Can the management of blood sugar levels in gestational diabetes mellitus cases be an indicator of maternal and fetal outcomes? The results of a prospective cohort study from India

Abstract

Background:Gestational diabetes mellitus (GDM) is emerging as an important public health problem in India owing to its increasing prevalence since the last decade. The issue addressed in the study was whether the management of blood sugar levels in GDM cases can predict maternal and fetal outcomes.Materials and Methods:A prospective cohort study was done for 1 year from October 1, 2013, to September 31, 2014, at 652 diabetic screening units as a part of the Gestational Diabetes Prevention and Control Project approved by the Indian Government in the district of Kanpur, state of Uttar Pradesh. A total of 57,108 pregnant women were screened during their 24–28th weeks of pregnancy by impaired oral glucose test. All types of maternal and perinatal outcomes were followed up in both GDM and non-GDM categories in the 2nd year (2013–2014) after blood sugar levels were controlled.Results:It was seen that for all kinds of maternal and fetal outcomes, the differences between GDM cases and non-GDM cases were highly significant (P < 0.0001, relative risk >1 in every case). Moreover, perinatal mortality also increased significantly from 5.7% to 8.9% when blood sugar levels increased from 199 mg/dl and above. Perinatal and maternal outcomes in GDM cases were also significantly related to the control of blood sugar levels (P < 0.0001).Conclusion:Blood sugar levels can be an indicator of maternal and perinatal morbidity and mortality in GDM cases, provided unified diagnostic criteria are used by Indian laboratories. However, to get an accurate picture on this issue, all factors need further study.

The Impact of Diagnostic Criteria for Gestational Diabetes Mellitus on Adverse Maternal Outcomes: A Systematic Review and Meta-Analysis

“…All studies were categorized as high quality [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 ]. A total of 95.9% studies were prospective or retrospective cohorts [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , …”

“…In addition, 34.69% of the studies were conducted in the U.S. [ 22 , 24 , 25 , 31 , 33 , 34 , 36 , 37 , 38 , 41 , 44 , 52 , 53 , 55 , 57 , 58 , 64 ], 14.2% in Australia [ 20 , 27 , 28 , 50 , 51 , 65 , 68 ], 28.5% in Asia [ 26 , 29 , 32 , 35 , 39 , 40 , 42 , 46 , 47 , 48 , 49 , 60 , 63 , 66 ], and 22.4% in Europe [ 21 , 23 , 30 , 43 , 45 , 54 , 56 , 59 , 61 , 62 , 67 ].…”

“…A total of 95.9% studies were prospective or retrospective cohorts and 4% were cross-sectional studies [20,21]. In addition, 17 (34.6%) studies used the GDM classification of group 1 [21,22,26,35,38,40,47,48,50,51,53,54,[59][60][61]64,67] and IADPSG; 7 (14.2%) group 2 [20,27,28,51,59,65,68], 3 (6.1%) group 3 [32,46,56], 1 (2%) group 4 [51], 19 (38.7%) group 5 [23][24][25]29,31,33,34,36,39,40,42,44,47,53,55,57,58,64,66], 6 (12.2%) group 6…”

The effect of a health literacy approach to counselling on the lifestyle of women with gestational diabetes: A clinical trial

“…The prevalence of gestational diabetes differs in different regions, which can be explained by factors, such as ethnic diversity, differences in lifestyle and nutrition and different screening protocols 3 . This disease influences maternal and fetal health and causes the emergence of numerous undesirable outcomes 4 . These complications include hypertension, preeclampsia, urinary tract infections, hydramnios, surgical interventions, the risk of developing type 2 diabetes in mothers in the future, and macrosomia followed by an increased risk of birth trauma, congenital anomalies, childhood obesity and growth disorders in neonates 5 .…”

Phubbing in Millennial Generation: Influence of Fear of Missing Out and Self Control

“…Based on the above exposure, FoMo and self-control were related to phubbing behavior, but the influence of both had not been studied in more detail. Meanwhile, the role of self-control also needs to be explored further because there were different results from previous studies (Davey S., et al, 2018;Isrofin & Munawaroh, 2021). Therefore, this study aimed to determine whether there was a relationship between FoMO and self-control of phubbing behavior in the millennial generation.…”