scholarly journals GESTATIONAL DIABETES MELLITUS

2016 ◽  
Vol 23 (01) ◽  
pp. 015-019
Author(s):  
Afsheen Qazi ◽  
Amin Fahim ◽  
Aneela Qureshi3 ◽  
Mazhar ul Haque

Objectives: The present study was designed to find the importance of properscreening and early diagnosis of gestational diabetes mellitus. Study Design: A prospective/descriptive study Place of Study: tertiary care hospital Hyderabad. Duration of Study: fromSeptember 2014 to November 2014. Materials and Methods: A total of 168 pregnant femalesbetween the ages of 20-40 years & in their 24th to 28th week of gestation were enrolled for thestudy. Oral Glucose Tolerance Test of all the participants was done after an overnight fasting of10-12 hours. All the participants were given 75gm of glucose per 100 ml of distilled water. Theblood samples were collected after two hours time for serum glucose levels. Results: Mostof the participants were below 26 years of age 47(27.9%) with the mean age of 30.2±5.83years. However the highest prevalence of GDM was observed in age group 31-35 years (36%).Among the 25 cases of gestational diabetes mellitus the highest number of patients with GDMwere multipara (40%) followed by parity of 3-4 gravida (32%). Twenty seven women (16%)women had family history of diabetes mellitus. Among these 12/27 (44.4%) women were foundwith GDM, compared to 15/141 (10.6%) who have no family history of diabetes mellitus. Total14 (8.33%) women were found obese, out of these 8 (57%) women had GDM while only 6(42.8%) women had no GDM. Conclusion: The prevalence of GDM in the present study isfound to be 14.8%. A prevalence of GDM was higher in the elderly multiparous females whowere overweight and had family history of diabetes mellitus.

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.


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.


2017 ◽  
Vol 4 (1) ◽  
pp. 112 ◽  
Author(s):  
Maxima Anand ◽  
Manan Anand ◽  
Devinder Singh Mahajan

Background: Diabetes is estimated to complicate 2-5% of all pregnancies of which 90% of those are detected during pregnancy i.e. gestational diabetes mellitus (GDM) and the rest are overt or pregestational i.e. either Type 1 or Type 2. According to ADA, approximately 7% of all pregnancies are complicated by GDM resulting in more than 2,00,000 cases annually. The aim was to study the incidence of GDM among pregnant women between 24 to 28 weeks of gestation, to evaluate and compare the occurrence of risk factors e.g.; family history of diabetes, prematurity, history of foetal loss and congenital anomaly associated with diabetes in pregnancy.Methods: 50gm of glucose, glucose challenge test (GCT) was given to women coming for antenatal check-up between 24 to 28 weeks of gestation irrespective of presence or absence of risk factors for GDM.1 hour glucose levels were checked. Patients with glucose levels more than 130mg/dl were subjected to 100gm of oral glucose tolerance test (OGTT) according to Carpenter and Coustan modification of the National Diabetes Data. Data was compiled and statistically analysed.Results: In this study it was observed that 20 (women had raised GCT, 11 (5.3%) women developed GDM out of 206 women. All GDM patients have one or more risk factors. Age >25 years (63.6%) fetal loss (36.3%), BMI (33.3%) are common risk factors followed by family history of diabetes (27.3%).Conclusions: Family history of diabetes and past history of congenital anomalies are statistically significant in GDM group as compared to non GDM.


2014 ◽  
Vol 58 (2) ◽  
pp. 197-204 ◽  
Author(s):  
Letícia Schwerz Weinert ◽  
Livia Silveira Mastella ◽  
Maria Lúcia Rocha Oppermann ◽  
Sandra Pinho Silveiro ◽  
Luciano Santos Pinto Guimarães ◽  
...  

