Glucose tolerance in pregnancy: Ethnic variation and influence of body habitus

Green, James R.; Pawson, Ivan G.; Schumacher, Laurie; Perry, Jean; Kretchmer, Norman

doi:10.1016/s0002-9378(11)90675-9

Cited by 90 publications

(43 citation statements)

References 13 publications

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“…The variations in GDM prevalence depending on the strata of maternal risk factors observed in our study are largely in agreement with earlier studies (16,17,24,27,28,32,34). The greatest prevalence of GDM was for the antecedents of the disease itself in previous pregnancy, obesity and chronic hypertension.…”

Section: Discussionsupporting

confidence: 92%

Prevalence of gestational diabetes mellitus: variations related to screening strategy used

Jiménez-Moleón

Bueno‐Cavanillas

Luna-del-Castillo

et al. 2002

European Journal of Endocrinology

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Objective: To determine the prevalence of gestational diabetes mellitus in a large general obstetric population and its variations depending on the presence of risk factors, and to evaluate how the gestational diabetes screening strategies applied might modify the observed prevalence in the population. Design: A retrospective cohort study. Methods: The study population was a total of 2574 pregnant women. Information about risk factors, screening and diagnosis of gestational diabetes was obtained. Frequency of risk factors under the American College of Obstetrics and Gynecologists (ACOG) and the American Diabetes Association (ADA) criteria, and observed and expected prevalence of gestational diabetes mellitus were calculated and compared for statistical significance. Results: Age $ 30 years, family history of diabetes, obesity and previous fetal macrosomia were the most frequent risk factors. Under ACOG recommendations, 45% of our general obstetric population would have been exempt from gestational diabetes mellitus screening, as compared with only 15.5% under ADA guidelines. Sixty-five patients were diagnosed as having gestational diabetes mellitus, giving an overall prevalence of 2.5% (confidence interval 2.0 -3.2). Among the low-risk women, prevalence values were 0.6% and 0.5% respectively under ACOG and ADA criteria, whereas for those presenting one or more risk factors rates were 4% and 2.9% respectively. Conclusions: In our general obstetric population, gestational diabetes mellitus prevalence was found to be approximately six times lower among low-risk gravidae than among the high-risk subjects, suggesting that selective screening might be beneficial. Nevertheless, selective gestational diabetes mellitus screening under ADA criteria seems to entail the same disadvantages as the selective screening strategies without any apparent benefits.

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Section: Discussionsupporting

confidence: 92%

Prevalence of gestational diabetes mellitus: variations related to screening strategy used

Jiménez-Moleón

Bueno‐Cavanillas

Luna-del-Castillo

et al. 2002

European Journal of Endocrinology

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“…Severity of glucose intolerance during pregnancy, insulin requirement during pregnancy, earlier diagnosis during pregnancy, family history of diabetes, recurrence of GDM, increasing parity, maternal age, prepregnancy obesity, weight gain during and after pregnancy, presence of islet cell antibodies, and delivery of a macrosomic infant were reportedly the key risk factors for DM in women with history of GDM [10,22,23]. However, wide geographic and ethnic variations in the incidence of abnormal glucose tolerance after GDM have been reported from numerous studies [1,24]. In this prospective study, we observed approximately 41% incidence rates when data were analyzed using the 5 years postpartum survival analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy, and women with GDM are at increased risk for type 2 diabetes mellitus (TY2DM) [1,2] [177][178][179][180][181][182][183] pregnancy is characterized by insulin resistance and enhanced insulin secretion as a compensatory mechanism to maintain normal glucose tolerance (NGT). However, previous studies indicated that in women with GDM more pronounced insulin resistance phenomena occurs [3].…”

Section: Introductionmentioning

confidence: 99%

Waist circumference is the key risk factor for diabetes in Korean women with history of gestational diabetes

Cho

Jang

Park³

et al. 2006

Diabetes Research and Clinical Practice

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“…However, the increase in prevalence has been highest among the Inuit (8)(9)(10)(11)(12). The prevalence of GDM was reported to vary with ethnicity (13), with high prevalence among Yup'ik Inuit (14) and other ethnic groups (13,(15)(16)(17)(18)(19). The prevalence of GDM among Yup'ik Inuit is thus twice as high as the U.S rate for all races, despite the fact that the Yup'ik Inuit having the lowest rate of diabetes mellitus among Alaska Natives (14).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of gestational diabetes mellitus among women born in Greenland: measuring the effectiveness of the current screening procedure

Pedersen

Jacobsen

Jørgensen

2010

International Journal of Circumpolar Health

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Objectives. To estimate the prevalence of gestational diabetes mellitus (GDM) among Greenlanders and to evaluate the quality of the current screening procedure for gestational diabetes. Study design. Observational retrospective study of consecutive birth-log data and medical records on pregnant women who had given birth in Nuuk during 2008. Methods. Information about maternal weight, weight gain in pregnancy, height, blood pressure, result of oral glucose tolerance test, family history of diabetes, smoking and alcohol habits, ethnicity, delivery and birth weight and length was collected for women who had given birth in Nuuk, Greenland, during 2008. Results. A total of 233 women born in Greenland who had given birth to a singleton in Nuuk 2008 were included in the study. Of those, 37% were defined as having a high risk for GDM and thus met the screening criteria for GDM used in Greenland. However, only 54% of those women were screened. The prevalence of gestational diabetes was calculated to be 4.3% among high-risk Greenlandic pregnant women (2/46) (95% CI 0-10.0%). Conclusions. Despite a suboptimal screening rate, the prevalence of GDM among Greenlanders seems to be relatively low and Greenlanders may thus be less prone to develop GDM. However, diabetes mellitus is a relatively new disease in Greenland, and glucose intolerance in pregnancy is more likely to affect the next generation. The screening rate is suboptimal, and it is recommended that the screening procedure be optimized in order to find and treat all women with GDM. The number of screened women compared to the number of births occurring annually could be used as an indicator of screening efficacy. Diabetes prevention initiatives should be given high priority to avoid high rates of GDM in the future, as increasing prevalence of the disease is now seen worldwide, regardless of race. (Int J Circumpolar Health 2010;69(x):352-360)

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Glucose tolerance in pregnancy: Ethnic variation and influence of body habitus

Cited by 90 publications

References 13 publications

Prevalence of gestational diabetes mellitus: variations related to screening strategy used

Prevalence of gestational diabetes mellitus: variations related to screening strategy used

Waist circumference is the key risk factor for diabetes in Korean women with history of gestational diabetes

Prevalence of gestational diabetes mellitus among women born in Greenland: measuring the effectiveness of the current screening procedure

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