Background. Diabetes requires significant disease management, patient-provider communication, and interaction between patients, family members, caregivers, and care teams. Emerging patient-facing technologies, such as cellular-enabled glucose meters, can facilitate additional care support and improve diabetes self-management. This study evaluated patient acceptability, feasibility, and efficacy of a diabetes care support program facilitated by cellular-enabled glucose meters. Methods. A two-phase study approach was taken. Get In Touch – Phase 1 (GIT-1) was a 1-month pilot involving patients with type 1 and type 2 diabetes. Get In Touch – Phase 2 (GIT-2) was a 12-month randomized controlled crossover trial involving patients with poorly-controlled type 2 diabetes. Results from GIT-1 and preliminary results from GIT-2 are presented. Results. GIT-1 participants with type 1 (n=6) and type 2 (n=10) diabetes reported the intervention and cellular-enabled glucose meter were easy to use and useful while identifying potential areas of improvement. GIT-2 participants in both the intervention (n=60) and control (n=60) groups saw significant improvements in treatment satisfaction and A1c change, with intervention participants experiencing slightly greater improvements in each after 6 months (p=0.09 and p=0.16, respectively) compared to control participants. Conclusions. Patients reported favorable acceptability of the intervention. Preliminary results from a randomized trial demonstrated potential of intervention to improve patient-reported and physiological health outcomes. Future studies should evaluate feasibility and efficacy over a longer period of time, with a greater number of participants, and targeting different populations of patients with diabetes. Provider perspectives and changes in provider behavior, clinical work flow, and caregiver burden should also be assessed.

Kumulative Dissertation, die sich mit den Herausforderungen der nichtinvasiven Blutglucosediagnostik sowie mit dem Qualitätsmonitoring von Biopharmazeutika am Beispiel Insulin beschäftigt. In beiden Forschungsbereichen wird die Infrarotspektroskopie eingesetzt, wobei verschiedene elektromagnetische Strahlungsbereiche (mitlleres und nahes Infrarot) zum Einsatz kommen. Ebenfalls werden unterschiedliche Messtechniken der Fourier-Transform-Infrarot-Spektroskopie eingesetzt, die die Vor- und Nachteile in den genannten Forschungsbereichen beleuchten.

Eleven participants living with non-insulin-requiring Type 2 Diabetes (T2DM) discussed their self-monitoring blood glucose (SMBG) experience. All had been recently diagnosed (< 2 years) and treated for diabetes with a self-regulating SMBG guideline for primary care practice. Their digitally-recorded interviews and photographed logbooks were analyzed thematically and interpreted through the lens of numeracy literature to answer 2 questions: 1. What is the meaning of SMBG among people with non-insulinrequiring T2DM? 2. How do people with non-insulin-requiring T2DM perceive the function of SMBG in diabetes self-management? The meanings of SMBG were patient competence, "It is easy, just a little pin prick"; patient control, "I can control it. It doesn't control me"; and patient security, "It is not that way anymore." Three periods of lived time were observed: Diagnosis "The numbers say I have diabetes"; "I just can't figure out why it does that"; and Routine "I make my numbers." Prominent numeracy functions emerged by time period. During Diagnosis primary numeracy functions included comparing SMBG results to target values. Participants expressed this experience as, "I am some kind of O.K." During applied numeracy functions included taking medication correctly. SMBG readings were experienced as a clue to the diabetes mystery, sometimes confusing the participants, "I just don't know why it does what it does," or answering questions, "Now there is no question marks." Numbers motivated some people for action "The numbers get me out a walking" or restraint "If I didn't have the numbers, I would be tempted to cheat." During Routine interpretive numeracy functioned to aid the evaluation of the efficacy of participant's health behavior change. Numbers had taken on meaning helping a person to "know where I am at." Clinical implications are suggested including adjustments to the selfregulating SMBG guideline for primary care practice. Findings are discussed in relation to personal knowledge processes (Sweeny, 1994) and related SMBG research. Participants concluded that routine SMBG is essential to maintaining and restraining health behavior. This study provides a model for use of SMBG in diabetes selfmanagement and patient perspectives on SMBG during the 2 years following T2DM diagnosis.

