The Impact of Socio Economic Factors on the Adherence of Patients with Gestational Diabetes Mellitus to Medical Recommendations

Author(s):  
Ali Akbar HAGHDOOST ◽  
Mohammad Reza BANESHI ◽  
Alireza RAZZAGHI ◽  
Adel NOORI

Background: Adherence to medical recommendations is very important to control gestational diabetes mellitus (GDM), as one of the most important disorders during pregnancy. In this study, we explored the impact of socioeconomic status (SES) on the adherence of a cohort of GDM in Iran. Methods: In this prospective study, 230 pregnant women with confirmed GDM were followed from Feb to Jun 2013 in a referral diabetic care center in Iran. The SES of subjects were quantified using a combined score generated by principal component analysis (PSA). Medical adherence score of subjects was measured in three follow up visits in a range of 0 to 10 and were linked to SES using linear regression model. Results: The adherence scores women in the first, second, and third follow up visits were 5.06±2.12, 5.46±2.06, and 5.08±1, respectively. Women fourth quartile of SES (the highest level of SES) has a least compliance to medical orders in comparison to first quartile of SES (the lowest level of SES) with the OR -2.75 (95% Cl: -3.17, -2.23). Conclusion: The medical adherence of pregnant women with GDM is significantly poorer in high SES groups. Therefore, as an important determinant, we may target high SES pregnant women to control the adverse effects of the disorder more efficiently.

2021 ◽  
Author(s):  
Fang Wang ◽  
Hui Cai ◽  
Min Li

Abstract Background: Gestational diabetes mellitus (GDM) increases the risk of various complications in both the mother and infant. Results: By comparing mothers with GDM and non-diabetic pregnant women, we analyzed the possible causes of GDM and the impact on the mother and newborn. Through research and tracking, we found that a sweet tooth and a high total calorie diet are the main factors leading to gestational diabetes. GDM can cause many complications in the parturient and unhealthy babies. A very important result is that our follow-up survey results show that almost all pregnant women with gestational diabetes instructed themselves to have gestational diabetes through a physical examination at a certain time before delivery, but they still suffered from diabetes when they were in the hospital. The harm caused by diabetes has nothing to do with the time of knowing about having diabetes, which shows that pregnant women and their families have not paid enough attention to and make effective treatment of gestational diabetes. Conclusion: Our results clarify the hazards of gestational diabetes, analyze possible causes, and emphasize the necessity of clinical intervention to control gestational diabetes.


Gut ◽  
2018 ◽  
Vol 67 (9) ◽  
pp. 1614-1625 ◽  
Author(s):  
Jinfeng Wang ◽  
Jiayong Zheng ◽  
Wenyu Shi ◽  
Nan Du ◽  
Xiaomin Xu ◽  
...  

ObjectiveThe initial colonisation of the human microbiota and the impact of maternal health on neonatal microbiota at birth remain largely unknown. The aim of our study is to investigate the possible dysbiosis of maternal and neonatal microbiota associated with gestational diabetes mellitus (GDM) and to estimate the potential risks of the microbial shift to neonates.DesignPregnant women and neonates suffering from GDM were enrolled and 581 maternal (oral, intestinal and vaginal) and 248 neonatal (oral, pharyngeal, meconium and amniotic fluid) samples were collected. To avoid vaginal bacteria contaminations, the included neonates were predominantly delivered by C-section, with their samples collected within seconds of delivery.ResultsNumerous and diverse bacterial taxa were identified from the neonatal samples, and the samples from different neonatal body sites were grouped into distinct clusters. The microbiota of pregnant women and neonates was remarkably altered in GDM, with a strong correlation between certain discriminatory bacteria and the oral glucose tolerance test. Microbes varying by the same trend across the maternal and neonatal microbiota were observed, revealing the intergenerational concordance of microbial variation associated with GDM. Furthermore, lower evenness but more depletion of KEGG orthologues and higher abundance of some viruses (eg, herpesvirus and mastadenovirus) were observed in the meconium microbiota of neonates associated with GDM.ConclusionGDM can alter the microbiota of both pregnant women and neonates at birth, which sheds light on another form of inheritance and highlights the importance of understanding the formation of early-life microbiome.


