Incidence of Risk Factors on the Onset of Gestational Diabetes Mellitus

In this study the authors evaluated the prevalence of Gestational Diabetes Mellitus (GDM) and the incidence in determining the occurrence thereof, given by the following risk factors: age, family history for Diabetes Mellitus (DM), Body Mass Index (BMI), smoking, diet, macrosomia in previous pregnancies and physical activity. To this end, they investigated a cohort of 61 pregnant women, who had at least one risk factor, in a total period of nine months, during which women checked in the Clinic of Endocrinology and Diabetology of the Hospital “F. Ferrari” in Casarano (Lecce) Italy, and were subjected to an anamnestic investigation and then to a diagnostic test (Oral Glucose Tolerance Test, OGTT 75 g). The anamnesis has allowed to identify the type of risk factors that are present in the population, while the OGTT has allowed to diagnose gestational diabetes. Later, an analysis of the cross-collected data was performed in order to evaluate the percentage incidence of the disease, in relation to risk factors observed. The authors’ results confirmed a prevalence of GDM of 26.23% and the existence of a close association between risk factors and GDM. In particular, the risk factors, macrosomia, BMI = 25 kg/m2, a hypercaloric diet, light physical activity, and age = 35 years, seem to have more influence than smoking and family history for DM, inducing the onset of the illness.

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Risk Factors for Pregnancy Complications and Postpartum Glucose Intolerance in Women With Gestational Diabetes Mellitus

10.21203/rs.3.rs-116971/v1 ◽

2020 ◽

Author(s):

Naohisa Masuko ◽

Kenji Tanimura ◽

Nobue Kojima ◽

Hitomi Imafuku ◽

Masashi Deguchi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Glucose Intolerance ◽

Pregnancy Complications ◽

Glucose Tolerance Test ◽

Tolerance Test ◽

Oral Glucose ◽

Hba1c Levels

Abstract This prospective cohort study aimed to evaluate the risk factors for pregnancy complications and postpartum glucose intolerance (GI) in women with gestational diabetes mellitus (GDM). A total of 140 women with GDM were enrolled. Of these, 115 underwent a 75-g oral glucose tolerance test (OGTT) at 12 weeks after delivery. Clinical factors and parameters in the antepartum 75-g OGTT associated with pregnancy complications and postpartum GI were evaluated. Women with GDM experienced pregnancy complications, including hypertensive disorders of pregnancy (HDP, n=19), preterm delivery (PD, n=17), heavy-for-date (HFD, n=19), and light-for-date (LFD, n=12), and 22 of the 115 women with GDM developed postpartum GI. The univariate and multivariable logistic regression analyses revealed the following risk factors: histories of hypertension (odds ratio [OR], 23.8; 95% confidence interval [CI], 4.2–134.7; p<0.01) for HDP; histories of hypertension (OR, 9.8; 95% CI, 2.5–38.9; p<0.01) for PD; HbA1c levels (OR, 7.6; 95% CI, 1.5–37.9; p<0.05) for HFD; and oral deposition index (DI) (OR, 0.1; 95% CI, 0.02–0.7; p<0.01) for postpartum GI. Higher HbA1c levels and lower oral DI on the antepartum 75-g OGTT may be useful markers for identifying GDM women who are at high risk for HFD and postpartum GI, respectively.

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To study the incidence of gestational diabetes mellitus and risk factors associated with GDM

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20170087 ◽

2017 ◽

Vol 4 (1) ◽

pp. 112 ◽

Cited By ~ 3

Author(s):

Maxima Anand ◽

Manan Anand ◽

Devinder Singh Mahajan

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Family History ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Challenge Test ◽

Oral Glucose ◽

Family History Of Diabetes ◽

Glucose Levels ◽

History Of

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.

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Intergenerational Metabolomic Analysis of Mothers with a History of Gestational Diabetes Mellitus and Their Offspring

International Journal of Molecular Sciences ◽

10.3390/ijms21249647 ◽

2020 ◽

Vol 21 (24) ◽

pp. 9647

Author(s):

Raffael Ott ◽

Xenia Pawlow ◽

Andreas Weiß ◽

Anna Hofelich ◽

Melanie Herbst ◽

...

