COVID-19 and Gestational Diabetes: A Systematic Review

In March 2020, the World Health Organization declared a pandemic state in response to the number of infected and killed by COVID-19. Gestational diabetes (GD) is characterized by physiological changes making pregnant women even more vulnerable to viral respiratory infections, such as SARS-CoV-2. For these reasons and due to the restriction of data related to DMG and the involvement by COVID-19, the importance of raising information about these two conditions is evident. Therefore, this study aimed to perform a literature review about the complications of COVID-19 in patients with GD. MEDLINE-PubMed, EMBASE, and Scielo databases were searched and followed the PRISMA guidelines. Only four studies were included in the systematic review. The complications and mortality are more significant in pregnant women with diabetes since hyperglycemia promotes immune changes in the inflammatory state and worsens insulin resistance. The imbalance in the immune response favors the development of infections, the most likely being viral respiratory infections. On the other hand, other studies show insufficient recent evidence to indicate that pregnant women are more susceptible to infection with severe acute coronavirus respiratory syndrome. There are divergences between studies concerning complications related to COVID-19 in patients with GD. In view of this scenario and from the information obtained, it is noted that the literature is scarce regarding the worsening of COVID-19 in patients with GD. Therefore, it is necessary to continue research on these mechanisms that may justify their correlation.

The Current and Future Role of Drugs and Probiotics in the Management of Inflammatory Bowel Disease

Inflammatory Bowel Disease (IBD) and other auto-inflammatory disorders are conditions caused by chronic and persistent intestinal inflammation, which is mainly represented by Ulcerative Colitis (UC) or Crohn’s Disease (CD), both of which typically arise as chronic inflammation of the gastrointestinal mucosa. Doctor’s main focus for treating IBD is the decrease on inflammation processes when the disease is active and promotes the maintenance of inflammation at normal levels. However, to deal with these two parameters is not easy, because the drugs usually used are related to several side effects and they are not totally effective to reduce inflammation and to keep the remission. Authors agree that the therapy approach should include drugs, dietary intervention and use of alternative substances as probiotics. The standard treatment approach for patients with CD and UC is traditionally done with the use of anti-inflammatory agents, like corticosteroids, mesalamine, immunomodulators such as azathioprine and methotrexate, and biologic agents such as infliximab and others. Probiotics are known as viable micro-organisms (or live microorganisms or live microbial dietary supplements) that may promote beneficial physiologic or therapeutic properties when used correctly. The interest in the role of these substances in improving human health is the reason of several researches. They may be used to help the immune system, to control gastro-intestinal infections and to prevent several diseases. Prebiotics, symbiotics, and probiotics may be helpful as adjuvants in the treatment of IBD. Probiotics are normally well-tolerated and are associated with few side effects which are undoubtedly important in the treatment of any disease.