Risk factors for abnormal postpartum glycemic states in women diagnosed with gestational diabetes by the International Association of Diabetes and Pregnancy Study Groups criteria

Hung, Tai‐Ho; Chuang, Ya-Chun; Chu, Fu-Chieh; Huang, Lulu; Shaw, Steven W.; Hsieh, T’sang‐T’ang; Chen, Szu‐Fu

doi:10.1111/jdi.13400

Cited by 6 publications

(3 citation statements)

References 37 publications

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“…24,25 Thus, it has been reported that older maternal age and insulin requirement were risk factors for post-partum glucose metabolism disorder, whereas high pre-gestational BMI and elevated fasting plasma glucose at GDM diagnosis were the major predictors for prediabetes. 26,27 In the present study, the level of HbA1C was not associated with a significant risk of postpartum prediabetes, and BMI was not included in the regression model because of substantial missing data. Older age as a factor for A2GDM: The age category ≥45 years had the highest prevalence of insulin requirement (42.9%) versus 17.4% and 22.5% in those aged <35 years and 35-44 years, respectively.…”

Section: Discussionmentioning

confidence: 76%

Insulin requiring Gestational Diabetes: Risk factors and correlation with postpartum diabetes and prediabetes

Ghamri

2023

Pak J Med Sci

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Objective: A2 gestational diabetes mellitus (A2GDM) is a more severe form of GDM that requires additional medical intervention, such as insulin or oral antidiabetic drug (OAD). The present study explored the determinants of A2GDM and analyzed the associated risk of post-partum diabetes or prediabetes. Methods: This retrospective study included 247 pregnant women, diagnosed with GDM and followed up until delivery at the Obstetric Medicine Clinic of King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between January 2014 and January 2018. Women with personal history of diabetes or prediabetes were excluded. Collected data included patient’s age, body mass index, personal history of thyroid dysfunction and GDM, HbA1c level at diagnosis, management of GDM (diet only, insulin, or OAD), and postpartum metabolic assessment. Results: The prevalence of A2GDM was 29.6%, of which 21.5% were insulin-requiring and 8.1% were OAD-requiring cases. The risk of A2GDM was independently associated with a positive history of GDM (OR=3.19, 95% CI = 1.41-7.20) and HbA1c >7% (OR=8.66, 95%CI = 2.15- 34.94); the model explained 20% of the variance of A2GDM. The postpartum assessment showed that 10.1% have developed prediabetes, while no one developed overt diabetes. Postpartum prediabetes was independently predicted by age category ≥45 years (OR=39.94, 95%CI = 4.62-345.06), history of GDM (OR=0.18, 95%CI = 0.03 – 0.97), and A2GDM (OR=6.96, 95%CI = 1.91-25.42). Conclusion: Approximately one-third of GDM patients in our institution require insulin or OAD for glycemic control and are at high risk of developing prediabetes postpartum. Adherence to and effectiveness of medical nutrition therapy should be further explored among GDM patients to improve their glycemic control and both maternal and fetal prognosis. doi: https://doi.org/10.12669/pjms.39.5.7648 How to cite this: Ghamri KA. Insulin requiring Gestational Diabetes: Risk factors and correlation with postpartum diabetes and prediabetes. Pak J Med Sci. 2023;39(5):---------. doi: https://doi.org/10.12669/pjms.39.5.7648 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 76%

Insulin requiring Gestational Diabetes: Risk factors and correlation with postpartum diabetes and prediabetes

Ghamri

2023

Pak J Med Sci

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“…[ 12 ] In a prospective cohort study of 493 women with GDM screened at 6 to 12 weeks postpartum, the history of fetal death was higher in women with PPpreDM. [ 13 ] Higher blood sugars at diagnosis of GDM are associated with persistent postpartum hyperglycemia,[ 14 15 ] and women with fetal death are more likely to have uncontrolled GDM. Previous history of fetal demise was a risk factor for PPDM in our study but not for prediabetes [ Table 2 ].…”

Section: Risk Factorsmentioning

confidence: 99%

“…Similar findings have been reported in other studies as well,[ 6 ] while some have failed to report a difference. [ 13 ]…”

Section: Risk Factorsmentioning

confidence: 99%

Antenatal factors and risk of postpartum hyperglycemia in women with gestational diabetes mellitus: A central India prospective cohort study

Bagde,

Shanbhag

et al. 2024

Journal of Family Medicine and Primary Care

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Introduction: Global prevalence of gestational diabetes mellitus (GDM) ranges from <1% to 28%. Risk of postpartum diabetes (PPDM) is 7 times higher in women with GDM. We aimed to identify antenatal risk factors associated with postpartum hyperglycemia so that these women may be subjected to targeted screening in a low resource setting. Methods: Screening for GDM was done with a 75gram GTT using IADPSG criteria in women between 28-29 weeks and post-partum screening for hyperglycemia was done using 75 gm 2hour OGTT. Results: Mixed effect linear regression model to assess PPDM as outcome against age, pre pregnancy weight, baby weight at birth, HbA1C and postpartum BMI as predictors was significant at overall level (p=0.00). HbA1C (p =0.00) and pre pregnancy weight (p=0.001) were significant at individual level. Same model for postpartum prediabetes was significant at overall level and assumed significance for pre pregnancy weight (p=0.00), baby birth weight (p= 0.001), postpartum BMI (p=0.00) and HbA1C (p= 0.05) at individual level. The same model for postpartum abnormal sugars (PPDM or prediabetes) was significant at overall level (p = 0.00). Conclusion: Women with GDM represent a vulnerable population that is likely to develop a chronic metabolic disease at a young age exposing them to morbidity associated with unrecognized untreated hyperglycemia. Easily detectable clinical and biochemical antenatal risk factors may help identify women eligible for targeted screening for early diagnosis and treatment as well as use of preventive interventions against type2 diabetes after GDM

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Risk factors associated with early postpartum glucose intolerance in women with a history of gestational diabetes mellitus: a systematic review and meta-analysis

Zhang

Liu

et al. 2023

Endocrine

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Risk factors for abnormal postpartum glycemic states in women diagnosed with gestational diabetes by the International Association of Diabetes and Pregnancy Study Groups criteria

Cited by 6 publications

References 37 publications

Insulin requiring Gestational Diabetes: Risk factors and correlation with postpartum diabetes and prediabetes

Insulin requiring Gestational Diabetes: Risk factors and correlation with postpartum diabetes and prediabetes

Antenatal factors and risk of postpartum hyperglycemia in women with gestational diabetes mellitus: A central India prospective cohort study

Risk factors associated with early postpartum glucose intolerance in women with a history of gestational diabetes mellitus: a systematic review and meta-analysis

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