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Graphical Models ◽

Area Under The Curve ◽

Tolerance Test ◽

Oral Glucose ◽

Sensitivity Index ◽

Cross Sectional

Shared metabolomic patterns at delivery have been suggested to underlie the mother-to-child transmission of adverse metabolic health. This study aimed to investigate whether mothers with gestational diabetes mellitus (GDM) and their offspring show similar metabolomic patterns several years postpartum. Targeted metabolomics (including 137 metabolites) was performed in plasma samples obtained during an oral glucose tolerance test from 48 mothers with GDM and their offspring at a cross-sectional study visit 8 years after delivery. Partial Pearson’s correlations between the area under the curve (AUC) of maternal and offspring metabolites were calculated, yielding so-called Gaussian graphical models. Spearman’s correlations were applied to investigate correlations of body mass index (BMI), Matsuda insulin sensitivity index (ISI-M), dietary intake, and physical activity between generations, and correlations of metabolite AUCs with lifestyle variables. This study revealed that BMI, ISI-M, and the AUC of six metabolites (carnitine, taurine, proline, SM(-OH) C14:1, creatinine, and PC ae C34:3) were significantly correlated between mothers and offspring several years postpartum. Intergenerational metabolite correlations were independent of shared BMI, ISI-M, age, sex, and all other metabolites. Furthermore, creatinine was correlated with physical activity in mothers. This study suggests that there is long-term metabolic programming in the offspring of mothers with GDM and informs us about targets that could be addressed by future intervention studies.

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Gestational diabetes mellitus prediction model: A risk factors analysis of pregnant women with gestational diabetes mellitus but have normal oral glucose tolerance test results in the second trimester of pregnancy

Technology and Health Care ◽

10.3233/thc-218006 ◽

2021 ◽

Vol 29 ◽

pp. 57-63

Author(s):

Jiayu Lu ◽

Song Zhang ◽

Hongqing Jiang ◽

Lin Yang ◽

Dongmei Hao ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Glucose Tolerance Test ◽

Tolerance Test ◽

Oral Glucose ◽

Second Trimester ◽

Oral Glucose Tolerance

BACKGROUND: Oral glucose tolerance test (OGTT) is a standard for the diagnosis of gestational diabetes mellitus (GDM). However, clinically, some cases with normal results were diagnosed as GDM in the third trimester. OBJECTIVE: To establish a risk model based on energy metabolism, epidemiology, and biochemistry that could predict the GDM pregnant women with normal OGTT results in the second trimester. METHODS: Qualitative and quantitative data were analyzed to find out the risk factors, and the binary logistic backward LR regression was used to establish the prediction model of each factor and comprehensive factor, respectively. RESULTS: The risk factors including the rest energy expenditure per kilogram of body weight, oxygen consumption per kilogram of body weight, if more than the weight gain criteria of the Institute of Medicine, the increase of body mass index between the second trimester and pre-pregnancy, and fasting blood glucose. By comparison, the comprehensive model had the best prediction performance, indicating that 85% of high-risk individuals were correctly classified. CONCLUSION: Energy metabolism, epidemiology, and biochemistry had better recognition ability for the GDM pregnant women with normal OGTT results in the second trimester. The addition of metabolic factors in the second trimester also improved the overall prediction performance.

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Gestational Diabetes in the Population Served by Brazilian Public Health Care. Prevalence and Risk Factors

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0039-1700797 ◽

2020 ◽

Vol 42 (01) ◽

pp. 012-018

Author(s):

Pâmela Antoniazzi dos Santos ◽

José Mauro Madi ◽

Emerson Rodrigues da Silva ◽

Daiane de Oliveira Pereira Vergani ◽

Breno Fauth de Araújo ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Tolerance Test ◽

