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Identification of biomarkers involved in the pathophysiology of gestational diabetes mellitus.
Šimják, Patrik ; Pařízek, Antonín (advisor) ; Karásek, David (referee) ; Novotný, Zdeněk (referee)
Identification of biomarkers involved in the pathophysiology of gestational diabetes mellitus ABSTRACT Gestational diabetes mellitus is a disorder of glucose metabolism that occurs in pregnancy and resolves after delivery. Increasing production of pregnancy-related hormones leads to insulin resistance which is not adequately compensated by increased insulin secretion. Since obesity is an important risk factor for gestational diabetes and is also associated with adipose tissue dysfunction and increased peripheral insulin resistance, the question arises as to what extent is the adipose tissue involved in the development of gestational diabetes. The first part of the thesis focuses on the identification of changes in plasma concentration and mRNA expression of adipokines fetuin A, fetuin B and FGF21. In our study we did not show that the presence of gestational diabetes significantly influenced the plasma concentration of fetuin A, fetuin B and FGF21 during pregnancy. An important finding was that women who had pregnancy complicated with gestational diabetes had a significantly higher concentration of FGF21 several months after delivery in comparison to healthy pregnant women. We have been able to demonstrate the production of fetuin A in the placenta and fetuin B in perineal and subcutaneous tissue. However,...
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First-trimester screening of pregnancy-related complications using plasma exosomal C19MC microRNAs
Špačková, Kamila ; Hromadníková, Ilona (advisor) ; Daňková, Pavlína (referee)
Pregnancy-related complications such as gestational hypertension, preeclampsia, fetal growth restriction, gestational diabetes mellitus, spontaneous preterm birth, and preterm premature rupture of membranes may have severe consequences for both the mother and the child. The development of reliable early screening methods for pregnancy-related complications has therefore been a long-term goal of obstetrics. New possibilities for prenatal diagnostics have opened with the discovery of circulating microRNAs in maternal plasma. MicroRNAs are short, noncoding, 21 to 23 nucleotides long, single-strand RNAs whose main function is to regulate gene expression. During pregnancy, both common and unique miRNAs are expressed by the placenta, amongst them the miRNAs of the C19MC cluster. Several C19MC miRNAs have been shown to display a different expression profile associated with certain pregnancy-related complications. This thesis identifies the plasma exosomal profiles of six C19MC miRNAs (miR-516-5p, miR-517-5p, miR-518b, miR-520a-5p, miR-520h, and miR-525-5p) in patients in their first trimester of gestation who later developed pregnancy-related complications, and compares them with profiles in patients with normal pregnancies.
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The risk of type 2 diabetes in women treated for gestational diabetes
Cvejnová, Michaela ; Anderlová, Kateřina (advisor) ; Krejčí, Hana (referee)
This bachelor's thesis deals with the subject of gestational diabetes mellitus (GDM), the most common metabolic disorder in pregnancy. GDM is a carbohydrate metabolism disorder that develops during pregnancy and disappears after delivery. GDM is associated with a lot of complications and risks for both mother and child. For this reason, it is very important to make an early diagnosis of GDM and start timely treatment, which includes lifestyle changes, regular physical activity, or drug therapy. The theoretical part summarizes current information on GDM. In the practical part, follow-up OGTT data obtained 3 - 6 months after delivery were analysed. The aim of the thesis was to assess OGTT results through a statistical analysis of data of women treated for GDM diagnosed in 2016 and 2017. Retrospective processing of medical records was done. It was found that 75 patients (48.1%) had positive follow-up OGTT results after delivery, out of which 70 patients (93.3%) had elevated fasting blood glucose. 7 patients (9.3%) had increased glycaemia at 120 minutes after the test. Positive OGTT results fell into the pre-diabetic range. Only a very small percentage of women undergo follow-up OGTT after delivery, although nearly half of them have positive OGTT results. Risk factors such as higher BMI before...
