1. FACULTY OF APPLIED MEDICAL SCIENCES LABORATORY MEDICINE DEPARTMENT Genetic Risk factors in Gestational diabetes Mr :Shadi Tarazi

2. Genetics The study of: Genes Heredity Genetic variation in living organisms

4. Human Genome Project The sequencing of the human genome holds benefits for many fields from molecular medicine to human evolution. Genotyping of specific viruses to direct appropriate treatment Identification of mutations linked to different forms of cancer The design of medication and more accurate prediction of their effects

5. Advancement in forensic applied sciences Biofuels and other energy applications Agriculture bioprocessing Commercial development of genomics research related to DNA based products, a multibillion-dollar industry

6. Molecular Diagnosis Modern test methods, based on the detection of DNA and RNA, offer many advantages over traditional methods for the detection of diseases. Accurate and faster detection of viruses, bacteria and genetic variations Accurate methods to screen the general public for cancer Accurate early diagnostic methods Provide more information about the disease to allow better treatment.

7. Molecular Diagnosis Reduced side effects from unnecessary treatments Better tools to monitor cancer patients accurately for both treatment success and/or likelihood of metastasis. Improved quality of life The overall global market for diagnostics was valued at $45.6 billion in 2012 and is expected to grow at about 7% annually over the next five years to reach a market size of $64.6 billion in 2017

8. Gestational Diabetes Women without previously diagnosed diabetes exhibit high blood glucose (blood sugar) levels during pregnancy. Gestational diabetes affects 3-10% of pregnancies. Gestational diabetes is caused when insulin receptors do not function properly. This is likely due to pregnancy-related factors such as the presence of human placental lactogen that interferes with susceptible insulin receptors.

9. Gestational diabetes generally has few symptoms and it is most commonly diagnosed by screening during pregnancy Gestational diabetes generally resolves once the baby is born GDM poses a risk to mother and child. This risk is largely related to uncontrolled high blood glucose levels and its consequences. Treatment resulting in better control of these levels can reduce some of the risks of GDM The two main risks GDM imposes on the baby are growth abnormalities and chemical imbalances after birth.

10. Risk Factors Polycystic Ovary Syndrome Maternal age - a woman's risk factor increases as she gets older (especially for women over 35 years of age). Being overweight, obese or severely obese Ethnicity Does genetics variation affect the probability of acquire GDM ?? Or even develop type II DM later on ??!!

11. Very little is known about the genetic predisposition for gestational diabetes mellitus (GDM). Genome-wide association studies and detect the reoccurrence rate in at least 30% of women with a history of GDM Potentially suggesting that there is a subgroup of women who may be genetically susceptible to develop GDM

12. Several studies have examined associations between genetic variants and the risk of gestational diabetes mellitus (GDM). All article related to genetics and GDM from 2001-2012 and also from 1950-2001 has been studied 12 SNPs from 10 genes had been collected. Six were related to insulin secretion Two to insulin resistance One to energy metabolism One to an inflammatory pathway

13. Genes and genetic variants related to insulin secretion Transcription factor 7-like 2 (TCF7L2) The rs7903146 variant in the TCF7L2 gene was the most widely studied variant in association with GDM, and showed a consistent and strong association across different populations T allele of rs7903146 was associated with an increased risk of GDM,also T allele of rs12255372.

16. Significant associations of GDM risk with nine SNPs in seven genes, most of which have been related to the regulation of insulin secretion. Transcription factor 7-like 2 (TCF7L2) Glucokinase (GCK) Potassium inwardly rectifying channel (KCNJ11) CDK5 regulatory subunit associated protein 1-like 1 (CDKAL1) Insulin-like growth factor 2 mRNA-binding protein 2 (IGF2BP2) Melatonin receptor 1B (MTNR1B) Insulin receptor substrate 1 (IRS1)

17. All these genetic loci associated with GDM risk (i.e. TCF7L2, GCK, KCNJ11, CDKAL1, IGF2BP2 and MTNR1B) have been related to the risk of develop T2DM later in life. These findings suggest an at least partly shared genetic basis between GDM and T2DM. which is not surprising given that both insulin resistance and defects in insulin secretion play key roles in the etiology of both GDM and T2DM. Women with a history of GDM have a more than 7-fold risk of developing T2DM later in life