Despite the increasing epidemic of diabetes mellitus affecting populations at different life stages, the global burden of gestational diabetes mellitus (GDM) is not well assessed. Systematically synthesized data on global prevalence estimates of GDM are lacking, particularly among developing countries. The hyperglycemic intrauterine environment as exemplified in pregnancies complicated by GDM might not only reflect but also fuel the epidemic of type 2 diabetes mellitus (T2DM). We comprehensively reviewed available data in the past decade in an attempt to estimate the contemporary global prevalence of GDM by country and region. We reviewed the risk of progression from GDM to T2DM as well. Synthesized data demonstrate wide variations in both prevalence estimates of GDM and the risk of progression from GDM to T2DM. Direct comparisons of GDM burden across countries or regions are challenging given the great heterogeneity in screening approaches, diagnostic criteria, and underlying population characteristics. In this regard, collaborative efforts to estimate global GDM prevalence would be a large but important leap forward. Such efforts may have substantial public health implications in terms of informing health policy makers and healthcare providers for disease burden and for developing more targeted and effective diabetes prevention and management strategies globally.

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Prevalence of Gestational Diabetes and Risk of Progression to Type 2 Diabetes: a Global Perspective.

The epidemic nature of diabetes mellitus in different regions is reviewed. The Middle East and North Africa region has the highest prevalence of diabetes in adults (10.9%) whereas, the Western Pacific region has the highest number of adults diagnosed with diabetes and has countries with the highest prevalence of diabetes (37.5%). Different classes of diabetes mellitus, type 1, type 2, gestational diabetes and other types of diabetes mellitus are compared in terms of diagnostic criteria, etiology and genetics. The molecular genetics of diabetes received extensive attention in recent years by many prominent investigators and research groups in the biomedical field. A large array of mutations and single nucleotide polymorphisms in genes that play a role in the various steps and pathways involved in glucose metabolism and the development, control and function of pancreatic cells at various levels are reviewed. The major advances in the molecular understanding of diabetes in relation to the different types of diabetes in comparison to the previous understanding in this field are briefly reviewed here. Despite the accumulation of extensive data at the molecular and cellular levels, the mechanism of diabetes development and complications are still not fully understood. Definitely, more extensive research is needed in this field that will eventually reflect on the ultimate objective to improve diagnoses, therapy and minimize the chance of chronic complications development.

Diabetes mellitus: The epidemic of the century

Gestational diabetes mellitus (GDM) is the most common metabolic disturbance during pregnancy. The prevalence is rising and correlates with the increase in maternal obesity over recent decades. The etiology of GDM is complex, with genetic and environmental factors implicated in mechanistic and epidemiological studies. GDM begets important short- and long-term health risks for the mother, developing fetus, and offspring. This includes the high likelihood of subsequent maternal type 2 diabetes (T2DM), and possible adverse cardiometabolic phenotypes in the offspring. The most clinically and cost-effective methods of screening for GDM remain uncertain. Whilst treatments with lifestyle and pharmacological interventions have demonstrated short-term benefits, the long-term impact for the offspring of intrauterine exposure to antidiabetic medication remains unclear.

Gestational Diabetes Mellitus: Mechanisms, Treatment, and Complications.

This is the protocol for a review and there is no abstract. The objectives are as follows: To evaluate the effects of lifestyle interventions in treating women with gestational diabetes.

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Lifestyle interventions for the treatment of women with gestational diabetes

https://dspace.stir.ac.uk/bitstream/1893/25524/1/Prevalence%20of%20Gestational%20Diabetes%20Mellitus%20in%20Europe%20final.pdf

Prevalence of gestational diabetes mellitus in Europe: A meta-analysis.

OBJECTIVE The use of the new International Association of the Diabetes and Pregnancy Study Groups criteria (IADPSGC) for the diagnosis of gestational diabetes mellitus (GDM) results in an increased prevalence of GDM. Whether their introduction improves pregnancy outcomes has yet to be established. We sought to evaluate the cost-effectiveness of one-step IADPSGC for screening and diagnosis of GDM compared with traditional two-step Carpenter-Coustan (CC) criteria.

RESEARCH DESIGN AND METHODS GDM risk factors and pregnancy and newborn outcomes were prospectively assessed in 1,750 pregnant women from April 2011 to March 2012 using CC and in 1,526 pregnant women from April 2012 to March 2013 using IADPSGC between 24 and 28 weeks of gestation. Both groups received the same treatment and follow-up regimes.