2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Lei Liu ◽  
Jiajin Hu ◽  
Liu Yang ◽  
Ningning Wang ◽  
Yang Liu ◽  
...  

Background. Obese women with gestational diabetes mellitus (GDM) have a higher risk of adverse outcomes than women with obesity or GDM alone. Our study is aimed at investigating the discriminatory power of circulatory Wnt1-inducible signaling pathway protein-1 (WISP1), a novel adipocytokine, on the copresence of prepregnancy overweight/obesity and GDM and at clarifying the relationship between the WISP1 level and clinical cardiometabolic parameters. Methods. A total of 313 participants were screened from a multicenter prospective prebirth cohort: Born in Shenyang Cohort Study (BISCS). Subjects were examined with a 2×2 factorial design for body mass index BMI≥24 and GDM. Between 24 and 28 weeks of pregnancy, follow-up individuals underwent an OGTT and blood sampling for cardiometabolic characterization. Results. We observed that the WISP1 levels were elevated in prepregnancy overweight/obesity patients with GDM, compared with nonoverweight subjects with normal blood glucose (3.45±0.89 vs. 2.91±0.75 ng/mL). Multilogistic regression analyses after adjustments for potential confounding factors revealed that WISP1 was a strong and independent risk factor for prepregnancy overweight/obesity with GDM (all ORs>1). In addition, the results of the ROC analysis indicated that WISP1 exhibited the capability to identify individuals with prepregnancy overweight/obesity and GDM (all AUC>0.5). Finally, univariate and multivariate linear regression showed that WISP1 level was positively and independently correlated with fasting blood glucose, systolic blood pressure, and aspartate aminotransferase and was negatively correlated with HDL-C and complement C1q. Conclusions. WISP1 may be critical for the prediction, diagnosis, and therapeutic strategies against obesity and GDM in pregnant women.


2020 ◽  
Vol 9 (2) ◽  
pp. 509 ◽  
Author(s):  
Caro Minschart ◽  
Kelly Amuli ◽  
Anouk Delameillieure ◽  
Peggy Calewaert ◽  
Chantal Mathieu ◽  
...  

The value of diabetes education, focusing on lifestyle measures, in women with gestational diabetes mellitus (GDM) is acknowledged, but requires intensive education and input of resources if done on an individual basis. Group education could be a valuable alternative to individual education. This study aims to investigate the impact of multidisciplinary group education on women’s knowledge about GDM, education, treatment satisfaction, and emotional status. Two hundred women with GDM were enrolled in a prospective observational study. Dutch speaking women were offered group education at their first visit after GDM diagnosis. Non-Dutch speaking women or women for whom group education was not possible received individual education. Individual follow-up with a dietitian was planned within two weeks for all women. Women receiving individual education (n = 100) were more often from an ethnic minority background compared to women in group education (n = 100) (32.0% (n = 31) vs. 15.3% (n = 15), p = 0.01). Knowledge about GDM significantly improved after education, with few differences between the two education settings. Both patients in group and individual education were equally satisfied with the content and duration of the initial and follow-up education. Of all group participants, 91.8% (n = 90) were satisfied with group size (on average three participants) and 76.5% (n = 75) found that group education fulfilled their expectations. In conclusion, women diagnosed with GDM were overall satisfied with the education session’s content leading to a better understanding of their condition, independent of the education setting. Group education is a valuable alternative to better manage the increasing workload and is perceived as an added value by GDM patients.