Objectives: The aims of this study were to estimate the local rate of postpartum diabetes screening after gestational diabetes mellitus (GDM) pregnancies, and to identify clinical variables associated with retesting rates and with the persistence of decreased glucose tolerance. Subjects and methods: Prospective cohort of GDM women with prenatal delivery at a specialized center, from November 2009 to May 2012. All women were advised to schedule a 6 weeks postpartum 75-g oral glucose tolerance test (OGTT). Results: Of the 209 women included, 108 (51.7%) returned to be tested with fasting plasma glucose (n = 14), OGTT (n = 93) or random glucose (n = 1). Return was associated with lower parity rate (2 vs. 3, p < 0.001) and higher pregnancy 2-h OGTT (165 vs. 155 mg/dL, p = 0.034), but not with socio-demographic characteristics. Four women (3.7%) had diabetes, 22 (20.4%) had impaired fasting glucose or impaired glucose tolerance. Persistent hyperglycemia was associated with a positive family history of diabetes (relative risk - RR 2.41, p = 0.050), diagnostic 2-h OGTT in pregnancy (RR 1.01, p = 0.045), insulin use during pregnancy (RR 2.37, p = 0.014), and cesarean section (RR 2.61, p = 0.015). Conclusions: Even though postpartum abnormalities were frequent in GDM, rates of postpartum diabetes screening were undesirably low. As no specific clinical profile defines who will adhere to postpartum testing, it is essential to encourage all women to reevaluate their glucose status, particularly those with a family history of diabetes and more severe hyperglycemia. Arq Bras Endocrinol Metab. 2014;58(2):197-204


2010 ◽  
Vol 2 (2) ◽  
pp. 109-113
Author(s):  
Paban K Sharma ◽  
Ashis Shrestha

ABSTRACT Background Maternal hyperglycemia is considered a risk factor for both fetus and mother which can lead to significant morbidity and sometimes, even mortality. Here, we present a two years study of gestational diabetes which was intended to see the incidence and its determinants in the Patan Hospital, Kathmandu, Nepal. Patan Hospital is a tertiary care level teaching hospital. Subjects and Methods All pregnant women visiting ANC clinic or admitted to the ward with the diagnosis of GDM from July 2005 to June 2007 at Patan Hospital were taken for the study. In Patan Hospital, pregnant ladies are routinely screened for diabetes with 50 gm glucose challenge test (GCT) and if the value is more than 140 mg/dl, they are subjected to 100 gm Oral Glucose Tolerance Test (OGTT). If two or more than two values are increased, they are managed as gestational diabetes. These cases of gestational diabetes are enrolled for the study. Data was collected by interview and laboratory investigations using standard set of questioner. Results Out of 13,382 consecutive deliveries, 53 patients were admitted with the diagnosis of gestational diabetes mellitus (GDM). Among them, 40.4% were Brahmin, 38.5% Newar, 11.5% Chettri and 9.6% from other cast. GDM was more common in the age group 26 to 35 years and was more prevalent in urban population than rural (urban 84.6% vs rural 15.4%). Similarly, it was more common in multipara patients. Only 28.8% of the cases were having polyhydramnios on ultrasound. Mean weight gain in pregnancy was 8.96 kg with a range of 3 to 20 kg approximately, 58% of patients had family history of diabetes, 48.7% of patients had history of GDM in previous pregnancy and 7.7% of patients had overt diabetes. Most of the patients needed insulin (92.3%) and only 7.7% of patients were managed with only diet and exercise. No significant fetomaternal complication was observed in our study. Conclusion There was significant number of cases diagnosed as GDM. All patients who were diagnosed early and treated accordingly had less complications related to mother and child.


