human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE The aim was to investigate the relationship between  body mass index ( BMI ) , plasma leptin , glucose , insulin and C-peptide levels in the offspring of diabetic mothers ( DM ) and non-diabetic healthy mothers ( HM ) . DESIGN Seventy-two offspring ( 37 girls and 35 boys , age 4 - 20 years ) of DM were investigated in a prospect i ve study . Those 14 - 16 years old ( Tanner stage II-IV ) were compared with age-matched offspring of HM ( 33 girls and 33 boys ) . RESULTS BMI strongly correlated with plasma leptin concentration in the offspring of both DM and HM children . There were higher BMI and plasma leptin and glucose levels in DM than in HM children . There was no difference in plasma insulin or C-peptide levels between HM and age-matched DM children . There was a highly significant positive correlation between plasma leptin and C-peptide in boys of DM . CONCLUSIONS The higher plasma leptin found in the offspring of DM reflects their higher BMI . A moderately high but still normal glycemia might be a pre clinical sign of insulin resistance or other disturbance of glucoregulation To test the feasibility of conducting a pragmatic r and omized controlled trial ( RCT ) comparing the International Association of Diabetes in Pregnancy Study Groups ( IADPSG ) versus Carpenter – Coustan diagnostic criteria for gestational diabetes ( GDM ) , and to examine patient and provider views on GDM screening . A single-blinded pragmatic pilot RCT . Participants with a singleton pregnancy between 24 and 28 weeks gestation received a 50 g oral glucose challenge test and if the value was < 200 mg/dL were r and omized to either the 2 h 75 g OGTT using the IADPSG criteria or the 3 h 100 g OGTT using the Carpenter – Coustan criteria . Primary outcome was the feasibility of r and omization and screening . Secondary outcomes included patient and provider views ( or preferences ) on GDM testing .  Sixty-eight women were recruited , 48 ( 71 % ) enrolled and 47 ( 69 % ) were r and omized . Participants in both study arms identified the main challenges to GDM testing to be : drinking the glucola , fasting prior to testing , waiting to have blood drawn , and multiple venipuntures . Women in both study arms would prefer the 2 h 75 g OGTT or whichever test is recommended by their doctor in a future pregnancy . Physicians and nurse midwives endorsed screening and were comfortable with being blinded to the GDM testing strategy and results values . Both pregnant women and providers value GDM screening , and pregnant women can be recruited to a blinded , r and omized GDM screening trial with minimal attrition and missing data STUDY OBJECTIVE To compare the diagnostic performances of 75 g and 100 g oral glucose tolerance tests in detecting  Gestational Diabetes Mellitus in Nigerian pregnant women . MATERIAL S AND METHODS 248 women in 3rd trimester attending antenatal clinic of the Lagos University Teaching Hospital , Lagos , between November 1997 and July 1999 were r and omly subjected to st and ard oral glucose tolerance tests ( OGTT ) . 110 had 100 g OGTT while 138 had 75 g OGTT . The plasma glucose response ( PGR ) was assessed and glucose tolerance status of each patient was determined using WHO ( 1985 ) criteria to interpret 75 g OGTT and National Diabetes Data Group ( NDDG ) ( 1979 ) criteria for 100 g OGTT . The PGR in the two study groups were compared . The prevalence rates of GDM using either of the two criteria were evaluated and compared . Incidences of foetal macrosomia in GDM cases diagnosed by either set of criteria were also compared . RESULTS The mean age of the study subjects was 30.7(+/-4.2 ) years while the BMI was 25.4(+/-4.9 ) kg/m2 . The mean parity was 1.33 . Traditional risk factors for GDM were found in 47.5 % of them . The plasma glucose response ( PGR ) to 100 g OGTT was found to be higher than that of 75 g OGTT at 1 hour , 2hour and 3 hour sampling times but the difference was only significant at 3rd hour ( p values = 0.68 , 0.137 , 0.007 respectively ) . The total area under the glucose response curve ( AUC ) for 75 g OGTT was 345.1 ( + /-49.5 ) AAU while for 100 g OGTT , it was 363.4(+/-61.4 ) AAU . The difference was not statistically significant ( p value > 0.05 ) . The prevalence rate of GDM diagnosed by 75 g OGTT was 11.6 % while that of 100 g OGTT was 4.5 % . The difference was significant ( p value = 0.04 ) . The incidence rate of foetal macrosomia among GDM cases diagnosed by 100 g OGTT was 66.7 % as against 23.1 % among those diagnosed by 75 g OGTT . Statistical difference could not be determined because of the small number . CONCLUSION Plasma glucose response to OGTT among Nigerian pregnant women has little or no respect for the load of the glucose administered . 