Risk of gestational diabetes mellitus in women with polycystic ovary syndrome: a systematic review and a meta-analysis

Toulis, Konstantinos; Goulis, Dimitrios G.; Kolibianakis, Efstratios M.; Venetis, Christos A.; Tarlatzis, Basil C.; Papadimas, Ioannis

doi:10.1016/j.fertnstert.2008.06.045

Cited by 120 publications

(100 citation statements)

References 23 publications

(15 reference statements)

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“…Estudos recentes têm demonstrado que, além dos fatores de risco clássicos pra DMG, uma história de SOP também pode estar associada a um aumento no risco para DMG (25). Existem, porém, muitas controvérsias em relação a essa associação, pois em estudos casos controle ela não foi encontrada (26). No presente estudo, esse fator não foi frequentemente referido pelas pacientes ou em seu prontuário médico, que inclui a avaliação das demais clínicas do hospital, mas não foram realizados exames específicos para seu diagnóstico.…”

Section: Discussionunclassified

Marcadores para o diagnóstico e tratamento de 924 gestações com diabetes melito gestacional

Detsch

Almeida

Bortolini

et al. 2011

Arq Bras Endocrinol Metab

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RESUMOObjetivos: Avaliar o perfil epidemiológico e a evolução de mulheres com diabetes melito gestacional (DMG), determinando fatores de risco para maior vigilância. Sujeitos e métodos: Foram estudadas 924 gestações de 916 pacientes, de 6 de novembro de 2001 a 21 de setembro de 2009. Resultados: Foram encontrados fatores de risco para DMG em 95,1% dos casos. A prevalência de diabetes materno, paterno e em outros familiares foi de 24,3%, 9,4% e 24,7%, respectivamente. Os fatores preditivos para uso de insulina foram: glicemia de jejum (GJ) no rastreamento ≥ 85, GJ no Teste Oral de Tolerância à Glicose (TOTG) ≥ 95, glicemia 2h após 75 g de glicose ≥ 200 mg/dL, DMG prévio, obesidade, HbA1c > 6% e história familiar de DM em parente de primeiro grau associada à obesidade ou DMG prévio, esta última a associação mais relevante (p < 0,05). Conclusões: Os fatores de risco analisados se mostraram altamente sensíveis para a detecção de DMG, e a disposição da história familiar reforça sua relação com o DM2. Recomenda-se maior vigilância a gestantes com fatores preditivos para necessidade de insulina. Arq Bras Endocrinol Metab. 2011;55(6):389-98 Descritores Diabetes gestacional; fatores de risco; controle metabólico; tratamento; insulina; complicações ABSTRACT Objectives: To evaluate the epidemiological profile and outcomes of women with gestational diabetes mellitus (GDM), determining risk factors for increased vigilance. Subjects and methods: We studied 924 pregnancies in 916 patients between November 6, 2001 and September 21, 2009. Results: Risk factors were found in 95.1% of cases. The prevalence of maternal diabetes, paternal diabetes and diabetes in other family members was 24.3%, 9.4% and 24.7%, respectively. Predictive factors for insulin use were: screening fasting glucose (FG) ≥ 85, Oral Glucose Tolerance Test (OGTT) FG ≥ 95, 2h glucose after 75 g ≥ 200 mg/dL, previous GDM, obesity, HbA1c > 6%, and the association of risk factors including family history of diabetes mellitus and obesity or previous GDM, the last one the most relevant (p < 0,05). Conclusions: Risk factors were very sensitive for GDM detection, and provision of family history strengthens its relationship with T2DM. Greater vigilance is recommended for patients with predictive factors for insulin requirement. Arq Bras Endocrinol Metab. 2011;55(6):389-98

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Section: Discussionunclassified

Marcadores para o diagnóstico e tratamento de 924 gestações com diabetes melito gestacional

Detsch

Almeida

Bortolini

et al. 2011

Arq Bras Endocrinol Metab

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“…The diagnostic criterion for GDM is the 75g, two-hour oral glucose tolerance test (OGTT). In fact, recent meta-analyses of pregnancy outcomes in women with PCOS demonstrated a significantly higher chance of developing GDM for PCOS women (odds ratios of about 2.90) (Boomsma et al, 2006) (Toulis et al, 2009 Boomsma et al, 2006). A comparison between the study designs revealed that the increased risks were predominantly found in cohort studies rather than in case-control studies.…”

Section: The Risk Of Gestational Diabetes In Women With Polycystic Ovmentioning

confidence: 99%

“…In the presence of PCOS and a preexisting state of increased insulin resistance accompanying the syndrome, hyperglycemia seems to be induced more easily. The high pre-conception insulin resistance might have a deleterious additive effect on pancreatic beta cells, which are incapable of coping with the additive physiological insulin resistance of pregnancy (Khattab et al, 2011), thereby leading to an increased incidence of GDM (Toulis et al, 2009). …”

Section: Preexisting Insulin Resistancementioning

confidence: 99%

“…Furthermore, pregnancies established after IVF carry an increased risk for maternal complications (Pinborg et al, 2004) (Shevell et al, 2005). However, the increased risk of developing GDM has been suggested to occur independently of obesity, as well as in populations without assisted reproductive techniques (Boomsma et al, 2006) (Toulis et al, 2009). …”

Section: The Influence Of Infertility Treatmentsmentioning

confidence: 99%

“…Confounding factors, such as obesity and the diverse ovulation induction treatments in infertile women with PCOS, can be considered potentially risk-increasing variables. Those coexisting factors, together with additional predisposing factors, such as a positive family history for diabetes mellitus, have been suggested to correlate with a generally increased risk for developing GDM and impaired glucose tolerance (Toulis et al, 2009). Comparable pathophysiological mechanisms of insulin resistance and impaired glucose tolerance can be found in GDM and in women with PCOS who demonstrate an increased tissue resistance to insulin.…”

Section: Conclusion and Future Research Areasmentioning

confidence: 99%

See 2 more Smart Citations

The Impact of Polycystic Ovarian Syndrome on Gestational Diabetes

Aust¹,

Ott²

2011

Gestational Diabetes

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Dietary advice interventions in pregnancy for preventing gestational diabetes mellitus

Tieu

Shepherd

Middleton

et al. 2017

Cochrane Database of Systematic Reviews

107

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Very low-quality evidence from five trials suggests a possible reduction in GDM risk for women receiving dietary advice versus standard care, and low-quality evidence from four trials suggests no clear difference for women receiving low- versus moderate- to high-GI dietary advice. A possible reduction in pregnancy-induced hypertension for women receiving dietary advice was observed and no clear differences were seen for other reported primary outcomes. There were few outcome data for secondary outcomes.For outcomes assessed using GRADE, evidence was considered to be low to very low quality, with downgrading based on study limitations (risk of bias), imprecision, and inconsistency.More high-quality evidence is needed to determine the effects of dietary advice interventions in pregnancy. Future trials should be designed to monitor adherence, women's views and preferences, and powered to evaluate effects on short- and long-term outcomes; there is a need for such trials to collect and report on core outcomes for GDM research. We have identified five ongoing studies and four are awaiting classification. We will consider these in the next review update.

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Risk of gestational diabetes mellitus in women with polycystic ovary syndrome: a systematic review and a meta-analysis

Cited by 120 publications

References 23 publications

Marcadores para o diagnóstico e tratamento de 924 gestações com diabetes melito gestacional

Marcadores para o diagnóstico e tratamento de 924 gestações com diabetes melito gestacional

The Impact of Polycystic Ovarian Syndrome on Gestational Diabetes

Dietary advice interventions in pregnancy for preventing gestational diabetes mellitus

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