Public Health Care ◽

Oral Glucose ◽

Diabetes Group ◽

Cross Sectional

Abstract Objective To assess the prevalence of gestational diabetes mellitus and the main associated risk factors in the population served by the Brazilian Unified Health System in the city of Caxias do Sul, state of Rio Grande do Sul. Materials and Methods A descriptive, cross-sectional and retrospective study was conducted. Maternal variables were collected from the medical records of all pregnant women treated at the basic health units in 2016. Hyperglycemia during pregnancy (pregestational diabetes, overt diabetes and gestational diabetes mellitus) was identified by analyzing the results of a 75-g oral glucose tolerance test, as recommended by the Brazilian Ministry of Health. Based on the data, the women were allocated into two groups: the gestational diabetes group and the no gestational diabetes group. Results The estimated prevalence of gestational diabetes among 2,313 pregnant women was of 5.4% (95% confidence interval [95%CI]: 4.56–6.45). Pregnant women with 3 or more pregnancies had twice the odds of having gestational diabetes compared with primiparous women (odds ratio [OR] = 2.19; 95%CI: 1.42–3.37; p < 0.001). Pregnant women aged 35 years or older had three times the odds of having gestational diabetes when compared with younger women (OR = 3.01; 95%CI: 1.97–4.61; p < 0.001). Overweight pregnant women were 84% more likely to develop gestational diabetes than those with a body mass index lower than 25 kg/m2 (OR = 1.84; 95%CI: 1.25–2.71; p = 0.002). A multivariable regression analysis showed that being overweight and being 35 years old or older were independent variables. Conclusion In this population, the prevalence of gestational diabetes mellitus was of 5.4%. Age and being overweight were predictive factors for gestational diabetes.

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Neonatal outcome in pregnancies complicated by gestational diabetes mellitus: a hospital based study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20180948 ◽

2018 ◽

Vol 5 (3) ◽

pp. 737 ◽

Cited By ~ 1

Author(s):

Masaraddi Sanjay K. ◽

Saranya Andal Kishore ◽

Nedunchezian P. ◽

Sulekha C.

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Family History ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Large For Gestational Age ◽

Oral Glucose ◽

Family History Of Diabetes ◽

History Of

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.

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The Association between Maternal/Fetal Insulin Receptor Substrate 1 Gene Polymorphism rs1801278 and Gestational Diabetes Mellitus in a Chinese Population

Gynecologic and Obstetric Investigation ◽

10.1159/000514971 ◽

2021 ◽

pp. 1-8

Author(s):

Lingling Wu ◽

Changping Fang ◽

Jun Zhang ◽

Yanchou Ye ◽

Haiyan Zhao

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gene Polymorphism ◽

Gestational Diabetes Mellitus ◽

Insulin Receptor ◽

Tolerance Test ◽

Oral Glucose ◽

Insulin Receptor Substrate ◽

Single Center ◽

Insulin Receptor Substrate 1

Objectives: Insulin receptor substrate 1 (IRS1) is a crucial factor in the insulin signaling pathway. IRS1 gene polymorphism rs1801278 in mothers has been reported to be associated with gestational diabetes mellitus (GDM). However, it is not clear whether IRS1 gene polymorphism rs1801278 in fetuses is associated with their mothers’ GDM morbidity. The purpose of this study is to analyze the association between maternal, fetal, or maternal/fetal IRS1 gene polymorphism rs1801278 and GDM risk. Design: The study was a single-center, prospective cohort study. In total, 213 pairs of GDM mothers/fetuses and 191 pairs of control mothers/fetuses were included in this study. They were recruited after they underwent oral glucose tolerance test during 24–28 weeks of gestation and followed up until delivery. All participants received the conventional interventions (diet and exercise), and no special therapy except routine treatment. Methods: A total of 213 pairs of GDM mothers/fetuses and 191 pairs of normal blood glucose pregnant mothers/fetuses were genotyped using PCR and DNA sequencing from January 2015 to September 2016. Maternal/fetal IRS1 gene polymorphism rs1801278 was analyzed and compared between 2 groups. Results: There were no significant differences in the frequency of individual mothers’ or fetuses’ IRS1 rs1801278 polymorphisms between 2 groups; if both the mothers and fetuses carried A allele, significantly lower GDM morbidity was observed in the mothers. Limitations: The sample size was relatively small as a single-center study. Conclusions: Our study suggested that maternal/fetal rs1801278 polymorphism of IRS1 is a modulating factor in GDM; both mothers/fetuses carrying the A allele of rs1801278 may protect the mothers against the development of GDM.

