scholarly journals Gestational diabetes mellitus is as innocent as you think?

Author(s):  
Gulsum Uysal ◽  
Mehmet Serdar Kutuk

Background: We aimed to compare fetal outcomes, fetal hypoxia, acidemia and maternal chracteristics including hemoglobin A1c, doppler indices between gestational diabetes mellitus (GDM) and pregestational diabetes mellitus (DM) among pregnant women treated with insulin.Methods: Data of pregnant patients with diagnosis of pregestational diabetes (type 1 and 2) and GDM who were treated with insulin (GDM A2 in White classification) was retrospectively collected and compared. Patients with active chronic systemic disease, multiple pregnancies, lost to follow up and detected fetal malformations were exluded. Maternal characteristics, umbilical doppler indices and amnion fluid index, gestational age at delivery, delivery characteristics (including vaginal delivery, or cesarean section) and newborn characteristics such as birth weight, Apgar score and umblical cord pH were all recorded.Results: A total of 130 patients (67 patients with GDM and 63 pregestational DM) were recruited to the study. There were no significant difference regarding type of delivery, fetal birth weight, umbilical cord Hb and gestational birth age. No other significant difference in frequency of low Apgar scores and fetal acidosis or metabolic acidosis were reported. HbA1c and blood glucose levels and insulin dosage were significantly statistically higher in pregestational group.Conclusions: The frequency of fetal distress parameters and poor fetal outcome were similar between groups although pregestaional diabetic patients had higher HbA1c rates. Therefore, patients with GDM (A2) should be followed up as closely as pregestational (overt) diabetic patients.

Author(s):  
Manisha R. Gandhewar ◽  
Binti R. Bhatiyani ◽  
Priyanka Singh ◽  
Pradip R. Gaikwad

Background: The aim of this study was to study the prevalence of gestational diabetes mellitus (GDM) using Diabetes in Pregnancy Study group India (DIPSI) criteria to diagnose patients with GDM and to study the maternal and neonatal outcomes.Methods: 500 patients attending the antenatal clinic between January 2013 to September 2014 with singleton pregnancies between 24 and 28 weeks of gestation were evaluated by administering 75g glucose in a nonfasting state and diagnosing GDM if the 2-hour plasma glucose was more than 140 mg/ dl. Women with multiple pregnancies, pre-existing diabetes mellitus, cardiac or renal disease were excluded from the study.Results: 31 women were diagnosed with GDM (prevalence 6.2%). The prevalence of risk factors such as age more than 25, obesity, family history of Diabetes Mellitus, history of GDM or birth weight more than 4.5kg in previous pregnancy and history of perinatal loss were associated with a statistically significant risk of developing GDM. Though the incidence of Gestational hypertension, polyhydramnios and postpartum haemorrhage was higher in the GDM group, it did not reach statistical significance. More women in the GDM group were delivered by LSCS. There was no significant difference in the incidence of SGA or preterm delivery in the groups. The mean birth weight in GDM group was higher than in the non GDM group.Conclusions: Early detection helps in preventing both maternal and fetal complications. This method of screening is convenient to women as it does not require them to be fasting.


2020 ◽  
Vol 16 (8) ◽  
pp. 895-899 ◽  
Author(s):  
Shahin Safian ◽  
Farzaneh Esna-Ashari ◽  
Shiva Borzouei

Aims: Investigation thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes mellitus. Background: This article was written to evaluate the thyroid function and anti-thyroid peroxidase (anti- TPO) antibodies in pregnant women with gestational diabetes mellitus (GDM). Method: A total of 252 women with GDM and 252 healthy pregnant women were enrolled. Thyroid tests, including TSH, FreeT3, Free T4, and anti-TPO were performed for all women at 24–28 weeks of gestation. Data analysis was then carried out using SPSS ver. 22. Result: There was a significant difference between the experimental group (38.4%) and the control group (14.06%) in terms of the prevalence of subclinical hypothyroidism (p= 0.016). The frequency of anti-TPO was higher in the experimental group than the control group and positive anti-TPO was observed in 18.6% of women with GDM and 10.3% of healthy pregnant women (P= 0.008). Conclusion: Thyroid disorders are observed in pregnant women with GDM more frequently than healthy individuals and it may be thus reasonable to perform thyroid tests routinely.


