scholarly journals Screening of Hemoglobin A1c in Gestational Diabetes among women attending metabolic clinic at a tertiary care hospital in Uttar Pradesh

2019 ◽  
Vol 10 (2) ◽  
pp. 26-30
Author(s):  
Vivek Sinha ◽  
Poonam Kachhawa

Background: Gestational diabetes mellitus (GDM) is a common medical condition that complicates pregnancies..Gestational diabetes mellitus (GDM) is a diabetic metabolic disorder that occurs in 4% of all pregnant women and 14% of ethnic groups with more prevalence of type II diabetes. It can be defined as increased or abnormal insulin resistance, decreased insulin sensitivity or glucose intolerance with first diagnosis during pregnancy. Aims and Objectives: The purpose of this study was to evaluate the diagnostic screening value of the HbA1c, prevalence of GDM and associated risk factors. Materials and Methods: The study was conducted at the metabolic clinic; in the department of Biochemistry located at SIMS, Hapur. A semi-structured pretested questionnaire was used for data collection. Following the DIPSI guidelines, patients with plasma glucose values >140 mg/dl were labeled as GDM. Statistical methods used were OR (CI95%), percentage, Chi square. Results: Out of 500, 6.72% had GDM. Among all GDM patients, 64.71% had age more than 30 years, 70.59% had BMI more than 25, 41.18% had gravida more than 3 and p- value was significant with regard to age and BMI. P value was found to be significant for risk factors namely positive family history of Diabetes Mellitus, history of big baby and presence of more than one risk factor. Conclusion: GDM is associated with high BMI, early pregnancy loss, family history of DM and previous history of big baby and there could be more than one risk factor. Thus universal screening followed by close monitoring of the pregnant women for early detection of GDM may help improving maternal and fetal outcomes.

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.


2020 ◽  
Vol 9 ◽  
pp. 1642
Author(s):  
Mina Etminan-Baksh ◽  
Sima Tadi ◽  
Monireh Hatami ◽  
Roksana Darabi

Background: Gestational diabetes mellitus (GDM) represents the most common metabolic complication during pregnancy. GDM is associated with maternal and fetal complications. Approximately 7% of all pregnancies are affected by GDM, resulting in more than 200,000 cases worldwide annually, and the prevalence may vary from 1% to 14% among all pregnancies. Accordingly, this study attempted to determine the prevalence and some risk factors of GDM. Materials and Methods: This hospital-based cross-sectional study was carried out at Boo-Ali hospital in Tehran, the capital of Iran. Four hundred non-diabetics pregnant women with a gestational age of 24-28 weeks who attended the Boo-Ali hospital outpatient department were included in our study. Demographic and anthropometric data including age, gravida, para, gestational age, family history of diabetes, history of GDM, weight, height, and body mass index (BMI) were collected. Blood samples were collected from the women at 24-28 weeks to diagnose GDM by oral glucose tolerance test (OGTT). We measured the 25-OH-D level in participants at 24-28 weeks. Results: Among the 400 pregnant women, 46 (11.5%) had GDM based on OGTT, and the mean age of GDM women were 30.78± 5.96 years. Among selected variables, BMI ≥25kg/m2, family history, and GDM history were associated with increased risks of GDM (odds ratio=2.49, 95% confidence interval [CI] 1.22–5.07;3.52, 95% CI 1.84–6.70; 19.57, and 95% CI 6.16–62.17, respectively). The association was more robust in the positive GDM history of women. Conclusion: High prevalence of GDM highlights more attention of health-care givers in screening pregnant women with risk factors. BMI as a modifiable risk factor for GDM needs more attention, and positive family history and previous GDM history should be considered in the core activities of pregnant women. [GMJ.2020;9:e1642] DOI:10.31661/gmj.v9i0.1642 


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):  
D. H. John ◽  
P. A. Awoyesuku ◽  
D. A. MacPepple ◽  
N. J. Kwosah

Background: Gestational diabetes mellitus (GDM) is a common cause of hyperglycaemia in pregnancy accounting for about 90% of all diabetic pregnancies. Women with GDM are at increased risk of maternal and fetal morbidity and mortality which are preventable through early diagnosis and treatment. Objective: The aim was to determine the prevalence of GDM, compare the maternal and neonatal complications among GDM and non-GDM pregnant women, and the risk factors associated with GDM. Methodology: A prospective cohort study was carried out among 105 pregnant women attending the antenatal clinic of RSUTH between February and August 2017. They were interviewed using a pre-structured questionnaire that covered variables related to socio-demographic factors and family, medical, and social history. Fasting blood sugar (FBS) was done after an overnight fast. Women who had FBS less than 7 mmol/L had 75 g Oral Glucose Tolerant Test (OGTT) done. Those diagnosed with gestational diabetes mellitus were the exposed group while those negative for GDM were the non-exposed group. Both groups were followed up to delivery, and maternal and fetal outcomes were noted. Statistical analysis was carried out using SPSS version 20 and significance set at p < 0.05. Results: The prevalence of GDM was 10.5%. Positive history of GDM in previous pregnancy was the only independent risk factor (p=0.04, Adj OR: 26.89, 95% CI 2.86 to 252.61). GDM mothers had a significantly higher risk of developing pre-eclampsia (RR=7.48; 95% CI =3.36 to 16.63). Neonates of GDM mothers were at increased risk of fetal macrosomia (RR =9.00; 95% CI=1.36 to 59.4) and neonatal admissions (RR=8.00; C.I =1.19 to 53.67). Conclusion: The study revealed that the prevalence of GDM was high and that those with GDM were at increased risk of developing fetal and maternal complications. A history of GDM in previous pregnancy was an essential risk factor for subsequent GDM.