100 g OGTT- based NDDG criteria was more stringent than 75 g OGTT-based WHO criteria in identifying GDM . However it appears to be more specific for detecting the complications associated with the condition though it will require a larger study to vali date this cl aim OBJECTIVE To demonstrate a role of early insulin secretion on plasma glucose levels after different amounts of oral glucose loads in pregnant women . MATERIAL AND METHOD Forty-one pregnant women with normal glucose tolerance according to the Carpenter and Coustan ' s criteria and 25 non-pregnant women ( control group ) with normal glucose tolerance according to the World Health Organization criteria were enrolled . Each subject was r and omly scheduled to perform both the 100-g and 75-g OGTT within a 1-week interval . Venous blood was drawn at fasting , 30- , 60- , 120- , and 180-minute intervals during both tests for determination of plasma glucose and serum insulin levels . RESULTS The mean ( + /- SE ) ages of the pregnant and control groups were 33.3 + /- 0.9 and 31.8 + /- 1.4 years , respectively . The mean gestational age at the time of performing OGTT of the pregnant group was 28.7 + /- 0.6 weeks . In the non-pregnant group , the plasma glucose concentrations were not different between 75-g and 100-g OGTT whereas the serum insulin levels at the 30 and 180 minutes of the 100-g OGTT were significantly higher than those of the 75-g OGT . In the pregnant group , both plasma glucose and serum insulin concentrations at the 120 and 180 minutes of the 100-g OGTT were significantly higher than those of the 75-g OGT . CONCLUSION The limited ability of early insulin secretion to increase when glucose load increased in the pregnant women could explain the high plasma glucose levels at 2 and 3 hours of 100-g OGTT compared to those of 75-g OGTT Background The risks associated with gestational diabetes mellitus ( GDM ) are well recognized , and there is increasing evidence to support treatment of the condition . However , clear guidance on the ideal approach to screening for GDM is lacking . Professional groups continue to debate whether selective screening ( based on risk factors ) or universal screening is the most appropriate approach . Additionally , there is ongoing debate about what levels of glucose abnormalities during pregnancy respond best to treatment and which maternal and neonatal outcomes benefit most from treatment . Furthermore , the implication s of possible screening options on health care costs are not well established . In response to this uncertainty there have been repeated calls for well- design ed , r and omised trials to determine the efficacy of screening , diagnosis , and management plans for GDM . We describe a r and omised controlled trial to investigate screening uptake rates and the clinical and cost effectiveness of screening in primary versus secondary care setting s. Methods / Design This will be an unblinded , two-group , parallel r and omised controlled trial ( RCT ) . The target population includes 784 women presenting for their first antenatal visit at 12 to 18 weeks gestation at two hospitals in the west of Irel and : Galway University Hospital and Mayo General Hospital . Participants will be offered  universal screening for GDM  at 24 to 28 weeks gestation in either primary care ( n = 392 ) or secondary care ( n = 392 ) locations . The primary outcome variable is the uptake rate of screening . Secondary outcomes include indicators of clinical effectiveness of screening at each screening site ( primary and secondary ) including gestational week at time of screening , time to access antenatal diabetes services for women diagnosed with GDM , and pregnancy and neonatal outcomes for women with GDM . In addition , parallel economic and qualitative evaluations will be conducted . The trial will cover the period from the woman ’s first hospital antenatal visit at 12 to 18 weeks gestation , until the completion of the pregnancy . Trial registration Current Controlled Trials : IS RCT Summary Background Diagnosis of gestational diabetes predicts risk of infants who are large for gestational age ( LGA ) and with high adiposity , which in turn aims to predict a future risk of obesity in the offspring . South Asian women have higher risk of gestational diabetes , lower risk of LGA , and on average give birth to infants with greater adiposity than do white European women . Whether the same diagnostic criteria for gestational diabetes should apply to both groups of women is unclear . We aim ed to assess the association between maternal glucose and adverse perinatal outcomes to ascertain whether thresholds used to diagnose gestational diabetes should differ between south Asian and white British women . We also aim ed to assess whether ethnic origin affected prevalence of gestational diabetes irrespective of criteria used . Methods We used data ( including results of a 26–28 week