Publications by authors named "Patricia Medici Dualib"

Diabetes in pregnancy increases maternal and fetal risks as well as the burden of chronic complications and comorbidities associated with this condition. In addition to HbA1c and blood glucose monitoring (BGM), continuous glucose monitoring systems (CGM) provide a complementary tool that enables comprehensive glycemic assessments and improves glycemic control. This review highlights the clinical value of CGM in the management of diabetes in pregnancy, encompassing type 1 diabetes, type 2 diabetes, gestational diabetes mellitus (GDM), but also early GDM.

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Aim: This study compared the performances of the Steno Type 1 Risk Engine (ST1RE) and the Scottish-Swedish risk model in a predominantly young and ethnically diverse type 1 diabetes (T1D) cohort.

Methods: This retrospective study included 435 adults with T1D and no prior cardiovascular disease (CVD). The comparative performance of the models in predicting 10-year CV events was assessed using Kaplan-Meier analysis, ROC curves, the Hosmer-Lemeshow test, and Cohen's kappa coefficient.

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Objective: Pregnancy in women with type 1 diabetes mellitus has been associated with adverse outcomes due to persistent hyperglycemia and impaired maternal-fetal interactions. Regulatory T cells seem to exert a critical role in this process. Pregnancy can change the profile of Treg cells and affect the outcome of pregnancy; therefore, our purpose was to characterize the profile of regulatory T cells in the peripheral blood of pregnant and nonpregnant (controls) women with type 1 diabetes mellitus.

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Lactation is known to improve insulin resistance, but this phenomenon remains poorly understood. Our goal was to evaluate whether subclinical inflammation could mediate the association between breastfeeding (BF) and improvement in glucose metabolism and markers of insulin resistance (MIRs) in the postpartum. A total of 95 adult women (≥18 years) with a BMI ≥ 25 kg/m from the outpatient clinic of the Federal University of São Paulo were followed from early pregnancy until 60 to 180 days postpartum.

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Background: The Steno Type 1 Risk Engine (ST1RE) was developed to aid clinical decisions in primary prevention for individuals with type 1 diabetes (T1D), as existing cardiovascular (CV) risk models for the general population and type 2 diabetes tend to underestimate CV risk in T1D. However, the applicability of ST1RE in different populations remains uncertain, as prediction models developed for one population may not accurately estimate risk in another. This study aimed to evaluate the performance of the ST1RE in predicting CV events among ethnically mixed T1D individuals and its association with the progression of microangiopathy complications.

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Article Synopsis
  • The study aimed to compare the effectiveness of standard nutritional guidance versus guidance supplemented with digital media (WhatsApp reminders) for pregnant women with gestational diabetes mellitus (GDM).* -
  • Conducted from February 2021 to January 2023, 81 women were divided into two groups, with results showing improved glycemic control and increased lipid intake in the group receiving digital reminders compared to those with standard guidance.* -
  • While glycemic control improved significantly with the addition of reminders, no notable changes were observed in calorie intake, other macronutrients, or the need for pharmacological treatment between the two groups.*
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Objective: To evaluate the association between neck circumference (NC) measured during pregnancy and markers of glucose metabolism measured 2-6 months postpartum in women with overweight/obesity with and without gestational diabetes (GDM).

Subjects And Methods: This prospective study enrolled 100 pregnant women (including 50 with GDM) with pregestational body mass index (BMI) ≥ 25 kg and < 40 kg/m². The cohort was stratified according to NC tertiles during pregnancy.

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Objectives: To evaluate a postpartum telephone-based lifestyle intervention to prevent diabetes in high-risk women with recent gestational diabetes mellitus (GDM).

Design: Multicentre parallel randomised clinical trial.

Setting: Specialised antenatal clinics in the Brazilian National System.

