Maria Grazia Dalfrà

University of Padua

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Annunziata Lapolla

University of Padua

Alessandra Bertolotto

Azienda Ospedaliera Universitaria Pisana

Gernot Desoyé

Medical University of Graz

Agnieszka Zawiejska

Jagiellonian University

Peter Damm

University of Copenhagen

Rosa Corcoy

Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine

Alexandra Kautzky‐Willer

Medical University of Vienna

David Simmons

Camden and Campbelltown Hospitals

Mireille N. M. van Poppel

University of Graz

David J. Hill

Lawson Health Research Institute

Cooperative Institutions

University of Padua

Advanced Micro Devices (Canada)

Associazione Medici Diabetologi

Istituti di Ricovero e Cura a Carattere Scientifico

Italian Society of Periodontology and Implantology

University of Pisa

University of Florence

Sapienza University of Rome

National Research Council

Medical University of Graz

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Reference Intervals for Hemoglobin A1c in Pregnant Women: Data from an Italian Multicenter Study

Clinical Chemistry (2006)

Andrea Mosca Renata Paleari Maria Grazia Dalfrà Graziano Di Cianni Ilaria Cuccuru

The reference intervals for hemoglobin A1c (Hb A1c) in pregnant women without diabetes are not well defined, and few examples of reference intervals established by networks of different laboratories are available.Five Italian Diabetic Care Units were involved in the study. Data were collected from 445 pregnant women without diabetes, selected on the basis of glucose challenge test results, and from 384 nonpregnant control women. The Hb A1c measurements were performed with HPLC systems aligned to the Diabetes Control and Complications Trial. Plasma glucose measurements were also performed locally. Both Hb A1c and glucose measurements were harmonized by running appropriate external quality assessment schemes. The reference intervals were calculated in terms of nonparametric 2.5th to 97.5th percentiles with 0.90 confidence intervals.The Hb A1c measurements were reproducible (CV = 2.0%) and accurate [mean (SE) difference from the target values, -0.10 (0.06)%]. Glucose measurements were also reproducible (mean CV = 3.2%) and accurate [difference from the target values, -0.01 (0.04) mmol/L]. To calculate common reference intervals, we merged the data collected in the different centers. The Hb A1c reference intervals were 4.0%-5.5% for pregnant nondiabetic women and 4.8%-6.2% for nonpregnant controls.Healthy pregnant women have lower Hb A1c concentrations than nonpregnant women. The reference intervals for Hb A1c in pregnant women should therefore be lower than those currently in use.

Reference values

Mean difference

Hemoglobin A

10.1373/clinchem.2005.064899

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Diabetic pregnancy outcomes in mothers treated with basal insulin lispro protamine suspension or NPH insulin: a multicenter retrospective Italian study

The Journal of Maternal-Fetal & Neonatal Medicine (2015)

Maria Grazia Dalfrà Angela Soldato Paolo Moghetti Simonetta Lombardi Carmela Vinci

The aim of this study was to study the efficacy and safety of long-acting insulin analog insulin lispro protamine suspension (ILPS) in diabetic pregnant women.In a multicenter observational retrospective study, we evaluated pregnancy outcome in 119 women affected by type 1 diabetes and 814 with gestational diabetes (GDM) treated during pregnancy with ILPS, compared with a control group treated with neutral protamine hagedorn (NPH) insulin.Among type 1 diabetic patients, fasting blood glucose at the end of pregnancy was significantly lower in ILPS-treated than in NPH-treated patients. HbA1c levels across pregnancy did not differ between groups. Caesarean section and preterm delivery rates were significantly lower in the ILPS-women. Fetal outcomes were similar in the ILPS and NPH groups. Among GDM women, fasting blood glucose at the end of pregnancy was significantly lower in ILPS-treated than in NPH-treated patients. Duration of gestation was significantly longer, caesarian section and preterm delivery rates were lower in the ILPS-treated group. In addition, there were significantly fewer babies with an excessive ponderal index or neonatal hypoglycemic episodes in the ILPS group than in the NPH group.Association of ILPS with rapid-acting analogs in pregnancy is safe in terms of maternal and fetal outcomes.

NPH insulin

Insulin lispro

10.3109/14767058.2015.1033619

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Gestational diabetes mellitus in Italy: A multicenter study

European Journal of Obstetrics & Gynecology and Reproductive Biology (2009)

Annunziata Lapolla Maria Grazia Dalfrà Matteo Bonomo Elena Parretti Domenico Mannino

10.1016/j.ejogrb.2009.04.023

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Prepregnancy BMI influences maternal and fetal outcomes in women with isolated gestational hyperglycaemia: A multicentre study

Diabetes & Metabolism (2010)

Annunziata Lapolla M. Bonomo Maria Grazia Dalfrà Elena Parretti Domenico Mannino

Fetal macrosomia

Gestational hypertension

10.1016/j.diabet.2010.01.008

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Elevations of inflammatory cytokines during and after pregnancy in gestational diabetes

Journal of Endocrinological Investigation (2009)

Maria Grazia Dalfrà Domenico Fedele Eugenio Ragazzi Chiara Cosma T. Bisson

10.1007/bf03346470

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New IADPSG recommendations: impact on care for gestational diabetes

