scholarly journals SAT-012 Screening for Gestational Diabetes Mellitus: Universal or Selective Screening? Screening for Gestational Diabetes Mellitus: Universal or Selective Screening?

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Bolanle Olajumoke Okunowo ◽  
Olufemi A Fasanmade ◽  
Ifedayo A Odeniyi ◽  
Augustine E Ohwovoriole
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Plasma Glucose ◽  
Risk Group ◽  
Oral Glucose ◽  
Selective Screening ◽  
History Of ◽  
The Impact

Abstract Screening for gestational diabetes mellitus: universal or selective screening? Introduction: The presence or absence of risk factors is often employed in screening for Gestational Diabetes Mellitus (GDM). The risk factors for GDM includes previous delivery of macrosomic babies, family history of type 2 diabetes mellitus, previous GDM among others. The impact of selective screening is yet to be fully evaluated in our environment. Objective To determine the impact of selective screening on diagnosis of gestational diabetes mellitus Methods The study was a prospective open cohort study carried out from 1st March to 30th November 2017 at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria. Ethical approval was obtained from the Health Research Ethics Committee of Lagos University Teaching Hospital (LUTH) before commencement of the study All the pregnant women were categorized into either risk group or control group based on the presence or absence of clinical risk factors for GDM. All participant had 75g Oral Glucose Tolerance test (OGTT) done at 24 to 28 weeks gestation and follow up till delivery. The data obtained were age, risk factors for GDM, fasting plasma glucose, one-hour post glucose load plasma glucose & two-hour post glucose load plasma glucose. The data were presented as mean, standard deviation, percentages & chi square. The p value ≤ 0.05 was considered significant Results Ninety pregnant women were screened for GDM. Forty-four women had risk factors for GDM while 46 were non risk group. Their mean age was 32.6± 5 years. The mean age for the risk & non-risk group were similar. The overall prevalence of GDM using the IADPSG criteria was 23.3%. The percentage of women in the risk group with GDM was 38.6% while those women in the non risk group with GDM was 8.7% which was statistically significant (p value 0.004). Discussion The most commonly identified risk factors for GDM in this study were family history of type 2 diabetes mellitus, history of unexplained miscarriage & previous history of delivery of macrosomic babies. Some women in the non-risk were diagnosed, even though the prevalence was lower than that observed among women with risk factors for GDM. Approximately one in ten women would have been missed if selective screening was employed in this study. Most of the women in the non-risk group who were diagnosed with GDM were managed with medical nutritional therapy while majority of women in the risk group had insulin therapy. Conclusion The findings in our study further supports the idea of universal screening for GDM in order to avoid missed diagnosis. Keywords: gestational diabetes mellitus, Screening, oral glucose tolerance test

scholarly journals Risk factor for gestational diabetes mellitus and impact of gestational diabetes mellitus on maternal and fetal health during the antenatal period

2021 ◽  
Author(s):  
Uma Jain ◽  
Kusumlata Singhal ◽  
Shikha Jain ◽  
Deepali Jain
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Congenital Malformation ◽  
Fetal Health ◽  
Antenatal Period ◽  
Study Results ◽  
History Of ◽  
The Impact

Background: Gestational diabetes mellitus (GDM) is defined as any degree of dysglycaemia that occurs for the first time or is first detected during pregnancy. The adverse effects of GDM on pregnant women are pre-eclampsia, PIH, PPH, polyhydramanios, PROM, meanwhile, there would be an increase in dystocia, birth injury, and cesarean sectionMethods: This retrospective study was conducted in a Gynecology clinic in District Shivpuri to find out the various risk factors for GDM and to evaluate the impact of GDM on maternal and fetal health during the antenatal period. 84 patients who were diagnosed with GDM were included in the study. Results: Among risk factors; BMI >25 kg/m2 before pregnancy was found in 15.47% of the case, family history of diabetes mellitus 8.33%, Previous history of macrosomia 17.85%, Poor reproductive history 17.85%, baby with congenital malformation 8.33%, H/o unexplained IUFD 11.90%. H/o polyhydramnios 15.47%. History of PCOS 13.09% and preeclampsia was found in 17.85% of cases. In antenatal complications; miscarriages was found in 15.47%. polyhydramnios in 17.85%. Oligohydramnios in 8.33%, preterm labor in 11.90%, PROM in 9.52%, pre-eclampsia in 17.85%, sudden IUFD in 8.33% and congenital malformation was found in 4.76% of cases. On USG; IUGR was found in 7.14% of cases. Large for date fetus in 16.66% of cases and the normal growth was found in 76.19% of cases.Conclusions- In conclusion appropriate and timely diagnosis and treatment of GDM will result in decreased maternal and neonatal adverse outcomes comparable to general population rates, therefore, early diagnosis is important.

scholarly journals To study the incidence of gestational diabetes mellitus and risk factors associated with GDM

