Gestational retinal microvasculature and the risk of 5 year postpartum abnormal glucose metabolism

Tan, Kok Hian; Aris, Izzuddin M.; Chong, Yap Seng; Saw, Seang Mei; Gluckman, Peter D.; Wang, Jie Jin; Wong, Tien Yin

doi:10.1007/s00125-017-4441-x

Cited by 8 publications

(7 citation statements)

References 37 publications

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“…A final number of 795 women with singleton pregnancies without pre-existing T2D were included in the study analysis and had the following variables: age, height and weight at first booking visit (≤13 weeks of gestation) (ZT-120 Health Scale, Digital Medical & Health-Care Scales, Hong Kong, China), gestational age at first booking, 75 g oral glucose tolerance test (OGTT) with fasting, 1- and 2-h glucose readings after 20 weeks of gestation (Mindray BS-800, Chemistry Analyzer, Shanghai, China), and offspring birthweight. We calculated body mass index (BMI) at the first booking visit (as an estimate of pre-pregnancy BMI) as weight in kilograms over square of height in meters ( 18 ).…”

Section: Methodsmentioning

confidence: 99%

Comparing Different Diagnostic Guidelines for Gestational Diabetes Mellitus in Relation to Birthweight in Sri Lankan Women

et al. 2018

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Introduction: While the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria is widely adopted in many countries, clinicians have questioned the applicability of these diagnostic thresholds for different races/ethnicities. We first compared the prevalence of gestational diabetes mellitus (GDM) diagnosed with different criteria including IADPSG, World Health Organization (WHO) 1999 and Sri Lankan national guidelines, and subsequently related individual guidelines-specific GDM prevalence to offspring birthweight in Sri Lanka.Materials and Methods: We retrospectively collected data on singleton pregnancies (n = 795) from two tertiary hospitals in Sri Lanka. We applied three diagnostic guidelines to define GDM, namely IADPSG criteria, the Sri Lankan national and WHO 1999 guidelines. We calculated the age- and first booking BMI-adjusted prevalence rates of GDM and assessed the association of GDM (using each guideline) with birthweight.Results: The age- and first booking BMI-adjusted GDM prevalence rates were 31.2, 28.0, and 13.1% for IADPSG criteria, Sri Lankan national and WHO 1999 guidelines, respectively. The IADPSG criteria identified 90 distinctive GDM cases at a lower cut-off of fasting glucose (from 5.1 to 5.5 mmol/L) while Sri Lankan national guideline identified 15 distinctive GDM cases at a lower cut-off for 2-h glucose (from 7.8 to 8.4 mmol/L). After adjusting for age, GDM diagnosed by IADPSG criteria was associated with higher birthweight [90.8 g, 95% CI: 10.8, 170.9], while the associations for GDM diagnosed either by Sri Lankan national or WHO 1999 guidelines were not significant.Conclusion: Adopting the IADPSG criteria for diagnosing GDM may be important in Sri Lankan pregnant population.

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Section: Methodsmentioning

confidence: 99%

Comparing Different Diagnostic Guidelines for Gestational Diabetes Mellitus in Relation to Birthweight in Sri Lankan Women

et al. 2018

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“…Gestational diabetes mellitus (GDM) is characterized as a disorder of glucose metabolism with the onset, or first appearance, occurring during pregnancy [ 1 ]. Normal pregnancy is diabetogenic due to the increased production of insulin (hyperinsulinemia) and insulin resistance (IR), in order to ensure adequate nutrition for the developing fetus [ 1 , 2 , 3 , 4 , 5 ]. Moreover, the increased concentration of hormones, such as estrogen, progesterone, and cortisol, as pregnancy progresses decreases the phosphorylation of insulin receptor substrate-1 (IRS-1), and may cause insulin resistance [ 2 ]; this is compensated by a higher production of insulin by beta cells of the islets of Langerhans.…”

Section: Introductionmentioning

confidence: 99%

Polish Women Have Moderate Knowledge of Gestational Diabetes Mellitus and Breastfeeding Benefits

