scholarly journals Geospatial Analysis of Birth Records to Target Programming for Mothers With Gestational Diabetes Mellitus in Michigan, 2013

2018 ◽  
Vol 134 (1) ◽  
pp. 27-35 ◽  
Author(s):  
Elizabeth MacQuillan ◽  
Amy Curtis ◽  
Kathleen Baker ◽  
Rajib Paul

Objectives: The incidence of gestational diabetes mellitus (GDM) in the United States has increased during the past several decades. The objective of this study was to use birth records and a combination of statistical and geographic information system (GIS) analyses to evaluate GDM rates among subgroups of pregnant women in Michigan. Materials and Methods: We obtained data on maternal demographic and health-related characteristics and regions of residence from 2013 Michigan birth records. We geocoded (ie, matched to maternal residence) the birth data, calculated proportions of births to women with GDM, and used logistic regression models to determine predictors of GDM. We calculated odds ratios (ORs) from the exponentiated beta statistic of the logistic regression test. We also used kernel density estimations and local indicators of spatial association (LISA) analyses to determine GDM rates in regions in the state and identify GDM hot spots (ie, areas with a high GDM rate surrounded by areas with a high GDM rate). Results: We successfully geocoded 104 419 of 109 168 (95.6%) births in Michigan in 2013. Of the geocoded births, 5185 (5.0%) were to mothers diagnosed with GDM. LISA maps showed a hot spot of 8 adjacent counties with high GDM rates in southwest Michigan. Of 11 064 births in the Southwest region, 829 (7.5%) were to mothers diagnosed with GDM, the highest rate in the state and a result confirmed by geospatial analyses. Practice Applications: Birth data and GIS analyses may be used to measure statewide pregnancy-associated disease risk and identify populations and geographic regions in need of targeted public health and maternal–child health interventions.

2017 ◽  
Vol 2 (2) ◽  

Background: Gestational diabetes mellitus is a condition that affects many pregnancies and ethnicity appears to be a risk factor. Data indicate that approximately 18% of Tamil women are diagnosed with gestational diabetes mellitus. Today, approximately 50,000 of Tamils live in Switzerland. To date, there is no official tool available in Switzerland that considers the eating and physical activity habits of this migrant Tamil population living in Switzerland, while offering a quick overview of gestational diabetes mellitus and standard dietetics management procedures. The NutriGeD project led by Bern University of Applied Sciences in Switzerland aimed at closing this gap. The aim of this present study was to evaluate the implementation potential of the tools developed in the project NutriGeD for dietetic counseling before their wide scale launch in Swiss hospitals, clinics and private practices. Method: An online survey was developed and distributed to 50 recruited healthcare professionals working in the German speaking region of Switzerland from October – December 2016 (31% response rate). The transcultural tools were sent to participants together with the link to the online survey. The evaluation outcome was analysed using binary logistic regression and cross tabulation analysis with IBM SPSS version 24.0, 2016. Results: 94% (N=47) respondents believed that the transcultural tools had good potential for implementation in hospitals and private practices in Switzerland. A binary logistic regression analysis revealed that the age of participants had a good correlation (42.1%) on recommending the implementation potential of the transcultural tool. The participants with age group 34- 54 years old where the highest group to recommend the implementation potential of the transcultural tool and this was found to be statistically significant (p=0.05). 74% (34 out of 50) of the respondents clearly acknowledged the need for transcultural competence knowledge in healthcare practices. 80% (N =40) of the respondents agreed that the information presented in the counseling display folder was important and helpful while 60% (N= 30) agreed to the contents being clinically applicable. 90% (N=45) participants recommended the availability of the evaluated transcultural tools in healthcare settings in Switzerland. Conclusion: The availability in healthcare practice of the evaluated transcultural tools was greatly encouraged by the Swiss healthcare practitioners participating in the survey. While they confirmed the need for these transcultural tools, feed-backs for minor adjustments were given to finalize the tools before their official launch in practice. The developed materials will be made available for clinical visits, in both hospitals and private practices in Switzerland. The Migmapp© transcultural tool can serve as a good approach in assisting healthcare professionals in all fields, especially professionals who practice in areas associated with diet - related diseases or disorders associated with populations at risk.


Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 121-OR ◽  
Author(s):  
TAO ZHOU ◽  
DIANJIANYI SUN ◽  
XIANG LI ◽  
YORIKO HEIANZA ◽  
HOIRUN NISA ◽  
...  

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1177.1-1177
Author(s):  
S. S. Shaharir ◽  
R. Mustafar ◽  
M. S. Mohamed Said ◽  
R. Abd Rahman

