scholarly journals Analysis and Intervention of Factors Affecting Abnormal Postpartum Glucose Tolerance and Gestational Recurrence in Gestational Diabetes

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Linhong Li ◽  
Gang Shi ◽  
Xiuping Zhang ◽  
Hongling Wang ◽  
Sujuan He
Keyword(s):  
Blood Glucose ◽  
Family History ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Pregnant Women ◽  
Influencing Factors ◽  
Oral Glucose ◽  
Family History Of Diabetes ◽  
History Of ◽  
Insulin Use

ObjectiveTo investigate the influencing factors of abnormal postpartum glucose tolerance and pregnancy recurrence in gestational diabetes mellitus (GDM) and to develop reasonable interventions to prevent postpartum glucose tolerance and recurrence of pregnancy. Methods. Retrospective analysis of clinical data of 238 GDM patients during pregnancy, including age, body mass index (BMI) before and after pregnancy, regular exercise during pregnancy, insulin use, family history of diabetes, fasting blood glucose (FPG) during pregnancy, oral glucose tolerance test (OGTT) 2 h time value, blood lipid index, and whether pregnant again. At the same time, the women were followed up by telephone or home visits to understand and guide the patient’s diet and exercise. The clinical characteristics of the two groups of patients were compared. According to the OGTT test, the recovery of glucose tolerance in pregnant women 6–8 weeks postpartum was divided into the normal postpartum glucose tolerance group and the abnormal group. Logistic multivariate analysis was used to find the influencing factors of postpartum glucose tolerance and recurrence of pregnancy. Results. Between 238 patients of followed-up, 150 pregnant women had abnormal postpartum glucose tolerance, accounting for 63.03%. There were 115 repregnants, of whom 37 (32.17%) had a recurrence of postpartum glucose tolerance. Pre and postpregnancy BMI, insulin use during pregnancy, family history of diabetes, FPG during pregnancy, OGTT 2 h values, and triglyceride (TG) were independent risk factors for abnormal postpartum diabetes and recurrence of pregnancy in GDM patients. Conclusions. Patients with GDM are at high risk of postpartum abnormal glucose tolerance and pregnancy recurrence, which may be influenced by the pregnant woman’s prepregnancy and postpartum BMI, insulin use during pregnancy, family history of diabetes, FPG, OGGT 2 h values during pregnancy, and TG levels. Therefore, health education for pregnant women should be strengthened in the clinic, with guidance on proper diet for weight control, increased exercise, and regular blood glucose screening and monitoring for those at risk.

scholarly journals Prevalence and cause of gestational diabetes mellitus in a tertiary care center in Kolar district: a population based study

2019 ◽  
Vol 8 (7) ◽  
pp. 2709
Author(s):  
Poojita Tummala ◽  
Munikrishna M. ◽  
Kiranmayee P.
Keyword(s):  
Diabetes Mellitus ◽  
Family History ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Tertiary Care ◽  
Oral Glucose ◽  
Care Hospital ◽  
Family History Of Diabetes ◽  
History Of

Background: Gestational diabetes mellitus (GDM) is carbohydrate intolerance at the onset of pregnancy which induces pathological short term or long term outcomes for both mother and baby. The aim of the present study was to know the prevalence of GDM in pregnant women who were attending the antenatal care (ANC) center at a tertiary care hospital in Kolar, Karnataka, India.Methods: This prospective study was conducted in Department of Obstetrics and Gynecology, Sri Devaraj Urs Medical College, a constituent of Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India. The duration of the study was two months. In this study, 108 pregnant women above 24 weeks of gestation were screened for GDM by oral glucose tolerance test. Fasting 2 milli liter blood was collected and were given 75 grams of glucose in 200 milli liters of water and asked to drink within 5 minutes. Again 2 milli liters venous blood was collected after 1 hour and 2 hours from all participants. Plasma sample was used for the estimation of glucose by glucose oxidase and peroxidase (GOD-POD) method.Results: Out of 108, 12 women (11.1%) were diagnosed with GDM. The prevalence rate was higher in the age group of 26-30 years (41.6%).  Among 12 diabetic women, five (47.2%) exercised regularly and seven (58.3%) did not doing exercise. Out of 12 GDM subjects, eight of them had family history of diabetes in first degree relatives; among which one was hypertensive and five were suffering from thyroid problems.Conclusions: In the present study, the prevalence of GDM was found to be 11.1%. Prevalence of GDM might be influenced by increasing age, pre pregnancy weight, family history of diabetes, past history of pregnancy complications, status of literacy and exercise.

