Risk perception and unrecognized type 2 diabetes in women with previous gestational diabetes mellitus

Women with a history of gestational diabetes mellitus (GDM) have a high chance of developing type 2 diabetes mellitus (T2DM) following the index pregnancy, however, little is known of women's perception of this risk. The objectives were to (1) determine women's perception of risk of future development of T2DM following a GDM pregnancy and (2) describe the prevalence of undetected dysglycaemia in a Canadian population. The study was designed as a 9–11 year follow-up study of women previously enrolled in a randomized controlled trial of tight versus minimal intervention for GDM. Women's perception of future risk of diabetes was determined by questionnaire. Fasting lipid profile, height and weight were performed on all participants. Oral glucose tolerance tests were performed on all women without prior history of diabetes mellitus type 2 (DM2). The study was conducted at Ottawa Hospital General Campus and Children's Hospital of Eastern Ontario, in Ottawa, Canada. Eighty-nine of 299 (30%) of the original cohort were recruited. Eighty-eight women completed the questionnaire and 77 women without known diabetes underwent two hour glucose tolerance testing. Twenty-three (30%) felt their risk was no different than other women or did not know, 27 (35%) felt risk was increased a little and 27 (35%) felt risk was increased a lot. Only 52% (40/77) had normal glucose tolerance. Of all, 25/88 (28%) patients had diabetes (11 previously diagnosed and 14 diagnosed within the study). Of those newly diagnosed with DM2, four (29%) were diagnosed by fasting glucose, six (42%) by two hour glucose tolerance test (GTT) alone and four (29%) by both. Twenty-four of the women (27%) had impaired glucose tolerance (IGT). Of those with IGT, 12 (57%) had a fasting food glucose < 5.6 mmol/L. In the high-risk perception group with newly diagnosed diabetes, two were overweight, seven were obese, four had a family history of DM2, and all had a waist circumference >88 cm. In conclusion the perception of being at high risk for T2DM did not prevent women from having undetected T2DM. Many factors are likely to contribute to this, including the reliance on screening tests (i.e. fasting glucose) rather than a two hour GTT to detect diabetes. Further studies on effective public and health-care provider education and intervention are needed to identify this high-risk population.

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Prevalence of newly diagnosed prediabetes, diabetes mellitus among the officers from Phuoc Long district of Binh Phuoc province

Vietnam Journal of Diabetes and Endocrinology ◽

10.47122/vjde.2020.40.4 ◽

2021 ◽

pp. 24-28

Author(s):

Thanh Long Le ◽

Trung Vinh Hoang

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Impaired Fasting Glucose ◽

Fasting Glucose ◽

Newly Diagnosed ◽

Personal Communications

Objective: To evaluate the prevalence of newly diagnosed prediabetes, diabetes mellitus among the officers from Phuoc Long district of Binh Phuoc province. Subjects and methods: 268 personals communications service was examined the impaired fasting glucose (G0); impaired glucose tolerance (G2) anh HbA1c. Results: Prevalence of prediabetes, type 2 diabetes mellitus by G0, G2, HbA1c as follows 16,0%; 13,1%; 17,9% and 3,8%; 6,7%; 2,2%. Common prevalence of prediabetes in 26,9%; type 2 diabetes mellitus in 7,1%. Conclusion: Personal communications service from Phuoc Long district have percentage of prediabetes higher compared to type 2 diabetes mellitus which of prediabetes was diagnosed by HbA1c which takes up the highest percentage; diabetes mellitus was diagnosed by G2which takes up the highest percentage.

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Abstract P214: Adherence to Dietary Patterns after Gestational Diabetes Mellitus and Risk of Subsequent Type 2 Diabetes

Circulation ◽

10.1161/circ.125.suppl_10.ap214 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Deirdre K Tobias ◽

Frank Hu ◽

Jorge Chavarro ◽

Bernard Rosner ◽

Dariush Mozaffarian ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

High Risk ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Dietary Patterns ◽