gestation oral glucose tolerance test ) of women from the Born in Bradford study , a prospect i ve study that recruited women attending the antenatal clinic at the Bradford Royal Infirmary , UK , between 2007 and 2011 and who intended to give birth to their infant in that hospital . We studied the association between fasting and 2 h post-load glucose and three primary outcomes ( LGA [ defined as birthweight > 90th percentile for gestational age ] , high infant adiposity [ sum of skinfolds > 90th percentile for gestational age ] , and caesarean section ) . We calculated adjusted odds ratios ( ORs ) and their 95 % confidence intervals ( CIs ) for a 1 SD increase in fasting and post-load glucose . We established fasting and post-load glucose thresholds that equated to an OR of 1·75 for LGA and high infant adiposity in each group of women to identify ethnic-specific criteria for diagnosis of gestational diabetes . Findings Of 13 773 pregnancies , 3420 were excluded from analyses . Of 10 353 eligible pregnancies , 4088 women were white British , 5408 were south Asian , and 857 were of other ethnic origin . The adjusted ORs of LGA per 1 SD fasting glucose were 1·22 ( 95 % CI 1·08–1·38 ) in white British women and 1·43 ( 1·23–1·67 ) in south Asian women ( pinteraction with ethnicity = 0·39 ) . Results for high infant adiposity were 1·35 ( 1·23–1·49 ) and 1·35 ( 1·18–1·54 ; pinteraction with ethnicity=0·98 ) , and for caesarean section they were 1·06 ( 0·97–1·16 ) and 1·11 ( 1·02–1·20 ; pinteraction with ethnicity=0·47 ) . Associations between post-load glucose and the three primary outcomes were weaker than for fasting glucose . A fasting glucose concentration of 5·4 mmol/L or a 2 h post-load level of 7·5 mmol/L identified white British women with 75 % or higher relative risk of LGA or high infant adiposity ; in south Asian women , the cutoffs were 5·2 mmol/L or 7·2 mml/L ; in the whole cohort , the cutoffs were 5·3 mmol/L or 7·5 mml/L. The prevalence of gestational diabetes in our cohort ranged from 1·2 % to 8·7 % in white British women and 4 % to 24 % in south Asian women using six different criteria . Compared with the application of our whole-cohort criteria , use of our ethnic-specific criteria increased the prevalence of gestational diabetes in south Asian women from 17·4 % ( 95 % CI 16·4–18·4 ) to 24·2 % ( 23·1–25·3 ) . Interpretation Our data support the use of lower fasting and post-load 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE The aim was to investigate the relationship between  body mass index ( BMI ) , plasma leptin , glucose , insulin and C-peptide levels in the offspring of diabetic mothers ( DM ) and non-diabetic healthy mothers ( HM ) . DESIGN Seventy-two offspring ( 37 girls and 35 boys , age 4 - 20 years ) of DM were investigated in a prospect i ve study . Those 14 - 16 years old ( Tanner stage II-IV ) were compared with age-matched offspring of HM ( 33 girls and 33 boys ) . RESULTS BMI strongly correlated with plasma leptin concentration in the offspring of both DM and HM children . There were higher BMI and plasma leptin and glucose levels in DM than in HM children . There was no difference in plasma insulin or C-peptide levels between HM and age-matched DM children . There was a highly significant positive correlation between plasma leptin and C-peptide in boys of DM . CONCLUSIONS The higher plasma leptin found in the offspring of DM reflects their higher BMI . A moderately high but still normal glycemia might be a pre clinical sign of insulin resistance or other disturbance of glucoregulation To test the feasibility of conducting a pragmatic r and omized controlled trial ( RCT ) comparing the International Association of Diabetes in Pregnancy Study Groups ( IADPSG ) versus Carpenter – Coustan diagnostic criteria for gestational diabetes ( GDM ) , and to examine patient and provider views on GDM screening . A single-blinded pragmatic pilot RCT . Participants with a singleton pregnancy between 24 and 28 weeks gestation received a 50 g oral glucose challenge test and if the value was < 200 mg/dL were r and omized to either the 2 h 75 g OGTT using the IADPSG criteria or the 3 h 100 g OGTT using the Carpenter – Coustan criteria . Primary outcome was the feasibility of r and omization and screening . Secondary outcomes included patient and provider views ( or preferences ) on GDM testing .  