scholarly journals Prevalence of Abnormal Glucose Tolerance in Obese Pregnant Women - A Study from a Tertiary Care Centre

2021 ◽  
Vol 10 (44) ◽  
pp. 3769-3774
Author(s):  
Ann Mary George ◽  
Ajay Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Pregnant Women ◽  
Oral Glucose ◽  
Government Medical College ◽  
Abnormal Glucose Tolerance ◽  
Family History Of Diabetes ◽  
Medical College ◽  
History Of

BACKGROUND Obesity has emerged as an important risk factor in modern obstetrics and poses a major threat to pregnancy by causing complications including gestational diabetes. It also increases the risk of cardiovascular diseases and diabetes mellitus in later life. Obesity creates major technical challenges in providing maternity services too. The objective of the study was to assess the prevalence of abnormal glucose tolerance in obese pregnant women in a Government Medical College over one year. METHODS A prospective observational study was conducted among obese pregnant women, registered at the Outpatient department of Obstetrics and Gynaecology at the Government Medical College, Kottayam from January 2017 to December 2017. 450 women were considered for the study after satisfying inclusion and exclusion criteria. BMI was calculated using pre-pregnant weight. An oral glucose test was performed with 75 gm glucose at 24 to 28 weeks of pregnancy after 8 hours of fasting. International Association of Diabetes and Pregnancy Study Group cut-offs i.e., fasting blood sugar values more than 92 mg/dl, 1hr value more than 180 mg/dl, 2 hr value more than 153 mg/dl were used as the criteria. Oral glucose tolerance was considered abnormal if any of the above values were impaired. RESULTS The prevalence of abnormal glucose tolerance among the 450 pregnant women was 35.6 %. The incidence of abnormal GTT increased with increasing age and in those with a history of menstrual irregularities and infertility treatment. No relation was found between economic status, family history of diabetes, preeclampsia and abnormal GTT. CONCLUSIONS Obesity turns to be a menace in the reproductive life of women that begins by affecting the fertility, continues to cause complications in pregnancy, increases morbidity in the long-term future and reduces the quality of life. Since more than one-third of the study population was affected by gestational diabetes, active intervention to reduce the weight preconceptionally is needed. KEY WORDS Obesity, Glucose Tolerance Test, Gestational Diabetes Mellitus, Body Mass Index, Pregnancy

scholarly journals Postpartum glucose tolerance status 6 to 12 weeks after gestational diabetes mellitus: a Brazilian cohort

2014 ◽  
Vol 58 (2) ◽  
pp. 197-204 ◽  
Author(s):  
Letícia Schwerz Weinert ◽  
Livia Silveira Mastella ◽  
Maria Lúcia Rocha Oppermann ◽  
Sandra Pinho Silveiro ◽  
Luciano Santos Pinto Guimarães ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Family History ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Oral Glucose ◽  
Diabetes Screening ◽  
Family History Of Diabetes ◽  
History Of ◽  
Postpartum Diabetes

