scholarly journals The correlation between the prevalence of gestational diabetes mellitus and maternal age in Southern China

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Jia-Yi Zhao ◽  
Qing Yu ◽  
Xiao-Ming Yang ◽  
Xiang-Xin Li

Abstract Objectives The present study aimed to survey the prevalence of gestational diabetes mellitus (GDM) in Southern China and further to analyze the correlation between the prevalence of GDM and maternal age. Methods A retrospective cross-sectional study was carried out at the Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, Foshan, China between January and April 2020. Oral glucose tolerance tests (OGTT) was performed, using a 75 g glucose load and venous samples were drawn at 0 h, 1 h and 2 h at 24–28 weeks of gestation. GDM was diagnosed by International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Results The prevalence of GDM was 14.87% by IADPSG criteria. The incidence of GDM outcome increased and plasma glucose levels remained high among the age subgroups (<20, 20–24, 25–29, 30–34, 35–39, ≥40 years old) in pregnant women. Moreover, the levels of plasma glucose levels after OGTT kept rising among the pregnant women with non-gestational diabetes mellitus (non-GDM). Furthermore, pregnant women were inclined to have abnormal plasma glucose values at 1 h and 2 h than initial fasting plasma glucose (FPG) after OGTT as the age increased. Conclusions Our findings demonstrate that the incidence of GDM outcome and plasma glucose levels increase as the maternal age increase.

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Mayu Watanabe ◽  
Akihiro Katayama ◽  
Hidetoshi Kagawa ◽  
Daisuke Ogawa ◽  
Jun Wada

Poor maternal glycemic control increases maternal and fetal risk for adverse outcomes, and strict management of gestational diabetes mellitus (GDM) is recommended to prevent neonatal and maternal complications. However, risk factors for the requirement of antenatal insulin treatment (AIT) are not well-investigated in the pregnant women with GDM. We enrolled 37 pregnant women with GDM and investigated the risk for AIT by comparing the patients with AIT (AIT group;n=10) and without insulin therapy (Diet group;n=27). The 1-h and 2-h plasma glucose levels and the number of abnormal values in 75 g OGTT were significantly higher in AIT group compared with Diet group. By logistic regression analysis, plasma glucose level at 1-h was significant predictor for AIT and the odds ratios were 1.115 (1.004–1.239) using forward selection method and 1.192 (1.006–1.413) using backward elimination method. There were no significant differences in obstetrical outcomes and neonatal complications. 1-h plasma glucose levels in 75 g OGTT are useful parameters in predicting the requirement for AIT in GDM. Both maternal and neonatal complications are comparable in GDM patients with and without insulin therapy.


2021 ◽  
Author(s):  
Jia-Ning Tong ◽  
Lin-Lin Wu ◽  
Yi-Xuan Chen ◽  
Xiao-Nian Guan ◽  
Kan Liu ◽  
...  

Abstract Purpose Previous studies have suggested that first-trimester fasting plasma glucose (FPG) is associated with gestational diabetes mellitus (GDM) and is a predictor of GDM. The aim of the present study was to explore whether first-trimester FPG levels can be used as a screening and diagnostic test for GDM in pregnant women. Methods This retrospective study included pregnant women who had their first-trimester FPG recorded at 9-13+6 weeks and underwent screening for GDM using the 2-hour 75 g oral glucose tolerance test (OGTT) between 24th and 28th gestational weeks. The cut-off values were calculated using a receiver operating characteristic (ROC) curve. Results The medical records of 28,030 pregnant women were analysed, and 4,669 (16.66%) of them were diagnosed with GDM. The mean first-trimester FPG was 4.62 ± 0.37 mmol/L. The total trend in the optimal cut-off value of first-trimester FPG in pregnant women was 4.735 mmol/L, with a sensitivity of 49%, a specificity of 67.6% and AUC of 0.608 (95% CI: 0.598-0.617, p༜0.001). Moreover, as the maternal age increased, the optimal cut-off values increased, respectively. The results suggest that first-trimester FPG can be considered a marker for identifying pregnant women with GDM. Conclusion The level of first-trimester FPG increased slightly with maternal age and, as maternal age increased, the optimal cut-off values increased, especially after age 30. The first-trimester FPG should be considered a screening marker when diagnosing GDM in pregnant women.


