Search

Start Over Creator Krejčí, Hana

3. Proč bychom měli přijmout nová mezinárodní kritéria pro diagnózu gestačního diabetes mellitus?

Creator:
Krejčí, Hana, Anderlová, Kateřina, and Andělová, Kateřina
Format:
electronic, electronic resource, remote, and elektronický zdroj
Type:
model:article, article, Text, práce podpořená grantem, přehledy, and TEXT
Subject:
gestační diabetes--diagnóza--prevence a kontrola, směrnice pro lékařskou praxi jako téma--normy, plošný screening--normy, prenatální péče--trendy, týmová péče o pacienty, hodnocení rizik--normy, ženské pohlaví, lidé, and těhotenství
Language:
Czech and English
Description:
V České republice je od roku 2008 zaveden celoplošný screening gestačního diabetes mellitus u těhotných žen. Od roku 2014 jsou však výsledky orálního glukózového tolerančního testu (oGTT), který je součástí screeningu, hodnoceny podle dvojích kritérií. Zatímco diabetologové a biochemici nově postupují podle doporučení Mezinárodní asociace pro studium diabetu v těhotenství (IADPSG), přejatého v řadě zemí a také WHO v roce 2013, čeští gynekologové zůstávají u původních diagnostických kritérií z roku 2008. Článek rozebírá nejdůležitější argumenty proti přijetí nových kritérií a vysvětluje důležitost jednotného postupu při screeningu a sledování gestačního diabetes mellitus., Since 2008 there have been screened all pregnant women for gestational diabetes in the Czech Republic. Nevertheless since 2014 the results of the oral glucose tolerance test (which is a part of the screening) have been evaluated by two different sets of diagnostic criteria. While diabetologists as well as biochemists newly use the criteria recommended by the International Association of Diabetes and Pregnancy Study Groups (IADPSG), accepted by various national medical societies and WHO in 2013 as well, czech gynecologists still use the former criteria accepted in 2008. In the article we analyse the most important arguments against the new criteria and explain the importance of unified methods of screening and follow-up of gestational diabetes (GDM)., Hana Krejčí, Kateřina Anderlová, Kateřina Andělová, and Literatura
Rights:
http://creativecommons.org/publicdomain/mark/1.0/ and policy:public

4. Steroids, steroid associated substances and gestational diabetes mellitus

Creator:
Hill, Martin, Pařízek, Antonín, Šimják, Patrik, Koucký, Michal, Anderlová, Kateřina, Krejčí, Hana, Vejražková, Daniela, Ondřejíková, Leona, Černý, Andrej, and Kancheva, Radmila
Format:
počítač and online zdroj
Type:
model:article and TEXT
Subject:
gestational diabetes mellitus, steroidome, sex hormone binding globulin, kisspeptin, and CRH
Language:
English
Description:
As gestational diabetes mellitus (GDM) is both a frequent and serious complication, steroid levels in pregnancy are extremely elevated and their role in pregnancy is crucial, this review focuses on the role of steroids and related substances in the GDM pathophysiology. Low SHBG levels are associated with insulin resistance and hyperinsulinemia, while also predicting a predisposition to GDM. Other relevant agents are placental hormones such as kisspeptin and CRH, playing also an important role beyond pregnancy, but which are synthesized here in smaller amounts in the hypothalamus. These hormones affect both the course of pregnancy as well as the synthesis of pregnancy steroids and may also be involved in the GDM pathophysiology. Steroids, whose biosynthesis is mainly provided by the fetal adrenal glands, placenta, maternal adrenal glands, and both maternal and fetal livers, are also synthesized in limited amounts directly in the pancreas and may influence the development of GDM. These substances involve the sulfated Δ5 steroids primarily acting via modulating different ion channels and influencing the development of GDM in different directions, mostly diabetogenic progesterone and predominantly anti-diabetic estradiol acting both in genomic and non-genomic way, androgens associated with IR and hyperinsulinemia, neuroactive steroids affecting the pituitary functioning, and cortisol whose production is stimulated by CRH but which suppresses its pro-inflammatory effects. Due to the complex actions of steroids, studies assessing their predominant effect and studies assessing their predictive values for estimating predisposition to GDM are needed.
Rights:
http://creativecommons.org/licenses/by-nc-sa/4.0/ and policy:public