Thesis (M. Sc. (Biochemistry)) --University of Limpopo, 2017 / Diabetes mellitus is a chronic metabolic disorder characterised by perpetual hyperglycaemia. Various oral pharmacological theraputic management strategies currently exist but are too expensive and having a host of undesirable side effects. Therefore people resort to the use of traditional medicinal plants as they offer a cost effective and readily available health care avenue. Despite the wide-spread use of traditional medicinal plants, several worrisome concerns about their effectiveness, clinical modes of action and safety have been raised. Leaves of five selected plants (Toona celliata, Seriphium plumosum, Schkuhria pinnata, Olea africana, Opuntia ficus-indica) were collected from Mankweng area, Capricon Local Municipality, Limpopo province, South Africa. Ground plant materials were exhaustively extracted by maceration in methanol, acetone or hexane. The presence of different plant secondary metabolites in the crude extracts was determined using various standard chemical tests and thin layer chromatography (TLC). A myriad of compounds which represented various secondary plant metabolites groups were observed on the TLC plates and were best resolved in the non-polar (BEA) and intermediate (CEF) mobile phases. The total phenolic content and total flavonoids of the different extracts were determined spectrophotometrically using the Folin-Ciocalteu`s phenol reagent method and Aluminium chloride colorimetric assay respectively. The plants contained comparatively higher amounts of total phenolic compounds as compared to the flavonoids. The antiglycation activity of the plant extracts were determined using the bovine serum albumin assay. The acetone extract of Seriphium plumosum (SPlA) exhibited the most glycation inhibitory activity among all the examined extracts, as it resulted in 2,22% glycation. The antioxidant potential of each of the different extracts was quantitatively determined spectrophotometrically using the 2, 2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging assay and the ferric ion reducing power assay. The methanol extract of Seriphium plumosum showed the best antioxidant activity among all the extracts in this study. It exhibited the lowest EC50 values of 0.72 mg/ml and 2.31 mg/ml for the DPPH scavenging activity and the ferric reducing power assay respectively. The cytotoxicity profiles of the different plant extracts on C2C12 cell line were determined using the 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium xiii bromide (MTT) assay. It was concluded that since the all the extracts investigated had CC50 values greater than 50 μg/ml they were generally non-toxic. The amount of glucose taken up by differentiated C2C12 cells was quantified using the glucose uptake assay. Treatment of the C2C12 cells with the hexane extract of Seriphium plumosum resulted in the best glucose utilisation effect of 35,77% which was higher than that of insulin which was 26,06% after 6 hours. The translocation assay was used to determine the effect of the plant extract on GLUT4 translocation while the expression of various mitogen activated protein kinases in the cells was determined using the human MAPK profiler assay. It was established that treatment with Seriphium plumosum hexane extract resulted in increased GLUT4 translocation from the intracellular vesicular stores to the cell surface membrane. The increase in GLUT4 translocation may have resulted from the upregulation of expression of phosphorylated Akt-1, Akt-2, GSK3β, ERK1, ERK2 p70S kinase and MKK3 under the influence of Seriphium plumosum hexane extract. The study documents a probable insulin-mimetic activity of the hexane extract of Seriphium plumosum. This activity may be responsible for its hypoglycaemic capability and may occur via the augmentation of proximal mitogen activated protein kinases involved in the GLUT4 translocation pathway. Further investigations need to be conducted to ascertain this novel finding which may help provide a cost-effective and readily available antidiabetic therapeutic agent. / National Research Foundation (NRF)

Type 2 diabetes mellitus (T2DM), presents a significant health burden globally, affecting millions of individuals, especially in the elderly population. While its association with cardiovascular diseases and cognitive impairments is well-documented, further research on the precise influence of glucose control on cognitive outcomes in elderly T2DM patients is necessary. This scoping review aims to address this gap by investigating the impact of HbA1c levels representing glycemic control on the risk of developing cognitive impairments in elderly patients with T2DM. A literature search was conducted on MEDLINE and eligible studies involved T2DM patients aged 60 or older, with documented cognitive function and glycemic status. Screening and selection processes were conducted following PRISMA guidelines, and three relevant articles were selected for review. Most of the findings suggest a possible association between higher HbA1c levels and cognitive decline. Such results provide valuable insights regarding medical approaches focusing on glucose control that could be created to prevent and delay cognitive decline in T2DM patients.

