1279-PUB: Postpartum Screening for Diabetes in Women with a History of Gestational Diabetes

BackgroundWomen with gestational diabetes (GDM) have an elevated risk of developing type 2 diabetes (T2DM). NICE Guidance recommends women who develop GDM are screened 6 weeks post-partum and annually thereafter.AimTo evaluate conformity to guidance of screening in women with GDM by 6-week post-partum fasting plasma glucose (FPG) and annual FPG and determine time between delivery and development of T2DM.MethodRecords at a tertiary referral centre were used to identify women (n = 54) diagnosed with GDM by antenatal oral glucose tolerance test between July 1999 and January 2007. Data from laboratory records were used to collect investigations of glycaemic status during the follow-up period (median follow-up 12.4 years, range 9.5–17.1 years).ResultsOf 252 women, 102 (40.2%) did not have a FPG at 6 weeks (+/−2 weeks). Of these, median time to first test was 1.2 years (range 0.04–10.8 years), with only 43.1% followed-up within 1 year. In those who had a 6-week FPG, 17 (11.3%) women had no further tests. A total of 84 (33% of those with gestational diabetes in the index pregnancy) women were diagnosed with T2DM; median time from delivery to diagnosis was 5.2 years (range 0.35–15.95). We found the only significant factor for a follow-up test at 1-year post-partum was the use of insulin.ConclusionOur data suggest an alternative approach is needed for monitoring women with a history of GDM. This needs to be appropriate for a generally healthy group in which traditional screening mechanisms may not be adequate or sufficient.

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Factors Associated with Clinician Adherence to USPSTF Diabetes Screening Recommendations

Journal of Primary Care & Community Health ◽

10.1177/21501327211016579 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110165

Author(s):

Elaine Seaton Banerjee ◽

Kyle Shaak ◽

Nicole Burgess ◽

Melanie Johnson ◽

Beth Careyva

Keyword(s):

Gestational Diabetes ◽

Adult Population ◽

Correct Diagnosis ◽

Retrospective Chart Review ◽

Diabetes Screening ◽

Factors Associated ◽

The Us ◽

History Of ◽

Missed Diagnosis ◽

Significant Health

Introduction/Objectives: Diabetes and prediabetes impact nearly half of the US adult population and are associated with significant health risks but may be underdiagnosed. Effective screening may improve diagnosis and give patients opportunity to manage their disease. The purpose of this study was to determine screening rates, identify characteristics predictive of screening, and evaluate correct diagnosis of diabetes and prediabetes. Methods: Retrospective chart review of 71 433 patients eligible for diabetes screening, defined by completing A1c test within the 3-year study period. Results: A total of 31.3% of eligible patients received diabetes screening. Factors associated with screening include older age, female sex, non-white race, Hispanic ethnicity, Medicare or Medicaid insurance, higher BMI, and having a medical comorbidity. History of prediabetes or gestational diabetes were the strongest predictors for diabetes screening, but history of gestational diabetes was under-documented. Of those screened, 10.4% had a result consistent with diabetes and 51.8% had a result consistent with prediabetes. However, 52.9% of these patients had a missed diagnosis. Conclusions: Findings of this study indicate the need for uniform coverage for diabetes screening for all insurances, increased documentation of gestational diabetes to improve screening for patients with this history, and improving accurate diagnosis after screening is completed.

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myo-Inositol Supplementation and Onset of Gestational Diabetes Mellitus in Pregnant Women With a Family History of Type 2 Diabetes: A prospective, randomized, placebo-controlled study

Diabetes Care ◽

10.2337/dc12-1371 ◽

2013 ◽

Vol 36 (4) ◽

pp. 854-857 ◽

Cited By ~ 75

Author(s):

R. D'Anna ◽

A. Scilipoti ◽

D. Giordano ◽

C. Caruso ◽

M. L. Cannata ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Family History ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Controlled Study ◽

History Of

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Effect of Gestational Diabetes Mellitus History on Future Pregnancy Behaviors: The Mutaba’ah Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010058 ◽

2020 ◽

Vol 18 (1) ◽

pp. 58

Author(s):

Nasloon Ali ◽

Aysha S. Aldhaheri ◽

Hessa H. Alneyadi ◽

Maha H. Alazeezi ◽

Sara S. Al Dhaheri ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Previous History ◽

