Gestational Diabetes Risk in Migrants. A Nationwide, Register-Based Study of all Births in Denmark 2004 to 2015

2020 ◽  
Vol 105 (3) ◽  
pp. e692-e703 ◽  
Author(s):  
Karoline Kragelund Nielsen ◽  
Gregers Stig Andersen ◽  
Peter Damm ◽  
Anne-Marie Nybo Andersen

Abstract Background Much remains to be understood about socioeconomic position and body mass index (BMI) in the pathways linking ethnicity, migration, and gestational diabetes mellitus (GDM). We investigated differences in GDM prevalence according to maternal country of origin and the role played by socioeconomic position and BMI on this relationship. Finally, we examined how length of residency was associated with GDM. Methods A register-based cohort study of the 725 482 pregnancies that resulted in a birth in Denmark, 2004 to 2015. Of these, 14.4% were by women who had migrated to Denmark. A GDM diagnosis was registered in 19 386 (2.7%) pregnancies, of which 4464 (23.0%) were in immigrant women. The crude risk of GDM according to maternal country of origin compared to Danish-born women ranged from an odds ratio (OR) of 0.50 (95% CI 0.34-0.71) for women from Sweden to an OR of 5.11 (95% CI 4.28-6.11) for women from Sri Lanka. Adjustment for socioeconomic position slightly attenuated the risks. Adjusting for BMI resulted in increased ORs for women, especially from Asian countries. The separate and joint effects of migration and overweight on GDM risk differed substantially between the countries of origin (P value interaction term < .001). Immigrants with 10 or more years of residency had a 56% increased risk of GDM (OR 1.56, 95% CI 1.44-1.68) compared to immigrants with less than 5 years in Denmark. This risk was somewhat diluted when adjusting for age and BMI. Conclusions This study demonstrates substantial variation in the risk of GDM according to country of origin. The risk associations are only slightly affected by socioeconomic position and BMI.

2021 ◽  
Author(s):  
Ravi BHUSHAN ◽  
Sonal Upadhyay ◽  
Shally AWASTHI ◽  
Monika Panday

Abstract Background Several molecular epidemiological studies have analyzed the associations between genetic variants and the risk of gestational diabetes mellitus (GDM). However, all these studies suffer from inconsistent and conflicting results owing to relatively smaller sample sizes, fewer genetic variants included in the research, and limited statistical power. Hence, a coherent review and meta-analysis were carried out to provide a quantitative summary related to the associations of commonly studied SNPs with GDM risk. Methods Eligible studies were retrieved from PubMed,updated on Dec. 2019. Based on several inclusion and exclusion criteria, 71 articles with 42928 GDM patients and 77793 controls were finally considered for meta-analysis. The genotype data from 23 variants of sixteen genes were statistically analyzed using RevMan v 5.2 software. Newcastle-Ottawa Scale (NOS) was used to assess the quality of the research article. Heterogeneity among studies was tested by I2 and odds ratio with 95% confidence interval (CI) was carried out for all five genetic models. Results The overall combined odds ratio reveals that variants like MTNR1B (rs1083963, rs1387153), GCK (rs1799884), CANP10 (rs3792267), and GCKR (rs780094) are significantly associated with GDM in all genetic models while CANP10 (rs5030952), ADRB (rs4994) and FTO (rs8050136) are not significantly associated with GDM in any genetic models. Variants MTNR1B (rs1083963, rs1387153) and GCK (rs1799884) are associated with increased risk (OR>1, p<0.05) of GDM, and all these are related to insulin secretion. Other variants related to insulin secretion like TCF7L2 (rs7903146) and SLC30A8 (rs1326634) are also associated with increased risk (OR>1, p<0.05) of GDM. On the contrary, CANP10 (rs3792267) and GCKR (rs780094) are found associated with decreased risk (OR<1, p<0.05) of GDM. Other variants are significantly associated with the GDM in at least one or more genetic models. Conclusion Our study identified that most of the variants related to insulin secretions like MTNR1B (rs1083963), GCK (rs1799884), TCF7L2 (rs7903146), GCKR (rs780094), and SLC30A8 (rs1326634) are more strongly associated (p<0.005) with GDM as compared to the variants related to the insulin resistance like PPARG (rs1801282), IRS1 (rs1801278) and ADIPOQ (rs266729).


