Gestational Diabetes Mellitus in Southeast Asia: A Scoping Review

Abstract

A rapid increase in the prevalence of gestational diabetes mellitus (GDM) has been associated with various factors such as urbanization, lifestyle changes, adverse hyperglycemic intrauterine environment, and the resulting epigenetic changes. Despite this, the burden of GDM has not been well-assessed in Southeast Asia. We comprehensively reviewed published Southeast Asian studies to identify the current research trend in GDM in this region. Joanna Briggs Institute’s methodology was used to guide the scoping review. The synthesis of literature findings demonstrates almost comparable clinical evidence in terms of risk factors and complications, challenges presented in diagnosing GDM, and its disease management, given the similarities of the underlying population characteristics in Southeast Asia. Evidence suggests that a large proportion of GDM risk in women may be preventable by lifestyle modifications. However, the GDM burden across countries is expected to rise, given the heterogeneity in screening approaches and diagnostic criteria, mainly influenced by economic status. There is an urgent need for concerted efforts by government and nongovernmental sectors to implement national programs to prevent, manage, and monitor the disease.

The Modulation of Gut Microbiota Composition in the Pathophysiology of Gestational Diabetes Mellitus: A Systematic Review

“…However, three studies have not reported the diagnostic criteria used in their study design [16,17,25]. The lack of international agreement in screening and diagnostic criteria for GDM often leads to variations in GDM prevalence among countries in the world [9], which could affect the interpretation of microbial findings. For example, countries that adopt low sensitivity diagnostic methods (e.g., reducing the two-hour threshold value of OGTT) may fail to identify women who are at risk of metabolic outcomes that lead to 'missing out' in total abundance and type of microbiota.…”

“…GDM affects roughly 25.1% of pregnancies worldwide [7]. Notably, the condition is linked to adverse maternal and neonatal effects, such as cesarean delivery, preeclampsia, and fetal macrosomia [8,9]. GDM also has long-term metabolic consequences for women, including an elevated risk of diabetes, dyslipidemia, coronary heart disease, and hypertension [9,10].…”

“…Notably, the condition is linked to adverse maternal and neonatal effects, such as cesarean delivery, preeclampsia, and fetal macrosomia [8,9]. GDM also has long-term metabolic consequences for women, including an elevated risk of diabetes, dyslipidemia, coronary heart disease, and hypertension [9,10]. Besides that, a 5-year prospective study showed that post-GDM women from South Asia suffered glucose intolerance at a much higher rate than women from other ethnic groups [11].…”

Differential analysis of the bacterial community in colostrum samples from women with gestational diabetes mellitus and obesity

“…Having an increased BMI during pregnancy increases 2–8 times the risk of developing Gestational Diabetes Mellitus (GDM) 11 – 13 . GDM is characterized by a chronic hyperglycemia recognized during the gestational period and has a global incidence of 15% 14 . Women with GDM present decreased insulin sensitivity and β-cell dysfunction, which increases the risk of developing type 2 diabetes, and metabolic syndrome and cardiovascular disease after pregnancy 15 , 16 .…”

Diagnosis, Management and Maternal, Neonatal Outcomes of Hyperglycaemia in Pregnancy Among Pregnant Women in a Rural District of Sri Lanka: A Cross Sectional Descriptive Study

“…Prevalence of some form of hyperglycaemia in pregnancy in the world is estimated to be around 16.7% (2). The incidence of hyperglycaemia in pregnancy has increased in South Asia (3). Hyperglycaemia in pregnancy, both gestational diabetes mellitus (GDM) and pre-existing diabetes mellitus (DM), are linked to several maternal and fetal/neonatal complications (4).…”