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Biomedical subjects

M Hod

Publications and source records attributed to M Hod.

120 records · Page 7Linked to original sources
PubMed1985

Glucose tolerance test in Israeli pregnant women.

An oral glucose tolerance test (GTT) was performed in 1,055 healthy Israeli women at various stages of pregnancy. The whole venous blood glucose levels were higher in Israeli pregnant women than in American pregnant women. By adding 2 SD to the mean values, the upper limits of the oral GTT in the Israeli pregnant women were higher than the corresponding limits in American pregnant women. According to our results, 2.7% of Israeli pregnant women have gestational diabetes. However, if American standards are used, then 3.7% of our population would be considered to have gestational diabetes. Each population should be evaluated, therefore, according to its specific standards. The mean +/- 2 SD glucose levels of the GTT in pregnant women at age greater than or equal to 30 years were higher than those of the entire population of pregnant women. It is suggested, therefore, that the GTT of each pregnant woman should be considered according to her age-group.

Adolescent↗
PubMedDate not supplied

Short- and long-range complications in offspring of diabetic mothers.

The perinatal mortality rate of infants of diabetic mothers (IDMs) has declined dramatically from 250 per 1000 live births in the 1960s to a near-normal 20 per 1000 live births in the 1980s. Five to 8% of all IDMs suffer from major congenital malformations, and it is the latter that are responsible for 50% of these perinatal deaths. It has been shown that tight glycemic control prior to conception and during pregnancy can prevent an excess rate of congenital malformations, fetal macrosomia, birth trauma, and neonatal respiratory distress syndrome. We briefly review the short- and long-range complications that occur in offspring of diabetic mothers (ODMs) from gestation through young adulthood. Short-term neonatal complications, such as hypoglycemia, hypocalcemia, hypomagnesemia, hyperbilirubinemia, and polycythemia, are related mainly to fetal hyperinsulinemia, hypoxemia, and prematurity. They are readily controllable within the setup of modern neonatal intensive care units. Long-range complications include an increased rate of childhood and adolescent obesity, impaired glucose tolerance or diabetes mellitus, and subtle neuropsychological dysfunctions. These may be related to the severity of the maternal hyperglycemia during pregnancy, the consequent fetal hyperinsulinemia, and third trimester maternal lipid metabolism disturbances. Today we have at hand the knowledge and tools to properly treat both pregestational and gestational diabetes. Increased education of the general practitioner and the target population regarding early referral of pregestational diabetic mothers and the implementation of screening programs for gestational diabetes will further reduce diabetic pregnancy-related morbidity.

Adolescent↗
PubMedDate not supplied

Pregnancy outcome in patients with insulin dependent diabetes mellitus and diabetic nephropathy treated with ACE inhibitors before pregnancy.

The preconception and intrapregnancy parameters that are relevant to outcome in women with insulin dependent diabetes mellitus (IDDM) and diabetic nephropathy remain controversial. We analyzed the types and frequencies of maternal and neonatal complications in 24 IDDM patients with diabetic nephropathy (24 pregnancies), all with preserved to mildly impaired renal function. All patients received treatment with captopril for at least six months prior to planned pregnancy and were maintained under strict glycemic control from at least three months before pregnancy to delivery. A successful pregnancy outcome (live, healthy infant without severe handicaps two years after delivery) was observed in 87.5% of the patients. Preexisting hypertension was the only parameter found to be significantly predictive of an unsuccessful outcome (p = 0.0004). We conclude that in patients with IDDM complicated by diabetic nephropathy, pre-pregnancy captopril treatment combined with strict glycemic control offers a prolonged protective effect against possible renal deterioration and probably improves pregnancy outcome.

Adult↗
PubMedDate not supplied

Developmental outcome of offspring of pregestational diabetic mothers.