Sixty-eight women were recruited , 48 ( 71 % ) enrolled and 47 ( 69 % ) were r and omized . Participants in both study arms identified the main challenges to GDM testing to be : drinking the glucola , fasting prior to testing , waiting to have blood drawn , and multiple venipuntures . Women in both study arms would prefer the 2 h 75 g OGTT or whichever test is recommended by their doctor in a future pregnancy . Physicians and nurse midwives endorsed screening and were comfortable with being blinded to the GDM testing strategy and results values . Both pregnant women and providers value GDM screening , and pregnant women can be recruited to a blinded , r and omized GDM screening trial with minimal attrition and missing data STUDY OBJECTIVE To compare the diagnostic performances of 75 g and 100 g oral glucose tolerance tests in detecting  Gestational Diabetes Mellitus in Nigerian pregnant women . MATERIAL S AND METHODS 248 women in 3rd trimester attending antenatal clinic of the Lagos University Teaching Hospital , Lagos , between November 1997 and July 1999 were r and omly subjected to st and ard oral glucose tolerance tests ( OGTT ) . 110 had 100 g OGTT while 138 had 75 g OGTT . The plasma glucose response ( PGR ) was assessed and glucose tolerance status of each patient was determined using WHO ( 1985 ) criteria to interpret 75 g OGTT and National Diabetes Data Group ( NDDG ) ( 1979 ) criteria for 100 g OGTT . The PGR in the two study groups were compared . The prevalence rates of GDM using either of the two criteria were evaluated and compared . Incidences of foetal macrosomia in GDM cases diagnosed by either set of criteria were also compared . RESULTS The mean age of the study subjects was 30.7(+/-4.2 ) years while the BMI was 25.4(+/-4.9 ) kg/m2 . The mean parity was 1.33 . Traditional risk factors for GDM were found in 47.5 % of them . The plasma glucose response ( PGR ) to 100 g OGTT was found to be higher than that of 75 g OGTT at 1 hour , 2hour and 3 hour sampling times but the difference was only significant at 3rd hour ( p values = 0.68 , 0.137 , 0.007 respectively ) . The total area under the glucose response curve ( AUC ) for 75 g OGTT was 345.1 ( + /-49.5 ) AAU while for 100 g OGTT , it was 363.4(+/-61.4 ) AAU . The difference was not statistically significant ( p value > 0.05 ) . The prevalence rate of GDM diagnosed by 75 g OGTT was 11.6 % while that of 100 g OGTT was 4.5 % . The difference was significant ( p value = 0.04 ) . The incidence rate of foetal macrosomia among GDM cases diagnosed by 100 g OGTT was 66.7 % as against 23.1 % among those diagnosed by 75 g OGTT . Statistical difference could not be determined because of the small number . CONCLUSION Plasma glucose response to OGTT among Nigerian pregnant women has little or no respect for the load of the glucose administered . 100 g OGTT- based NDDG criteria was more stringent than 75 g OGTT-based WHO criteria in identifying GDM . However it appears to be more specific for detecting the complications associated with the condition though it will require a larger study to vali date this cl aim OBJECTIVE To demonstrate a role of early insulin secretion on plasma glucose levels after different amounts of oral glucose loads in pregnant women . MATERIAL AND METHOD Forty-one pregnant women with normal glucose tolerance according to the Carpenter and Coustan ' s criteria and 25 non-pregnant women ( control group ) with normal glucose tolerance according to the World Health Organization criteria were enrolled . Each subject was r and omly scheduled to perform both the 100-g and 75-g OGTT within a 1-week interval . Venous blood was drawn at fasting , 30- , 60- , 120- , and 180-minute intervals during both tests for determination of plasma glucose and serum insulin levels . RESULTS The mean ( + /- SE ) ages of the pregnant and control groups were 33.3 + /- 0.9 and 31.8 + /- 1.4 years , respectively . The mean gestational age at the time of performing OGTT of the pregnant group was 28.7 + /- 0.6 weeks . In the non-pregnant group , the plasma glucose concentrations were not different between 75-g and 100-g OGTT whereas the serum insulin levels at the 30 and 180 minutes of the 100-g OGTT were significantly higher than those of the 75-g OGT . In the pregnant group , both plasma glucose and serum insulin concentrations at the 120 and 180 minutes of the 100-g OGTT were significantly higher than those of the 75-g OGT . CONCLUSION The limited ability of early insulin secretion to increase when glucose load increased in the pregnant women could explain the high plasma glucose levels at 2 and 3 hours of 100-g OGTT compared to those of 75-g OGTT Background The risks associated with gestational diabetes mellitus ( GDM ) are well recognized , and there is increasing evidence to support treatment of the condition . However , clear guidance on the ideal approach to screening for GDM is lacking . Professional groups continue to debate whether selective screening ( based on risk factors ) or universal screening is the most appropriate approach . Additionally , there is ongoing debate about what levels of glucose abnormalities during pregnancy respond best to treatment and which maternal and neonatal outcomes benefit most from treatment . Furthermore , the implication s of possible screening options on health care costs are