Follow-up of postpartum women with gestational diabetes mellitus (GDM)

Chang, Ying; Chen, Xu; Cui, Hongyan; Zhang, Zhikun; Cheng, Lan

doi:10.1016/j.diabres.2014.08.020

Cited by 29 publications

(27 citation statements)

References 20 publications

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“…The increased risk for major cardiovascular events in people with type 2 diabetes in addition to other traditional risk factors [ 15 , 20 ] and at an early age [ 21 ] is well documented. Despite this, and the recommendation for annual screening for type 2 diabetes in women diagnosed with GDM [ 22 ] and evidence that lifestyle changes can improve outcomes [ 23 ], there is a paucity of reports on screening, and low rates have been reported [ 24 , 25 ]. The current National Institute for Health and Care Excellence (NICE) guidelines recommend screening for type 2 diabetes (between 6 and 13 weeks postpartum and an annual glycated hemoglobin [HbA1c] test) and lifestyle changes (weight control, diet, and exercise) for women diagnosed with GDM [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

Increased risk of ischemic heart disease, hypertension, and type 2 diabetes in women with previous gestational diabetes mellitus, a target group in general practice for preventive interventions: A population-based cohort study

et al. 2018

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BackgroundGestational diabetes mellitus (GDM) is associated with developing type 2 diabetes, but very few studies have examined its effect on developing cardiovascular disease.Methods and findingsWe conducted a retrospective cohort study utilizing a large primary care database in the United Kingdom. From 1 February 1990 to 15 May 2016, 9,118 women diagnosed with GDM were identified and randomly matched with 37,281 control women by age and timing of pregnancy (up to 3 months). Adjusted incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were calculated for cardiovascular risk factors and cardiovascular disease. Women with GDM were more likely to develop type 2 diabetes (IRR = 21.96; 95% CI 18.31–26.34) and hypertension (IRR = 1.85; 95% CI 1.59–2.16) after adjusting for age, Townsend (deprivation) quintile, body mass index, and smoking. For ischemic heart disease (IHD), the IRR was 2.78 (95% CI 1.37–5.66), and for cerebrovascular disease 0.95 (95% CI 0.51–1.77; p-value = 0.87), after adjusting for the above covariates and lipid-lowering medication and hypertension at baseline. Follow-up screening for type 2 diabetes and cardiovascular risk factors was poor. Limitations include potential selective documentation of severe GDM for women in primary care, higher surveillance for outcomes in women diagnosed with GDM than control women, and a short median follow-up postpartum period, with a small number of outcomes for IHD and cerebrovascular disease.ConclusionsWomen diagnosed with GDM were at very high risk of developing type 2 diabetes and had a significantly increased incidence of hypertension and IHD. Identifying this group of women in general practice and targeting cardiovascular risk factors could improve long-term outcomes.

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Section: Introductionmentioning

confidence: 99%

Increased risk of ischemic heart disease, hypertension, and type 2 diabetes in women with previous gestational diabetes mellitus, a target group in general practice for preventive interventions: A population-based cohort study

et al. 2018

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“…As the total follow-up rate was low [11,39], women with a previous history of GDM need to be classified according to a risk scale. Patients with both high Glu120 and high HbA1c levels, and with previous GDM, should undergo a 75-g OGTT annually for at least 2 years.…”

Section: Discussionmentioning

confidence: 99%

Postpartum risk of diabetes and predictive factors for glucose intolerance in East Asian women with gestational diabetes

Inoue

Ishikawa

Takeda

et al. 2018

Diabetes Research and Clinical Practice

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“…As a consequence of growing obesity prevalence and advancing maternal age, the incidence of gestational diabetes mellitus (GDM) 1 is gradually increasing worldwide, ranging from 5.8% to 12.9% (1). A large epidemiological survey in Tianjin, China, shows that the incidence of GDM has risen from 6.9% in 2008 to 9.9% in 2010 (2). Previous studies have indicated that GDM women were at a higher risk of adverse perinatal outcomes, including preeclampsia, infection, premature delivery, increased caesarean rates and premature rupture of membrane (PROM) 3-5).…”

mentioning

confidence: 99%

Development of Multimarker Diagnostic Models from Metabolomics Analysis for Gestational Diabetes Mellitus (GDM)

Hou

Meng

Zhao

et al. 2018

Molecular & Cellular Proteomics

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Although metabolomics are desirable to understand the pathophysiology of gestational diabetes mellitus (GDM), comprehensive metabolomic studies of GDM are rare. We aimed to offer a holistic view of metabolites alteration in GDM patients and investigate the possible multimarker models for GDM diagnosis. Biochemical parameters and perinatal data of 131 GDM cases and 138 controls were collected. Fasting serum samples at 75 g oral glucose tolerance test were used for metabolites by ultra performance liquid chromatography-quadrupole-time of flight-mass spectrometry, ultra performance liquid chromatography-triple triple-quadrupole-mass spectrometry and gas chromatography- time-of- flight mass spectrometry platforms. Significant changes were observed in free fatty acids, bile acids, branched chain amino acids, organic acids, lipids and organooxygen compounds between two groups. In receiver operating characteristic (ROC) analysis, different combinations of candidate biomarkers and metabolites in multimarker models achieved satisfactory discriminative abilities for GDM, with the values of area under the curve (AUC) ranging from 0.721 to 0.751. Model consisting of body mass index (BMI), retinol binding protein 4 (RBP4), n-acetylaspartic acid and C16:1 (cis-7) manifested the best discrimination [AUC 0.751 (95% CI: 0.693-0.809), < 0.001], followed by model consisting of BMI, Cystatin C, acetylaspartic acid and 6,7-diketoLCA [AUC 0.749 (95% CI: 0.691-0.808), < 0.001]. Metabolites alteration reflected disorders of glucose metabolism, lipid metabolism, amino acid metabolism, bile acid metabolism as well as intestinal flora metabolism in GDM state. Multivariate models combining clinical markers and metabolites have the potential to differentiate GDM subjects from healthy controls.

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Follow-up of postpartum women with gestational diabetes mellitus (GDM)

Cited by 29 publications

References 20 publications

Increased risk of ischemic heart disease, hypertension, and type 2 diabetes in women with previous gestational diabetes mellitus, a target group in general practice for preventive interventions: A population-based cohort study

Increased risk of ischemic heart disease, hypertension, and type 2 diabetes in women with previous gestational diabetes mellitus, a target group in general practice for preventive interventions: A population-based cohort study

Postpartum risk of diabetes and predictive factors for glucose intolerance in East Asian women with gestational diabetes

Development of Multimarker Diagnostic Models from Metabolomics Analysis for Gestational Diabetes Mellitus (GDM)

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