To address the challenge of accurate, low cost and robust biosensors for diabetes management and early detection of diabetes complications, we have developed novel, robust sensing chemistry (or receptors) for electrochemical POC biosensors. The biosensors have been developed for the bio-markers associated with diabetes management such as glycated haemoglobin (HbA1c), glycated albumin, glucose, biomarkers associated with diabetes complications such as microalbuminuria, urine creatinine and albumin-to-creatinine ratio (ACR) and biomarkers associated with anaemia and malnutrition conditions such as haemoglobin and serum albumin. For haemoglobin detection, a new POC bio sensing technique has been developed based on Aza-heterocyclic chemicals. The repeatability and accuracy of the biosensor have been tested on real pathology samples. The glycated form of haemoglobin, called glycated haemoglobin or HbA1c, is the gold standard test in diabetes management as it gives the 90-days average blood glucose value. We demonstrate a simple method for electrochemical detection of HbA1c by combining bosonic affinity principle along with aza-heterocyclic receptors. The technique has been verified on the real clinical patient samples. Albumin is the most abundant protein in the human blood. Human serum albumin (HSA) is either alone or an associative biomarker in several chronic diseases like necrosis, nephrosis, hepatitis, malnutrition, arthritis, immune disorders, cancer, diabetes and in some severe infections. In pathology laboratories, the serum albumin is usually tested on serum samples and not in whole blood samples. Since albumin is not a metalloproteinase, it is very difficult to develop electrochemical POC biosensor. We have developed a novel technique for the electrochemical detection of serum albumin in whole blood samples, by exploiting its binding property with redox active copper salts. The accuracy of technique has been verified on both real human blood plasma as well as whole blood samples. Glycated albumin, which is the glycated form of serum albumin, is emerging as a novel biomarker for diabetes management, as it gives the average blood glucose value of 15-20 days. It is also extremely useful in chronic kidney disease patients and patients with hemoglobinopathies where HbA1c can give the erroneous results. By combining the copper chemistry along with bosonic affinity principle, we present the first ever demonstration of glycated albumin sensing. Instant blood glucose monitoring is an integral part of diabetes management. Most of the glucometers available in the market are based on glucose oxidase enzyme. We have demonstrated a low cost non-enzymatic electrochemical technique for blood glucose detection using alkaline methylene blue chemistry. The accuracy of the technique has been verified on real human blood plasma samples. Glucometer is one of the most easily available POC biosensor and a useful tool for diabetes population. India has second largest diabetes population in the world. To analyse the accuracy of the POC glucometers which are available in Indian market, a comprehensive study was conducted. The results were compared with clinical accuracy guidelines using exhaustive statistical analysis techniques. The shortcomings of the commercial glucometers are elucidated, regarding different international standards. Diabetic nephropathy is one of the major diabetes complications and is the primary cause of chronic kidney disease (CKD). The presence of albumin in urine is a well-established biomarker for the early detection of diabetic nephropathy. We have developed a technique for electrochemical detection of microalbuminuria for point of care applications by exploring the binding property of human albumin with electrochemically active molecules like copper and hemin. Methylene blue mediated sensing technique has also been proposed. Urine Albumin-to creatinine ratio (ACR) is another variant of the microalbumuria test that can be done any time and does not suffer from the dilution factor of urine. Iron binding property of creatinine is exploited to develop creatinine biosensor, thus enabling POC ACR tests.

No description available.