2008 ◽  
Vol 14 (3) ◽  
pp. 85 ◽  
Author(s):  
Frances Doran

This paper reports on a mixed methods study which sought to explore the role of physical activity in relation to the management of gestational diabetes mellitus (GDM); the impact of a diagnosis of GDM on a woman?s life; follow-up support and factors that both hinder and support women to engage in physical activity post-partum in order to reduce their risk of developing future type 2 diabetes. Thirty-eight women who had a pregnancy complicated by GDM completed surveys. In-depth interviews were then conducted with a subset of eight women who completed these surveys, to further explore their experiences. Women reported making changes to their lifestyle to improve diet and engage in physical activity during pregnancy. These changes were harder to sustain after the baby was born. In this study few women underwent the recommended six-weekly oral glucose tolerance testing, and post-partum follow-up support was virtually non-existent. There is a clear role for health promotion across a number of sectors to support sustained behaviour change in this high-risk group of women. Factors are identified that could enhance follow-up support, particularly for lifestyle change.


2005 ◽  
Vol 19 (2) ◽  
pp. 83-87 ◽  
Author(s):  
Ana Chapper ◽  
Artur Munch ◽  
Camila Schermann ◽  
Carolina Carraro Piacentini ◽  
Maria Thereza Martins Fasolo

This cross-sectional study investigated the impact of pregestational overweight and obesity on periodontal status of patients with gestational diabetes mellitus (GDM). Sixty pregnant women with gestational diabetes mellitus (GDM) were recruited for the study. According to the pregestational body mass index (BMI), patients were classified into 3 groups: normal, overweight or obese. The periodontal assessment parameters were the presence of gingival bleeding (GB) and bleeding on probing (BOP) per tooth. Clinical attachment loss (CAL) was assessed per tooth and classified according to following values: 1) absence of attachment loss; 2) between 1 and 2 mm, 3) between 3 and 5 mm; and 4) CAL > 6 mm. The means of individual percentage of teeth with GB and BOP and the means of the individual classified values of CAL were compared through ANOVA. Differences between the groups were established through post hoc Bonferroni test for multiple comparisons (p < 0.05). The analysis revealed significant differences between the normal group and the obese group considering GB (52.76% ± 27.99% and 78.85% ± 27.44%, respectively) and CAL (2.21 ± 0.41 and 2.61 ± 0.54, respectively). Although an increase was found in BOP as the BMI increased (ranging from 55.65% to 75.31%), no statistically significant differences were found among the groups. Patients with GDM and pregestational obesity had significantly more gingivitis and periodontal attachment loss that those with normal pregestational BMI. Periodontal treatment should be considered in the establishment of future recommendations for metabolic control for this special group of patients.


Jurnal NERS ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. 162
Author(s):  
Tri Ismu Pujiyanto ◽  
Indah Wulaningsih

Introduction: Gestational Diabetes Mellitus (GDM) is becoming one of the major public health problems. It is important to screen the GDM and for the case to be managed by nurses. Nurses are needed to care for pregnant women with GDM, and the work experience of nurses is directly related to the assistance and quality of care provided. However, nurses face some barriers in understanding the GDM and providing good management thereof. This study explored the experiences of nurses of caring for GDM patients.Methods: This study was a phenomenological approach qualitative research. Participants were 10 nurses who provide care for pregnant women with GDM selected by purposive sampling technique with sampling criteria. Data analysis used the Colaizzi method.Results: There were five categories, e.g. empathy, inspiration to find ways to treat patients very well, feeling of ambivalence, self-preservation to develop potential, and the impact on the nurses of caring for GDM.Conclusion: Sustaining the nursing workforce and improving their working experiences are essential to meet the care needs of pregnant women with GDM. Nurses should understand to promote empathy, and there is a need to improve the job satisfaction and morale of nurses. At the institutional level, policy makers should make efforts to improve the nursing clinical practice environment, increase the nursing management role, the maternity nursing education and training, achieve a proper skill mix of the health workforce, and, overall, attract, prepare and sustain nurses regarding caring for pregnant women with high risk GDM.


2017 ◽  
Author(s):  
Seda Sancak ◽  
Ali Ozdemir ◽  
Kerem Yiğit Abacar ◽  
Ayhan Celik ◽  
Nalan Okuroğlu ◽  
...  

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