---

Background&Objective: Due to side-effects of diabetes mellitus in pregnancy, the rapid diagnosis and its treatment is very important. The aim of this study is to determine gestational diabetes mellitus (GDM) incidence in pregnant women. Materials&Methods: This survey is an analytic cross sectional study that evaluated 401 pregnant women in Babol Obstetrics Clinic. A Glucose Challenge Test (GCT) was done for all of the high risk women for diabetes in the first trimester and for other pregnant women in 24-28 gestational weeks. If GCT was positive (Blood sugar>135 mg/dl one hour after oral administration of 50gr Glucose), then a Glucose Tolerance Test (GTT) was done. For women with a positive GTT, the diagnosis was GDM. Results: In 401 pregnant women with a mean age of 24.69±5.31 four patients had overt diabetes (1%). In another 397 women, a GCT was done and 44 women (11% of all patients) had a positive GCT and 19 patients (4.7% of all patients) had GDM of those with GDM 26.3% need insulin therapy in addition to a diabetic diet. We noted there was also a positive relation between age and impaired GCT (P<0.05). Conclusion: GCT is recommended as screening test in 24-28 gestational weeks for all pregnant women.

---

Background and Objective: Diabetes mellitus is one of the most common serious metabolic disorders characterized by hyperglycemia, altered metabolism of lipids, carbohydrates and proteins. Gestational diabetes mellitus (GDM), affects 3.5–5% of all human pregnancy. Therefore, this study was done to evaluate the effect of gestational diabetes on astrocyte density in CA1 and CA3 subfields of hippocampus in rat male offspring.

Materials and Methods: In this experimental study, 12 Wistar Dams rats were randomly allocated in control and diabetic groups. Gestational diabetes induced by 40 mg/kg/body weight of streptozotocin at the first day of gestation (GD) in experimental group and controls were received an equivalent volume normal saline injection intraperitoneally (IP). Six male offspring of cases and controls dams, at the 7, 21 postnatal day (P7, P21) were randomly selected. Animals were scarified using chloroform anesthesia. The coronal sections of brain by 6 micrometer serially were prepared. The sections were stained with PTAH. The number of astrocytes was evaluated in 100000 μm² area of CA1 and CA3 in 1000X magnification. Data was analyzed by SPSS-11.5 and t-test.

Results: In CA1 subfield of hippocampus in offspring, the number of astrocytes  significantly reduced by 36.25% and 36.37% in diabetic group in compare to controls in the P7 and P21, respectively (P<0.05). In CA3, astrocytes density significantly reduced 36.35% and 26.5% in GD in comparison with controls in the P7 and P21, respectively (P<0.05).

Conclusion: This study showed that the uncontrol gestational diabetes significantly reduces astrocytes density in CA1 and CA3 subfields of hippocampus in rat offspring.

---

Background and Objective: Some studies have shown that pregnant women with abnormal glucose challenge test (GCT) and normal oral glucose challenge test (OGTT) have the chance of adverse pregnancy outcomes including macrosomia, pre-eclampsia and increase of cesarean section rate. This study was performed to determine the pregnancy outcomes in women with abnormal glucose challenge test. Materials and Methods: This case –control study was done on 60 pregnant women with abnormal GCT (more than 130 mg/dl) and normal OGTT and 67 pregnant women with normal GCT (less than 130 mg/dl) in Kermanshah ,Iran during September 2010-March 2011. Results: Delivery with Vacum, polyhydroamnus, pre-eclampsia pyelonephritis and low birth weight significantly was higher in cases than controls (P<0.05). But there was a non significant difference in stillbirth, neonatal abnormality, neonatal respiratory distress and shoulder dystocia between case and control groups. Conclusion: Polyhydramnious, pre‌eclampsia and pyelonephrities and low birth weight are more frequent in pregnant women with abnormal GCT and normal OGTT in compare to pregnant women with normal GCT.

---

Background and Objective: Gestational diabetes is affected 3-12% of women and occurs at the final stage of second trimester. This study was done to determine the fructosamine and glycated hemoglobin level in pregnant women with abnormal glucose challenge test. Methods: This case – control study was carried out on 96 pregnant women with glucose challenge test (GCT)>140 mg/dl as cases and 96 pregnant women with GCT<140 mg/dl as controls. The serum fructosamine and glycated hemoglobin determined using ELISA and chemical methods, respectively. Results: In pregnant woman with abnormal GCT, there was a significant correlation with glycated hemoglobin and fructosamine. The glycated hemoglobin correlation was more significant compared to fructosamine (0.63 to 0.24). There was not significant correlation between GCT with fructosamine and glycated hemoglobin in individuals with normal GCT. Conclusion: The measurement of glycated hemoglobin is more accurate than fructosamine in pregnant women with abnormal glucose challenge test.