INTRODUÇÃO: A segurança da administração de anestésicos locais com vasoconstritor em pacientes diabéticos submetidos à cirurgia oral não está bem fundamentada na literatura. OBJETIVO: Investigar a ocorrência de variação da glicemia nos períodos pré, trans e pós-operatório de exodontia de dentes superiores, sob anestesia local com lidocaína 2% sem e com adrenalina 1:100.000, em portadores de diabetes mellitus tipo 2. Secundariamente, avaliar os efeitos hemodinâmicos e o grau de ansiedade. MÉTODOS: Estudo prospectivo e randomizado com pacientes portadores de diabetes acompanhados na Unidade Clinica de Coronariopatia Crônica do Instituto do Coração do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo. A monitorização contínua da glicemia durante 24 horas foi realizada através do MiniMed Continuous Glucose Monitoring System (CGMS, Medtronic). Os pacientes foram divididos em dois grupos: LSA - que recebeu 5,4 mL lidocaína 2% sem adrenalina e LCA - que recebeu 5,4 mL de lidocaína 2% com adrenalina 1:100.000. Os níveis de glicemia foram avaliados nas 24 horas (período basal) e nos tempos determinados: uma hora antes, durantes e até uma hora após a exodontia (período de procedimento). Os parâmetros hemodinâmicos foram avaliados por meio de um medidor de pressão arterial digital automático e o nível de ansiedade através de uma escala. RESULTADOS: Dos 400 pacientes avaliados, 70 foram incluídos no estudo, sendo 35 randomizados no grupo LSA e 35 no grupo LCA. A análise das médias da glicemia nos grupos LSA e LCA durante os períodos (basal e procedimento) não demonstrou diferença estatisticamente significativa (p=0,229 e p=0,811, respectivamente). Também não houve diferença significativa (p=0,748) na glicemia entre os grupos em cada tempo avaliado. Entretanto, nos dois grupos houve decréscimo significativo da glicemia (p < 0,001) ao longo dos tempos avaliados. Os grupos LSA e LCA não apresentaram diferenças significativas em relação à PAS (p=0,176), à PAD (p=0,913), à FC (p=0,570) e ao nível de ansiedade. CONCLUSÃO: A administração de 5,4mL de lidocaína 2% com adrenalina 1:100.000 não provocou alteração significativa da glicemia, parâmetros hemodinâmicos e nível de ansiedade em relação ao grupo sem vasoconstritor / INTRODUCTION: The safety of administration of local anesthetics with epinephrine for diabetic patients undergoing oral surgery is not well grounded in the literature. OBJECTIVE: To investigate the occurrence of variation of glucose in the pre, intra and postoperative extraction of upper teeth under local anesthesia with lidocaine 2% with and without 1:100.000 epinephrine in patients with type 2 diabetes mellitus. Secondly, to evaluate the hemodynamic effects and degree of anxiety. METHODS: A prospective randomized study of patients with diabetes attended in Coronary Chronic Clinics Unit, Heart Institute, Hospital das Clinicas in University of São Paulo Medical School. Continuous monitoring of blood glucose for 24 hours was performed using MiniMed Continuous Glucose Monitoring System (CGMS, Medtronic) and the patients were divided into two groups: LSA - which received 5.4 mL of 2% lidocaine without epinephrine and LCA - which received 5.4 mL of 2% lidocaine with 1:100,000 epinephrine. Blood glucose levels were assessed at 24 hours (baseline period) and at certain times: one hour before, during, and up to one hour after oral surgery (procedure period). We evaluated the hemodynamic parameters through a digital automatic pressure meter and anxiety level was measured by the scale. RESULTS: Of 400 patients evaluated, 70 were included in these study, 35 were randomized in the LSA group and 35 in the group LCA. The analysis of mean glicemia in groups LSA and LCA during the baseline period and procedure showed no statistically significant difference (p = 0.229 and p = 0.811, respectively). There was no difference in blood glucose (p = 0.748) between the groups at each time evaluated. However, in both groups there was a significant decrease in blood glucose (p < 0.001) over the time periods studied. The groups showed no significant differences regarding SBP (p = 0.176), DBP (p = 0.913), HR (p = 0.570) and anxiety level. CONCLUSION: The administration of 5.4 mL of 2% lidocaine with epinephrine 1:100.000 caused no significant change in blood glucose, hemodynamic parameters and level of anxiety compared to the group without vasoconstrictor

<p>Bosiljak (Ocimum basilicum L.) pripada familiji Lamiaceae i jedna je od najrasprostranjenijih i najče&scaron;će gajenih biljaka &scaron;irom sveta. Njegova upotreba je &scaron;iroko rasprostranjena zbog bogatog sadržaja i skladnog odnosa vitamina, minerala kao i različitih fenolnih jedinjenja kao glavnih nosilaca antioksidativne aktivnosti. Poslednjih godina velika pažnja je usmerena ka fenolnim fitokomponentama kao potencijalnim promoterima zdravlja. Ciljevi ovog rada bili su ispitivanje kvalitativnih i kvantitativnih karakteristika, kao i biohemijskih aktivnosti ekstrakata bosiljka dobijenih različitim rastvaračima, kao i ispitivanje uticaja farmaceutsko-tehnolo&scaron;ke formulacije u obliku mikrovezikula ekstrakta bosiljka na glikemijski, lipidni i oksido-redukcioni status kod oglednih životinja, u odnosu na vodeni ekstrakt. In vitro ispitivanja su uključivala analizu 100 ekstrakata dobijenih različitim rastvaračima i stepenom usitnjenosti. Ukupni