RESULTS The use of IADPSGC resulted in an important increase in GDM rate (35.5% vs. 10.6%) and an improvement in pregnancy outcomes, with a decrease in the rate of gestational hypertension (4.1 to 3.5%: −14.6%, P < 0.021), prematurity (6.4 to 5.7%: −10.9%, P < 0.039), cesarean section (25.4 to 19.7%: −23.9%, P < 0.002), small for gestational age (7.7 to 7.1%: −6.5%, P < 0.042), large for gestational age (4.6 to 3.7%: −20%, P < 0.004), Apgar 1-min score <7 (3.8 to 3.5%: −9%, P < 0.015), and admission to neonatal intensive care unit (8.2 to 6.2%: −24.4%, P < 0.001). Estimated cost savings was of €14,358.06 per 100 women evaluated using IADPSGC versus the group diagnosed using CC.

CONCLUSIONS The application of the new IADPSGC was associated with a 3.5-fold increase in GDM prevalence in our study population, as well as significant improvements in pregnancy outcomes, and was cost-effective. Our results support their adoption.

https://care.diabetesjournals.org/content/diacare/37/9/2442.full.pdf

Introduction of IADPSG Criteria for the Screening and Diagnosis of Gestational Diabetes Mellitus Results in Improved Pregnancy Outcomes at a Lower Cost in a Large Cohort of Pregnant Women: The St. Carlos Gestational Diabetes Study

Poster: "ECR 2013 / C-1419 / Do we know where to look at the glossopharyngeal nerve? Gross anatomy, cross-sectional imaging references and pathology" by: "J. M. Garcia Santos1, C. Vazquez Olmos1, S. Sanchez Jimenez1, N. Sanchez Izquierdo1, M. J. Moreno Cascales1, J. Lailhacar Marty2, M. A. Fernandez-Villacanas1; 1Murcia/ES, 2Puerto Montt/CL"

Do we know where to look at the glossopharyngeal nerve? Gross anatomy, cross-sectional imaging references and pathology

Poster: "SERAM 2014 / S-1313 / Utilidad de la ecografia con contraste intravenoso en la valoracion de los quistes renales complejos." by: "M. L. Maso Navarro1, M. Carrillo Garcia1, C. M. Ortiz Morales1, S. Sanchez Jimenez1, J. R. Olalla Munoz2, E. Alcaraz Mateo1; 1Murcia/ES, 2Murcia /ES"

Utilidad de la ecografía con contraste intravenoso en la valoración de los quistes renales complejos.

Objetivos Docentes
1. Repasar la anatomia de la arteria carotida externa (ACE) y sus ramas.
2. Identificar sus relaciones anatomicas en imagenes axiales.
3. Mostrar como la cirugia del cuello afecta a estos vasos.



Revision del tema
La arteria carotida externa (ACE) es la menor de las dos ramas terminales de la arteria carotida comun (ACC). Emerge de la bifurcacion carotidea, a nivel del borde superior del cartilago tiroides, a la altura de C4, en lo que se denomina el triangulo carotideo. Localizandose anterior y medial a la arteria carotida interna (ACI) en el 80% de los casos.
Tiene un trayecto craneal y medial. Pasa profunda al vientre posterior del musculo digastrico, describe una curva convexa medialmente que la acerca a la amigdala palatina, atraviesa el diafragma de los musculos estileos y penetra en la celda de la glandula parotida. Termina en la glandula parotida, por detras y proxima al cuello del condilo de la mandibula bifurcandose en dos ramas terminales.
Los troncos de la mayoria de sus ramas se encuentran en el triangulo carotideo, el cual esta delimitado superiormente por el vientre posterior del musculo digastrico, inferiormente por el vientre superior del musculo omohioideo, y posteriormente por el borde anterior el musculo esternocleidomastoideo

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Sandra Sánchez Jiménez

Papers

Introduction of IADPSG Criteria for the Screening and Diagnosis of Gestational Diabetes Mellitus Results in Improved Pregnancy Outcomes at a Lower Cost in a Large Cohort of Pregnant Women: The St. Carlos Gestational Diabetes Study

Do we know where to look at the glossopharyngeal nerve? Gross anatomy, cross-sectional imaging references and pathology

Utilidad de la ecografía con contraste intravenoso en la valoración de los quistes renales complejos.

La gran olvidada: la arteria carótida externa