Diabetes Management (2011)

Annunziata Lapolla Nino Cristiano Chilelli Maria Grazia Dalfrà

SUMMARY If gestational diabetes mellitus (GDM) is not recognized and treated, it has a negative impact on maternal and fetal health. No general consensus on how best to screen for and diagnose this disease has been established to date. The Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study and two randomized trials on the treatment of mild GDM have confirmed the close relationship between maternal glycemia and perinatal outcome. In the light of these findings, new recommendations have recently been formulated by the International Association of Diabetes and Pregnancy Study Groups (IADPSG), also concerning the diagnosis of overt diabetes early in pregnancy and routine screening for GDM at 24 gestational weeks with a 75 g oral glucose tolerance test, considering even only one higher than normal value sufficient for a diagnosis of GDM. Here we discuss the possible impact of these new recommendations on the treatment of GDM.

10.2217/dmt.11.39

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Pregnancy after Bariatric Surgery: Nutrition Recommendations and Glucose Homeostasis: A Point of View on Unresolved Questions

Nutrients (2023)

Silvia Burlina Maria Grazia Dalfrà Annunziata Lapolla

Obesity is increasing in all age groups and, consequently, its incidence has also risen in women of childbearing age. In Europe, the prevalence of maternal obesity varies from 7 to 25%. Maternal obesity is associated with short- and long-term adverse outcomes for both mother and child, and it is necessary to reduce weight before gestation to improve maternal and fetal outcomes. Bariatric surgery is an important treatment option for people with severe obesity. The number of surgeries performed is increasing worldwide, even in women of reproductive age, because improving fertility is a motivating factor. Nutritional intake after bariatric surgery is dependent on type of surgery, presence of symptoms, such as pain and nausea, and complications. There is also a risk of malnutrition after bariatric surgery. In particular, during pregnancy following bariatric surgery, there is a risk of protein and calorie malnutrition and micronutrient deficiencies due to increased maternal and fetal demand and possibly due to reduction of food intake (nausea, vomiting). As such, it is necessary to monitor and manage nutrition in pregnancy following bariatric surgery with a multidisciplinary team to avoid any deficiencies in each trimester and to ensure the well-being of the mother and fetus.

10.3390/nu15051244

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Long-term cardio-metabolic effects after gestational diabetes: a review

The Journal of Maternal-Fetal & Neonatal Medicine (2021)

Silvia Burlina Maria Grazia Dalfrà Annunziata Lapolla

Women with GDM are at high risk of metabolic syndrome and type 2 diabetes (T2DM). A relationship with GDM and future development of cardiovascular disease (CVD) has been also recognized. Pregnancy and postpartum period in women with GDM give us the opportunity to identify the underlying, often unrecognized, CVD risk factors. Ideally, the postpartum follow-up of this women should be done by a multidisciplinary team to evaluate their cardio-metabolic risk and to counseling regarding lifestyle modification (healthy diet and regular physical activity) and breastfeeding that can reduce their risk. Longer follow-up of these women should be individualized, focusing attention on women at medium-high cardio-metabolic risk. The link between GDM and T2DM-CVD offers us a great opportunity for the diseases prevention.

Metabolic disease

10.1080/14767058.2021.1903863

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Pregnancy and Diabetes

Frontiers in diabetes (2014)

Annunziata Lapolla Maria Grazia Dalfrà

Achieving good metabolic control during the period prior to conception is the key to reducing congenital malformations that can occur in pregnancies complicated by diabetes. Various different glycated hemoglobin (HbA1c) levels (the gold standard for ascertaining metabolic control in diabetes) and glucose levels have been recommended. The current guidelines and latest studies on the best levels to obtain in diabetic women before and during pregnancy are reported here and discussed. Finally, the optimal therapeutic approach and the possible beneﬁts and risks related to the use of the new insulin analogues in pregnancy will be analyzed.

Diabetes in pregnancy

10.1159/000363461

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Zenodo (CERN European Organization for Nuclear Research) (2020)

Silvia Burlina Cristina Banfi Maura Brioschi Silvia Visentin Maria Grazia Dalfrà

This record contains raw data related to the article" IS THE PLACENTAL PROTEOME IMPAIRED IN WELLCONTROLLED GESTATIONAL DIABETES?" ABSTRACT
In pregnancy complicated by gestational diabetes (GDM), the human placenta shows several pathological functional and structural changes, but the extent to which maternal glycemic control contributes to placental abnormalities remains unclear. The aim of this study was to profile and compare the proteome of placentas from healthy pregnant women and those with GDM, to investigate the placenta-specific protein composition and possible changes of its function in presence of GDM. Quantitative proteomic analysis, based on LC-MS^E approach, revealed that higher (≈15% increase) levels of galectin 1 and collagen alpha-1 XIV chain (although the difference regarding the latter was at the limit of significance) were present in GDM samples, while heat shock 70 kDa protein 1A/1B was less abundant in GDM placental tissue. These data seem to indicate that GDM, when well-controlled, did not markedly affect the placental proteome.

Proteome

10.5281/zenodo.3695495

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