Objectives: The aims of this study were to estimate the local rate of postpartum diabetes screening after gestational diabetes mellitus (GDM) pregnancies, and to identify clinical variables associated with retesting rates and with the persistence of decreased glucose tolerance. Subjects and methods: Prospective cohort of GDM women with prenatal delivery at a specialized center, from November 2009 to May 2012. All women were advised to schedule a 6 weeks postpartum 75-g oral glucose tolerance test (OGTT). Results: Of the 209 women included, 108 (51.7%) returned to be tested with fasting plasma glucose (n = 14), OGTT (n = 93) or random glucose (n = 1). Return was associated with lower parity rate (2 vs. 3, p < 0.001) and higher pregnancy 2-h OGTT (165 vs. 155 mg/dL, p = 0.034), but not with socio-demographic characteristics. Four women (3.7%) had diabetes, 22 (20.4%) had impaired fasting glucose or impaired glucose tolerance. Persistent hyperglycemia was associated with a positive family history of diabetes (relative risk - RR 2.41, p = 0.050), diagnostic 2-h OGTT in pregnancy (RR 1.01, p = 0.045), insulin use during pregnancy (RR 2.37, p = 0.014), and cesarean section (RR 2.61, p = 0.015). Conclusions: Even though postpartum abnormalities were frequent in GDM, rates of postpartum diabetes screening were undesirably low. As no specific clinical profile defines who will adhere to postpartum testing, it is essential to encourage all women to reevaluate their glucose status, particularly those with a family history of diabetes and more severe hyperglycemia. Arq Bras Endocrinol Metab. 2014;58(2):197-204

scholarly journals Risk Factors for Gestational Diabetes Mellitus

2017 ◽  
Vol 5 (1-2) ◽  
pp. 49-53
Author(s):  
Zinat Begum ◽  
Dewan Shahida Banu ◽  
Shaila Sharmeen Shanta ◽  
Shitil Ibna Islam
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Socioeconomic Status ◽  
Family History ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Plasma Glucose ◽  
Oral Glucose ◽  
Family History Of Diabetes ◽  
History Of

Objective: The present study was undertaken to determine the risk factors for Gestational Diabetes Mellitus (GDM) presented at Bangladesh Institute of Research in Diabetes, Endocrine & Metabolic Disorders (BIRDEM). Materials & methods: The present case-control study was conducted at BIRDEM Hospital, Dhaka over a period of 6 months from July to December 2011. A total of 100 pregnant women (20 cases and 80 controls) were consecutively enrolled in the study. Pregnant women who developed diabetes at their 3rd trimester were cases (n = 20), while pregnant women free from diabetes at their 3rd trimester were controls (n = 80). The diagnosis of GDM was made using a two-step approach. Pregnant women were initially screened by measuring the plasma glucose concentrations 1 hour after a 50 gram of oral glucose challenge. A diagnostic oral glucose tolerance test was performed on the subset of women whose plasma glucose concentrations exceded the threshold value for glucose (> 140 mg/dl). Result: The study showed that older patients (≥ 25 years) were predominant in both case and control groups. The groups were almost comparable in terms of socioeconomic status and occupation. The distribution of gestational age was also similar between groups (33.1 ± 6.3 vs. 34.2 ± 3.9 years, p = 0.476). Majority (85%) of the cases had family history of diabetes (p < 0.001). Thirty five percent of cases were nulipara and 65% multipara compared to 51.3% and 48.7% respectively of the control (p = 0.076). No significant difference was observed between the groups in terms of preterm labour and PROM (p = 0.690 and 0.220 respectively). Forty percent of cases had past history of GDM compared to 3.8% of controls (p < 0.001). The fasting plasma glucose and plasma glucose 2 hrs after 75 g of glucose ingestion were significantly higher in pregnant women having GDM than those in normal pregnant women (8.3 ± 3.1 vs. 4.1 ± 0.5 mmol/L, p < 0.001;12.9 ± 4.8 vs. 5.9 ± 1.2 mmol/L, p < 0.001 respectively). Conclusion: The study concluded that none of the sociodemographic characteristics like age, socioeconomic status and occupation was found to be associated with GDM. However, pregnant women with family history of diabetes are at risk of developing GDM significantly more than those without GDM. Multipara tend to develop GDM more frequently than the primipara does. Past incidence of GDM increases the risk of GDM in the subsequent pregnancy. Ibrahim Card Med J 2015; 5 (1&2): 49-53

scholarly journals Neonatal outcome in pregnancies complicated by gestational diabetes mellitus: a hospital based study

