Geographic, Ethnic, and Racial Variations in the Incidence of Gestational Diabetes Mellitus

Hadden, David R.

doi:10.2337/diab.34.2.s8

Cited by 97 publications

(37 citation statements)

References 5 publications

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“…The epidemiological approach to this problem is difficult because of the considerable differences in both mortality and morbidity from congenital malformations in different countries [58,59]. The WHO reports show that recorded overall mortality from spina bifida and hydrocephalus, the commonest neural tube defect, varies from less than 1 per 100,000 births in Scandanavian countries to over 50 per 100,000 in the United Kingdom, with the USA and other European countries intermediate.…”

Section: Fetal Abnormalitiesmentioning

confidence: 99%

“…It is the opinion of the present reviewer that the difficulty in reaching a simple agreed position on definition, diagnosis and screening arises from two distinct aspects of the subject. Firstly, there may very well be a difference in the disorder between different populations with different genetic, nutritional and environmental backgrounds in different countries, and there have been no useful comparisons between such populations using standard criteria [58]. Secondly, there is a legitimate difference in outlook between the obstetrician who tends to adopt an interventionist policy in the belief that the fetuses of mothers with this condition are at risk of dying in utero [78], and the epidemiologist who reflects that the condition might almost be abolished if the diagnostic criteria were reset at a slightly higher level [79].…”

Section: Gestational Diabetesmentioning

confidence: 99%

“…From the short term point of view of the pregnant mother and her baby, it would seem that good antenatal care must exclude the possibility of gestational diabetes; the risk of this condition, however, apart from a degree of fetal macrosomia, is low. Various authorities have tried to reconcile the different standards proposed [58,85]. The European viewpoint is probably more in favour of the 75 g oral glucose tolerance test, and co-operative studies in progress should produce an unselected baseline from which to define the appropriate (95th centre?)…”

Section: Gestational Diabetesmentioning

confidence: 99%

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Diabetes in pregnancy 1985

Hadden

1986

Diabetologia

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The art of obstetrics is not a subject which is often discussed in the pages of Diabetologia. However, as the care of the diabetic mother and her offspring is rightly an interdisciplinary responsibility between obstetrician, diabetologist and neonatologist, it is important that each has a close understanding of the various problems. Dr. M. I. Drury (Dublin), speaking as an internist, raises a question on the optimum time and method of delivery of the baby; this has more than purely obstetrical implications. Drs. L. Molsted-Pedersen (Copenhagen) and C. K~ihl (Copenhagen and Klampenborg), obstetrician and internist from the longest-established joint obstetric/diabetic service in the world, present a Scandinavian view on the management of pregnancy. Both centres have distinguished records in the management of diabetic pregnancy. The different viewpoints in Denmark and in Ireland are clear -in Copenhagen, therapeutic abortion is practiced in a pregnancy at risk of severe congenital malformation; in Dublin it is not. Dr. Drury quotes a perinatal loss of 13 of 285 pregnancies (4.5%) in the past 5 years, but does not include the recognised spontaneous abortions which, on his overall figures, are about 10% of conceptions. Dr. Molsted-Pedersen reports a perinatal loss of 3 of 201 infants (1.5%), excluding 17 spontaneous and 9 induced abortions. If these 9 aborted pregnancies, which were performed due to a risk of severe congenital malformation, were included as fatalities, the Copenhagen figure would be 12 of 210 (5.5%). Of course, we do not know if all those 9 fetuses were affected. The spontaneous abortion rate was 17 of 223 (8.0%). Thus, if total fetal loss is taken as the index, there appears to be little difference between the two centres. The clinical controversy on the timing and method of birth in the different centres will continue --pundits can be conservative as well as radical, and, as Dr. Drury remarks, the truth probably lies somewhere in between.The bottom line in reports on the management of diabetes in pregnancy used to be the perinatal mortality (from 28 weeks gestation to the end of the first week of life). With the continuing improvement in neonatal care, more babies who would have died during the perinatal period are surviving beyond the seventh day of life. As a result, their subsequent deaths are not recorded in many publications. Even greater emphasis will fall on the quality of life for those infants surviving with a major congenital abnormality (heart and neural tube defect) which produces profound childhood morbidity. Prevention of these congenital abnormalities is the most important aim of pre-and early conceptional care of the diabetic mother. Both centres which report their recent results in this issue would agree that there has been an improvement even in the past 5 years -the problem is to define exactly which developments account for the change for the better, and which previously-trusted techniques can safely be allowed to fall by the wayside.