Previous Pregnancy ◽

Prenatal Health ◽

Supplement Use ◽

History Of ◽

Future Pregnancy

Gestational diabetes mellitus (GDM) increases the risk of adverse pregnancy outcomes in any pregnancy and recurrence rates are high in future pregnancies. This study aims to investigate the effect of self-reported history of previous GDM on behaviors in a future pregnancy. This is an interim cross-sectional analysis of the pregnant women who participated in the Mutaba’ah Study between May 2017 and March 2020 in the United Arab Emirates. Participants completed a baseline self-administered questionnaire on sociodemographic and pregnancy-related information about the current pregnancy and previous pregnancies. Regression models assessed the relationships between self-reported history of GDM and pre-pregnancy and pregnancy behaviors in the current pregnancy. Out of 5738 pregnant parous women included in this analysis, nearly 30% (n = 1684) reported a history of GDM in a previous pregnancy. Women with a history of previous GDM were less likely to plan their current pregnancies (adjusted odds ratio (aOR): 0.84, 95% confidence interval (CI) 0.74–0.96) and more likely to be worried about childbirth (aOR: 1.18, 95% CI 1.03–1.36). They had shorter interpregnancy intervals between their previous child and current pregnancy (aOR: 0.88, 95% CI 0.82–0.94, per SD increase). There were no significant differences between women with and without a history of GDM in supplement use, sedentary behavior, or physical activity before and during this current pregnancy. Nearly a third of parous pregnant women in this population had a history of GDM in a previous pregnancy. Pregnant women with a previous history of GDM were similar to their counterparts with no history of GDM in the adopted pre-pregnancy and prenatal health behaviors. More intensive and long-term lifestyle counseling, possibly supported by e-health and social media materials, might be required to empower pregnant women with a history of GDM. This may assist in adopting and maintaining healthy prenatal behaviors early during the pregnancy or the preconception phase to minimize the risk of GDM recurrence and the consequential adverse maternal and infant health outcomes.

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Perception of and Motivation for Physical Activity among Women with a History of Gestational Diabetes

Women ◽

10.3390/women1020010 ◽

2021 ◽

Vol 1 (2) ◽

pp. 109-119

Author(s):

Julie Breinholm Svarrer Jakobsen ◽

Josefine Stæhr Brodersen ◽

Zainab Afshan Sheikh ◽

Karoline Kragelund Nielsen

Keyword(s):

Physical Activity ◽

Gestational Diabetes ◽

Social Relations ◽

Phenomenological Approach ◽

Physically Active ◽

Individual Interviews ◽

Women’S Perceptions ◽

History Of ◽

Competing Priorities

(1) Background: Women with a history of gestational diabetes mellitus (GDM) have a high risk of developing type 2 diabetes (T2DM). This risk can be reduced with lifestyle interventions, including physical activity. However, studies have shown that many women with prior GDM are not physically active. The aim of this study was to investigate the motivation for physical activity among women with prior GDM. (2) Methods: A qualitative study was carried out based on a phenomenological approach using semi-structured individual interviews with nine Danish women between 29 and 36 years of age with a minimum of one earlier GDM-affected pregnancy. (3) Results: Five themes were identified; perception of physical activity, risk perception, emotional distress, competing priorities and social support. The perception of physical activity varied among the women. The GDM diagnosis or the awareness of elevated risk for T2DM did not seem to be a decisive factor for the women’s motivation to be active. Competing priorities, including being in control of everyday life choices and support from social relations, were found to be important motivational factors. (4) Conclusion: Future interventions for women with prior GDM to increase motivation for physical activity should be compatible with and take into account the women’s perceptions, earlier lived experiences, possible competing priorities and support systems.

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667 Effects of Sleep-Extend on glucose metabolism in women with a history of gestational diabetes: A pilot study

SLEEP ◽

10.1093/sleep/zsab072.665 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A261-A261

Author(s):

Sirimon Reutrakul ◽

Pamela Martyn-Nemeth ◽

Laurie Quinn ◽

Kirstie Danielson ◽

Brett Rydzon ◽

...