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Article Synopsis
  • The TOP1 study examined the effects of switching from twice-daily basal insulin to once-daily insulin glargine (Gla-300) in adults with type 1 diabetes (T1D), focusing on glycemic control and quality of life over 28 weeks.
  • Despite no significant change in HbA1c levels after switching insulin regimens, participants experienced meaningful reductions in fasting blood glucose and improved overall glycemic profiles.
  • Patients also reported a significant increase in treatment satisfaction and a decrease in hypoglycemic events, indicating a positive impact on their diabetes management and quality of life.
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Article Synopsis
  • Diet plays a significant role as a risk factor for gestational diabetes mellitus (GDM), but studies on the link between women's diet and glucose tolerance during pregnancy are limited.
  • This study aimed to explore how previous dietary habits affect the results of glucose tolerance tests (GTT) in women with GDM, focusing on the potential inverse relationship between antioxidant micronutrient intake and abnormal GTT results.
  • Findings indicated that women with only one abnormal GTT value had higher fiber, vitamin D, and vitamin C intake compared to those with two or more abnormal values, suggesting a connection between these nutrients and better glucose tolerance.
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Introduction: The prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide. Strategies to decrease this risk should be strongly encouraged. Lactation has been associated, for the mother, with reduction in future T2DM risk in several studies.

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Objective: Pregnant women with type 1 diabetes (T1D) have an increased risk of maternal-fetal complications. Regarding treatment, continuous subcutaneous insulin infusion (CSII) has advantages compared to multiple daily injections (MDI), but data about the best option during pregnancy are limited. This study's aim was to compare maternal-fetal outcomes among T1D patients treated with CSII or MDI during pregnancy.

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Objectives: The present study aimed to evaluate the performance of QuantusFLM software, which performs quantitative ultrasound analysis of fetal lung texture, in predicting lung maturity in fetuses of diabetic mothers.

Methods: The patients included in this study were between 34 and 38 weeks and 6 days gestation and were divided into two groups: (1) patients with diabetes on medication and (2) control. The ultrasound images were performed up to 48 h prior to delivery and analyzed using QuantusFLM software, which classified each fetus as high or low risk for neonatal respiratory morbidity based on lung maturity or immaturity.

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Background: The incidence of gestational diabetes mellitus (GDM) is increasing worldwide, and has been associated with some changes in the gut microbiota. Studies have shown that the maternal gut microbiota pattern with hyperglycemia can be transmitted to the offspring. The study aimed to evaluate the gut microbiota of obese postpartum women with and without previous GDM and their offspring.

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Introduction: To assess the intention of actual pregnancy and its influence on glycated hemoglobin (HbA1c) profile before and during the pregnancy of women with previous diabetes mellitus (DM).

Methods: Prospective cohort study included pregnant women with previous DM assisted from October/2018 to October/2019. Data were collected with standardized questionnaire and from medical records.

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Objective: To evaluate the association of neck circumference (NC) with gestational diabetes (GDM) and adverse outcomes in women with overweight and obesity.

Subjects And Methods: This prospective study included 132 (BMI > 25 kg/m) pregnant women without and with GDM. Standardized questionnaire and biochemical/physical evaluation were performed during the 1 to 3 trimester.

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Background: Gestational Diabetes Mellitus (GDM) is one of the most prevalent complications of pregnancy and can cause adverse maternal and fetal outcomes. The maternal gut microbiota is involved in several metabolic functions, but it is not yet known its role in GDM physiopathology. This study aims to review the role of gut microbiota in pregnancies that evolved with GDM.

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Ketosis-prone type 2 diabetes (KPD) is an emerging form of diabetes mellitus characterized by unprovoked ketoacidosis, absence of autoimmunity and beta-cell dysfunction. The KPD may improve after initial glycemic compensation and evolve to exogenous insulin independence, most cases were observed in populations with African or Hispanic backgrounds. We reviewed the literature on KPD and, to date, only one case of KPD has been described in Brazil's multi-ethnic population.

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Article Synopsis
  • The study investigated the rates and variables associated with potentially life-threatening conditions (PTLC) and maternal near misses (MNM) in pregnant women with type 1 diabetes mellitus (T1DM) at a Brazilian tertiary hospital from 2005 to 2015.
  • Out of 137 T1DM patients, there were 8 cases of MNM (5.84%) and 51 cases of PTLC (37.23%), but no maternal deaths were reported, indicating a significant near miss rate per 1,000 live births.
  • The study found that prolonged hospital stays were the most common PTLC criteria in both MNM and PTLC cases, but no significant associations were found between prenatal factors or sociodem
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