2018 ◽  
Vol 5 (3) ◽  
pp. 737 ◽  
Author(s):  
Masaraddi Sanjay K. ◽  
Saranya Andal Kishore ◽  
Nedunchezian P. ◽  
Sulekha C.
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Family History ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Large For Gestational Age ◽  
Oral Glucose ◽  
Family History Of Diabetes ◽  
History Of

Background: Gestational diabetes mellitus (GDM) is amongst the most common medical complications of pregnancy associated with adverse maternal and perinatal outcomes. The prevalence of GDM is increasing worldwide especially in India with increasing obesity and lifestyle and dietary changes. Hence this study was undertaken to study the prevalence of GDM and to evaluate its neonatal outcomes.Methods: This was a prospective study. During the study period, 205 pregnant women between 24 to 28 weeks of gestation were screened for GDM using 75 g oral glucose tolerance test (OGTT) and were diagnosed to have GDM based on WHO criteria. Risk factors for GDM, maternal and neonatal outcomes were studied.Results: The prevalence of GDM in the study population was 7.8%. Prevalence of GDM cases was significantly associated with body mass index (BMI) >25 kg/m2, family history of diabetes, previous macrosomia/large for gestational age (LGA) baby and past history of GDM with p <0.001 and with multiparity (p = 0.024). Maternal age >25 years was not statistically associated with prevalence of GDM (p = 0.358). Incidence of pre-eclampsia and polyhydramnios were significantly higher among GDM cases. Operative delivery and assisted (forceps) delivery had strongly significant association with GDM (p <0.001). GDM cases were significantly associated with higher birth weight (>3.5 kg) in the neonates (p <0.001). Hypoglycemia was the most common complication noted in neonates of GDM women. Incidence of respiratory distress, transient tachypnea of the newborn (TTN), polycythemia and neonatal hyperbilirubinemia were also significantly more common among neonates born to GDM women.Conclusions: BMI >25 kg/m2, family history of diabetes, past GDM and previous LGA baby were important risk factors for GDM. The study emphasizes the need to screen all pregnant women for GDM, so that timely diagnosis and intervention will reduce both maternal and perinatal complications.

scholarly journals GESTATIONAL DIABETES MELLITUS

2016 ◽  
Vol 23 (01) ◽  
pp. 015-019
Author(s):  
Afsheen Qazi ◽  
Amin Fahim ◽  
Aneela Qureshi3 ◽  
Mazhar ul Haque
Keyword(s):  
Diabetes Mellitus ◽  
Family History ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Tertiary Care ◽  
Oral Glucose ◽  
Care Hospital ◽  
Family History Of Diabetes ◽  
Number Of Patients ◽  
History Of

Objectives: The present study was designed to find the importance of properscreening and early diagnosis of gestational diabetes mellitus. Study Design: A prospective/descriptive study Place of Study: tertiary care hospital Hyderabad. Duration of Study: fromSeptember 2014 to November 2014. Materials and Methods: A total of 168 pregnant femalesbetween the ages of 20-40 years & in their 24th to 28th week of gestation were enrolled for thestudy. Oral Glucose Tolerance Test of all the participants was done after an overnight fasting of10-12 hours. All the participants were given 75gm of glucose per 100 ml of distilled water. Theblood samples were collected after two hours time for serum glucose levels. Results: Mostof the participants were below 26 years of age 47(27.9%) with the mean age of 30.2±5.83years. However the highest prevalence of GDM was observed in age group 31-35 years (36%).Among the 25 cases of gestational diabetes mellitus the highest number of patients with GDMwere multipara (40%) followed by parity of 3-4 gravida (32%). Twenty seven women (16%)women had family history of diabetes mellitus. Among these 12/27 (44.4%) women were foundwith GDM, compared to 15/141 (10.6%) who have no family history of diabetes mellitus. Total14 (8.33%) women were found obese, out of these 8 (57%) women had GDM while only 6(42.8%) women had no GDM. Conclusion: The prevalence of GDM in the present study isfound to be 14.8%. A prevalence of GDM was higher in the elderly multiparous females whowere overweight and had family history of diabetes mellitus.

