar and femur) was observable in all groups and a significant correlation between BMI and BMD was found. Adjusting for age and BMI, the effect of lifestyle on BMD at all sites was investigated. Occupation was associated with BMD in postmenopausal, but not in premenopausal women. Among the investigated dietary items, milk, yogurt and cheese were all associated with increased BMD in at least one region in diabetic patients. Smoking was not associated with BMD.
Conclusion: Type 2 Diabetes does not seem to be complicated by bone loss and osteoporosis. Physical activity and milk consumption in postmenopausal diabetic women can be a protective factor against bone loss.

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Background: Recurrent GDM are more common in women with previous GDM. Also GDM is an important risk factor for abnormal glucose tolerance and type 2 diabetes during postpartum. This study aims to determine the prevalence of postpartum IGT and T2DM in women with previous GDM.
Methods: A cohort study was conducted on 2416 pregnant women referred to five Tehran university hospital clinics. The universal screening was performed with a GCT-50g and those with plasma glucose level130mg/dl, were diagnosed as having GDM if they had an impaired GTT-100g based on Carpenter and Coustan criteria. All pregnancies were followed up until delivery. Available GDM patients underwent an OGTT-75gr within 6 to 12 weeks after delivery. Postpartum diabetes mellitus was diagnosed according to ADA criteria. Student T test and ANOVA used for comparing means of variables and Chi Square used for comparing of frequency of variables. Value of P less than 0.5 determine as significant different.
Results: the prevalence of GDM was 4.7%. In fallow up 85.9% of women with GDM were screen in postpartum. 16.3% of women required insulin treatment and other patients were managed with diet. Prevalence of postpartum diabetes mellitus and IGT were 8.1% (CI 95%: 3.5-15.4) and 21.4% (CI 95%: 13.7-30.8) respectively, and 70.5% returned to normoglycemy.
Conclusion: Abnormal glucose tolerance is a common disorder in the early postpartum in GDM patients. Because of the high incidence of glucose tolerance disorders in women with previous GDM, screening, diagnosis and management during pregnancy was important for prevention of these disorders. Following up these mothers after delivery is highly recommended.

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Background: Women with gestational diabetes mellitus (GDM) have a reported 3% to 65% risk of developing type 2 diabetes. This study aims to identify the factors in GDM patients which can predict the risk of postpartum impaired glucose tolerance (T2DM+IGT) and T2DM.
Methods: A cohort study was conducted on 2416 pregnant women referred to five university hospital clinics. The universal screening was performed with a GCT- 50g and those with plasma glucose level  130mg/dl, were diagnosed as GDM if they had an impaired GTT-100g based on Carpenter and Coustan criteria. All pregnancies were followed until delivery. Available GDM patients underwent an OGTT-75gr within 6 to 12 weeks after delivery. Postpartum diabetes mellitus was diagnosed according to ADA criteria.
Results: Such factors as FBS105 during pregnancy, insulin requirement during pregnancy and BMI≥27kg/m2 before pregnancy were more prevalent in postpartum diabetic patients as compared with normal controls, significantly. Multivariate analysis suggested that gestational requirement for insulin and BMI≥27kg/m2 were the best predictors for developing postpartum diabetes. Also history of abortion, gestational requirement for insulin and BMI≥27kg/m2 were the best predictors for postpartum IGT.
Conclusion: Women with GDM have a substantially increased risk of developing postpartum IGT or diabetes. High glucose levels, insulin requirement during pregnancy, history of abortion and BMI≥27kg/m2 are the best predictors for postpartum diabetes and IGT.

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Background: Gestational diabetes mellitus is a common metabolic disorder in pregnancy. Low levels of sex hormone–binding globulin level (SHBG) is associated with increased insulin resistance and hyperinsulinemia. The aim of this study was comparison of SHBG levels between gestational diabetic pregnant women and normal ones.
Methods: Serum SHBG concentration were measured in 38 women with gestational diabetes and in 143 women with normal pregnancy. The levels of Insulin, C-peptide and testosterone were measured and Insulin resistance was estimated via HOMA Index. Insulin sensitivity was estimated via QUIKE Index.
Results: Serum SHBG concentrations was significantly lower in the diabetic group (P=0.015). In a logistic regression model after adjustment of age, body mass index (BMI) and number of gravid, lower than 25 percentile of SHBG was independently effective in prediction of gestational diabetes mellitus.
Conclusion: SHBG concentrations are lower in gestational diabetic pregnant women and low levels account as a predictor of gestational diabetes mellitus.

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Background: Few studies have investigated maternal leptin concentrations in women with pregnancies complicated by gestational diabetes mellitus (GDM), and these published results are conflicting. We examined the association between plasma leptin concentration and GDM risk.
Methods: As a cross-sectional study 741 pregnant women that referred to five university hospital clinics were recruited. The universal screening was performed with a GCT-50g and those with plasma glucose level ≥130mg/dl, were diagnosed as GDM if they had an impaired GTT-100g based on Carpenter and Coustan criteria. The level of insulin was measured during OGTT-100g. Also maternal plasma leptin concentrations were measured.
Results: GDM patients had higher age, parity, BMI, and serum leptin concentration as compare with normal pregnancies. In logistic regression model serum leptin levels were independent factor for GDM.
Conclusion: Serum leptin concentrations can predict GDM.