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Section: Fetal Abnormalitiesmentioning

confidence: 99%

Section: Gestational Diabetesmentioning

confidence: 99%

Section: Gestational Diabetesmentioning

confidence: 99%

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Diabetes in pregnancy 1985

Hadden

1986

Diabetologia

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“…It is characterised by impaired insulin secretion and action [2,3]. Gestational diabetes complicates about 1 to 3% of all pregnancies in the western world [4], whereas higher rates are reported among small ethnic groups [5]. There is no international consensus regarding the definition of diagnostic criteria for GDM.…”

Section: Introductionmentioning

confidence: 99%

Genotypic and phenotypic differences between Arabian and Scandinavian women with gestational diabetes mellitus

et al. 2004

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Aims/hypothesis. Gestational diabetes mellitus is a heterogeneous disorder characterised by impaired insulin secretion and action. Our aim was to study whether autoimmunity, variations in genes affecting insulin secretion and action, or both, contribute to the development of gestational diabetes and whether the pathogenesis of the disease differs between women with a Scandinavian or Arabian background. Methods. We studied a total of 500 unrelated women with gestational diabetes (400 Scandinavian and 100 Arabian) and 550 unrelated pregnant non-diabetic control women (428 Scandinavian and 122 Arabian) matched for ethnicity. Results. Arabian women with gestational diabetes were 50% more insulin resistant for the same BMI compared with Scandinavian women with the disease (homeostasis model assessment [HOMA-IR]; 3.2±0.3 vs 2.2±0.2, p=0.02). Both Scandinavian (4.2% vs 0.9%, p=0.008) and Arabian (4.6% vs 0.0%, p=0.03) women with gestational diabetes had a higher frequency of GAD antibodies (GAD65Ab) than the matched controls. The frequency of HLA-DQB1 risk genotypes was slightly higher in Scandinavian women

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“…Incidence was similar in both the study and control groups (14.4 vs. 11.8%). In the literature the incidence of gestational diabetes varies between 1.4% and 14% depending on the characteristics of the population studied and the screening method (8). Placenta previa was the second most common complication.…”

Section: Discussionmentioning

confidence: 99%

Are pregnancy complications increased in poor responders?

Parlakgumus¹,

Haydardedeoğlu²,

Şimşek³

et al. 2011

J Turkish German Gynecol Assoc

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Objective: To investigate whether pregnancy complications are increased in poor responders to ovarian stimulation in IVF treatment. Material and Methods:We reviewed the antenatal follow up and birth records of 26 poor responders to ovarian stimulation and 125 normoresponder patients in an IVF program.Results: Eighty nine (71.2%) of the normoresponders and 22 (84.6%) of the poor responders had no pregnancy complications. Gestational diabetes was present in 18 (14.4%) of the normoresponders and 3 (11.5%) of the poor responders. Seven of the normoresponders had placenta previa (5.6%). Two of the normoresponders (1.6%) had pregnancy induced hypertension. Two (1.6%) of the normoresponders had preeclampsia. One patient from each group had fetal anomaly (3.8% for poor responders vs. 0.8% for normoresponders). Cholestasis of pregnancy was present in two of the normoresponders (1.6%) and the 2 patients (7.7%) who delivered prematurely also belonged to this group. Conclusion:Our results revealed that pregnancy complications were not increased in patients with a reduced ovarian reserve when compared to their age matched counterparts. (J Turkish-German Gynecol Assoc 2011; 12: 1-3) Key words: Pregnancy complications, poor ovarian reserve, IVF, poor response Received: 13 August, 2010 Accepted: 22 November, 2010 Amaç: IVF tedavisinde ovaryen stimülasyona kötü yanı veren hastalarda gebelik komplikasyonlarının artıp artmadığını incelemek. Gereç ve Abstract ÖzetOriginal Investigation 1

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Geographic, Ethnic, and Racial Variations in the Incidence of Gestational Diabetes Mellitus

Cited by 97 publications

References 5 publications

Diabetes in pregnancy 1985

Diabetes in pregnancy 1985

Genotypic and phenotypic differences between Arabian and Scandinavian women with gestational diabetes mellitus

Are pregnancy complications increased in poor responders?

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