Increased Prevalence of Gestational Diabetes Mellitus Among Women With Diagnosed Polycystic Ovary Syndrome

Lo, Joan C.; Feigenbaum, Seth L.; Escobar, Gabriel J.; Yang, Jingrong; Crites, Yvonne; Ferrara, Assiamira

doi:10.2337/dc06-0877

Cited by 103 publications

(66 citation statements)

References 29 publications

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“…Finally, the observed associations may be explained by residual confounding from unmeasured factors in the individual studies. Most studies adjusted for maternal age, ethnicity, parity, history of GDM, family history of diabetes, BMI, and total energy intake; however, less than one-half of the studies adjusted for other lifestyle factors, such as physical activity and smoking, and very few adjusted for gestational weight gain, previous macrosomia, polycystic ovary syndrome, or socioeconomic status, which may be important risk factors of GDM (43)(44)(45). Furthermore, because diets comprise a combination of food items, singling out the effect of an individual food item is difficult.…”

Section: Discussionmentioning

confidence: 99%

The Role of Energy, Nutrients, Foods, and Dietary Patterns in the Development of Gestational Diabetes Mellitus: A Systematic Review of Observational Studies

et al. 2015

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OBJECTIVEDiet may influence the risk of gestational diabetes mellitus (GDM), but inconsistent findings have been reported. The purpose of this study was to synthesize evidence from observational studies on the associations between dietary factors and GDM. RESEARCH DESIGN AND METHODSMedline and Embase were searched for articles published until January 2015. We included observational studies of reproductive-aged women that reported on associations of maternal dietary intake before or during pregnancy, including energy, nutrients, foods, and dietary patterns, with GDM. All relevant results were extracted from each article. The number of comparable studies that adjusted for confounders was insufficient to perform a meta-analysis. RESULTSThe systematic review included 34 articles comprising 21 individual studies (10 prospective cohort, 6 cross-sectional, and 5 case-control). A limited number of prospective cohort studies adjusting for confounders indicated associations with a higher risk of GDM for replacing 1-5% of energy from carbohydrates with fat and for high consumption of cholesterol ( ‡300 mg/day), heme iron ( ‡1.1 mg/day), red and processed meat (increment of 1 serving/day), and eggs ( ‡7 per week). A dietary pattern rich in fruit, vegetables, whole grains, and fish and low in red and processed meat, refined grains, and high-fat dairy was found to be beneficial. The current evidence is based on a limited number of studies that are heterogeneous in design, exposure, and outcome measures. CONCLUSIONSThe findings support current dietary guidelines to limit consumption of foods containing saturated fat and cholesterol, such as processed meat and eggs, as part of an overall balanced diet. Further large prospective studies are warranted.Gestational diabetes mellitus (GDM), defined as glucose intolerance with onset or first recognition during pregnancy (1), is a common pregnancy complication affecting ;7% of pregnancies (1,2). During the past 20 years, its prevalence has increased substantially across a range of multiethnic populations and is expected to continue

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Section: Discussionmentioning

confidence: 99%

The Role of Energy, Nutrients, Foods, and Dietary Patterns in the Development of Gestational Diabetes Mellitus: A Systematic Review of Observational Studies

et al. 2015

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Section: Hedderson and Associatesmentioning

confidence: 99%

“…PCOS is a reproductive condition characterized by increased serum levels of circulating adrenal androgens, anovulation, and insulin resistance (30). The risk of GDM appears to be higher among women with PCOS compared with women without PCOS (30,31). Women with PCOS often are prescribed oral contraceptives, especially those containing low androgenic activity (32), to treat their condition.…”

Section: Hedderson and Associatesmentioning

confidence: 99%

Androgenicity of Progestins in Hormonal Contraceptives and the Risk of Gestational Diabetes Mellitus

Hedderson

Ferrara

Williams³

et al. 2007

Diabetes Care

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OBJECTIVE -There is some evidence that use of hormonal contraceptives, particularly the more androgenic formulations, can alter a woman's glucose tolerance. We examined the association between hormonal contraceptive use, categorized by the androgenicity of the progestin component, and risk of gestational diabetes mellitus (GDM) in a nested case-control study.RESEARCH DESIGN AND METHODS -Case (n ϭ 356) and control (n ϭ 368) subjects were selected from a multiethnic cohort of 14,235 women who delivered a singleton live birth between 1 January 1996 and 30 June 1998, who were screened for GDM at 24 -28 gestational weeks, and who were members of Kaiser Permanente for at least 5 years before pregnancy. GDM was defined using the National Diabetes Data Group plasma glucose cutoffs. Information concerning hormonal contraceptive use during the 5 years before pregnancy was obtained from medical charts and some pharmacy data.RESULTS -There was a suggestion that compared with no hormonal contraceptive use, use of a low-androgen hormonal contraceptive before pregnancy was associated with a slight reduction in risk of GDM (odds ratio 0.84 [95% CI 0.58 -1.22]), whereas use of a high-androgen hormonal contraceptive was associated with a modest increase in GDM risk (1.43 [0.92-2.22 ]).CONCLUSIONS -The effects of hormonal contraceptive use on GDM risk may vary by the androgenicity of the progestin component.

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“…7 PCOS is associated with an increased risk of the metabolic syndrome (11 times greater), gestational diabetes mellitus (GDM) (2.4 times greater), type 2 diabetes, hypertension, dyslipidemia, subfertility, spontaneous abortions, cardiovascular events, and the premature development of hormone-sensitive carcinomas. [8][9][10] Metformin Therapy A magic bullet therapy for PCOS would result in weight loss, improve insulin resistance, restore normal ovulatory cycles, increase fertility, decrease hyperandrogenism, decrease the rate of spontaneous abortions, and decrease the risk of GDM. The current frontrunner for this magic bullet is the biguanide metformin.…”

Section: In Briefmentioning

confidence: 99%

Polycystic Ovary Syndrome and Pregnancy: Is Metformin the Magic Bullet?

Zisser¹

2007

Diabetes Spectrum

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In Brief This article reviews the literature regarding the effects of metformin therapy in pregnant women with polycystic ovary syndrome on weight loss,fertility, early pregnancy loss, malformations, gestational diabetes mellitus,perinatal mortality, placental clearance, lactation, and early childhood development. The pharmacology of metformin is also presented. Preliminary data suggest that metformin for this population may be both safe and effective. Large blinded, randomized clinical trials are underway to confirm the preliminary safety data.

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Increased Prevalence of Gestational Diabetes Mellitus Among Women With Diagnosed Polycystic Ovary Syndrome

Cited by 103 publications

References 29 publications

The Role of Energy, Nutrients, Foods, and Dietary Patterns in the Development of Gestational Diabetes Mellitus: A Systematic Review of Observational Studies

The Role of Energy, Nutrients, Foods, and Dietary Patterns in the Development of Gestational Diabetes Mellitus: A Systematic Review of Observational Studies

Androgenicity of Progestins in Hormonal Contraceptives and the Risk of Gestational Diabetes Mellitus

Polycystic Ovary Syndrome and Pregnancy: Is Metformin the Magic Bullet?

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