The Boston Gestational Diabetes Studies: Review and Perspectives

O’Sullivan, John B.

doi:10.1007/978-1-4471-1680-6_26

Cited by 64 publications

(42 citation statements)

References 10 publications

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“…In these cases, the study that included the most participants was abstracted. In several instances, particularly with the Boston cohort, several reports on cumulative incidence were made on a cohort as it aged; in these instances, all reports were included (4,(12)(13)(14)(15)(16)(17).…”

Section: Search For Published Datamentioning

confidence: 99%

Gestational Diabetes and the Incidence of Type 2 Diabetes

2002

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OBJECTIVE -To examine factors associated with variation in the risk for type 2 diabetes in women with prior gestational diabetes mellitus (GDM).RESEARCH DESIGN AND METHODS -We conducted a systematic literature review of articles published between January 1965 and August 2001, in which subjects underwent testing for GDM and then testing for type 2 diabetes after delivery. We abstracted diagnostic criteria for GDM and type 2 diabetes, cumulative incidence of type 2 diabetes, and factors that predicted incidence of type 2 diabetes.RESULTS -A total of 28 studies were examined. After the index pregnancy, the cumulative incidence of diabetes ranged from 2.6% to over 70% in studies that examined women 6 weeks postpartum to 28 years postpartum. Differences in rates of progression between ethnic groups was reduced by adjustment for various lengths of follow-up and testing rates, so that women appeared to progress to type 2 diabetes at similar rates after a diagnosis of GDM. Cumulative incidence of type 2 diabetes increased markedly in the first 5 years after delivery and appeared to plateau after 10 years. An elevated fasting glucose level during pregnancy was the risk factor most commonly associated with future risk of type 2 diabetes.CONCLUSIONS -Conversion of GDM to type 2 diabetes varies with the length of follow-up and cohort retention. Adjustment for these differences reveals rapid increases in the cumulative incidence occurring in the first 5 years after delivery for different racial groups. Targeting women with elevated fasting glucose levels during pregnancy may prove to have the greatest effect for the effort required. Diabetes Care 25:1862-1868, 2002G estational diabetes mellitus (GDM), or impaired glucose intolerance first diagnosed during pregnancy (1), affects ϳ14% of pregnancies, or 135,000 women a year in the U.S., and is a risk factor for type 2 diabetes in the mother (2). The magnitude of the reported risk varies widely; it is unclear how much of the variation is explained by variations in ethnicity, length of follow-up, selection criteria, and tests for GDM and type 2 diabetes (3-5). Understanding the basis of differences in risk could affect screening protocols for type 2 diabetes in women with a history of GDM and identify women with GDM who may be candidates for studies of preventive interventions of type 2 diabetes.To examine the relative importance of several sources of variation on the risk of type 2 diabetes in women with GDM, we performed a systematic review of the literature, examining the cumulative incidence of type 2 diabetes in women with GDM. We examined the study design, ethnicity, criteria for diagnosis of GDM and type 2 diabetes, length of follow-up, and other predictive factors. We hypothesized that much of the difference in the risk reported among studies could be explained by different lengths of follow-up, ethnic variation, and the diagnostic criteria used. RESEARCH DESIGN AND METHODS -We searched PubMedfor studies published from 1965 to 2001 using the search strategy "gestational ...

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Section: Search For Published Datamentioning

confidence: 99%

Gestational Diabetes and the Incidence of Type 2 Diabetes

2002

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“…Studies have shown patients with GDM are at an increased risk of developing Type 2 diabetes in the future. 18 …”

Section: Gestational Diabetes Mellitus (Gdm)mentioning

confidence: 99%

Using surrogate markers in primary electronic patient record systems to confirm or refute the diagnosis of diabetes

Bagheri¹,

A²,

Chan³

et al. 2009

Journal of Innovation in Health Informatics

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Background UK primary care records are computerised and these records are used for both research and quality improvement. However, there is disparity in the prevalence of diabetes found in epidemiological studies compared with that reported through the UK's national quality improvement scheme. Objective To investigate how non-diagnostic computer data could be used to identify, confirm or refute prevalent cases of people with diabetes. Method We carried out a literature review to identify the most accurate non-diagnostic markers. For each type of diabetes we focused on four broad areas; demographic details, biochemical markers, clinical features and therapeutic strategies. Sample markers were tested by calculating their positive predictive value (PPV) and sensitivity (Sn) and their ability to differentiate between types of diabetes. Results Biochemical markers were useful in identifying cases of diabetes but not in differentiating between types of diabetes as the same plasma glucose criterion is used to diagnose Type 1, Type 2, and 'other' types of diabetes; the lack of a 'fasting' qualifier blunts the use of this marker.Auto-immune markers were the most accurate in identifying Type 1 diabetes but are not recorded frequently in primary care.

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“…Entretanto, está bem estabelecido que essas mulheres têm alto risco para desenvolver o diabete tipo 2 na vida futura. No trabalho clássico de Sullivan 11 , o diabete foi diagnosticado em 36% das mulheres, 22 a 28 anos após a gravidez complicada por DMG (gravidez-índice). Estas mulheres apresentavam outras características que atualmente confi guram a síndrome da resistência à insulina-obesidade central, dislipidemia e hipertensão, todas associadas ao maior risco de morbidade.…”

Section: A Responsabilidade Com O Feto E Recém-nascidounclassified

A responsabilidade do obstetra sobre o diagnóstico e o tratamento do diabete melito gestacional

Rudge¹,

Calderon²

2006

Rev. Bras. Ginecol. Obstet.

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The Boston Gestational Diabetes Studies: Review and Perspectives

Cited by 64 publications

References 10 publications

Gestational Diabetes and the Incidence of Type 2 Diabetes

Gestational Diabetes and the Incidence of Type 2 Diabetes

Using surrogate markers in primary electronic patient record systems to confirm or refute the diagnosis of diabetes

A responsabilidade do obstetra sobre o diagnóstico e o tratamento do diabete melito gestacional

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