Early glucose intolerance postpartum of gestational diabetes associated with overload test with 50 grams of glucose

2016 ◽  
Vol 62 (5) ◽  
pp. 30-31
Author(s):  
Dora Varillas ◽  
VF Varillas
Keyword(s):  
Blood Glucose ◽  
High Risk ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Pregnant Women ◽  
Glucose Intolerance ◽  
The United States ◽  
Normal Vaginal Delivery ◽  
Loading Test ◽  
History Of

Introduction. The glucose intolerance later gestational diabetes is a very important indicator that helps establish the prognosis of diabetes in pregnant women who have had gestational diabetes (1). In this study we followed for one year to all gestational diabetes who were treated at the Hospital of Fuerteventura in endocrinology consultation,Canary Island, Spain. The aim was to study what factors might be related to glucose intolerance in the immediate postpartum.Materials and methods. All pregnant women served with the diagnosis of gestational diabetes during April 2012 to May 2013, diagnosed according to the criteria of the ADA (2), were subjected to routine procedure of specialized gynecology and endocrinology unit, first: test loading test with 50 grams of glucose, and if blood glucose was greater whom 140 mgdl,SOG was performed with 100 grams glucose three hours. All these patients were followed up with a minimum of a monthly review by both gynecology and endocrinology as was given a standard diet and as controls if necessary insulin treatment. In addition glycemia in the first quarter, glycated hemoglobin in the second and third quarter was measured, if there was family history of diabetes, as well as history of previous gestational diabetes, presence of other diseases, hypertension in pregnancy, if they had done treatment with diet or insulin. Finally, it determines if the birth was eutocic or dystocia. All the analyzes were performed in the Hospital Fuerteventura laboratory by standard autoanalyzer. SPSS v.24 program for frequency valuations and statistical analyzes. Was measured frequencies, all dependent and independent variables and logistic regression analysis, ANOVA and linear correlation with statistical significance of ≤0.05 was performed.Results. Of the 60 diabetic gestational included in the study, 49 completed the assessment of oral glucose tolerance test at 0 and 120 minutes, 81'7%, of these 57.1% were normal, 41.8% had glucose intolerance which were 26.5% impaired fasting glucose and 14’3 were intolerant, 2.5 were diabetic. In these patients: 57.6 percent had a normal vaginal delivery and 39.0% were dystocia. When we analyze all the variables according to the diagnosis of glucose intolerance, just correlated test 50 grams of glucose, ANOVA (p <0.033) with degrees of impaired glucose tolerance and there was a correlation positive linear between higher blood glucose value post 50 grams of glucose and glucose intolerance in the immediate postpartum. When we analyze dystocia, there was no correlation with any of the studied variables.Discussion. Interestingly in this study it is among correlation values loading test with 50g glucose and the presence of glucose intolerance and diabetes immediately after birth of gestational diabetes. It is known that after 50 grams of glucose greater than 200 glucose has an almost certain chance of having gestational diabetes (2) and according to some centers especially in the United States is not necessary to make a confirmatory SOG (2), however, their relationship to the immediate postpartum, it has not been seen in another study that we know until now and therefore part of their predictive value for gestational diabetes, could already give us an indication of glycemic alteration itself will happen in the immediate postpartum (3). Compared with other studies, the prevalence of glucose intolerance is similar to other high-risk populations, such as the Indian population (4), which gives the Canarian population at high risk of developing diabetes in the future. This study shows that the overload test with 50 grams of glucose is not only indicative of a very high suspicion of gestational diabetes, but can also help establish the prognosis of a future change in glucose metabolism in gestational diabetes.