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.


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.


Author(s):  
Nirav K. Nimavat ◽  
Roma S. Dadwani ◽  
Girija P. Kartha

Background: Prevalence of gestational diabetes mellitus (GDM) vary widely depending on the region of the country, dietary habits, and socio-economic status. This study was undertaken to determine the prevalence of GDM and risk factors associated with it, in women attending an antenatal care (ANC) clinic at urban health training center in Rajkot city, Gujarat.Methods: This study enrolled women, with estimated gestational age between 24 and 28 week, attending UHC in Rajkot. After informing, women who consented to participate were given a standardized 75 g oral glucose tolerance test (OGTT). A proforma containing general information on demographic characteristics, socio-economic status, education level, parity, family history of diabetes and/or hypertension was filled up. Diabetes in pregnancy study group India (DIPSI) criteria for 75 g 2-h OGTT was used for diagnosing GDM.Results: Total of 366 women participated in the study and GDM was diagnosed in 36 (9.8%) women. Age, parity, BMI, family history of DM and hypertension were accessed and found to be not significant. History of hypertension in previous pregnancy was statistically significant with occurrence of GDM in present pregnancy.Conclusions: The prevalence of GDM was found to be 9.8 per cent in a UHC, Rajkot. Appropriate interventions are required for control of GDM and modifications of risk factors. 


2021 ◽  
Vol 17 (37) ◽  
pp. 48-56
Author(s):  
Yuli Puspita DEVI ◽  
Rumaisah ABDILLAH ◽  
Muthmainnah MUTHMAINNAH

Background: Gestational Diabetes Mellitus (GDM) is a glucose tolerance disorder that first appears during pregnancy. GDM can cause a variety of obstetric and perinatal complications for pregnant women and their fetuses. The prevalence of GDM in the city of Surabaya in 2015 amounted to 2.29%, increasing to 3.88% in 2018. Aim: The purpose of this study was to analyze the determinants (family history of diabetes mellitus, BMI, history of birth weight, parity, and the age of the pregnant woman) that influence the GDM. Methods: This research is an analytical study with an observational approach. The research design was carried out using a case-control study. In this study, the number of samples was 36 people, 6 cases, and 30 people as controls, and were taken randomly. The data source obtained from secondary data (medical records of pregnant women) at Mulyorejo Health Center Surabaya. The analysis used in this study was a simple logistic regression test. Results and Discussion: The result showed an effect of a family history of diabetes mellitus (p = 0.035) on the incidence of GDM. Parity was a potential variable (p = 0.077) on the incidence of GDM. Meanwhile, BMI, history of birth weight, and mother's age did not affect the incidence of GDM. Conclusion: Pregnant women with a family history of diabetes who are not balanced with maintaining a good lifestyle can experience complications of developing GDM.


Author(s):  
Galuh Sitorukmi ◽  
◽  
Bhisma Murti ◽  
Yulia Lanti Retno Dewi ◽  
◽  
...  

Background: Gestational diabetes mellitus (GDM) is a serious pregnancy complication, in which women without previously diagnosed diabetes develop chronic hyperglycemia during gestation. Studies have revealed that the family history of diabetes is an important risk factor for the gestational diabetes mellitus. The purpose of this study was to investigate effect of family history with diabetes mellitus on the risk of gestational diabetes mellitus. Subjects and Method: This was meta-analysis and systematic review. The study was conducted by collecting published articles from Pubmed, Google Scholar, Scopus, Science Direct, and Springer Link electronic databases, from year 2010 to 2020. Keywords used risk factor, gestational diabetes mellitus, family history, and cross-sectional. The inclusion criteria were full text, using English language, using cross-sectional study design, and reporting adjusted odds ratio. The study population was pregnant women. Intervention was family history of diabetes mellitus with comparison no family history of diabetes mellitus. The study outcome was gestational diabetes mellitus. The collected articles were selected by PRISMA flow chart. The quantitative data were analyzed by random effect model using Revman 5.3. Results: 7 studies from Ethiopia, Malaysia, Philippines, Peru, Australia, and Tanzania were selected for this study. This study reported that family history of diabetes mellitus increased the risk of gestational diabetes mellitus 2.91 times than without family history (aOR= 2.91; 95% CI= 2.08 to 4.08; p<0.001). Conclusion: Family history of diabetes mellitus increases the risk of gestational diabetes mellitus. Keywords: gestational diabetes mellitus, diabetes mellitus, family history Correspondence: Galuh Sitorukmi. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 085799333013. DOI: https://doi.org/10.26911/the7thicph.05.55


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