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Shuko Takahashi ◽  
Kozo Tanno ◽  
Yuki Yonekura ◽  
Haruki Shimoda ◽  
Ryohei Sasaki ◽  
...  

Abstract The association between incidence of diabetes mellitus (DM) and living conditions has not been studied after natural disasters. We compared the incidence of DM between individuals living in temporary housing (TH) and those living in other types of accommodation (non-TH) five years after the 2011 Great East Japan Earthquake. Longitudinal follow-up was conducted from 2011 to 2015 in a cohort of 7,491 residents of coastal communities in Iwate Prefecture directly impacted by the 2011 disaster (mean age, 61.6 years; men, 36.0%). We calculated the odds ratio of new onset of DM in the TH group (n = 2,372) compared with the non-TH group (n = 5,119) using discrete-time logit models stratified by sex and age classes (64 years or younger and older than 65 years). The TH group showed a significantly higher odds ratio (OR) for DM in men aged 64 years or younger (OR [95% confidence interval (CI)], 1.71 [1.03–2.85]; P-value = 0.040). In women, living conditions were not significantly associated DM. Survivors relocated to TH appeared to be at an increased risk of new onset DM.


2020 ◽  
Vol 16 ◽  
Author(s):  
Salman Khazaei ◽  
Erfan Ayubi ◽  
Saeid Bashirian ◽  
Ronak Hamzehei ◽  
Ensiyeh Jenabi

Background: The relationship between gestational diabetes and postpartum depression (PPD) is poorly understood and seldom studied. Objective: In an effort to explore this issue, the present study investigated the relationship between gestational diabetes and PPD. Methods: The present cross-sectional study was performed with 342 women who were referred to four urban health centers of Hamadan city, west of Iran. We used convenience sampling as a method to recruit women in each health center. We used a researcher-made checklist for gathering data on socio-demographic characteristics and potential risk factors of PPD. The Persian validated version of the Edinburgh Postnatal Depression Scale (EPDS) was used to assess PPD. Univariate and multivariable binary logistic regression was applied to estimate the odds ratio (OR) (95% confidence interval [CI]). Results: Gestational diabetes was identified as the most important risk factor for PPD with OR (95% CI) of 2.19 (1.11, 4.31); P-value=0.02 after adjusting for other variables. Moreover, the adjusted odds ratio showed that PPD among lesseducated women (primary school) was 3.5 times higher compared to women with a university education (OR=3.54, 95% CI: 1.27, 9.84; P-value=0.01). Conclusion: Our findings suggested that PPD is more likely among women with gestational diabetes and those who were less educated. Interventional and educational activities for reducing the risk of PPD can be targeted for use with this population.


2021 ◽  
Vol 10 (4) ◽  
pp. 835
Author(s):  
Manoja P. Herath ◽  
Jeffrey M. Beckett ◽  
Andrew P. Hills ◽  
Nuala M. Byrne ◽  
Kiran D. K. Ahuja

Exposure to untreated gestational diabetes mellitus (GDM) in utero increases the risk of obesity and type 2 diabetes in adulthood, and increased adiposity in GDM-exposed infants is suggested as a plausible mediator of this increased risk of later-life metabolic disorders. Evidence is equivocal regarding the impact of good glycaemic control in GDM mothers on infant adiposity at birth. We systematically reviewed studies reporting fat mass (FM), percent fat mass (%FM) and skinfold thicknesses (SFT) at birth in infants of mothers with GDM controlled with therapeutic interventions (IGDMtr). While treating GDM lowered FM in newborns compared to no treatment, there was no difference in FM and SFT according to the type of treatment (insulin, metformin, glyburide). IGDMtr had higher overall adiposity (mean difference, 95% confidence interval) measured with FM (68.46 g, 29.91 to 107.01) and %FM (1.98%, 0.54 to 3.42) but similar subcutaneous adiposity measured with SFT, compared to infants exposed to normal glucose tolerance (INGT). This suggests that IGDMtr may be characterised by excess fat accrual in internal adipose tissue. Given that intra-abdominal adiposity is a major risk factor for metabolic disorders, future studies should distinguish adipose tissue distribution of IGDMtr and INGT.