scholarly journals Risk Factors Associated with Gestational Diabetes among Pregnant Women in Owerri Municipal Council, Southeastern Nigeria

2013 ◽  
Vol 5 (1) ◽  
pp. 39-46 ◽  
Author(s):  
JC Nwaokoro ◽  
CO Emerole ◽  
SNO Ibe ◽  
AN Amadi ◽  
INS Dozie
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Significant Relationship ◽  
Previous History ◽  
Southeastern Nigeria ◽  
Family History Of Diabetes ◽  
Factors Associated ◽  
History Of

Background Gestational diabetes is emerging as a serious public health problem in Nigeria where the largest number of people with diabetes in Africa occurs. Current studies in Nigeria give an overall prevalence of gestational diabetes as 13.4% among pregnant women with unidentified risk factors. Aims and Objectives This study aimed at investigating the risk factors associated with gestational diabetes. Materials and Methods A cross-section analytical study design was adopted for this research and comprising a total of 100 pregnant women receiving ante-natal health care service at the Federal Medical Center, Owerri. A structured questionnaire including a set of detailed pre-determined questions was administered on the subjects. Data collected were analyzed statistically, using chi-square and T test. Results The results obtained suggest that there is a significant relationship (p<0.05) between previous macrosomic baby, parity, previous history of caesarean section, family history of diabetes and occurrence of gestational diabetes, respectively. However, there is no significant relationship (p>0.05) between history of miscarriages and stillbirth, socioeconomic status and occurrence of gestational diabetes. A family history of diabetes is independently and significantly associated with the development of gestational diabetes itself even after adjusting for other risk factors. Conclusion This study will be a working tool to guide obstetricians and midwives in counseling and advising women of their risk of developing GDM. DOI: http://dx.doi.org/10.3126/ajms.v5i1.8302 Asian Journal of Medical Science Vol.5(1) 2014 pp.39-46  

Study the Effect of Maternal Factors on Prevalence of Gestational Diabetes Mellitus and Effect of Treatment Types on Serum Blood Glucose

2021 ◽  
pp. 5264-5269
Author(s):  
Shaymaa Hasan Abbas ◽  
Sura Abbas Khdair
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Glucose ◽  
Family History ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Blood Glucose Level ◽  
Family History Of Diabetes ◽  
Treatment Groups ◽  
History Of

Introduction: Gestational diabetes mellitus (GDM) is one of the most common medical problems occurred during pregnancy. GDM increase the chance for developing type 2 diabetes meletus by seven times. The overall prevalence of GDM in pregnancy is 1-14% according to the American Diabetes Association. Material and Methods: a self-administered questionnaire was used to collect data. The information was collected from pregnant women with gestational DM to assess some maternal risk factors and compare blood glucose level according to different treatment types for GDM. Results: The present study reported that (40.38%) of GDM patients have advanced age (≥35 yrs.). First pregnancy was a risk factors for GDM and it was reported by (9.62%). History of HT and GDM during prior pregnancies were reported by (11.54%) and (% 34.62) respectively. Hypertension or preeclampsia in the current pregnancy was reported by (3.85%). Positive family history of diabetes was associated with (26.92%) GDM patients. All Patients of the present study reported no previous PCOS and smoking history. Also in this study, 44 patients out of 52 GDM patients use medications to control the glucose intolerance, while other patients control it by diet. There were no statistical differences found between treatment groups in term of blood glucose control. Conclusion: Age, history of GDM in the previous pregnancies and family history of diabetes mellitus were identifiable as a risk factors for GDM and their effect were significant in this study while the effect of other risk factors were non-significant. No statistical differences found between treatment groups in term of blood glucose level control and no group achieved the glycemic target.

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