2017 ◽  
Vol 4 (1) ◽  
pp. 112 ◽  
Author(s):  
Maxima Anand ◽  
Manan Anand ◽  
Devinder Singh Mahajan
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Family History ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Challenge Test ◽  
Oral Glucose ◽  
Family History Of Diabetes ◽  
Glucose Levels ◽  
History Of

Background: Diabetes is estimated to complicate 2-5% of all pregnancies of which 90% of those are detected during pregnancy i.e. gestational diabetes mellitus (GDM) and the rest are overt or pregestational i.e. either Type 1 or Type 2. According to ADA, approximately 7% of all pregnancies are complicated by GDM resulting in more than 2,00,000 cases annually. The aim was to study the incidence of GDM among pregnant women between 24 to 28 weeks of gestation, to evaluate and compare the occurrence of risk factors e.g.; family history of diabetes, prematurity, history of foetal loss and congenital anomaly associated with diabetes in pregnancy.Methods: 50gm of glucose, glucose challenge test (GCT) was given to women coming for antenatal check-up between 24 to 28 weeks of gestation irrespective of presence or absence of risk factors for GDM.1 hour glucose levels were checked. Patients with glucose levels more than 130mg/dl were subjected to 100gm of oral glucose tolerance test (OGTT) according to Carpenter and Coustan modification of the National Diabetes Data. Data was compiled and statistically analysed.Results: In this study it was observed that 20 (women had raised GCT, 11 (5.3%) women developed GDM out of 206 women. All GDM patients have one or more risk factors. Age >25 years (63.6%) fetal loss (36.3%), BMI (33.3%) are common risk factors followed by family history of diabetes (27.3%).Conclusions: Family history of diabetes and past history of congenital anomalies are statistically significant in GDM group as compared to non GDM.

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 A retrospective study to assess prevalence of gestational diabetes mellitus among those who delivered in Saveetha Medical College and Hospital

2019 ◽  
Vol 8 (9) ◽  
pp. 3475
Author(s):  
Sharmila Kumar Gopalan ◽  
Kohila Kalimuthu
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Retrospective Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Previous History ◽  
Oral Glucose ◽  
Family History Of Diabetes ◽  
Medical College ◽  
History Of

Background: Gestational diabetes mellitus (GDM) defined as any degree of carbohydrate intolerance with onset or first recognition during pregnancy contributes to about 90% of diabetes complicating pregnancy. GDM imposes risks for both mother and fetus, some of which continues throughout the life of mother and child. The objective of the present study was to determine the prevalence of gestational diabetes mellitus and the associated risk factors among those who delivered in Saveetha medical college and hospital.Methods: A retrospective study was conducted by analysing the medical records of the patients who were admitted in the Department of Obstetrics and Gynaecology over a period of 1 year at Saveetha medical college and hospital, Chennai, Tamil Nadu, India. The diagnosis of GDM was made mainly by 75gm one step oral glucose tolerance test (OGTT). The guideline endorses 2-hours 75-gm OGTT, irrespective of last meal timings with a cut off value of ≥140 mg/dl. All data was analysed by simple descriptive statistics and percentage method.Results: In the present study, the total number of deliveries for 1 year from April 2018 - March 2019 were 511 and among those the total number of antenatal mothers with GDM who delivered were 46. Therefore the prevalence of GDM was calculated to be 9% or 90 per thousand deliveries. In the present study, 37 (65.1%) pregnant women of GDM group were seen in the age group of above 25 years, 27 (58.59%) were multiparous, 25(54.25%) pregnant females with GDM were found to have overweight and obese out of 46 cases.Conclusions: Our current study concludes the Prevalence of GDM in Saveetha Medical College Hospital is 9% between April 2018-March 2019. We have identified the following risk factors for developing GDM: multiparity≥2; previous history of diabetes mellitus; age ≥ 25; BMI ≥25; and family history of diabetes.

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 Study of Risk Factors for Conegnital Heart Defect in a Tertiary Level Hospital

2018 ◽  
Vol 27 (1) ◽  
pp. 51-56
Author(s):  
Ferdousi Hossain Poly ◽  
Syeda Afroza ◽  
Hasanur Rahman ◽  
Md Imran Hassan
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Maternal Age ◽  
Congenital Heart ◽  
Heart Defects ◽  
Medical College ◽  
History Of ◽  
The Difference