fenolni i flavonoidni sadržaj, kao i antioksidativna aktivnost određena je spektrofotometrijskom metodom. Takođe, kvantifikovane i kvalifikovane su fenolne komponente (fenolne kiseline i flavonoidi) primenom visokoefikasne tečne hromatografije (HPLC). In vivo ispitivanje je rađeno na 84 albino laboratorijska pacova soja Wistar. Per os su primenjivani vodeni ekstrakt bosiljka, rastvor natrijumove soli monoketoholne kiseline, njihove kombinacije, kao i ekstrakt u obliku farmaceutsko-tehnolo&scaron;ke formulacije, mikrovezikula. Posle sedmodnevnog tretmana, merene su koncentracije glukoze u krvi, a nakon žrtvovanja, u serumu su određeni parametri lipidnog statusa i antioksidativnog stresa. Ex vivo analizama procenjivani su efekti ekstrakta bosiljka na enzimske i neenzimske parametre antioksidativnog odbrambenog sistema i oksidativne modifikacije lipida. Praćen je i uticaj tretmana na akutno o&scaron;tećenje jetre usled primene paracetamola. Svi analizirani ekstrakti bosiljka su pokazali prisustvo velikog broja fenolnih jedinjenja iz klase fenolnih kiselina i flavonoida. Detektovane i kvantifikovane aktivne komponente bile su fenolne kiseline: hlorogenska, p-hidroksibenzoeva, kafena, vanilinska, ferulna, rozmarinska i cimetna, kao i apigenin, kvercetin, naringenin i rutin kao predstavnici flavonoidnih jedinjenja. Primena ekstrakta bosiljka i natrijumove soli monoketoholne kiseline, same ili u kombinaciji, a takođe i u farmaceutsko-tehnolo&scaron;koj formulaciji, pokazale su smanjenja o&scaron;tećenja tokom oksidativnog stresa, značajno antidijabetesno delovanje, povoljan uticaj na lipidni status i protektivni efekat na funkcije jetre i bubrega. Na osnovu dobijenih rezultata može se zaključiti da ekstrakt bosiljka sadrži značajnu količinu fenolnih jedinjenja odgovornih za antioksidativnu aktivnost. Vodeni ekstrakt bosiljka, sam ili u kombinaciji sa monoketoholnom kiselinom, i u obliku farmaceutsko-tehnolo&scaron;ke formulacije snižava nivo glukoze u krvi, ubrzava obnovu &beta; ćelija, ima povoljan efekat na lipidni status i ne dovodi do toksičnih promena na jetri i bubrezima kod eksperimentalnih životinja.</p> / <p>Basil (Ocimum basilicum L.) belongs to the family Lamiaceae and represents one of the most widespread and most commonly cultivated plant worldwide. Its use is widespread due to its rich content and harmonious relationship of vitamins, minerals and various phenolic compounds which are responsible for the antioxidant activity. In recent years, great attention is directed to phenolic phytocomponents as potential promoters of health. The objectives of this study were to test the qualitative and quantitative characteristics, as well as the biochemical activity of basil extracts obtained by various solvents and investigate the impact of pharmaceutical technological formulation of basil extract on glycemic, lipid and oxidation-reduction status of the aqueous extract in the experimental animals. In vitro studies have included 100 extracts obtained by various solvents and degrees of fragmentation. Total phenolic and flavonoid content, as well as antioxidant activity was determined by spectrophotometric method. Also, phenolic compounds (phenolic acids and flavonoids) were qualified and quantified using high performance liquid chromatography (HPLC). In vivo testing was performed on 84 laboratory albino Wistar rats. The aqueous extract of basil, a solution of sodium salt of monoketocholic acid, their combinations, as well as an extract in the form of the pharmaceutical technological formulation were administered per os. After seven-day-treatment, the concentrations of glucose were measured in the blood and after sacrificing of animals, the lipid and antioxidative parameters were determined in serum. Ex vivo analysis assessed the effect of the extract of basil on the parameters of enzymatic and non-enzymatic antioxidant defense system and the oxidative modification of lipids. The effect of paracetamol on acute liver injury was also monitored. All analyzed basil extracts showed the presence of the large number of phenolic compounds from the class of phenolic acids and flavonoids. Chlorogenic, p-hydroxybenzoic, caffeic, vanillic, ferulic, rosmarinic, and cinnamic acid, as well as apigenin, quercetin, naringenin and rutin were detected and quantified. The application of basil extracts and the sodium salt of monoketocholic acid, either alone or in combination, and also in pharmaceutical technological formulation of microvesicles has shown a reduction in damage during oxidative stress, then a significant antidiabetic activity, favorable effect on the lipid profile and protective effect on the liver and kidney function. Based on these results it can be concluded that basil extract contains significant amounts of phenolic compounds responsible for antioxidant activity. The aqueous extract of basil, alone or in combination with monoketocholic acid, and in the form of the pharmaceutical technological formulations lowers glucose levels in the blood, accelerates the restoration of &beta; cells, has a favorable effect on the lipid status and does not lead to toxic changes in the liver and kidneys in experimental animals.</p>