Background:The risks of insulin resistance and diabetes mellitus are elevated in systemic lupus erythematosus (SLE) patients. The use of glucocorticoid and anti-double stranded DNA antibodies positive are among the factors reported to be associated with the risk of gestational diabetes mellitus (GDM) in SLE patients. However, the relationship between GDM in Asian SLE patients is still obscure.Objectives:To determine the prevalence of gestational diabetes mellitus (GDM) in a multi-ethnic SLE cohort in Malaysia and the associated risk factors.Methods:This was a retrospective study of SLE pregnant women who have completed their antenatal care in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) from 2004 until 2019. Screening and diagnosis of gestational diabetes mellitus (GDM) were as recommended in the guidelines by the Ministry of Health Malaysia. Information on SLE disease activity and treatment at 6 months before pregnancy and during pregnancy were determined from the medical records. Univariate and multi-variable logistic regression analyses were performed to determine the factors associated with GDM in the SLE patients.Results:A total of 89 patients with 202 pregnancies were included in the study. Malay was the predominant ethnic in this cohort (n=82, 67.2%), followed by Chinese (n=33,27.0%) and Indian (n=7, 5.7%). The most common system involvement of SLE was musculoskeletal (n=91, 74.6%), followed by haematological (n=78, 63.9%), lupus nephritis (54.9%, n=67) and mucocutaneous (n=66, 54.1%). The prevalence of GDM was 8.9% (n=18). More patients with GDM had positive anti-cardiolipin IgG antibody (aCL IgG) and lupus anticoagulant (LA) antibody as compared to the patients with no GDM, (55.6% vs 25.8%, p=0.01) and (50.0% vs 25.4%, p=0.05) respectively. On the other hand, the use of hydroxychloroquine (HCQ) in pregnancy was significantly lower in GDM patients (11.1%) as compared to no GDM group (39.1%), p=0.02. There was no significant difference in the ethnicity, SLE system involvement, disease activity status and immunosupressant use including steroid, azathioprine and cyclosporine A at 6 months before and during pregnancy between the GDM and non-GDM group. A forward logistic regression which include aCL IgG, LA and HCQ use in pregnancy, only the HCQ use remained significantly associated with lower risk of GDM in the model with OR= 0.12, 95% C.I = 0.02-0.94, p=0.04.Conclusion:Our study demonstrates the potential benefit of hydroxychloroquine in reducing the risk of gestational diabetes mellitus in SLE patients. The prevalence of antiphospholipid antibodies particularly aCL IgG and LA was found to be higher among patients with GDM. Further prospective studies are needed to confirm this association.References:[1]Dong Y, Dai Z, Wang Z, et al. Risk of gestational diabetes mellitus in systemic lupus erythematosus pregnancy: a systematic review and meta-analysis. BMC Pregnancy and Childbirth. 2019 May;19(1):179. DOI: 10.1186/s12884-019-2329-0.Disclosure of Interests:None declared


2009 ◽  
Vol 12 (3) ◽  
pp. 165-174 ◽  
Author(s):  
Yaozhu Chen ◽  
William W. Quick ◽  
Wenya Yang ◽  
Yiduo Zhang ◽  
Alan Baldwin ◽  
...  

2020 ◽  
Author(s):  
Tolulope Odedokun ◽  
Larissa F Weir ◽  
James K Aden

Abstract Introduction Gestational diabetes mellitus (GDM) affects approximately 1-14% of all pregnancies in the United States and has significant maternal and neonatal consequences. Developing GDM can increase a patient’s risk of developing overt diabetes in the future which may impact a soldier’s readiness. The purpose of this study is to compare the incidence of GDM in active duty females compared with civilian dependents. Materials and Methods This retrospective cohort analysis was performed at a military medical center with IRB approval. Active duty and dependent status women who delivered between June 1, 2014 and April 30, 2015 were identified along with incidence of GDM. Sample size calculation determined a need for 391 women in each group to observe a 5% difference in rate of GDM with a power of 80%. Chi-squared analysis was used to compare rates of GDM. Results Rates of GDM were similar between the two cohorts (active duty = 9.95%, dependent = 9.72%, P = .91). Age, gravidity, and prepregnancy BMI were also similar between groups. The rate of diet-controlled GDM were different between the two cohorts (active duty = 53.8%, dependent = 34.2%, P = .02). Conclusions This study highlights active duty females have similar rates of GDM as dependents. Gestational diabetes mellitus is known to affect short- and long-term maternal and neonatal outcomes and can impact a soldier’s readiness. Further research is required to determine the long-term impact of GDM in active duty females and best practices to decrease rates of GDM in the military population.


2014 ◽  
Vol 38 (1) ◽  
pp. 14-21 ◽  
Author(s):  
Argyro Syngelaki ◽  
Alice Pastides ◽  
Reena Kotecha ◽  
Alan Wright ◽  
Ranjit Akolekar ◽  
...  

Objectives: To develop and validate a prediction model for gestational diabetes mellitus (GDM) at 11-13 weeks' gestation based on maternal characteristics and history and to compare its performance with the method recommended by the National Institute of Health and Care Excellence (NICE) and five other published prediction models. Methods: A predictive logistic regression model for GDM was developed from 1,827 cases (2.4%) who developed GDM and 73,334 unaffected controls. A 5-fold cross-validation study was performed to validate this model and to compare its performance with those of the NICE guidelines and the previously published models. Results: In the logistic regression model, maternal age, weight, height, racial origin, family history of diabetes, use of ovulation drugs, birth weight, and previous history of GDM were found to be significant predictors of GDM. In screening for GDM in the 5-fold cross-validation study, detection rates (DRs) were higher (p < 0.0001) for the proposed model (DR = 83.2%) than for the NICE guidelines (DR = 77.5%) for a false positive rate of approximately 40% (determined by NICE). The area under the receiver operating characteristic curve of the new model was higher (p < 0.0001) than that of the previous five models (0.823 vs. 0.688-786). Conclusions: Early effective screening for GDM can be achieved based on maternal characteristics and history.


2016 ◽  
Vol 30 (21) ◽  
pp. 2607-2612 ◽  
Author(s):  
Brianne E. Bimson ◽  
Barak M. Rosenn ◽  
Sara A. Morris ◽  
Elizabeth B. Sasso ◽  
Rachelle A. Schwartz ◽  
...  

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