2020 ◽  
Vol 12 ◽  
pp. 1759720X2098121
Author(s):  
Gustavo Constantino de Campos ◽  
Raman Mundi ◽  
Craig Whittington ◽  
Marie-Josée Toutounji ◽  
Wilson Ngai ◽  
...  

Aims: The objective of this review was to examine the relationship between osteoarthritis (OA) and mobility-related comorbidities, specifically diabetes mellitus (DM) and cardiovascular disease (CVD). It also investigated the relationship between OA and mortality. Methods: An overview of meta-analyses was conducted by performing two targeted searches from inception to June 2020. The association between OA and (i) DM or CVD ( via PubMed and Embase); and (ii) mortality ( via PubMed) was investigated. Meta-analyses were selected if they included studies that examined adults with OA at any site and reported associations between OA and DM, CVD, or mortality. Evidence was synthesized qualitatively. Results: Six meta-analyses met inclusion criteria. One meta-analysis of 20 studies demonstrated a statistically significant association between OA and DM, with pooled odds ratio of 1.41 (95% confidence interval: 1.21, 1.65; n = 1,040,175 patients). One meta-analysis of 15 studies demonstrated significantly increased risk of CVD among OA patients, with a pooled risk ratio of 1.24 (1.12, 1.37, n = 358,944 patients). Stratified by type of CVD, OA was shown to be associated with increased heart failure (HF) and ischemic heart disease (IHD) and reduced transient ischemic attack (TIA). There was no association reported for stroke or myocardial infarction (MI). Three meta-analyses did not find a significant association between OA (any site) and all-cause mortality. However, OA was found to be significantly associated with cardiovascular-related death across two meta-analyses. Conclusion: The identified meta-analyses reported significantly increased risk of both DM and CVD (particularly, HF and IHD) among OA patients. It was not possible to confirm consistent directional or causal relationships. OA was found to be associated with increased mortality, but mostly in relation to CVD-related mortality, suggesting that further study is warranted in this area.


Author(s):  
Yi Wang ◽  
Fengjiang Sun ◽  
Ping Wu ◽  
Yichao Huang ◽  
Yi Ye ◽  
...  

Abstract Context While the associations between thyroid markers and gestational diabetes mellitus (GDM) have been extensively studied, the results are inconclusive and the mechanisms remain unclear. Objective We aimed to investigate the prospective associations of thyroid markers in early gestation with GDM risk, and examine the mediating effects through lipid species. Methods This study included 6068 pregnant women from the Tongji-Shuangliu Birth Cohort. Maternal serum thyroid markers (free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone, thyroid peroxidase antibody, and thyroglobulin antibody) were measured before 15 weeks. Deiodinase activity was assessed by fT3/fT4 ratio. Plasma lipidome were quantified in a subset of 883 participants. Results Mean age of the participants was 26.6 ± 3.7 years, and mean gestational age was 10.3 ± 2.0 weeks. Higher levels of fT4 were associated with a decreased risk of GDM (OR=0.73 comparing the extreme quartiles; 95% CI 0.54, 0.98, Ptrend =0.043), while higher fT3/fT4 ratio was associated with an increased risk of GDM (OR=1.43 comparing the extreme quartiles; 95% CI 1.06, 1.93, Ptrend =0.010) after adjusting for potential confounders. Multiple linear regression suggested that fT3/fT4 ratio was positively associated with alkylphosphatidylcholine 36:1, phosphatidylethanolamine plasmalogen 38:6, diacylglyceride 18:0/18:1, sphingomyelin 34:1, and phosphatidylcholine 40:7 (false discovery rate adjusted P&lt;0.05). Mediation analysis indicated 67.9% of the association between fT3/fT4 ratio and GDM might be mediated through the composite effect of these lipids. Conclusions Lower concentration of serum fT4 or higher fT3/fT4 ratio in early pregnancy was associated with an increased risk of GDM. The association of fT3/fT4 ratio with GDM was largely mediated by specific lipid species.