2020 ◽  
Vol 8 (1) ◽  
pp. e001234
Author(s):  
Sayuri Nakanishi ◽  
Shigeru Aoki ◽  
Junko Kasai ◽  
Ryosuke Shindo ◽  
Soichiro Obata ◽  
...  

IntroductionThis study aimed to assess the validity of applying the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria for the diagnosis of gestational diabetes mellitus (GDM) at any time during pregnancy.Research design and methodsThis multicenter cohort study was conducted at five Japanese facilities from January 2018 to April 2019. The study cohort included women at a high risk of GDM who met one or more of the following IADPSG criteria during early pregnancy: fasting plasma glucose (FPG) ≥92 mg/dL and 75 g oral glucose tolerance test (OGTT) value of ≥180 mg/dL at 1 hour, or ≥153 mg/dL at 2 hour (hereafter early-onset GDM). Women diagnosed with early-onset GDM were followed up without therapeutic intervention and underwent the 75 g OGTT again during 24–28 weeks of gestation. Those exhibiting the GDM patterns on the second 75 g OGTT were diagnosed with true GDM and treated, whereas those exhibiting the normal patterns were diagnosed with false positive early GDM and received no therapeutic intervention.ResultsOf the 146 women diagnosed with early-onset GDM, 69 (47%) had normal 75 g OGTT values at 24–28 weeks of gestation, indicating a false-positive result. FPG levels were significantly higher in the first 75 g-OGTT test than in the second 75 g-OGTT test (93 mg/dL and 87.5 mg/dL, respectively; p<0.001). FPG levels were high in 86 (59%) women with early-onset GDM during early pregnancy but in only 39 (27%) women during mid-pregnancy. Compared with false positive early GDM, true GDM was more frequently associated with adverse pregnancy outcomes.ConclusionsAlthough women with early-onset GDM were followed up without treatment, the results of repeated 75 g OGTT during mid-pregnancy were normal in about 50%. Our data did not support the adoption of IADPSG thresholds for the diagnosis of GDM prior to 20 weeks of gestation.


Author(s):  
Disha Andhiwal Rajput ◽  
Jaya Kundan Gedam

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.


2018 ◽  
Vol 26 (1) ◽  
pp. 96-105 ◽  
Author(s):  
S. V. Yankina ◽  
N. V. Shatrova ◽  
S. V. Berstneva ◽  
D. N. Pavlov

Gestational diabetes mellitus (GDM) is a serious medical and social problem, because it greatly increases the frequency of adverse pregnancy outcomes for mother and fetus. The frequency of GDM in the general population of different countries varies from 1% to 14% and average 7%, in Russia this figure is estimated at 4.5%. Aim. To evaluate the prevalence of GDM in Ryazan Regional clinical perinatal center for the last 3 years and examine its influence on the course and outcome of pregnancy. Materials and Methods. The analysis of the birth history data and exchange cards of 1690 pregnant women from 2015 to 2017 at Ryazan Regional clinical perinatal center. Results. GDM was diagnosed in 193 women (prevalence – 11.4%), with 62 pregnant women on the basis of the results of oral glucose tolerance test performed in the period of 24-30 weeks. It was established that the course of pregnancy and delivery in patients with GDM was characterized by a high percentage of complications (late gestosis – 18.1%, anemia – 11.3%, swelling – 11.9%, early toxicosis – 4.6%, poly-hydramnios – 12.4%, chronic pyelonephritis – 5.1% and threatened miscarriage – 3.6%). Pregnancy outcome study revealed that the majority – 60.6% of pregnancies ended in natural births. Preterm birth was noted in 15% of cases, of which 2 cases were of perinatal fetal death. The frequency of delivery by cesarean section – 39.4%. The frequency of childbirth large fetus was 21.8%, higher than in women with normal blood glucose levels. Conclusions. The prevalence of GDM in Ryazan Regional clinical perinatal center for the last 3 years was 11.4%. Complications during pregnancy were observed in 153 women (79.2%) of with GDM. The most frequent complications were; late gestosis, pregnancy anemia, edema, early toxemia, polyhydramnios, chronic pyelonephritis, and threatened miscarriage. In pregnant women with GDM, adverse outcomes of pregnancy were more common than in women with normoglycemia. Significant differences were obtained in the frequency of premature birth, macrosomia of the fetus and asphyxia during childbirth.