2021 ◽  
pp. 1-3
Author(s):  
Sanjana Patil ◽  
Rameshwari Malshetty

Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with the onset or first recognition during pregnancy with or without remission after the end of pregnancy. Worldwide prevalence of GDM is reported between 1.4 – 14 percent. The data regarding prevalence and outcomes of GDM will help in planning and allocation of resources and the preventive strategies at the hospital and community level. There are few studies conducted in this region describing the prevalence, associated risk factors, maternal and neonatal outcomes associated with GDM. This was retrospective study conducted at a tertiary care hospital in India. Data was obtained from January 2018 to January 2019. Women between 24-28 weeks of gestation were included in the study. The information collected included the following parameters: age, residence status, gravid status, family history of diabetes or history of diabetes in first degree relative, past history of GDM. Neonatal outcomes like stillbirths, macrosomia, hyperbilirubinemia were recorded. Most common age of presentation of GDM was 26-30 years. Gravida < 3 accounted for most of the cases. Urban residents accounted for 55.8% of the cases. Most of the cases of GDM had at least one risk factor like history of hypertension or diabetes mellitus. Most common adverse maternal outcome was cephalopelvic disproportion followed by Casearean section and least common was abruptio placentae. Most common adverse fetal outcome was hyperbilirubinemia followed by macrosomia and least common was stillbirth. Early diagnosis and appropriate treatment of GDM will help in preventing maternal and fetal adverse outcomes and delay development of diabetes in high-risk individuals. The prevalence of GDM is going to increase in the near future exponentially, hence there is need for various community-based prevalence studies in different geographical regions of India to determine the exact prevalence and regional differences of GDM.


2018 ◽  
Vol 5 (3) ◽  
pp. 737 ◽  
Author(s):  
Masaraddi Sanjay K. ◽  
Saranya Andal Kishore ◽  
Nedunchezian P. ◽  
Sulekha C.

Background: Gestational diabetes mellitus (GDM) is amongst the most common medical complications of pregnancy associated with adverse maternal and perinatal outcomes. The prevalence of GDM is increasing worldwide especially in India with increasing obesity and lifestyle and dietary changes. Hence this study was undertaken to study the prevalence of GDM and to evaluate its neonatal outcomes.Methods: This was a prospective study. During the study period, 205 pregnant women between 24 to 28 weeks of gestation were screened for GDM using 75 g oral glucose tolerance test (OGTT) and were diagnosed to have GDM based on WHO criteria. Risk factors for GDM, maternal and neonatal outcomes were studied.Results: The prevalence of GDM in the study population was 7.8%. Prevalence of GDM cases was significantly associated with body mass index (BMI) >25 kg/m2, family history of diabetes, previous macrosomia/large for gestational age (LGA) baby and past history of GDM with p <0.001 and with multiparity (p = 0.024). Maternal age >25 years was not statistically associated with prevalence of GDM (p = 0.358). Incidence of pre-eclampsia and polyhydramnios were significantly higher among GDM cases. Operative delivery and assisted (forceps) delivery had strongly significant association with GDM (p <0.001). GDM cases were significantly associated with higher birth weight (>3.5 kg) in the neonates (p <0.001). Hypoglycemia was the most common complication noted in neonates of GDM women. Incidence of respiratory distress, transient tachypnea of the newborn (TTN), polycythemia and neonatal hyperbilirubinemia were also significantly more common among neonates born to GDM women.Conclusions: BMI >25 kg/m2, family history of diabetes, past GDM and previous LGA baby were important risk factors for GDM. The study emphasizes the need to screen all pregnant women for GDM, so that timely diagnosis and intervention will reduce both maternal and perinatal complications.


2021 ◽  
Author(s):  
Peilin Ouyang ◽  
You Yiping ◽  
Jia Xiaozhou ◽  
Yang Liqin

Abstract Women with polycystic ovary syndrome are prone to develop gestational diabetes mellitus, a disease which may have significant impact on the postpartum health of both mother and infant. We performed a retrospective cohort study to develop and test a model that could predict gestational diabetes mellitus in the first trimester in women with polycystic ovary syndrome. Our study included 520 pregnant women who were referred to the obstetrics department between December 2017 and March 2020 with a diagnosis of polycystic ovary syndrome. Of these women, 171 were diagnosed with gestational diabetes mellitus in the second trimester. Univariate analysis revealed that in the first trimester, parity, family history of diabetes, age, body mass index (BMI), testosterone, low density lipoprotein cholesterol, triglyceride(TG), total cholesterol(TC), fasting plasma glucose(FPG), Hemoglobin A1c (HbA1C), diastolic blood pressure(DBP),and insulin levels were predictive factors of gestational diabetes mellitus (P<0.05). Logistic analysis revealed that TG, age, HbA1C, Insulin, TC, BMI and family history of diabetes were independent risk factors for gestational diabetes mellitus. The area under the ROC curve of the gestational diabetes mellitus risk prediction model was 0.917 in this retrospective analysis, demonstrating the great ability to predict. The sensitivity and specificity of the prediction model were 0.814 and 0.871, respectively. The Hosmer–Lemeshow test also showed a good fit to the test.