The aim of this study was to investigate the one-year developmental outcome of offspring of mothers with pregestational diabetes mellitus (PGDM). We prospectively evaluated 31 women with PGDM (21 with type 1 DM and 10 with type 2 DM) and 41 nondiabetic controls during pregnancy and for one year follow-up. Data showed that offspring of mothers with PGDM scored lower than controls in all aspects of development--mental, psychomotor, and exploration/orientation. Despite the good metabolic control of the mothers with PGDM, their offpsring showed a less favorable developmental outcome at one year than infants of nondiabetic mothers. MDI score and PDI score were significantly lower in the diabetic group than in the controls (91.04 vs 98.15, p<0.05 and 85.15 vs 95.54, p<0.05, respectively). In addition, the orientation/engagement score was lower in the diabetic group as compared with the nondiabetic group (41.04 vs 45.50, p<0.05). Whereas no significant difference was found between the type 1 and type 2 groups with regard to the MDI score, type 2 infants scored lower on the PDI than infants in the type 1 group (78.1 vs 89.3) but higher on the motor quality score (34.0 vs 31.3). These preliminary findings support the need for ongoing large scale developmental follow-up studies of offspring born to diabetic mothers in order to elucidate whether they have cognitive impairment later in life.

Adult↗
PubMedDate not supplied

Dynamic parameters of glycine metabolism in diabetic human pregnancy measured by [15N]glycine and gas chromatography-mass spectrometry.

This study presents kinetic parameters of glycine metabolism during pregnancy and the influence of fuel availability in the maternal compartment. The effect of gestational diabetes mellitus (diet treated) and pre-gestational diabetes mellitus (diet and insulin treated), accompanied by increased fetal growth on [15N]glycine kinetic parameters, compared to normal pregnancies with normal fetal growth, has been determined. This process was measured by administration of a single-dose of [15N]glycine to post-absorptive normal and diabetic pregnant women during the third trimester of pregnancy. Gas chromatography-mass spectrometry was used to determine the 15N enrichment of plasma glycine, and to calculate the pool sizes, turnover rate constants, fluxes and metabolic clearance rates. Glycine pool sizes in pre-gestational diabetes were significantly larger than those in normal pregnancy and gestational diabetes. Glycine turnover rate constants and metabolic clearance rates were not significantly different between the normal pregnant women and the two diabetic groups of pregnant women. Glycine fluxes were significantly higher in the pre-gestational diabetic pregnant women than in gestational diabetes and normal pregnancy. The pre-gestational diabetic pregnant women delivered fetuses with higher birth weights than the other two groups.

Adult↗
PubMedDate not supplied

Prevalence of congenital anomalies and neonatal complications in the offspring of diabetic mothers in Israel.

The prevalence of diabetes in pregnancy and its fetal and perinatal consequences in a large population of Israeli pregnant women during the last decade are presented. The study population consisted of 878 gestational diabetic women, 132 pre-gestational diabetic women, and 380 healthy pregnant women who served as controls. Minor congenital anomalies ranging between 19.4 and 20.5%, major congenital anomalies between 1.80 and 6.82%, and neonatal complications, such as macrosomia (5.6-25.0%), hypoglycemia (0.9-7.8%), hyperbilirubinemia (8.2-16.7%), hypocalcemia (2.7-5.5%) and polycythemia (3.8-13.3%), were observed in the study population. Despite meticulous maternal glucose control, we could not entirely eliminate fetal and neonatal complications. The definition of the normal and abnormal fetal intrauterine metabolic environment remains to be elucidated.

Congenital Abnormalities↗
PubMedDate not supplied

The fetus of the diabetic mother: growth, malformations and methods of surveillance by ultrasonography--the Beilinson Medical Center experience.

Some important issues continue to plague the perinatologist caring for the pregnant diabetic. These issues deal principally with fetal surveillance to prevent macrosomia, idiopathic prematurity and multiple congenital anomalies. In this report particular emphasis is placed upon the role of transvaginal and transabdominal ultrasonography in monitoring fetal growth and in early detection of congenital anomalies. New modalities, such as Doppler flow measurements and nuclear magnetic resonance imaging, are described in addition to our experience at the Beilinson Medical Center in monitoring diabetic pregnancies by these modalities.

Congenital Abnormalities↗
PubMedDate not supplied

Hydralazine-induced hepatitis in pregnancy.

During 1983, 38 patients with pregnancy-induced hypertension were treated with hydralazine-apresoline (1-hydrazinophthalazine). During the course of their treatment, five of these patients showed evidence of the HELLP syndrome described by Weinstein (hemolysis, thrombocytopenia, and elevated liver enzymes). Evidence is presented on the role of hydralazine in producing hepatocellular damage. Liver function is compromised during the natural course of pregnancy-induced hypertension, and 5-10% of preeclamptic patients develop the HELLP syndrome. In many places hydralazine is the drug of choice in the treatment of pregnancy-induced hypertension.

Chemical and Drug Induced Liver Injury↗