Lis-Kuberka

Orczyk-Pawiłowicz

2021

IJERPH

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Gestational diabetes mellitus (GDM) is a multifaceted disease and is associated with complications for newborns and mothers. The aim of the study was to assess Polish women’s knowledge concerning GDM and their attitude to breastfeeding. As a research tool, an anonymous online survey that included 33 questions, grouped into three main sections—sociodemographic and obstetric variables, risk factors for GDM and neonatal adverse outcomes, and knowledge about breastfeeding—was used and administered online. A total of 410 women aged from 18 to 45 participated in this study. Based on the survey, it was demonstrated that the women had moderate knowledge concerning the maternal risk factors and adverse neonatal outcomes associated with GDM and, additionally, the short- and long-term effects of breastfeeding. Significantly deeper knowledge about GDM, including breastfeeding by GDM mothers, was observed among hyperglycemic mothers in comparison to normoglycemic mothers. However, knowledge concerning the health benefits of breastfeeding was not related to the mothers’ glycemic status. In conclusion, educational programs must include pre-pregnancy education of women and place emphasis on explaining the mechanism of development of GDM and the transformation of GDM to type 2 diabetes. This is crucial for changing the public’s perception of GDM as a temporary, reversible clinical entity.

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“…As a result, the retinal microvascular morphology can be altered during pregnancy [26], and its dysfunction may contribute to the diabetogenic progression during pregnancy. So, we can speculate that retinal changes occurred even in CMDP patients without DR [9–11] although the Diabetic Retinopathy Preferred Practice Pattern from the American Academy of Ophthalmology (https://www.aao.org/preferred-practice-pattern/diabetic-retinopathy-ppp-updated-2017) reported that DR is usually not present in patients with GDM.…”

Section: Discussionmentioning

confidence: 99%

“…There are many other methods to evaluate the retinal vasculature and CMDP during pregnancy, for example, fundus photographs [9], laser Doppler images [10, 11], and optical coherence tomography (OCT) [12, 13]. Since none of these methods constitute a direct evaluation of the vasculature, they are not comparable to conventional FA.…”

Section: Introductionmentioning

confidence: 99%

Relationship between Size of the Foveal Avascular Zone and Carbohydrate Metabolic Disorders during Pregnancy

Sugimoto

Wakamatsu

Miyata

et al. 2019

BioMed Research International

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Aim To determine whether the area of the foveal avascular zone (FAZ), as a morphological indicator of the microcirculation of the perifoveal capillary network, changes in the carbohydrate metabolism disorders during pregnancy (the gestational age of patients with gestational diabetes mellitus (GDM) and preexisting diabetes (PexD)). Methods Ten normal individuals and 41 eyes of 41 patients, 28 with GDM and 13 with PexD, were studied. A 3 × 3 mm area of the FAZ of the superficial capillary plexus layer (SCP) and the deep capillary plexus layer (DCP) was determined by optical coherence tomography angiography (OCTA; RS-3000 Advance, NIDEK). The significance of the correlation between the size of the FAZ and the weeks of pregnancy was determined. Results The area of the FAZ of the SCP was 0.38 ± 0.11 mm2 (normal eyes), 0.41 ± 0.16 mm2 (GDM), and 0.43 ± 0.10 mm2 (PexD). The area of the FAZ of the DCP was 0.78 ± 0.23 mm2 (normal eyes), 0.69 ± 0.16 mm2 (GDM), and 0.79 ± 0.25 mm2 (PexD). No significant difference in the FAZ sizes was observed between the groups. The average number of weeks of pregnancy was 24.1 ± 8.2 weeks in the eyes with GDM and 23.3 ± 11.4 weeks in the eyes with PexD (P > 0.05). Significant correlations were found between the size of the FAZ of the SCP and the number of weeks (r = 0.37, P=0.04 for GDM, and r = 0.49, P=0.04 for PexD, Spearman's rank-order correlation coefficient). Conclusions For GDM and PexD under established glycemic control, the area of the FAZ is not affected, but vascular changes occurred at the early phase of pregnancy.

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Gestational retinal microvasculature and the risk of 5 year postpartum abnormal glucose metabolism

Abstract: Retinal microvasculature in pregnant women was associated with abnormal glucose metabolism 5 years postpartum. Alteration of microvascular structure during pregnancy may signal subclinical changes that underlie the development of prediabetes and diabetes.

Cited by 8 publications

References 37 publications

Comparing Different Diagnostic Guidelines for Gestational Diabetes Mellitus in Relation to Birthweight in Sri Lankan Women

Comparing Different Diagnostic Guidelines for Gestational Diabetes Mellitus in Relation to Birthweight in Sri Lankan Women

Polish Women Have Moderate Knowledge of Gestational Diabetes Mellitus and Breastfeeding Benefits

Relationship between Size of the Foveal Avascular Zone and Carbohydrate Metabolic Disorders during Pregnancy

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