Author(s):  
Shaymaa Hasan Abbas ◽  
Sura Abbas Khdair

Introduction: Gestational diabetes mellitus (GDM) is one of the most common medical problems occurred during pregnancy. GDM increase the chance for developing type 2 diabetes meletus by seven times. The overall prevalence of GDM in pregnancy is 1-14% according to the American Diabetes Association. Material and Methods: a self-administered questionnaire was used to collect data. The information was collected from pregnant women with gestational DM to assess some maternal risk factors and compare blood glucose level according to different treatment types for GDM. Results: The present study reported that (40.38%) of GDM patients have advanced age (≥35 yrs.). First pregnancy was a risk factors for GDM and it was reported by (9.62%). History of HT and GDM during prior pregnancies were reported by (11.54%) and (% 34.62) respectively. Hypertension or preeclampsia in the current pregnancy was reported by (3.85%). Positive family history of diabetes was associated with (26.92%) GDM patients. All Patients of the present study reported no previous PCOS and smoking history. Also in this study, 44 patients out of 52 GDM patients use medications to control the glucose intolerance, while other patients control it by diet. There were no statistical differences found between treatment groups in term of blood glucose control. Conclusion: Age, history of GDM in the previous pregnancies and family history of diabetes mellitus were identifiable as a risk factors for GDM and their effect were significant in this study while the effect of other risk factors were non-significant. No statistical differences found between treatment groups in term of blood glucose level control and no group achieved the glycemic target.


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Erica P Gunderson ◽  
Amy Krefman ◽  
Cora E Lewis ◽  
Janet Catov ◽  
Norrina B Allen

Hypothesis: Gestational diabetes mellitus (GDM) is a disorder of glucose metabolism during pregnancy characterized by pancreatic beta cell dysfunction and greater insulin resistance, but it is unclear whether dysfunction exists before pregnancy. The disposition index (DI) is a physiologic measure of beta cell compensation for insulin resistance strongly predictive of future diabetes. This prospective study evaluates whether a clinical approximation of DI before pregnancy is associated with risk of GDM. Methods: This analysis included 696 women (45% black, 55% white) enrolled in the CARDIA Study, a U.S. multi-center prospective cohort of young adults aged 18-30 at baseline (1985-86) who gave birth at least once during 30 years of follow up, reported GDM status and had fasting glucose and insulin measured before one or more post-baseline births. DI was defined as HOMA-B divided by HOMA-IR using standard formulas. Multinomial logistic regression models estimated odds ratios (OR) and 95%CI for GDM among pre-pregnancy DI tertiles (low, moderate, high) and fully adjusted for time to birth, race, age, parity, BMI, lifestyle behaviors and family history of diabetes, and also stratified by pre-pregnancy BMI. Results: 9% of women reported GDM (64/696) for 794 births. 55% of GDM and 30% of non-GDM were categorized as low DI. Low pre-pregnancy DI compared to moderate DI was associated with higher fully adjusted odds of GDM (OR=2.71, 95%CI:1.37-5.35) in the entire sample. In models stratified by pre-pregnancy BMI, low DI was associated with 4-fold higher odds of GDM among Overweight/Obese (OR=4.22, 95%CI: 1.35-13.91) and somewhat attenuated higher odds of GDM among Normal BMI (OR=1.94, 95%CI: 0.78–4.86); Table 1. Only family history of diabetes was strongly associated with GDM independent of DI. Conclusions: Inadequate beta cell compensation is present before pregnancy and discriminates greatest risk of GDM among high BMI, and may identify higher risk among women of normal BMI.


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