International Journal of Endocrinology and Metabolism
Volume:5 Issue: 3, sep 2007

To describe antenatal maternal complications and neonatal outcomes caused by gestational diabetes mellitus. This descriptive observa-tional study was conducted in the Department of Obstetrics and Gynaecology (Obs & Gynae), Baha-wal Victoria Hospital, Bahawalpur, Pakistan, over a the period of one year, from January 1 to December 31, 2003. Fifty pregnant women diagnosed by glu-cose tolerance tests as diabetics were enrolled as study subjects and followed regularly at the Obs & Gynae out-patient department. Blood glucose levels were controlled by diet per se or with insulin and subjects were hospitalized for insulin dose adjust-ment and management of complications. Feotal well being was assessed by ultrasound, kick count and cardiotocography. Time and mode of delivery was decided upon at 36th week of gestation. Intra-partum maternal blood glucose level was monitored and fetal monitoring was done by external cardioto-cography. Out of a total of 1429 women delivered, 50(3.5%) were diagnosed as GDM and studied. Forty-four (88%) patients were above 25 years of age and 38(76%) were multiparous. Thirty-two (64%) subjects required insulin to control GDM. Most fre-quent maternal and feotal complications were poly-hydramnios 9(18%) and macrosomia 18(36%), respec-tively. One out of fifty subjects had a spontaneous miscarriage and one had intrauterine death. Caesar-ean section was done in 29(58%) patients. Total number of babies delivered alive were 48(96%). GDM was diagnosed in 3.5% of preg-nant women. Most of the subjects were above 25 years and multiparous. Most common maternal complication was polyhydramnios and caesarean section was a common mode of delivery. Macro-somia and jaundice were most prominent complica-tions among neonates.

Several studies have assessed marital relationship in patients with different chronic diseases. However, literature lacks data regarding this issue in diabetic patients receiving renal replacement therapy. Here, we report our preliminary findings regarding the differences of marital relationship between diabetics being treated for End-Stage Renal Disease (ESRD) and diabetics with normal kidney function. Mateirlas and In a case-control study, 94 diabetic patients were divided into three groups ac-cording to renal replacement therapy: group I, renal transplanted subjects (n=38); group II, hemodialysis patients (n=20); group III, diabetics without ESRD (n=36). The groups were matched for gender, age and educational levels. Group I and II were also matched with regard to the duration of ESRD. In-formation on parameters, clinical data, and marital relationship measures was gathered. Marital rela-tionship was evaluated with the Revised Dyadic Ad-justment Scale, which includes four domains of Dy-adic Consensus, Affection Expression, Dyadic Satis-faction and Dyadic Cohesion, with lower scores in-dicating greater impairment in marital relationship. Scores of different subscales were compared be-tween the groups. No significant difference was found be-tween the groups with respect to any of the study subscales. In group I, marital relationship and scores of the four marital quality measures were better in patients without any history of renal graft rejection than subjects with such a history. We did not find any difference regard-ing marital relationship between diabetic patients with and without ESRD. It also seems that the qual-ity of marital relationship is independent of the type of renal replacement therapy.

Hemodialysis patients (HD) with functional iron deficiency (FID) often develop resistance to re-combinant human erythropoietin (rHuEpo). Re-cent studies suggest that intravenous ascorbic acid (IVAA) may circumvent rHuEpo resistance, while oral AA is readily attainable. The aim of this study was to evaluate efficacy and safety of oral versus intravenous vitamin C in FID and whether this can improve anemia in hemodialy-sis patients. In this study, 31 hemo-dialysis patients with serum ferritin >100 µg/L, transferin saturation (Tsat) <30% and Hb<11g/dL were selected and randomly divided into the oral and IV groups. The IVAA group received vi-tamin C 1.5 g, administered weekly and the oral group, 125 mg vitamin C daily for two months. Hb, ferritin, serum iron, Tsat and serum oxalate were measured at the beginning of the study and 2 months later. Independent–sample T-Test were used for intergroup comparison. P value <0/05 was considered significant. Mean Hb difference was 1.1±0.7 g/dL in the oral and 0.1±1 g/dL in the IVAA group, being significantly higher in the oral group (p=0.02). There were no significant differences between the two groups in the delta means of ferritin & Tsat (p=0.5, p=0.3). Delta means of serum oxalate in the 2 groups were 0.05±0.4 mg/L, and 0.1± 0.3 mg/L respectively, difference not significant (p=0.3). Oral AA significantly increased Hb in HD patients suffering from FID. Considering the feasibility and cost-effectiveness, clinicians could consider oral instead IVAA in rHuEpo hy-poresponsive patients undergoing HD.

Iranians have recently showed a rapid nutritional transition toward a more sedentary lifestyle and un-healthy dietary practices, these changes being more obvious in younger adults. Limited information however exists on different sub-classes. The main objective of this study was to evaluate the obesity prevalence and its lifestyle related behaviors in all female personnel working in administrative posi-tions at Ahvaz Jundi-Shahpour University, Iran. In this cross-sectional study, all 101 female staff of the university, aged 20-45y, were interviewed and data on their food frequency, physical activity, drug and medical histories, was documented and anthropometric questionnaires were also completed and scored. Data collection was carried out during spring 2005. Percent of body fat was measured using the bioelectrical impedance analysis (BIA) method. Based on the BIA method, overweight and obesity rates were determined in 34.6 and 40.6 per-cent of women, respectively, and central obesity was prevalent in 27% of them. Women with bachelor de-grees had less body fat percentage and body mass index (BMI) than those with lower degrees (31.8±5.6 vs 35.5±5.8 percent; p<0.002 and 25.5±3.9 vs 28.5±4.5 kg/m²; p<0.003). About 30% of the subjects ate bis-cuits and dates during working hours as snacks. Moreover, except for breads, the score of consuming other food groups based on food guide pyramid was low. The higher vegetable oil intake, the higher the body fat percentage (p<0.05). There were no rela-tionships between consumption of other food groups with anthropometric and clinical parameters. However, 83% of individuals did not engage in ei-ther daily of weekly physical activity programs. Re-peated weight loss programs were associated with increase in body fat percentage (p<0.05). Obesity and overweight rates are highly prevalent in female university staff, and the higher educational levels are associated with less body fat percentage. High-calorie snacks and sedentary life-style seem to be the main reasons of gaining weight in women working in administrative jobs; they need to control their snacks and to include more physical activity programs in their daily schedules.

World-wide it is estimated that over 2.5 million peo-ple are blind due to diabetes mellitus. The exact pathogenesis of diabetic retinopathy is not fully un-derstood. Some factors may act simultaneously in the pathogenesis diabetic retinopathy. Although ma-jor advances in the clinical diagnosis and treatment of diabetic retinopathy and its associated complica-tions have been achieved over the past 5 decades, diabetic retinopathy remains the leading cause of new blindness among working-age coincides with peak fertility and childbearing years, individuals in developed countries. Understanding the risk factors that may lead to progression among diabetic women in pregnancy is of great important in the manage-ment of diabetic retinopathy. Patients who are in good glucose control at the start of pregnancy and who maintain tight control during pregnancy have little risk of progression of retinopathy. Slowing the progression of retinopathy and reducing visual loss in pregnancy seems to be by the use of laser photo-coagulation before pregnancy