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Incidence of diabetes mellitus and associated risk factors in the adult population of the Basque country, Spain

Scientific Reports ◽

10.1038/s41598-021-82548-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Inés Urrutia ◽

◽

Alicia Martín-Nieto ◽

Rosa Martínez ◽

J Oriol Casanovas-Marsal ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Family History ◽

Basque Country ◽

Adult Population ◽

Tolerance Test ◽

Oral Glucose ◽

Family History Of Diabetes ◽

History Of ◽

Incident Cases

AbstractThe aim of this study was to estimate the incidence of diabetes mellitus in the Basque Country and the risk factors involved in the disease by reassessing an adult population after 7 years of follow-up. In the previous prevalence study, 847 people older than 18 years were randomly selected from all over the Basque Country and were invited to answer a medical questionnaire, followed by a physical examination and an oral glucose tolerance test. In the reassessment, the same variables were collected and the resulting cohort comprised 517 individuals of whom 43 had diabetes at baseline. The cumulative incidence of diabetes was 4.64% in 7 years and the raw incidence rate was 6.56 cases/1000 person-years (95%CI: 4.11–9.93). Among the incident cases, 59% were undiagnosed. The most strongly associated markers by univariate analyses were age > 60 years, dyslipidaemia, prediabetes and insulin resistance. We also found association with hypertension, obesity, family history of diabetes and low education level. Multivariate analysis adjusted for age and sex showed that a set of risk factors assessed together (dyslipidaemia, waist-to-hip-ratio and family history of diabetes) had great predictive value (AUC-ROC = 0.899, 95%CI: 0.846–0.953, p = 0.942), which suggests the need for early intervention before the onset of prediabetes.

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Breastfeeding Duration and Development of Dysglycemia in Women Who Had Gestational Diabetes Mellitus: Evidence from the GUSTO Cohort Study

Nutrients ◽

10.3390/nu13020408 ◽

2021 ◽

Vol 13 (2) ◽

pp. 408

Author(s):

Sumali S. Hewage ◽

Xin Yu Hazel Koh ◽

Shu E. Soh ◽

Wei Wei Pang ◽

Doris Fok ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Tolerance Test ◽

Diabetes Risk ◽

Breastfeeding Duration ◽

Oral Glucose ◽

Inverse Association ◽

Index Pregnancy

(1) Background: Breastfeeding has been shown to support glucose homeostasis in women after a pregnancy complicated by gestational diabetes mellitus (GDM) and is potentially effective at reducing long-term diabetes risk. (2) Methods: Data from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study were analyzed to understand the influence of breastfeeding duration on long-term dysglycemia (prediabetes and diabetes) risk in women who had GDM in the index pregnancy. GDM and dysglycemia four to seven years postpartum were determined by the oral glucose tolerance test (OGTT). A Poisson regression model with a robust error variance was used to estimate incidence rate ratios (IRRs) for dysglycemia four to seven years post-delivery according to groupings of the duration of any breastfeeding (<1, ≥1 to <6, and ≥6 months). (3) Results: Women who had GDM during the index pregnancy and complete breastfeeding information and OGTT four to seven years postpartum were included in this study (n = 116). Fifty-one women (44%) had postpartum dysglycemia. Unadjusted IRRs showed an inverse association between dysglycemia risk and ≥1 month to <6 months (IRR 0.91; 95% confidence interval [CI] 0.57, 1.43; p = 0.68) and ≥6 months (IRR 0.50; 95% CI 0.27, 0.91; p = 0.02) breastfeeding compared to <1 month of any breastfeeding. After adjusting for key confounders, the IRR for the ≥6 months group remained significant (IRR 0.42; 95% CI 0.22, 0.80; p = 0.008). (4) Conclusions: Our results suggest that any breastfeeding of six months or longer may reduce long-term dysglycemia risk in women with a history of GDM in an Asian setting. Breastfeeding has benefits for mothers beyond weight loss, particularly for those with GDM.

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