scholarly journals Gestational Diabetes in Malaysia: A Systematic Review of Prevalence, Risk Factors and Outcomes

2021 ◽  
Vol 50 (8) ◽  
pp. 2367-2377
Author(s):  
Lieng Teng Cheong ◽  
Ken Yong Foo ◽  
Mun Lum Ka ◽  
Yung Toh Shen ◽  
Xuan Hii Chan ◽  
...  

Gestational diabetes mellitus (GDM) is glucose intolerance first diagnosed during pregnancy. In Malaysia, the prevalence, risk factors, and maternal/foetal outcomes vary somewhat among the local studies. In this systematic review of Malaysian studies, we synthesise relevant data from 13 journal articles (including 10,285 women with gestational diabetes). A meta-analysis of twelve datasets showed a prevalence of 21.5% (95% CI 17.3 to 25.9%, random effect model). Clinical factors in the mother found to increase her risk of GDM were consistent with international data. A meta-analysis of complications showed statistically significant increase for macrosomia (OR 3.08, 95% CI 1.77 to 5.36) but not for pre-eclampsia (OR 1.44, 95% CI 0.52 to 4.00) and caesarean delivery (OR 1.31, 95% CI 0.98 to 1.75). The high prevalence of gestational diabetes mellitus and documented adverse consequences support the need for universal screening of this condition in all pregnant women in Malaysia.

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Zhongwei Zhou ◽  
Hongmei Chen ◽  
Mingzhong Sun ◽  
Huixiang Ju

Aim. To evaluate the association between mean platelet volume (MPV) and gestational diabetes mellitus (GDM). Methods. A systematic literature search was performed in PubMed, EMBASE, Web of Science, and The Cochrane Library up to 4 September 2017. Pooled standardized mean differences (SMD) and 95% confidence interval (CI) were calculated using a random-effect model. Results. Nineteen studies comprising 1361 GDM patients and 1911 normal pregnant women were included. MPV was increased in GDM patients when compared with healthy pregnant women (SMD: 0.79; 95% CI: 0.43–1.16; P<0.001). Subgroup analyses revealed that such trend was consistent in the third-trimester (SMD: 1.35; 95% CI: 0.72–1.98), Turkish (SMD: 0.81; 95% CI: 0.43–1.19), and Italian (SMD: 2.78; 95% CI: 2.22–3.34) patients with GDM and the patients diagnosed based on Carpenter and Coustan criteria (SMD: 1.04; 95% CI: 0.42–1.65). Significantly higher MPV also were observed within cross-sectional studies (SMD: 0.99; 95% CI: 0.49–1.49). Remarkable between-study heterogeneity and potential publication bias were observed in this meta-analysis; however, sensitivity analysis indicated that the results were not unduly influenced by any single study. Conclusions. GDM patients are accompanied by increased MPV, strengthening the clinical evidence that MPV may be a predictive marker for GDM.


2020 ◽  
Vol 11 (6) ◽  
pp. 599-616 ◽  
Author(s):  
Maleesa M. Pathirana ◽  
Zohra S. Lassi ◽  
Claire T. Roberts ◽  
Prabha H. Andraweera

AbstractGestational diabetes mellitus (GDM) is a pregnancy complication that affects one in seven pregnancies. Emerging evidence demonstrates that children born of pregnancies complicated by GDM may be at increased risk of cardiovascular disease (CVD) in adulthood. Therefore, the aim of this study was to determine cardiovascular risk factors in offspring exposed to GDM in utero. PubMed, CINAHL, SCOPUS, and EMBASE databases were searched. Information was extracted on established CVD risk factors including blood pressure, lipids, blood glucose, fasting insulin, body mass index (BMI), and endothelial/microvascular function. The review protocol is registered in PROSPERO (CRD42018094983). Prospective and retrospective studies comparing offspring exposed to GDM compared to controls (non-GDM pregnancies) were considered. We included studies that defined GDM based on the International Association of Diabetes and Pregnancy Study Groups (IADPSG) definition, or prior definitions. The PRISMA guidelines were followed in conducting this systematic review. Methodological quality was assessed using the Newcastle–Ottawa Quality Assessment Scale. Study selection, data extraction, and quality assessment were done by two independent reviewers. The data were pooled using a random-effects model. Of 59 eligible studies, 24 were included in the meta-analysis. Offspring exposed to GDM had higher systolic blood pressure (mean difference (MD): 1.75 mmHg, 95% CI 0.57–2.94; eight studies, 7264 participants), BMI z-score (MD 0.11, 95% CI 0.02–0.20; nine studies, 8759 participants), and glucose (standard MD 0.43, 95% CI 0.08–0.77; 11 studies, 6423 participants) than control participants. In conclusion, offspring exposed to GDM have elevated systolic blood pressure, BMI, and glucose. Those exposed to GDM in utero may benefit from early childhood blood pressure measurements.