---

Background and Objective: Modification of life style, nutrional regiment and insulin therapy is used for improvement of pregnancy outcomes in pregnant women with gestational diabetes mellitus (GDM). This study was done to evaluate the effect of the dietary approaches to stop hypertension (DASH) eating plan on pregnancy outcomes in pregnant women with gestational diabetes mellitus. Methods: In this clinical trial study, 52 women with GDM were randomly divided into DASH and control groups for 4 weeks. The control diet contained 45-55% carbohydrates, 15-20% protein and 25-30% total fat. The DASH was rich in fruits, vegetables, whole grains and low-fat dairy products, and contained lower amounts of saturated fats, cholesterol and refined grains with a total of 2400 mg/day sodium. The numbers of women whom commenced insulin therapy after dietary intervention, the mode of delivery and prevalence of polyhydramnios were assessed. The length, weight and head circumference of infants were measured during the first 24 h after birth. Results: 46.2% of women in the DASH group needed to have a cesarean section, this rate for the control group was 80.8% (P<0.05). The percentage of those who needed to commence insulin therapy after intervention was 23% for DASH group vs 73% for controls (P<0.05). Infants born to mothers on the DASH group had significantly lower body weight (3222.7 vs 3818.8 g, P<0.05), head circumference (34.2 vs 35.1 cm, P<0.05) and ponderal index (2.50 vs 2.87 kg/m3, P<0.05) compared to those born to mothers on the control diet. Conclusion: Consumption of dietary approaches to stop hypertension for 4 weeks among pregnant women with GDM resulted in improved pregnancy outcomes.

---

Background and Objective: Pregnancy is a period of women’s life which is usually associated with reducing maternal daily physical activity. However, maintaining adequate daily physical activity is important for mother and fetus. This study was conducted to determine the relationship between exercise before and during pregnancy and gestational diabete mellitus (GDM).

Methods: This case-control study was conducted on 80 pregnant women with gestational diabete mellitus and 57 non-diabetic pregnant women. Physical activity during one and eight years before, and first and second trimesters of pregnancy was recorded through interview.

Results: Regular participation in exercise activities in non-diabetic women were significantly more than diabetic women during all periods (P<0.05). Regular participation in exercise during one year before and second trimester of pregnancy was inversely correlated to GDM (P<0.05). Energy expenditure of second trimester of pregnancy was significantly correlated to reduce GDM (P<0.05).

Conclusion: Regular exercise before and during pregnancy can be effective in reducing the probability of GDM. Exercise during one year before and especially second trimester of pregnancy are more important predictors of GDM.

---

Background and Objective: Gestational diabetes mellitus (GDM) is usually a disease caused by inadequate insulin production in pregnant women. GDM induces abnormal fetal growth.This study was done to evaluate the BMP2 and BMP4 genes expression in the development of the embryos heart in induced gestational diabetes of C57BL/6 mice.
Methods: In this experimental study, 8-week old adult C57BL/6 mice were randomly divided into diabetic and control groups. After mating of animals, the dams in diabetic group were received a single dose of 150 mg/kg/bw of streptozotocin on gestational day 1 of pregnancy, intrapereatonally. After 11.5 days of pregnancy, the embryos of both groups were extracted and heart tissue was extracted. RNA total tissue of the heart was extracted by trazole. After extracting RNA, expression of BMP2 and BMP4 genes in the heart of both groups was estimated by Real-time PCR.
Results: There was no singnificant diference in expression of BMP2 and BMP4 genes in the heart of 11.5 days of embryos in gestational diabetes mellitus group and control group.
Conclusion: Gestational diabetes mellitus had no effect on the expression of BMP2 and BMP4 genes in the development of the embryos heart.

---

Background and Objective: Gestational diabetes (GDM) is a metabolic disorder which is caused by insufficient secretion of insulin. GDM is a risk factor for embryo during pregnancy and it is possible leads to congenital heart defects (CHD). Some of these defects may be due to a change in the expression of some of the important structural genes in the heart. Desmocollin 2 and collagen structural genes have important role in the cell adhesion of the cardiomyocytes.This study was done to determine the effect of gestational diabetes on expersion of desmocollin 2 and col5a2 structural genes in C57BL mouse embryo heart.
Methods: In this experimental study, 12 adult female and six adult male C57BL mice were used.After mating of the animals and observation of the vaginal plug, the female mice with vaginal plug were randomly divided into diabetic and control groups. At the first day of pregnancy, Induction of gestational diabetes mellitus in dams in the diabetic group was performed by the intraperitoneal (IP) injection of Streptozotocin with a dose of 150 mg / kg body weight per day in GD1. While in the control group, only citrate buffer was injected.Cesarean Surgery was done at E11.5 and embryo's heart was extracted from the body.Extraction of RNA, cDNA, and quantitative measurements of the amount of RNA were performed using Real -Time PCR.
Results: Induction of gestational diabetes increased the expersion of desmocollin 2 and col5a2 structural genes in compared to controls, althought only the expersion of desmocollin 2 gene was significant (P<0.05).
Conclusion: We suggest that the induction of DM lead to upregulation of structural genes primarily including desmocollin 2 and col5a2 in embryos heart development.

---

Background and Objective: Diabetes mellitus is one of the most common metabolic and global health threats. The gene needed for the development of the TBX20 gene is the fusion of the gene, and the defect in the sequence and expression of this gene also causes heart defects. Due to significant prevalence of gestational diabetes mellitus in human population, this study was done to evaluate the effect of TBX20-induced gestational diabetes mellitus in the heart of the mice embryo at 11.5 days.
Methods: This experimental study was done on induced diabetic C57BL/6 female mice. Gestational diabetes induced by interaperitoneal injection of sterptozotocin at GD1. On the day of pregnancy 11.5, embryonic heart samples from these mice were isolated. After extraction of RNA, cDNA synthesis of RNA was performed. The Real Time-PCR technique was used to determine the expression of TBX20 gene. Expression level   of TBX20 gene in experimental and control was calculated using the 2^–∆∆CT method.
Results: Expression of TBX20 gene in diabetic specimens was twice as high as the control samples, which was statistically significant (P<0.05).
Conclusion: It seems, increasing TBX20 gene expression in embryonic heart tissue may be one of the complications of gestational diabetes mellitus and can lead to abnormalities in the heart embryo.