Dietary Pattern ◽

Lower Risk ◽

History Of

Background: Adherence to healthful dietary patterns is associated with lower risk of type 2 diabetes (T2DM) in the general population. Women with a history of gestational diabetes mellitus (GDM) are at particularly high risk for future type 2 diabetes (T2DM), though relations of dietary patterns with incident T2DM in this population are unknown. Hypothesis: We hypothesize that adherence to healthful dietary patterns among women with prior GDM is inversely associated with incident T2DM. Methods: We evaluated 4,413 participants from the Nurses' Health Study II longitudinal cohort with a history of GDM in one or more pregnancies. GDM was ascertained by self-report of a physician's diagnosis and has been previously validated in a subsample with confirmation of over 90% by medical record review. Participants were free of chronic disease at baseline and followed from 1991 through 2007. Dietary pattern adherence scores were derived for the alternate Mediterranean Diet (aMED), Dietary Approaches to Stop Hypertension (DASH), and the alternate Healthy Eating Index (aHEI) based on validated food frequency questionnaires assessed after GDM and updated every 4 years thereafter. Incident T2DM was assessed every 2 years through previously validated questionnaire responses. Multivariable Cox proportional hazards models estimated the relationship of each dietary pattern with incident T2DM, adjusting for age, total energy intake, parity, age at first birth, race/ethnicity, parental history of T2DM, oral contraceptive use, menopausal status, and smoking status. Body mass index (BMI) was included in a subsequent model. Results: There were 491 cases of incident T2DM over 52,743 person-years of observation. In multivariable analyses, the aMED, DASH, and aHEI dietary patterns were each inversely associated with incident T2DM. For each 1 standard deviation increase in score, the aMED pattern was associated with a 24% lower risk (HR=0.76 [95% CI: 0.67, 0.86] p<0.0001), DASH with an 18% lower risk (HR=0.86 [95% CI: 0.73, 0.92] p=0.0005), and aHEI with a 30% lower risk (HR=0.70 [95% CI: 0.61, 0.79] p<0.0001). Further adjustment for BMI moderately but not completely attenuated these findings: (aMED: HR=0.85 [95% CI: 0.75, 0.97] p=0.014; DASH: HR=0.91 [95% CI: 0.80, 1.02] p=0.11; aHEI: HR=0.84 [95% CI: 0.73, 0.96] p=0.009). Conclusions: Adherence to healthful dietary patterns is associated with a lower incidence of T2DM among women following a diagnosis of GDM, and may be partially mediated by BMI. These findings have implications for prevention efforts in this high-risk population.

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619-P: The Impact of Type 2 Diabetes Mellitus Risk Perception on Adoption of Preventive Strategies in Women with a History of Gestational Diabetes

Diabetes ◽

10.2337/db20-619-p ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 619-P

Author(s):

AMANDA V. VU ◽

NORMAN TURK ◽

O. KENRIK DURU ◽

CAROL MANGIONE ◽

HEMALI PANCHAL ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Risk Perception ◽

Gestational Diabetes ◽

Preventive Strategies ◽

History Of ◽

Diabetes Mellitus Risk ◽

The Impact

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Gestational diabetes and its implication for the future development of type 2 diabetes and cardiovascular disease

The Journal of AMD ◽

10.36171/jamd19.22.3.07 ◽

2019 ◽

Vol 22 (3) ◽

pp. 133

Author(s):

Lencioni, C.

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Cardiovascular Diseases ◽

Gestational Diabetes ◽

Glucose Tolerance ◽

Lifestyle Changes ◽

Pharmacological Interventions ◽

History Of

Gestational Diabetes Mellitus (GDM) is a very common complication of pregnancy. Although glucose tolerance returns to normal levels after delivery in the majority of women with GDM, this condition represents an early stage in the natural history of type 2 Diabetes Mellitus. Moreover, women with previous GDM exhibit an increased cardiovascular risk profile and a raised incidence of cardiovascular diseases. Lifestyle changes and pharmacological interventions might be able to reduce the incidence of type 2 diabetes in women with previous Gestational Diabetes, results are still not conclusive although encouraging. Pharmacological interventions are not yet recommended for prevention. Long term continuous program specifically addressed to women with previous GDM should be implemented, especially addressed to encourage them to regularly check glucose tolerance, lipid profile and other parameters related to cardiovascular diseases, aimed at improving women’s health. In this paper, we will review the relationship between type 2 diabetes, cardiovascular diseases and a history of GDM. KEY WORDS gestational diabetes; type 2 diabetes; cardiovascular disease.

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Preventing Type 2 Diabetes in Women with Previous Gestational Diabetes: Reviewing the Implementation Gaps for Health Behavior Change Programs

Seminars in Reproductive Medicine ◽

10.1055/s-0040-1722315 ◽

2021 ◽

Author(s):

Siew Lim ◽

Mingling Chen ◽

Maureen Makama ◽

Sharleen O'Reilly

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

High Risk ◽

Gestational Diabetes ◽

Health Behavior ◽

Diabetes Prevention ◽

Prevention Programs ◽

Health Behavior Change ◽

History Of

AbstractGestational diabetes mellitus (GDM) places a woman at high risk of developing subsequent type 2 diabetes mellitus (T2DM), particularly in the first 5 years postpartum. Engaging women in health behavior change during this period is challenging and current diabetes prevention programs were developed for middle-aged adults, all of which have limited the evidence on successful implementation for this high-risk population. In this review, we will first summarize the effects of existing diabetes prevention programs in women with a history of GDM. Second, we suggest that the programs need to be modified according to the facilitators and barriers faced by this population. Third, we propose that improving program penetration, fidelity, and participation is critical for population-level success. Finally, we outline the research priorities to improve the implementation of diabetes prevention programs for postpartum women with a history of GDM.

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