2020 ◽  
Author(s):  
Uchenna Cosmas Ugwu ◽  
Osmond Chukwuemeka Ene

Abstract Background: Gestational diabetes mellitus (GDM) is a disease condition present during pregnancy and if not properly managed would have severe effect on the maternal and neonatal health. This research determined the effect of diabetes education program (DEP) on gestational diabetes mellitus knowledge (GDMK) among diabetic pregnant women (DPW) and significant differences within groups.Methods: This study was based on a pretest – posttest measures of experimental research design involving experimental (n=110) and control (n=110) groups. A total of 220 DPW were purposively recruited from public hospitals in Nigeria between October and December 2019. The DEP was delivered to DPW in experimental group. The Gestational Diabetes Mellitus Knowledge Questionnaire (GDMKQ) of 0.774 was used for data collection. The statistical analysis was completed using IBM SPSS version 22. Results: The results revealed that no statistically significant difference existed on GDM history (P=0.801>0.05), smoking habit (P=0.0615>0.05), parity status (P=0.503>0.05), and level of education (P=0.720>0.05), while difference was observed on alcohol status (P=0.011<0.05), and age by birth (P=0.009<0.05). Also, while no significant difference existed between the DPW in the treatment and control groups on GDMK pretest measures (P=0.901>0.05), difference existed between the DPW in the intervention and control groups on GDMK posttest scores (P=0.026<0.05). Also, the higher percentage score (78%) of DPW in the experimental group in the posttest GDMK measures which is higher than the score in the pretest measures (55%) of the same group were indications that DEP has significant effect on GDMK among DPW.Conclusion: This demonstrates that reliable interventions are effective in combating pregnancy-related complications. This requires collaborative efforts by concerned bodies to combat notable complications during pregnancy using reliable intervention.Trial Registration: In retrospect, the Pan African Clinical Trial Registry documented the study with registration trial code (Trial No.: PACTR201903003187005)


2018 ◽  
Vol 626 ◽  
pp. 451-457 ◽  
Author(s):  
Fengxiu Ouyang ◽  
Ning Tang ◽  
Hui-Juan Zhang ◽  
Xia Wang ◽  
Shasha Zhao ◽  
...  

2019 ◽  
Vol 9 (2) ◽  
pp. 127-132
Author(s):  
Faryal Mustary ◽  
TA Chowdhury ◽  
Ferdousi Begum ◽  
Nusrat Mahjabeen

Background: Diabetes mellitus is the most frequently encountered endocrine disorder in pregnancy and is associated with adverse outcomes if remain undiagnosed or untreated. This study was done to compare the maternal and perinatal outcome of pregestational diabetes mellitus (PGDM) with that of gestational diabetes (GDM). Methods: This observational analytical study with group comparison was carried out in the Department of Obstetrics and Gynaecology, BIRDEM General Hospital, Dhaka from July 2015 to June 2016. This study was conducted on two groups of pregnant women: group A (PGDM) and group B (GDM). A total of 100 cases were selected and in each group 50 pregnant women were enrolled. Singleton pregnancy and age 18 to 45 years were included. Pregnancy with hypertension, heart disease, renal disease and other metabolic disorders were excluded. Results: In this study mean gestational age of the study subjects were 35.72 ± 2.61 weeks and 36.58 ± 2.34 weeks in PGDM and GDM groups. History of GDM [34.0% vs 16.0%], intrauterine death (IUD) [14.0% vs 2.0%] and abortion [22.0% vas 6.0%] were significantly higher among PGDM patients than GDM patients. Regarding present pregnancy complications, polyhydramnios [32.0% vs 14.0%], preterm delivery [38.0% vs 20.0%], vulvovaginitis [28.0% vs 12.0%] and premature rupture of membrane (PROM) [24.0% vs 8.0%] were significantly higher in PGDM than GDM patients. Wound infection was significantly high in PGDM groups [35.7% vs 11.1%] among the patients delivered by lower uterine Cesarean section (LUCS). Regarding perinatal complications, hypoglycemia [22.0% vs 8.0%], birth asphyxia [24.0% vs 8.0%], RDS [24.0% vs 8.0%] were significantly higher among PGDM comparing GDM patients. Conclusion: The maternal and perinatal outcomes of pregestational diabetes mellitus were less favorable than those of gestational diabetes mellitus. Birdem Med J 2019; 9(2): 127-132


2017 ◽  
Vol 16 (2) ◽  
pp. 55-62
Author(s):  
Rinku Joshi ◽  
Rosy Malla ◽  
Madhur Dev Bhattarai ◽  
Dhan Bahadur Shrestha