A congenital heart defect is a heart problem which is present at birth, caused by improper development of the heart during fetal development. In majority of cases there is no known reason for the heart to develop improperly. Some type of congenital heart defects are related to chromosomal abnormality(5-6%), some are to single gene defect(3-5%) or environmental factors(2%). In 85-90% of cases there is no identifiable cause and are generally considered to be caused by multifactorial inheritance. There are some maternal factors which have some role in cardiovascular malformations. These include high maternal age(above 30 years), maternal obesity, consanguinity among the parents, fever during pregnancy, gestational diabetes mellitus, smoking, alcohol consumption, ingestion of any teratogenic drug including homeopathy and herbal medicine. Objective of the study: To evaluate the risk factors associated with congenital heart disease. Methodology: A case control study was conducted at paediatric department of Sir Salimullah Medical College & Mitford Hospital following approval of the protocol from 1st January 2013 to 30th June 2014. Children fulfilling the inclusion criteria-(0-5 year old children of both sexes admitted in paediatric units of Mitford Hospital with any type of congenital heart disease confirmed by echocardiography) were considered as cases. A similar number of age and sex matched children admitted in Mitford Hospital without any cardiac defect were considered as controls. Data were collected by questionnaire. Results: The results show that majority of the cases are male. Maternal age (27.09 ± 4.63) and BMI (24.10 ± 2.28) both are significantly higher in cases than those of controls. Among the cases 31.8% mothers had consanguineous marriage (p=0.001) and 27.1% mothers had history of fever during pregnancy whereas it was present in 9.3% mothers of controls, the difference is significant statistically (p=0.001). Among the cases 34.6% mothers had history of gestational diabetes mellitus and only 18.9% controls had so and the difference is significant statistically (p=0.014). Conclusion: Relatively old age and more weight during pregnancy, consanguinity between parents, fever during pregnancy, history of gestational diabetes mellitus are the main risk factors of congenital heart defects in children J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 51-56

scholarly journals The application of 50g oral glucose challenge test in screening for gestational diabetes mellitus in patients attending antenatal care OPD

2017 ◽  
Vol 6 (5) ◽  
pp. 1952
Author(s):  
Disha Andhiwal Rajput ◽  
Jaya Kundan Gedam
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Plasma Glucose ◽  
Gestational Hypertension ◽  
Challenge Test ◽  
Oral Glucose ◽  
Average Risk ◽  
Glucose Challenge Test ◽  
Glucose Challenge

Background: To screen patients at average risk for Gestational Diabetes using 50g Glucose Challenge test, to ascertain the prevalence of Gestational diabetes through further diagnostic testing and to prevent and manage complications. Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable severity with onset or first recognition during pregnancy. Women with GDM are at risk for maternal and foetal complications, so it is important to screen all the pregnant woman.Methods: This study was conducted in 198 patients between 24 and 28 weeks of gestation, attending the Antenatal clinic. 50g oral glucose is administered irrespective of time of the last meal and plasma glucose is measured one hour later. Patients with plasma glucose levels more than 140 mg/dl were subjected to a 100g oral glucose tolerance test, patients with two or more abnormal reading were labelled as GDM and managed accordingly.Results: Prevalence of GDM in our study was 9.59%. Maternal complications like gestational hypertension, vaginal infections and foetal complications were much higher in GDM patients as compare to non GDM group.Conclusions: GDM is a disease which adversely affects both mother as well as foetus. It is concluded that 50 gm glucose challenge test at 24-28 weeks of gestation with a cut-off value of 140 mg/dl is a reliable screening test for GDM. This test offers the best combination of ease and economy of use and reproducibility in screening for gestational diabetes mellitus in average risk patients.

scholarly journals Burden, risk factors and maternal and offspring outcomes of gestational diabetes mellitus (GDM) in sub-Saharan Africa (SSA): a systematic review and meta-analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Barnabas Kahiira Natamba ◽  
Arthur Araali Namara ◽  
Moffat Joha Nyirenda
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Meta Analysis ◽  
Previous History ◽  
Sub Saharan Africa ◽  
African Women ◽  
History Of ◽  
Sub Saharan

Abstract Background The burden, determinants and outcomes of gestational diabetes mellitus (GDM) in sub-Saharan Africa are not known. We summarized existing evidence on the prevalence, risk factors and complications of GDM in the region. Methods PubMed was searched from inception to January 31st 2019. Studies were included if carried out in any of the sub-Saharan Africa countries and were available as abstracts or full texts. Interventional studies and those only including qualitative data were excluded. We employed random effects modelling to estimate the pooled GDM prevalence and risk ratios (RRs) for risk factors and outcomes of GDM and their 95%CI. Results 283 papers were identified in the initial search, 33 of which met the inclusion criteria. Data on GDM burden suggest a pooled prevalence of 9% (95%CI, 7–12%). Family history of type 2 diabetes and previous history of GDM, macrosomia, stillbirth and abortion were important risk factors of GDM. In addition, being overweight or obese, over 25 years of age or hypertensive increased the risk of GDM. In terms of complications, GDM more than doubles the risk macrosomia (RR; 95%CI: 2.2; 1.1–4.4). Conclusions There is a high burden of gestational diabetes mellitus in sub-Saharan Africa, but more studies are needed to document locally important risk factors as well as maternal and offspring outcomes. Interventions to reduce obesity among older African women might lead to reduced risk of GDM in sub-Saharan Africa.

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.

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