scholarly journals Gestational Diabetes in the Population Served by Brazilian Public Health Care. Prevalence and Risk Factors

2020 ◽  
Vol 42 (01) ◽  
pp. 012-018
Author(s):  
Pâmela Antoniazzi dos Santos ◽  
José Mauro Madi ◽  
Emerson Rodrigues da Silva ◽  
Daiane de Oliveira Pereira Vergani ◽  
Breno Fauth de Araújo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Tolerance Test ◽  
Public Health Care ◽  
Oral Glucose ◽  
Diabetes Group ◽  
Cross Sectional

Abstract Objective To assess the prevalence of gestational diabetes mellitus and the main associated risk factors in the population served by the Brazilian Unified Health System in the city of Caxias do Sul, state of Rio Grande do Sul. Materials and Methods A descriptive, cross-sectional and retrospective study was conducted. Maternal variables were collected from the medical records of all pregnant women treated at the basic health units in 2016. Hyperglycemia during pregnancy (pregestational diabetes, overt diabetes and gestational diabetes mellitus) was identified by analyzing the results of a 75-g oral glucose tolerance test, as recommended by the Brazilian Ministry of Health. Based on the data, the women were allocated into two groups: the gestational diabetes group and the no gestational diabetes group. Results The estimated prevalence of gestational diabetes among 2,313 pregnant women was of 5.4% (95% confidence interval [95%CI]: 4.56–6.45). Pregnant women with 3 or more pregnancies had twice the odds of having gestational diabetes compared with primiparous women (odds ratio [OR] = 2.19; 95%CI: 1.42–3.37; p < 0.001). Pregnant women aged 35 years or older had three times the odds of having gestational diabetes when compared with younger women (OR = 3.01; 95%CI: 1.97–4.61; p < 0.001). Overweight pregnant women were 84% more likely to develop gestational diabetes than those with a body mass index lower than 25 kg/m2 (OR = 1.84; 95%CI: 1.25–2.71; p = 0.002). A multivariable regression analysis showed that being overweight and being 35 years old or older were independent variables. Conclusion In this population, the prevalence of gestational diabetes mellitus was of 5.4%. Age and being overweight were predictive factors for gestational diabetes.

scholarly journals Gestational diabetes mellitus prediction model: A risk factors analysis of pregnant women with gestational diabetes mellitus but have normal oral glucose tolerance test results in the second trimester of pregnancy

2021 ◽  
Vol 29 ◽  
pp. 57-63
Author(s):  
Jiayu Lu ◽  
Song Zhang ◽  
Hongqing Jiang ◽  
Lin Yang ◽  
Dongmei Hao ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Second Trimester ◽  
Oral Glucose Tolerance

BACKGROUND: Oral glucose tolerance test (OGTT) is a standard for the diagnosis of gestational diabetes mellitus (GDM). However, clinically, some cases with normal results were diagnosed as GDM in the third trimester. OBJECTIVE: To establish a risk model based on energy metabolism, epidemiology, and biochemistry that could predict the GDM pregnant women with normal OGTT results in the second trimester. METHODS: Qualitative and quantitative data were analyzed to find out the risk factors, and the binary logistic backward LR regression was used to establish the prediction model of each factor and comprehensive factor, respectively. RESULTS: The risk factors including the rest energy expenditure per kilogram of body weight, oxygen consumption per kilogram of body weight, if more than the weight gain criteria of the Institute of Medicine, the increase of body mass index between the second trimester and pre-pregnancy, and fasting blood glucose. By comparison, the comprehensive model had the best prediction performance, indicating that 85% of high-risk individuals were correctly classified. CONCLUSION: Energy metabolism, epidemiology, and biochemistry had better recognition ability for the GDM pregnant women with normal OGTT results in the second trimester. The addition of metabolic factors in the second trimester also improved the overall prediction performance.

scholarly journals Risk Factors for Pregnancy Complications and Postpartum Glucose Intolerance in Women With Gestational Diabetes Mellitus

2020 ◽  
Author(s):  
Naohisa Masuko ◽  
Kenji Tanimura ◽  
Nobue Kojima ◽  
Hitomi Imafuku ◽  
Masashi Deguchi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Glucose Intolerance ◽  
Pregnancy Complications ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Hba1c Levels