Keyword(s):

Physical Activity ◽

Pilot Study ◽

Glucose Metabolism ◽

Gestational Diabetes ◽

Sleep Duration ◽

Control Group ◽

Healthy Living ◽

Short Sleep ◽

History Of ◽

Sleep Extension

Abstract Introduction Experimental and epidemiological data have linked insufficient sleep to increased diabetes risk. Women with a history of gestational diabetes (GDM) have a 7-fold greater risk of developing type 2 diabetes. This pilot study explored the feasibility of a sleep extension intervention in women with a history of GDM and short sleep, and the effects on glucose metabolism. Methods Women age 18–45 years with a history of GDM (at least 1 year postpartum) and actigraphy confirmed short sleep duration (<7h/night) on weekdays were randomized at a ratio of 1 control (healthy living information) to 2 cases (6 weeks of “Sleep Extend” intervention: use of a Fitbit, weekly digital content, interactive tools, and coach delivered feedback in order to increase sleep duration). An oral glucose tolerance test (OGTT), 7-day actigraphy recording and questionnaires were obtained at baseline and 6 weeks (at the end of the intervention). Results Twelve women (mean (SD) age 40.3 (4.5) years) participated (n=8 Sleep Extend, n=4 control). Compared to baseline, nightly sleep duration increased in Sleep Extend group (+30.6 (48.8) minutes) but decreased in the control group (-6.8 (22.9) minutes). Both fasting and 2-h glucose levels from OGTT increased in both groups but were greater in the control group (Sleep extend vs. healthy living: fasting glucose +2.1 (9.8) vs. +12.8 (7.3) mg/dL; 2-h glucose +8.2 (21.9) vs. +20.0 (19.4) mg/dL). Self-reported sleep quality improved in both groups. When compared controls, Sleep Extend participants reported improved fatigue symptoms (Promis fatigue score change -5.1 (9.3) vs. 7.0 (1.0), p=0.008), and self-reported physical activity tended to increase (+1614 (3659) vs. -2900 (3922) MET-minutes/week). Combining all participants, an increase in sleep duration correlated with a decrease in fatigue (r= -.62, p=0.04) and anxiety symptoms (r= -.69, p=0.02). Conclusion Sleep extension through coaching and use of remote monitoring is feasible in women with a history of GDM. It appears to decrease fatigue and may improve glucose metabolism and physical activity. Support (if any) NIDDK P30 DK092949

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Pregnancy outcomes in women with preexisting thyroid diseases: a French cohort study

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174420001051 ◽

2020 ◽

pp. 1-10

Author(s):

Marion Lecorguillé ◽

Juliane Léger ◽

Anne Forhan ◽

Marie Cheminat ◽

Marie-Noëlle Dufourg ◽

...

Keyword(s):

Thyroid Hormone ◽

Gestational Diabetes ◽

Head Circumference ◽

Thyroid Diseases ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Fetal Head ◽

History Of ◽

Multivariable Regression ◽

Multivariable Regression Models

Abstract Women with thyroid diseases at the beginning of pregnancy may have suboptimal thyroid hormone levels because of potential difficulties in compensating for the physiological thyroid hormone changes occurring in pregnancy. Our objective was to study the association between preexisting thyroid diseases, pregnancy complications, and neonatal anthropometry. In total, 16,395 women from the ELFE French longitudinal birth cohort were included, and 273 declared pre-pregnancy thyroid diseases. Associations were investigated with multivariable regression models, with adjustment for relevant potential confounders. Body mass index (BMI) was additionally adjusted for in a second stage. As compared with other women, women with pre-pregnancy thyroid diseases were more frequently obese (19.6% vs. 9.8%) and had greater odds of gestational diabetes development (odds ratio [OR] = 1.58 [95% confidence interval [CI] 1.08, 2.30]) or had undergone treatment for infertility (OR = 1.57 [95% CI 1.07, 2.31]). After adjustment for BMI, the association with gestational diabetes was no longer significant (OR = 1.27 [95% CI 0.86, 1.88]). After excluding women with another medical history, those with pre-pregnancy thyroid diseases had increased odds of premature rupture of membranes (OR = 1.51 [95% CI 1.01, 2.25]). Children born from mothers with hypothyroidism before conception due to a disease or as a potential side effect of treatment had a smaller head circumference at birth than other children (β = −0.23 [95% CI −0.44, −0.01] cm). In conclusion, pre-pregnancy thyroid diseases were associated with risk of infertility treatment, gestational diabetes, and premature rupture of membranes. The association between history of hypothyroidism and moderate adverse effects on fetal head circumference growth needs replication.

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