Introduction: Diabetes has become a significant health problem all over the world and its prevalence is increasing rapidly, including in Nepal. Prevalence of gestational diabetes mellitus (GDM) is directly related to the prevalence of type 2 diabetes. Women who areoverweight or obese before they become pregnant are more at risk of GDM irrespective of other factors.Though the risk of developing GDM in shown to be higher in overweight or obese women, there are very few studies done to show such observation in the urban population of Nepal.Methods: This was a hospital based cross-sectional prospective study conducted among the women attending ante partum clinic, in a tertiary level hospital, located at Lalitpur for one-year duration in 2009. All overweight (pre-pregnancy body mass index (BMI)>23) urban women at 24-28 weeks of gestation were enrolled.Fasting blood glucose, screening 50-g oral glucose challenge test(OGTT) and 2-hr OGTT following overnight fastingwas done as per need based on their test results and GDM was diagnosed based on standard guidelines.Results: Out of 256 women majority of women had BMI >25 kg/m2 (n=180),and 151(59%) were multiparous and 105 (41%) were primiparas. Positive screening test was obtained in 51 women (19.9%).The incidence of GDM by ADA and WHO criteria was 10 (3.9%) and 16 (6.3%) respectively. There was statistically non-significant difference in the rate of positive screening test and BMI (p=0.09). The abnormal screening test between primiparous and multiparous was significant (p=0.01).Conclusion: This study showed a high pre-pregnancy BMI and the incidence of GDMamong the patients enrolled. The rate of positive screening test is also higher than the previous studies so, GDM is a growing issue and must be well addressed.


2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Ya Zhang ◽  
Jiashen Shao ◽  
Feifei Li ◽  
Xianming Xu

Objective.To identify factors predicting the need for insulin therapy in pregnancies complicated by gestational diabetes mellitus (GDM).Methods. A total of 1352 patients with GDM diagnosed by the 75-g/2-h oral glucose tolerance test (OGTT) were enrolled in this study. Univariate and multivariate analysis were performed; receiver operating characteristics (ROC) were also drawn.Results. There was a significant difference in factors such as maternal age, pregestational BMI, first visit SBP, first visit DBP, FBG of first visit, FBG at time of OGTT, 75-g OGTT glucose value (fasting, after 1 h and 2 h), and serum HbA1c level at diagnosis between patients with insulin therapy and patients with medical nutrition therapy (MNT) alone. Multivariate analysis showed that higher FBG at time of OGTT, first 75 g OGTT 2 h plasma glucose, and HbA1c concentration at diagnosis lead to more likely need of insulin therapy.Conclusion. The probability of insulin therapy can be estimated in pregnant women with GDM based on fasting and 2 h glucose values during OGTT and HbA1c value at diagnosis of GDM.


2016 ◽  
Vol 8 (02) ◽  
pp. 101-105 ◽  
Author(s):  
Suheyla Gorar ◽  
Bulent Alioglu ◽  
Esranur Ademoglu ◽  
Seyit Uyar ◽  
Handan Bekdemir ◽  
...  

ABSTRACT Context: Impact of gestational diabetes mellitus (GDM) on the coagulation system, dynamics involved at a pathophysiological level and the exact mechanism remain unclear. Aims: To evaluate the association between diabetes-related parameters and hemostatic factors to search for a tendency of thrombosis in GDM. Settings and Design: Nineteen pregnant women who had GDM, 16 healthy pregnant and 13 healthy nonpregnant controls admitted to the Endocrinology outpatient clinics were enrolled in the study. Subjects and Methods: Fasting and postprandial glucose, hemoglobin A1c and insulin levels, and insulin resistance; fructosamine, thrombin activatable fibrinolysis inhibitor (TAFI), tissue factor pathway inhibitor (TFPI), plasminogen activator inhibitor Type-1 (PAI-1), tissue-type plasminogen activator (t-PA), fibrinogen, plasminogen and hemoglobin levels, platelet counts, prothrombin time (PT), and activated partial thromboplastin time (aPTT) were studied. Statistical Analysis Used: One-way analysis of variance, Kruskal–Wallis, and post hoc Tukey honestly significant difference or Conover’s nonparametric multiple comparison tests for comparison of the study groups. Results: PT and aPTT were significantly lower in GDM patients compared to controls (P < 0.05), whereas fibrinogen and plasminogen levels were significantly higher in this group compared to both nonpregnant and healthy pregnant controls (P < 0.05 for each). TAFI, TFPI, PAI-1, and tissue t-PA levels were not significantly different among groups. Conclusions: Our findings indicate tendency to develop thrombosis in GDM similar to diabetes mellitus; but more comprehensive studies with larger sample size are needed to determine the relationship between GDM and hemostasis.


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