not well established . In response to this uncertainty there have been repeated calls for well- design ed , r and omised trials to determine the efficacy of screening , diagnosis , and management plans for GDM . We describe a r and omised controlled trial to investigate screening uptake rates and the clinical and cost effectiveness of screening in primary versus secondary care setting s. Methods / Design This will be an unblinded , two-group , parallel r and omised controlled trial ( RCT ) . The target population includes 784 women presenting for their first antenatal visit at 12 to 18 weeks gestation at two hospitals in the west of Irel and : Galway University Hospital and Mayo General Hospital . Participants will be offered  universal screening for GDM  at 24 to 28 weeks gestation in either primary care ( n = 392 ) or secondary care ( n = 392 ) locations . The primary outcome variable is the uptake rate of screening . Secondary outcomes include indicators of clinical effectiveness of screening at each screening site ( primary and secondary ) including gestational week at time of screening , time to access antenatal diabetes services for women diagnosed with GDM , and pregnancy and neonatal outcomes for women with GDM . In addition , parallel economic and qualitative evaluations will be conducted . The trial will cover the period from the woman ’s first hospital antenatal visit at 12 to 18 weeks gestation , until the completion of the pregnancy . Trial registration Current Controlled Trials : IS RCT Summary Background Diagnosis of gestational diabetes predicts risk of infants who are large for gestational age ( LGA ) and with high adiposity , which in turn aims to predict a future risk of obesity in the offspring . South Asian women have higher risk of gestational diabetes , lower risk of LGA , and on average give birth to infants with greater adiposity than do white European women . Whether the same diagnostic criteria for gestational diabetes should apply to both groups of women is unclear . We aim ed to assess the association between maternal glucose and adverse perinatal outcomes to ascertain whether thresholds used to diagnose gestational diabetes should differ between south Asian and white British women . We also aim ed to assess whether ethnic origin affected prevalence of gestational diabetes irrespective of criteria used . Methods We used data ( including results of a 26–28 week gestation oral glucose tolerance test ) of women from the Born in Bradford study , a prospect i ve study that recruited women attending the antenatal clinic at the Bradford Royal Infirmary , UK , between 2007 and 2011 and who intended to give birth to their infant in that hospital . We studied the association between fasting and 2 h post-load glucose and three primary outcomes ( LGA [ defined as birthweight > 90th percentile for gestational age ] , high infant adiposity [ sum of skinfolds > 90th percentile for gestational age ] , and caesarean section ) . We calculated adjusted odds ratios ( ORs ) and their 95 % confidence intervals ( CIs ) for a 1 SD increase in fasting and post-load glucose . We established fasting and post-load glucose thresholds that equated to an OR of 1·75 for LGA and high infant adiposity in each group of women to identify ethnic-specific criteria for diagnosis of gestational diabetes . Findings Of 13 773 pregnancies , 3420 were excluded from analyses . Of 10 353 eligible pregnancies , 4088 women were white British , 5408 were south Asian , and 857 were of other ethnic origin . The adjusted ORs of LGA per 1 SD fasting glucose were 1·22 ( 95 % CI 1·08–1·38 ) in white British women and 1·43 ( 1·23–1·67 ) in south Asian women ( pinteraction with ethnicity = 0·39 ) . Results for high infant adiposity were 1·35 ( 1·23–1·49 ) and 1·35 ( 1·18–1·54 ; pinteraction with ethnicity=0·98 ) , and for caesarean section they were 1·06 ( 0·97–1·16 ) and 1·11 ( 1·02–1·20 ; pinteraction with ethnicity=0·47 ) . Associations between post-load glucose and the three primary outcomes were weaker than for fasting glucose . A fasting glucose concentration of 5·4 mmol/L or a 2 h post-load level of 7·5 mmol/L identified white British women with 75 % or higher relative risk of LGA or high infant adiposity ; in south Asian women , the cutoffs were 5·2 mmol/L or 7·2 mml/L ; in the whole cohort , the cutoffs were 5·3 mmol/L or 7·5 mml/L. The prevalence of gestational diabetes in our cohort ranged from 1·2 % to 8·7 % in white British women and 4 % to 24 % in south Asian women using six different criteria . Compared with the application of our whole-cohort criteria , use of our ethnic-specific criteria increased the prevalence of gestational diabetes in south Asian women from 17·4 % ( 95 % CI 16·4–18·4 ) to 24·2 % ( 23·1–25·3 ) . Interpretation Our data support the use of lower fasting and post-load 
    Output:
    