Abstract This prospective cohort study aimed to evaluate the risk factors for pregnancy complications and postpartum glucose intolerance (GI) in women with gestational diabetes mellitus (GDM). A total of 140 women with GDM were enrolled. Of these, 115 underwent a 75-g oral glucose tolerance test (OGTT) at 12 weeks after delivery. Clinical factors and parameters in the antepartum 75-g OGTT associated with pregnancy complications and postpartum GI were evaluated. Women with GDM experienced pregnancy complications, including hypertensive disorders of pregnancy (HDP, n=19), preterm delivery (PD, n=17), heavy-for-date (HFD, n=19), and light-for-date (LFD, n=12), and 22 of the 115 women with GDM developed postpartum GI. The univariate and multivariable logistic regression analyses revealed the following risk factors: histories of hypertension (odds ratio [OR], 23.8; 95% confidence interval [CI], 4.2–134.7; p<0.01) for HDP; histories of hypertension (OR, 9.8; 95% CI, 2.5–38.9; p<0.01) for PD; HbA1c levels (OR, 7.6; 95% CI, 1.5–37.9; p<0.05) for HFD; and oral deposition index (DI) (OR, 0.1; 95% CI, 0.02–0.7; p<0.01) for postpartum GI. Higher HbA1c levels and lower oral DI on the antepartum 75-g OGTT may be useful markers for identifying GDM women who are at high risk for HFD and postpartum GI, respectively.

Incidence of Risk Factors on the Onset of Gestational Diabetes Mellitus

2012 ◽  
Vol 2 (3) ◽  
pp. 8-22
Author(s):  
E. De Franchis ◽  
A. Ferramosca ◽  
V. Zara ◽  
L. Piper
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Risk Factors ◽  
Family History ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Close Association ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Total Period

In this study the authors evaluated the prevalence of Gestational Diabetes Mellitus (GDM) and the incidence in determining the occurrence thereof, given by the following risk factors: age, family history for Diabetes Mellitus (DM), Body Mass Index (BMI), smoking, diet, macrosomia in previous pregnancies and physical activity. To this end, they investigated a cohort of 61 pregnant women, who had at least one risk factor, in a total period of nine months, during which women checked in the Clinic of Endocrinology and Diabetology of the Hospital “F. Ferrari” in Casarano (Lecce) Italy, and were subjected to an anamnestic investigation and then to a diagnostic test (Oral Glucose Tolerance Test, OGTT 75 g). The anamnesis has allowed to identify the type of risk factors that are present in the population, while the OGTT has allowed to diagnose gestational diabetes. Later, an analysis of the cross-collected data was performed in order to evaluate the percentage incidence of the disease, in relation to risk factors observed. The authors’ results confirmed a prevalence of GDM of 26.23% and the existence of a close association between risk factors and GDM. In particular, the risk factors, macrosomia, BMI = 25 kg/m2, a hypercaloric diet, light physical activity, and age = 35 years, seem to have more influence than smoking and family history for DM, inducing the onset of the illness.

scholarly journals Dysbiosis of maternal and neonatal microbiota associated with gestational diabetes mellitus

Gut ◽  
2018 ◽  
Vol 67 (9) ◽  
pp. 1614-1625 ◽  
Author(s):  
Jinfeng Wang ◽  
Jiayong Zheng ◽  
Wenyu Shi ◽  
Nan Du ◽  
Xiaomin Xu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Potential Risks ◽  
The Impact