2021 ◽  
Vol 1 ◽  
pp. 959-968
Author(s):  
Endang Susilowati ◽  
Endang Surani ◽  
Isna Hudaya

AbstractThe incidence of stunting in children can cause the low quality of a country's Human Resources (HR). Stunting causes poor cognitive abilities, low productivity, and increased risk of disease resulting in long-term losses for the Indonesian economy. Stunting also has other long-term impacts, namely the risk of suffering from chronic diseases such as diabetes mellitus (DM), coronary heart disease, hypertension, cancer, and stroke. Community participation is needed in the government's efforts to tackle stunting. Community behavior problems that are factors that cause stunting include 1) Lack of environmental hygiene 2) Lack of knowledge of mothers about health and nutrition 3) Busy parents 4) Poverty. GERMAS CETING (Community Movement to Prevent Stunting) is a community movement that is carried out jointly and continuously in order to increase public awareness in stunting prevention efforts with the main target of the entire community being Cadres, pregnant women and mothers of toddlers and other potential groups by integrating all specific interventions and interventions. sensitive. The purpose of this activity is to increase the knowledge of cadres and mothers of toddlers about stunting and to improve the skills of cadres and mothers of toddlers in making additional food according to the child's age. The implementation method used is problem identification, determining problem solving framework, conducting pre test, providing Health Education and training, conducting post test. There was an increase in mother's knowledge about exclusive breastfeeding, MP-ASI and PHBS. The results of the analysis are known p value 0.000. Keywords: Germas; ceting; cadres; mother of toddlers AbstrakKejadian stunting pada anak dapat menyebabkan rendahnya kualitas Sumber Daya Manusia (SDM) suatu negara. Keadaan Stunting menyebabkan buruknya kemampuan kognitif, rendahnya produktivitas, serta meningkatnya risiko penyakit mengakibatkan kerugian jangka panjang bagi ekonomi Indonesia. Stunting juga menimbulkan dampak jangka panjang yang lain yaitu berisiko menderita penyakit kronis seperti diabetes mellitus (DM), jantung koroner, hipertensi, kanker, dan stroke. Partisipasi masyarakat sangat dibutuhkan dalam dalam upaya pemerintah untuk penanggulangan stunting. Masalah perilaku masyarakat yang menjadi faktor penyebab stunting antara lain 1) Kurangnya menjaga kebersihan lingkungan 2) Kurangnya pengetahuan ibu mengenai kesehatan dan gizi 3) Kesibukan orangtua 4) Kemiskinan. GERMAS CETING (Gerakan masyarakat cegah stunting) merupakan gerakan masyarakat yang dilakukan secara bersama dan berkesinambungan dalam rangka meningkatkan kesadaran masyarakat dalam upaya pencegahan stunting dengan sasaran seluruh masyarakat utamanya adalah Kader, ibu hamil dan ibu balita serta kelompok potensial lainnya dengan mengintegrasikan seluruh intervensi spesifik dan intervensi sensitive. Tujuan dari kegiatan ini adalah meningkatkan pengetahuan kader dan ibu balita tentang Stunting serta Meningkatkan ketrampilan kader dan ibu balita dalam pembuatan makanan tambahan sesuai dengan usia anak. Metode pelaksanaan yang digunakan adalah identifikasi masalah, menentukan kerangka pemecahan masalah, melakukan pre test, memberikan Pendidikan Kesehatan dan pelatihan, melakukan pos test. Terjadi peningkatan pengetahuan ibu tentang ASI eksklusif, MP-ASI dan PHBS. Hasil Analisa diketahui p value 0.000. Kata kunci: Germas; ceting;kader;ibubalita


2017 ◽  
Vol 10 (3) ◽  
pp. 120-124 ◽  
Author(s):  
Margaret Bublitz ◽  
Suzanne De La Monte ◽  
Susan Martin ◽  
Lucia Larson ◽  
Ghada Bourjeily

Background Women with childhood maltreatment histories are at increased risk for adverse birth outcomes. Mechanisms explaining this link are poorly understood. Past research is limited by sampling pregnant women at low risk for adverse maternal and neonatal outcomes. Methods This pilot study was a secondary data analysis of 24 women with gestational diabetes mellitus; 17% of the sample also reported a maltreatment history. Women provided a blood sample to measure inflammatory cytokines and insulin resistance, and saliva samples to measure diurnal cortisol. Birth outcomes for past and current pregnancies were recorded. Results Histories of maltreatment were associated with elevated interleukin-15 and a marginally greater incidence of preterm delivery in current and past pregnancies. Conclusions This pilot study was the first to demonstrate an association between childhood maltreatment history and inflammatory cytokine levels in pregnant women diagnosed with gestational diabetes mellitus.


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