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Metabolic specifics of women with a positive history of gestational diabetes
Jarošová, Adéla ; Vejražková, Daniela (advisor) ; Krejčí, Hana (referee)
Gestational diabetes (GDM) is a disorder of glucose metabolism arising for the first time in pregnancy and spontaneously receding after birth. The issue of GDM is very topical since, according to the latest update of diagnostic criteria, up to 17% of pregnant women is threatened by this disorder. The incidence of GDM correlates with the increasing prevalence of overweight/obesity and metabolic syndrome. It is proved that women who have had gestational diabetes have an enormously increased risk of developing type 2 diabetes mellitus (DM2T). The risk accosiated with a gestational diabetes pregnancy stretches beyond the host, and can affect the fetus both directly (e. g. macrosomia development), and epigenetically (increases susceptibility to obesity, DM2T development or cardiovascular disease). Significant influence on the development of GDM (or DM2T) is a body composition that is directly related to lifestyle (nutritional intake and physical activity) and genetic role i salso involved. Early intervention may help delay the risk of developing DM2T and other metabolic complications. In this diploma thesis we monitored metabolic profiles of glucose and lipids and body composition based on anthropometric examination and questionnaires of nutritional income and physical activity. For the complex...
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Diet by gestational diabetes mellitus
Svobodová, Kateřina ; Flekač, Milan (advisor) ; Šoupal, Jan (referee)
The bachelor thesis deals with gestational diabetes mellitus, mainly delicated to risk factors and dietary restriction before and during pregnancy. The aim of this work is to identify potential risk factors that could affect the eventual progression of gestational diabetes. Most of my hypotheses are specifically related to this objective. The partial aim is a level of women's awareness about this disease. My work is divided into theoretical and practical part. The theoretical part is a collection and summarization of the available current information about gestational diabetes. GDM is a disorder of carbohydrate tolerance, which is diagnosed in pregnancy by a screening examination (usually at 24 - 28 weeks), and it disappears in postnatal period. There are many severe risks for the woman and the fetus during the pregnancy and after childbirth. There is also a high risk of emergence of type 2 diabetes in the future. Primary treatment is an adjustment food and life style. Diet system is regulated in amount of carbohydrate intake and distribution into multiple smaller doses. If this is not sufficient, the onset of insulin therapy is necessery. The practical part is focused on comparison, usage a retrospective analysis of medical history data based on of a questionnaire surfy. There was two groups of...
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Nutrition of women with pregnant diabetes and pregnant diabetics of the 1st type - recommendation and reality
ŠTYBNEROVÁ, Monika
This bachelor thesis deals with nutrition of women suffering from gestational diabetes mellitus and pregnant type 1 diabetics. The theoretical part focuses on the description of diabetes in general, directly on gestational diabetes mellitus and the number of risks that threaten mother, fetus and newborn. This is followed by a separate chapter dedicated to the nutrition of these women. The research was attended by 5 gestational diabetics and 5 type 1 diabetics. The aim was to map the eating habits of gestational diabetics and pregnant type 1 diabetics. From the evaluated meal plans, the respondents prefer to eat. The energy intake corresponds to their needs. The amount of carbohydrates is lower, but the lower the standards are set, on the contrary, the fat intake is higher than the prescribed standard. Nevertheless, proportional representation is consistent with the recommendations of the Czech Diabetes Society. The average amount of fiber received was around 20 g per day, although the recommended daily dose is 30 g. The questionnaire evaluations show that respondents are informed about appropriete eating habis and are aware of the risks that they impose on themselves and their children if they do not follow dietary recommendations and diet. Therefore, they try to eat rationally and follow nutritional recommendations so as not to endanger their health or the health of their children. Theya lead acitive livestyles, most of them go for walks every day, some also go swimming or deal with pregnancy yoga.