ObjectiveThe initial colonisation of the human microbiota and the impact of maternal health on neonatal microbiota at birth remain largely unknown. The aim of our study is to investigate the possible dysbiosis of maternal and neonatal microbiota associated with gestational diabetes mellitus (GDM) and to estimate the potential risks of the microbial shift to neonates.DesignPregnant women and neonates suffering from GDM were enrolled and 581 maternal (oral, intestinal and vaginal) and 248 neonatal (oral, pharyngeal, meconium and amniotic fluid) samples were collected. To avoid vaginal bacteria contaminations, the included neonates were predominantly delivered by C-section, with their samples collected within seconds of delivery.ResultsNumerous and diverse bacterial taxa were identified from the neonatal samples, and the samples from different neonatal body sites were grouped into distinct clusters. The microbiota of pregnant women and neonates was remarkably altered in GDM, with a strong correlation between certain discriminatory bacteria and the oral glucose tolerance test. Microbes varying by the same trend across the maternal and neonatal microbiota were observed, revealing the intergenerational concordance of microbial variation associated with GDM. Furthermore, lower evenness but more depletion of KEGG orthologues and higher abundance of some viruses (eg, herpesvirus and mastadenovirus) were observed in the meconium microbiota of neonates associated with GDM.ConclusionGDM can alter the microbiota of both pregnant women and neonates at birth, which sheds light on another form of inheritance and highlights the importance of understanding the formation of early-life microbiome.

Lipid Profile in Pregnant Women with and without Gestational Diabetes Mellitus: A Case-Control Study

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Zeynab Farsangi ◽  
Ghazal Zoghi ◽  
Masoumeh Kheirandish ◽  
Roghayeh Shahbazi ◽  
Masoumeh Mahmoudi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Lipid Profile ◽  
Gestational Age ◽  
Demographic Data ◽  
Density Lipoprotein ◽  
Tolerance Test ◽  
Oral Glucose

Background: Gestational diabetes mellitus (GDM), the most common metabolic disorder of pregnancy, is associated with alterations in circulating lipids. Objectives: The aim of this study was to compare lipid profiles in women with and without GDM. Methods: This study was performed on 84 pregnant women at 26 - 30 weeks of gestation (42 pregnant women with GDM as cases and 42 healthy pregnant women as controls). After obtaining informed consent and gathering demographic data, subjects underwent a 75 g oral glucose tolerance test, and lipid profile was also measured in all subjects. Results: We found that high-density lipoprotein (HDL) levels were significantly higher in the GDM group (53.10 ± 1.72 vs. 46.64 ± 1.70 mg/dL, P = 0.008). Total cholesterol (228.96 ± 52.03 vs. 211.59 ± 41.83 mg/dL) and triglyceride (TG) levels (225.58 ± 89.84 vs 208.38 ± 80.66 mg/dL) were also higher in the GDM group; however, the differences were not statistically significant (P = 0.770 and P = 0.327, respectively). On the contrary, low-density lipoprotein was found to be non-significantly higher in the healthy group (144.54 ± 26.01 vs 122.41 ± 4.82 mg/dL, P = 0.709). Besides, there was a significant association between HDL levels and GDM (OR 1.049; CI 95% (1.009 - 1.090), P = 0.015). This association remained significant when adjusted for age, BMI, and gestational age (OR 1.010; CI 95% (1.002 - 1.017), P = 0.009). No significant association was found between GDM and TG, cholesterol, and LDL levels. Conclusions: HDL levels are significantly higher in pregnant women with GDM compared to pregnant women without GDM. HDL level is significantly associated with GDM even after adjustment for age, BMI, and gestational age.

scholarly journals Intergenerational Metabolomic Analysis of Mothers with a History of Gestational Diabetes Mellitus and Their Offspring

2020 ◽  
Vol 21 (24) ◽  
pp. 9647
Author(s):  
Raffael Ott ◽  
Xenia Pawlow ◽  
Andreas Weiß ◽  
Anna Hofelich ◽  
Melanie Herbst ◽  
...  
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Graphical Models ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Sensitivity Index ◽  
Cross Sectional

Shared metabolomic patterns at delivery have been suggested to underlie the mother-to-child transmission of adverse metabolic health. This study aimed to investigate whether mothers with gestational diabetes mellitus (GDM) and their offspring show similar metabolomic patterns several years postpartum. Targeted metabolomics (including 137 metabolites) was performed in plasma samples obtained during an oral glucose tolerance test from 48 mothers with GDM and their offspring at a cross-sectional study visit 8 years after delivery. Partial Pearson’s correlations between the area under the curve (AUC) of maternal and offspring metabolites were calculated, yielding so-called Gaussian graphical models. Spearman’s correlations were applied to investigate correlations of body mass index (BMI), Matsuda insulin sensitivity index (ISI-M), dietary intake, and physical activity between generations, and correlations of metabolite AUCs with lifestyle variables. This study revealed that BMI, ISI-M, and the AUC of six metabolites (carnitine, taurine, proline, SM(-OH) C14:1, creatinine, and PC ae C34:3) were significantly correlated between mothers and offspring several years postpartum. Intergenerational metabolite correlations were independent of shared BMI, ISI-M, age, sex, and all other metabolites. Furthermore, creatinine was correlated with physical activity in mothers. This study suggests that there is long-term metabolic programming in the offspring of mothers with GDM and informs us about targets that could be addressed by future intervention studies.