2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Qiang Wei ◽  
Xiaomin Pu ◽  
Li Zhang ◽  
Yi Xu ◽  
Meifan Duan ◽  
...  

Introduction. The aim of the present study was to examine placental levels of DUSP9 mRNA and protein and to investigate the potential role of DUSP9 in the development of gestational diabetes mellitus (GDM). Methods. Placental tissues from pregnant women with GDM (n=17) and normal healthy pregnant women (n=16) were collected at delivery. The expression of DUSP9 mRNA in placental tissue was analyzed by real-time PCR, while the expression of DUPS9 protein was evaluated by immunohistochemistry and western blot. Differences in the expression levels of DUSP9 mRNA and protein between the two groups were assessed, as well as potential correlations between DUSP9 mRNA expression levels and relevant clinical indicators. Results. Blood glucose levels were significantly higher in the GDM group than in the control group, based on an oral glucose tolerance test. DUSP9 protein was expressed in the placental cytotrophoblasts in both groups, and placental levels of DUSP9 protein and mRNA were significantly higher in women with GDM. Placental DUSP9 mRNA levels in all 33 women correlated moderately with delivery gestational week (R=0.465, P=0.006), fasting plasma glucose (R=0.350, P=0.046), 1-hour postload plasma glucose (R=0.363, P = 0.038), and 2-hour postload plasma glucose (R=0.366, P=0.036), but not with maternal age, preconception body mass index, prenatal body mass index, or neonatal birth weight. Multiple linear regression analysis indicated that delivery gestational week was an influence factor of DUSP9 mRNA levels (β1=0.026, P<0.05). Conclusions. DUSP9 upregulation in the placenta of GDM pregnant women may promote insulin resistance, which may correlate with the occurrence of GDM. But there is still possibility that DUSP9 upregulation was the results of insulin resistance and/or hyperglycemia. Further research is needed to explore the role of DUSP9 in GDM.


Author(s):  
Poojita Tummala ◽  
Munikrishna M. ◽  
Kiranmayee P.

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.


2012 ◽  
Vol 167 (4) ◽  
pp. 561-567 ◽  
Author(s):  
Jelena Todoric ◽  
Ammon Handisurya ◽  
Thomas Perkmann ◽  
Bernhard Knapp ◽  
Oswald Wagner ◽  
...  

ObjectiveProgranulin (PGRN) was recently introduced as a novel marker of chronic inflammatory response in obesity and type 2 diabetes capable of directly affecting the insulin signaling pathway. This study aimed to investigate the role of PGRN in gestational diabetes mellitus (GDM), which is regarded as a model for early type 2 diabetes.MethodsPGRN serum levels were measured in 90 pregnant women (45 GDM and 45 normal glucose tolerance (NGT)). In addition, PGRN was measured during a 2-h, 75 g oral glucose tolerance test in 20 pregnant women (ten GDM and ten NGT) and in 16 of them post partum (ten GDM and six NGT).ResultsPGRN concentrations were significantly higher in pregnant women compared with post partum levels (536.79±31.81 vs 241.53±8.86, P<0.001). Multivariate regression analyses showed a strong positive correlation of PGRN with estrogen and progesterone. The insulinogenic index, a marker of early insulin secretion, displayed a positive correlation with PGRN, both during and after pregnancy (R=0.47, P=0.034; R=0.63, P=0.012). HbA1c and the oral glucose insulin sensitivity index showed significant post partum associations with PGRN (R=0.43, P=0.049; R=−0.65, P=0.009).ConclusionsPGRN concentrations are markedly lower after pregnancy regardless of the gestational glucose tolerance state. PGRN levels per se do not discriminate between mild GDM and NGT in pregnant women. Therefore, the development of GDM appears to be due to impaired β-cell function that is not related to PGRN effect.


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