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Midwifery care about a woman diagnosed with gestational diabetes mellitus
KADLECOVÁ, Kristýna
Midwifery care about a woman diagnosed with gestational diabetes mellitus Abstract The bachelor thesis is focused on the midwife's care of a woman with a diagnosis of gestational diabetes mellitus. In the theoretical part, there several issues are described, such as gestational diabetes mellitus, its diagnosis and treatment, birth, puerperium, newborn, role of midwife, education, communication and related gestational diabetes mellitus. The survey was conducted with women in their home environment during March 2017. A qualitative method was used to carry out the research part. Data collection was conducted through semi-structured interviews with women diagnosed with gestational diabetes mellitus during pregnancy. Semi-structured interviews were carried out on prior agreement and with the consent of women. The interview contained 8 open questions, which were supplemented, if necessary, with other questions. Data analysis was done by the hand-coded method, or pen and paper method. Answers of individual respondents were identified by codes that were then categorized under each subcategory. One goal was set for this bachelor thesis. The objective was to find out what opinions women have on the possible necessary lifestyle changes in relation to gestational diabetes mellitus. Based on this aim, three research questions have been identified. The first one was focused on how the woman perceived the diagnosis. The second question tried to find out the changes in the lifestyle of women with gestational diabetes mellitus. And the third one was how the woman was educated by a midwife about the lifestyle change. The research revealed that all respondents, after being diagnosed with gestational diabetes mellitus, changed their existing lifestyle. All respondents carefully followed the treatment diet throughout the pregnancy until the end of the puerperium. Of these, two respondents included physical activity in their treatment as a quick walk. A research survey also showed that the midwife gave women limited information about GDM and lifestyle changes. Respondents were totally educated about a lifestyle change at the diabetes clinic, but they did not consider the midwife in the area as a educator. As a result, midwives tend to rely on the education of women from the diabetes clinic, and they only complete women's knowledge. The results of this research can serve ast the information material for midwives who want to improve their care of a woman during pregnancy or who are currently preparing for this profession.
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Extracellular microRNAs and their role in pathologies especially in the field of gynecology and obstetrics.
Štěrbová, Monika ; Hromadníková, Ilona (advisor) ; Balušíková, Kamila (referee)
microRNAs (miRNAs) represent a relatively newly discovered group of RNA molecules and they serve to regulate gene expression. In spite of processes of differentiation, proliferation and apoptosis, miRNAs influence the whole biological systems, such as embryogenesis, oncogenesis, and immunity. There have been a number of experiments in recent years concerning diagnoses and predictions of complications during pregnancy, and tumour growth. Extracellular miRNA molecules participating in circulation of patients are used in the non-invasive diagnostics. RNA molecules usually get into the extracellular fluid during the apoptosis process. I chose four diseases, which extracellular miRNA have diagnostic potential - preeclampsia, intrauterine growth retardation, gestational diabetes mellitus and breast cancer - for my work. An aberrant expression of different levels of various extracellular miRNAs has been reported in these diseases but the clinical use of microRNAs in the diagnosis and prediction of those still requires further research and optimization. Keywords: breast cancer, extracellular nucleic acids, fetal growth retardation, gestational diabetes mellitus, microRNA, PCR, preeclampsia
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Screening of diabetes mellitus in pregnancy by oral glucose tolerance test.
HAUSEROVÁ, Ivana
The theme of bachelors thesis is screening of diabetes mellitus in pregnancy by laboratory examination of oral glucose tolerance test. The introductory part is devoted to the history, the definition of diabetes, causes of disease, complications, diagnosis, treatment, and even the importance of this test for pregnant women. Currently, testing is performed on all pregnant women at 24th 28th week of pregnancy. The exception are women who are found in at least two risk factors in history: family history of diabetes, fetal birth weight greater than 4000 g, obesity, diabetes mellitus in previous pregnancies, the presence of sugar in the urine (glycosuria), previous stillbirth, hypertension or preeclampsia in previous pregnancies, recurrent miscarriages. Those women are considered as high risk and oral glucose tolerance test is done as soon as possible in the first trimester. The practical part is focused on the implementation of oral glucose tolerance test and includes pre-analytical, analytical and postanalytical stage. Here I am trying to identify possible mistakes in the laboratory setting in all its phases. This section includes the results of measurements between 26 January 2011 and 24 April 2011 in a clinical laboratory Tabor There were 108 examined women. In this measurement I found out the number of women with gestational diabetes mellitus and compared it with the available literature. The measurement of blood glucose was carried out on biochemical ADVIA 1800 Chemistry Systems from Siemens. The principle of the method is Trinders reactions with glucose oxidase. Glucose is determined after enzymatic oxidation in the presence of glucose oxidase. The generated hydrogen peroxide reacts with peroxidase catalyzed the phenol and 4-aminophenazone, and thereby forming a reddish-purple as an indicator dye, whose concentration is determined photometrically. Wavelength measurements 505/694nm. The intensity of the resulting compound is directly proportional to glucose concentration. To answer the research question, what is the relationship between the number of risk factos and the number of captured women with gestational diabetes mellitus in the selected file, I used printed questionnaire, where I examined the representation of individual risk factors. These important faeks I had put to clearly chart. The questionnaire filled my clients during the time that they spent in the examination of oGTT in the waiting room KLT.
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