2017 ◽  
Vol 5 (4) ◽  
pp. 253-263 ◽  
Author(s):  
Faezeh Kiani ◽  
Marzieh Saei Ghare Naz ◽  
Fatemeh Sayehmiri ◽  
Kourosh Sayehmiri ◽  
Hakimeh Zali

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Sonia Menon ◽  
Joel Francis ◽  
Natasha Zdraveska ◽  
Alfred Dusabimana ◽  
Samit Bhattacharyya

Abstract Background Diabetes mellitus (DM) is burgeoning as a global chronic health condition. Some studies suggest that tuberculosis (TB) can even cause diabetes in those not previously known to be diabetic, which as a corollary can add to the already heavy global DM burden. The World Health Organization (WHO) recommends screening for DM at the start of TB treatment; however, it remains to be elucidated which patients with TB-induced hyperglycaemia are at risk for developing DM and who would benefit from a more regular follow-up. This systematic review will aim to firstly synthesise literature on the irreversibility of TB-induced hyperglycaemia in individuals with previously undiagnosed type 2 diabetes mellitus and secondly to synthesise literature on risk factors for progression from TB-induced hyperglycaemia to overt DM in previously undiagnosed. Methods We will search for relevant studies in electronic databases such as PubMed, EMBASE, PROQUEST, and SCOPUS. Furthermore, references will be hand searched to identify other studies. A flow diagram will be drawn to identify the studies retrieved from each database. We will review all publications that include studies containing data on impaired glucose metabolism upon TB diagnosis, and the quality of all eligible studies will be assessed using the Newcastle-Ottawa Scale. We will further conduct a meta-analysis to pool estimates on the risk of progression of persistent hyperglycaemia to overt DM within this population group, as well as the risk factors for this progression. We will use a random effect model to assess heterogeneity, will carry out sensitivity analysis to explore the influence of a single study on the overall estimate, and will report our findings from our systematic review and meta-analysis according to PRISMA guidelines. Egger’s test will be performed to explore the presence of selective reporting bias. If data allow, we will perform a subgroup/meta-regression analysis. Summary effects will be reported using odds ratio, hazard ratio, and relative risk ratios. Furthermore, any clinical, epidemiological, and public health research gaps we identify will be described in a research proposal.


2021 ◽  
Vol 12 ◽  
Author(s):  
Xingyun Zhu ◽  
Lina Zhao ◽  
Jing Chen ◽  
Chu Lin ◽  
Fang Lv ◽  
...  

PurposeThe effect of physical activity on glycemic variability remains controversial. This meta-analysis aimed to assess the overall effect of physical activity treatment on glycemic variability in patients with diabetes.MethodsPubMed/MEDLINE, Embase, and Cochrane databases were searched for clinical trials that conducted in patients with type 1 diabetes mellitus and type 2 diabetes mellitus with reports of the mean amplitude of glycemic excursion (MAGE), time in range (TIR), time above range (TAR), or time below range (TBR). Eligible trials were analyzed by fixed-effect model, random effect model, and meta-regression analysis accordingly.ResultsIn total, thirteen trials were included. Compared with the control group, physical activity intervention was significantly associated with increased TIR (WMDs, 4.17%; 95% CI, 1.11 to 7.23%, P&lt;0.01), decreased MAGE (WMDs, -0.68 mmol/L; 95% CI, -1.01 to -0.36 mmol/L, P&lt;0.01) and decreased TAR (WMDs, -3.54%; 95% CI, -5.21 to -1.88%, P&lt;0.01) in patients with diabetes, but showed insignificant effects on TBR. Patients with higher baseline BMI levels was associated with a greater decrease in MAGE (β=-0.392, 95% CI: -0.710, -0.074), and patients with lower baseline HbA1c levels was associated with a greater increase in TBR during physical activities (β=-0.903, 95% CI: -1.550, -0.255).ConclusionPhysical activity was associated with significantly decreased glycemic variability in patients with diabetes. Patients with higher BMI might benefit more from physical activity therapy in terms of a lower MAGE. Hypoglycemia associated with physical activity treatment still warranted caution, especially in patients with intensive glycemic control.Systematic Review RegistrationPROSPERO [CRD42021259807].


2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Kai Wei Lee ◽  
Siew Mooi Ching ◽  
Vasudevan Ramachandran ◽  
Anne Yee ◽  
Fan Kee Hoo ◽  
...  

2020 ◽  
Vol 11 (3) ◽  
pp. 244-245
Author(s):  
Maleesa M. Pathirana ◽  
Zohra S. Lassi ◽  
Claire T. Roberts ◽  
Prabha H. Andraweera

AbstractThis commentary is an author response to Lu and Wang, regarding the manuscript entitled ‘Cardiovascular risk factors in offspring exposed to gestational diabetes mellitus in utero: Systematic review and meta-analysis’. We address their concern regarding duplication of studies in the meta-analysis and the quality of included studies.


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