Genetics of Gestational Diabetes Mellitus
•Transferir como PPTX, PDF•
3 gostaram•1,517 visualizações
Presented by Dr. Mashfiqul Hasan (Phase B Resident, Endocrinology & Metabolism) on 27th May, 2013
Recomendados
Mais conteúdo relacionado
Mais procurados
Mais procurados (20)
Destaque
Destaque (20)
Semelhante a Genetics of Gestational Diabetes Mellitus
Semelhante a Genetics of Gestational Diabetes Mellitus (20)
Mais de Endocrinology Department, BSMMU
Mais de Endocrinology Department, BSMMU (19)
Último
Último (20)
Genetics of Gestational Diabetes Mellitus
- 1. Genetics of GDM Dr. Mashfiqul Hasan Phase B Resident Department of Endocrinology BSMMU 1
- 2. Overview of presentation • What is GDM • Pathogenesis of GDM • Importance of GDM • Genetics of GDM • Scope of Genetic study in BSMMU • Principles of genetic study 2
- 3. 1. WHAT IS GDM? 3
- 4. Definition • Any degree of glucose intolerance with onset or first recognition during pregnancy • Whether or not the condition persisted after pregnancy • Not excluding the possibility that unrecognized glucose intolerance may have antedated or begun concomitantly with the pregnancy 4
- 6. To overcome the limitation • Screen women with risk factors for type 2 diabetes for diabetes at their initial prenatal visit, using standard diagnostic criteria • Women with diabetes found at this visit should receive a diagnosis of overt, not gestational, diabetes 6
- 7. Diagnostic criteria • Still much controversies • ADA 2013 • When any of the following plasma glucose values are exceeded – – Fasting ≥ 5.1 mmol/L – 1h ≥ 10.0 mmol/L – 2h ≥ 8.5 mmol/L 7
- 8. 2. PATHOGENESIS OF GDM 8
- 9. Hormone & fuel balance in pregnancy • Early pregnancy – Prepare the mother – Accentuation of fat deposition – Expansion of β cell mass – α cells remain unchanged 9
- 10. Hormone & fuel balance in pregnancy • As the pregnancy progresses – Increasing insulin resistance (50%) – Increased insulin production from the previously expanded cells (threefold) – Increased lipolysis in adipose tissue leads to a shift toward fatty acid utilization by maternal tissues 10
- 11. Hormone & fuel balance in pregnancy • Increased insulin resistance – Facilitated Anabolism • Increased lipolysis in mother – Accelerated starvation 11
- 12. It is said that a large proportion of GDM women are experiencing Future T2DM in advance 13
- 13. 3. IMPORTANCE OF GDM 14
- 14. Prevalence • Reflects prevalence of type 2 DM in population • GDM affects 3% to 15% of pregnancies • In Bangladesh, a pilot study done in a tertiary care hospital showed that the prevalence of GDM was 7.8% • >30% in GDM study, BSMMU 15
- 15. Complications of GDM • Fetal risk • Maternal risk • Future risk of DM 16
- 16. 4. GENETICS OF GDM 17
- 17. Heritability of GDM • Positive family history (45.1% in GDM study, BSMMU) • Both GDM women and their offspring are at increased risk of future development of T2DM • It can be hypothesized that GDM and type 2 diabetes share a common genetic background • It is not known whether there are genetic risk loci specific to GDM 18
- 18. 19
- 19. Genetic factors in T2DM • Differences between ethnic groups • Concordance in Monozygotic twins • Clustering in family • Polygenic inheritence 20
- 20. Approaches for genetic study 1. Candidate gene study 2. Genome wide association study 21
- 21. 22
- 22. 23
- 23. 24
- 24. 5. SCOPE OF GENETIC STUDIES 25
- 25. Scope of GDM study, BSMMU • To investigate whether the candidate genes that confer susceptibility to T2DM are also correlated with GDM in pregnant Bangladeshi women. 26
- 26. 6. PRINCIPLES OF GENETIC STUDY 27
- 27. Building blocks of DNA 28
- 28. 29
- 29. 30
- 30. 31
- 31. ‹#›
- 32. ‹#›
- 34. Thank You 35