scholarly journals Diagnostic value of glycemic markers HbA1c, 1,5-anhydroglucitol and glycated albumin in evaluating gestational diabetes mellitus

2017 ◽  
Vol 8 (12) ◽  
pp. 161-167 ◽  
Author(s):  
Baris Saglam ◽  
Sezer Uysal ◽  
Sadik Sozdinler ◽  
Omer Erbil Dogan ◽  
Banu Onvural
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Glycated Albumin ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Significant Difference ◽  
Glycemic Markers

Background: The oral glucose tolerance test (OGTT) is the current established method performed worldwide to diagnose gestational diabetes mellitus (GDM). The purpose of this study was to assess the utility of the use of long- and short-term markers of glycemic status. Methods: The study group was composed of 80 pregnant women, 40 with GDM and 40 with normal glucose tolerance. GDM was diagnosed with the American Diabetes Association criteria. Glycemic markers were measured in the OGTT blood samples of women at 24–28 weeks of gestation. Results: HbA1c was significantly higher in the GDM group when compared with the controls, whereas 1,5-anhydroglucitol (1,5-AG) levels were significantly lower. There was not a significant difference between the groups for glycated albumin. Whereas HbA1c levels were correlated with fasting and 1 h glucose and negatively correlated with mean corpuscular volume, 1,5-AG was only negatively correlated with the first hour glucose. No difference was found for the diagnostic performances of HbA1c and 1,5-AG (receiver operating characteristic of the area under the concentration curve values were 0.756 and 0.722, respectively). Conclusion: HbA1c and 1,5-AG alone does not have sufficient diagnostic accuracy to diagnose GDM. 1,5-AG values were correlated with post-load glucose values in pregnant women so will improve the GDM management and be useful to predict complications.

scholarly journals Demographic profile of pregnant women and effect of anaemia in gestational diabetes mellitus: a cross sectional study from rural Assam

2020 ◽  
Vol 7 (6) ◽  
pp. 2303
Author(s):  
Subrata Chanda ◽  
Amarjeet Singh
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Cross Sectional Study ◽  
Oral Glucose ◽  
Sectional Study ◽  
Cross Sectional ◽  
Demographic Profile ◽  
Resource Setting

Background: In Assam, gestational diabetes mellitus (GDM) screening is not routinely done during antenatal check-up in Assam, whereas anemia screening is done. Consequently, state-wide GDM estimate and its association with anemia in rural Assam is not available. Hence, we aim to study the demographic profile of pregnant women and their anaemia in relation to prevalence of gestational diabetes mellitus in rural Assam.Methods: The present study was part of a larger community based cross-sectional study, conducted in Assam to determine the prevalence of GDM. The pregnant women in the gestational age of 24-28 weeks, who were free of any chronic illnesses, screened for Anaemia and, GDM through oral glucose tolerance test (OGTT) as per diabetes in pregnancy study group in India guideline.Results: A total of 1212 pregnant women underwent the OGTT and test for haemoglobin estimation. Mean age of GDM women was (24.40±4.60 years), slightly higher than non-GDM women (23.50±4.04 years, p=0.007). After hemoglobin estimation, 83% of pregnant women found to be anaemic, 77% of these were GDM positive, which is quite significant with p value 0.025. A higher fraction of the pregnant mothers in our study were found suffering from anemia (83%). The independent association of GDM and anemia adjusted for other variables showed an inverse relationship.Conclusions: Though prevalence of anaemia and GDM in low resource setting in rural Assam found to be quite high, but they have inverse relationship. Anaemic pregnant women were found to be GDM protective. 

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