Introdução e objetivos – A finalidade prioritária no tratamento do diabetes mellitus gestacional (DMG) é alcançar níveis de glicemia materna tão próximos da normalidade quanto possível, a fim de reduzir os efeitos adversos associados à hiperglicemia na gestação. A auto verificação da glicemia capilar (perfil glicêmico) é o método mais usado para a monitorização do controle metabólico na gestação complicada por diabetes. Nosso objetivo foi analisar as associações entre os perfis glicêmicos maternos com os principais desfechos da gestação numa população de mulheres com DMG acompanhadas em ambulatório de pré-natal especializado em hospital universitário no sul do Brasil, Hospital de Clínicas de Porto Alegre (HCPA). Desenho e metodotologia – conduzimos um estudo de coorte prospectiva de gestantes referidas da rede de atenção primária de saúde pública para tratamento do DMG no HCPA, acompanhadas do diagnóstico ao parto. Pesquisamos associações entre os resultados dos perfis glicêmicos com o peso de nascimento e com o risco de recém-nascidos grandes para idade gestacional e de desfechos adversos perinatais. Resultados – acompanhamos 440 mulheres com DMG. A média do índice de massa corporal (IMC) foi 33.3kg/m2. 351 bebês (79.8%) mostraram peso adequado à idade gestacional no nascimento. As médias de glicemia nos perfis pré e pósprandiais aumentaram com o avanço na categoria de peso nascimento. Três ou mais perfis glicêmicos anormais foram o fator de risco mais robusto para o nascimento de bebês grandes (OR 3.15 1.51-6.55) e para o desenvolvimento de desfechos adversos perinatais (OR 2.28 1.59-3.29). O ganho de peso materno durante o tratamento associou-se ao risco de recém-nascido grande para idade gestacional, assim como o IMC pré-gestacional, esse último também fator de risco independente para eventos perinatais adversos. Conclusão – perfis glicêmicos anormais em mais de 2 ocasiões foram o fator de risco mais relacionado ao nascimento de um bebê grande para a idade gestacional e para o desenvolvimento de complicações neonatais. Efeito benéfico do tratamento do DMG, guiado pelos perfis glicêmicos, foi a maioria de recém-nascidos com peso adequado à idade gestacional nessa coorte, apesar da incidência de desfechos perinatais adversos não ter sido diferente entre as categorias de peso fetal de nascimento. / Background and objective – a priority target in the treatment of gestational diabetes mellitus (GDM) is attaining maternal glucose levels as close as possible to euglycemia, in order to decrease the adverse outcomes linked to hyperglycemia. Self-performed capillary glucose (glycemic profile) is the most widely used method for metabolic monitoring in pregnancy complicated by diabetes. We intended to analyze the associations of maternal glycemic profile to main pregnancy outcomes in a population of GDM women treated in a specialized prenatal clinic at a university hospital in South Brazil, Hospital de Clínicas de Porto Alegre (HCPA). Research design and methodology – we conducted a prospective cohort study of pregnant women, referred from public primary health care for treatment of GDM at HCPA, between 2008 and 2015. We searched associations of glycemic profiles to birth weight, large for gestational age newborn and adverse neonatal outcomes. Results – we followed 440 GDM women from diagnosis to delivery. Mean prepregnancy body mass index (BMI) was 33.3kg/m2; 351 babies (79.8%) had appropriate birth weight for gestational age. Mean glucose in pre-prandial and postprandial profiles increased with raising birth weight category. Three or more abnormal glycemic profiles showed the strongest association to a large baby (OR 3.15 1.51-6.55) and to a composite of adverse neonatal outcomes (OR 2.28 1.59- 3.29). Gestational weight gain in the course of treatment was associated to large babies, as pre-pregnancy BMI, the latter also an independent risk factor for adverse neonatal outcome. Conclusion – abnormal maternal glycemic profiles in more than two occasions were the stronger risk factor for delivering a large baby and for developing neonatal complications. A beneficial effect of GDM treatment, guided by glycemic profiles, was that most of our newborns had birth weight appropriate for gestational age, although incidence of adverse neonatal outcomes had been no different across birth weight categories.