Low potassium level during the first half of pregnancy is associated with lower risk for the development of gestational diabetes mellitus and severe pre-eclampsia

Abstract. Introduction: The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. High cholesterol intake may increase the risk of hyperglycemia, yet little research has evaluated the relation between cholesterol or egg as a main source of dietary cholesterol and GDM. We aimed to study this association among pregnant Iranian women. Methods and Participants: Four hundred sixty-two pregnant women participated in this case-control study. Participants’ dietary intake, weight, height, and blood pressure were obtained and BMI was calculated. Fasting plasma glucose and liver enzymes were also measured. Logistic regression was used to obtain odds ratios and 95% confidence intervals for GDM across tertiles of cholesterol and egg consumption. Results: Among study participants, 115 consumed less than one, 194 consumed one and the remaining participants consumed more than one egg per week (mean cholesterol intake 121.31±61.69 mg/d). Participants within the highest tertile of egg consumption had 41% lower risk of GDM (OR: 0.59; 95% CI: 0.35-0.99) compared with those in the lowest tertile (P=0.01). Higher egg consumption was associated with lower risk of having high blood pressure (P=0.01). The difference in odds of GDM and high blood pressure between the highest and the lowest tertile of cholesterol consumption was not significant, even after controlling for age, energy intake, number of children and socio-economic status. Conclusion: Higher dietary intake of egg during pregnancy was associated with lower odds of GDM. We found no significant association between cholesterol intake and odds of GDM. Further research are needed to confirm these results and determine causality.

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Abstract P214: Adherence to Dietary Patterns after Gestational Diabetes Mellitus and Risk of Subsequent Type 2 Diabetes

Circulation ◽

10.1161/circ.125.suppl_10.ap214 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Deirdre K Tobias ◽

Frank Hu ◽

Jorge Chavarro ◽

Bernard Rosner ◽

Dariush Mozaffarian ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

High Risk ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Dietary Patterns ◽

Dietary Pattern ◽

Lower Risk ◽

History Of

Background: Adherence to healthful dietary patterns is associated with lower risk of type 2 diabetes (T2DM) in the general population. Women with a history of gestational diabetes mellitus (GDM) are at particularly high risk for future type 2 diabetes (T2DM), though relations of dietary patterns with incident T2DM in this population are unknown. Hypothesis: We hypothesize that adherence to healthful dietary patterns among women with prior GDM is inversely associated with incident T2DM. Methods: We evaluated 4,413 participants from the Nurses' Health Study II longitudinal cohort with a history of GDM in one or more pregnancies. GDM was ascertained by self-report of a physician's diagnosis and has been previously validated in a subsample with confirmation of over 90% by medical record review. Participants were free of chronic disease at baseline and followed from 1991 through 2007. Dietary pattern adherence scores were derived for the alternate Mediterranean Diet (aMED), Dietary Approaches to Stop Hypertension (DASH), and the alternate Healthy Eating Index (aHEI) based on validated food frequency questionnaires assessed after GDM and updated every 4 years thereafter. Incident T2DM was assessed every 2 years through previously validated questionnaire responses. Multivariable Cox proportional hazards models estimated the relationship of each dietary pattern with incident T2DM, adjusting for age, total energy intake, parity, age at first birth, race/ethnicity, parental history of T2DM, oral contraceptive use, menopausal status, and smoking status. Body mass index (BMI) was included in a subsequent model. Results: There were 491 cases of incident T2DM over 52,743 person-years of observation. In multivariable analyses, the aMED, DASH, and aHEI dietary patterns were each inversely associated with incident T2DM. For each 1 standard deviation increase in score, the aMED pattern was associated with a 24% lower risk (HR=0.76 [95% CI: 0.67, 0.86] p<0.0001), DASH with an 18% lower risk (HR=0.86 [95% CI: 0.73, 0.92] p=0.0005), and aHEI with a 30% lower risk (HR=0.70 [95% CI: 0.61, 0.79] p<0.0001). Further adjustment for BMI moderately but not completely attenuated these findings: (aMED: HR=0.85 [95% CI: 0.75, 0.97] p=0.014; DASH: HR=0.91 [95% CI: 0.80, 1.02] p=0.11; aHEI: HR=0.84 [95% CI: 0.73, 0.96] p=0.009). Conclusions: Adherence to healthful dietary patterns is associated with a lower incidence of T2DM among women following a diagnosis of GDM, and may be partially mediated by BMI. These findings have implications for prevention efforts in this high-risk population.

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An Exploratory Analysis of Factors Associated with Low Risk Perception for Developing Type 2 Diabetes amongst Low-income, Primarily Latina Women with prior Gestational Diabetes Mellitus

10.21203/rs.2.21040/v1 ◽

2020 ◽

Author(s):

Priyanka Athavale ◽

Ndola Prata ◽

Karen Sokal-Gutierrez ◽

Maureen Lahiff ◽

Adriana Najmabadi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Perception ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Low Income ◽

Lower Risk ◽

Post Partum ◽

Latina Women ◽

Migrant Status ◽

Spanish Speaking

Abstract Background: Gestational diabetes mellitus (GDM) is a significant contributor to the development of diabetes (DM2) post-partum, with higher rates amongst low-income and Latina women. Understanding one’s risk perception for developing DM2 postpartum amongst women with GDM can help target preventive interventions that promote positive health behaviors and lifestyle changes. This study aims to assess how the interplay of individual level factors, healthcare based factors, and structural factors influence risk perception for developing DM2 amongst low-income, primarily migrant Latina women with recent gestational diabetes mellitus. Methods: Data is from the baseline assessment of the STAR MAMA intervention. Women (N=171) receiving prenatal care at low-income urban clinics in San Francisco Bay Area were surveyed for basic demographics, healthcare access, and health-related behaviors. The outcome variable, risk perception for developing DM2 post-partum, was measured using the RPS-DM tool. Associations between risk perception for developing DM2 and individual, health-care based and structural (eg. health insurance, food insecurity, educational attainment) covariates were estimated using descriptive statistics and logistic regression. Results: Although all participants had a high risk for subsequently developing DM2, 76% reported lower risk perception for developing diabetes within the next 1, 5, and 10 years. Migrant status, less than high school education, and food insecurity were associated with lower risk perception (p<0.05). Spanish-speaking women with GDM who did not have family histories of DM2 were at greatest risk of underestimating their DM2 risk (OR=6.5; CI= (1.149, 11.795)). On the other hand, Spanish-speaking women who had family histories of DM2 were more likely to correctly assess their DM2 risk (OR=0.16; CI= (0.031, 0.824)). Conclusions: Structural and individual factors, rooted in migrant status and cultural backgrounds, influence personal risk perception. The majority of high-risk GDM women in this sample underestimate their risk for developing diabetes. This poses an opportunity for the healthcare system to improve patient-provider communication to improve risk perceptions and motivation for behavioral risk reduction. Improved counseling regarding risk perception for vulnerable, migrant populations with GDM is critical to accurately convey risk and engage individuals in preventive behaviors. Trial Registration: The clinical trial registration number is: NCT02240420 and date of registration: 9/11/2014.

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