Diabetes in pregnancy among Sri Lankan women: gestational or pre-gestational?

Jayathilaka, K.M.P.N.; Dahanayake, Shamalka; Abewardhana, R; Ranaweera, Akp; Rishard, Mrm; Wijeyaratne, CN

doi:10.4038/sjdem.v1i1.4181

Cited by 10 publications

(12 citation statements)

References 16 publications

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“…A higher GDM prevalence in Asians has been demonstrated in the literature previously. Some publications have also shown evidence of worse outcome in Asian PGDM subjects compared to their GDM counterparts (Ferrara, 2007; Jayathilaka, Dahanayake, Abewardhana, Ranaweera, & Rishard, 2012; Shefali, Kavitha, Deepa, & Mohan, 2006) Our findings suggest that races with the highest predilection for diabetes during pregnancy may not necessarily have the highest racial predilection for type 2 or type 1 DM. To our knowledge, this is the first time that such racial/ethnic comparisons have been made between PGDM and GDM in a single population.…”

Section: Discussionsupporting

confidence: 52%

Pre-gestational versus gestational diabetes: A population based study on clinical and demographic differences

Fong

Serra

Herrero

et al. 2014

Journal of Diabetes and its Complications

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Aims To assess the clinical and demographic differences in patients with pre-gestational diabetes mellitus (PGDM) compared to those with gestational diabetes (GDM). Methods Using the 2001–2007 California Health Discharge Database, we identified 22,331 cases of PGDM and 147,097 cases of GDM via ICD-9-CM codes after excluding cases which were missing race or age data or with extremes of age. Data analyzed included demographics, pre-existing medical conditions, antepartum complications, and intrapartum complications. Logistic regression was used to adjust for potential confounders. Results Both PGDM and GDM incidences increased during the study period. Advancing age was associated with increased prevalence of both diseases. Although Asians were found to have the highest prevalence of GDM, they, along with Caucasians, were found have the lowest prevalence of PGDM. Conditions with increased frequency in PGDM versus GDM included chronic hypertension, renal disease, thyroid dysfunction, fetal CNS malformation, fetal demise, pyelonephritis, and eclampsia. Subjects with PGDM were more likely than those with GDM to have a shoulder dystocia, failed induction of labor, or undergo cesarean delivery. Conclusions We have demonstrated clinical morbidities and demographic factors which differ in patients with PGDM compared to patients with GDM. Our findings suggest PGDM to be associated with significantly higher morbidity when compared to GDM. Our findings also suggest that races with the highest tendency for GDM during pregnancy may not necessarily have the highest tendency for PGDM outside of pregnancy.

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Section: Discussionsupporting

confidence: 52%

Pre-gestational versus gestational diabetes: A population based study on clinical and demographic differences

Fong

Serra

Herrero

et al. 2014

Journal of Diabetes and its Complications

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“…Lwanga and Lemeshow equation 15 was used for the sample size calculation. According to previous study findings prevalence of GDM in Sri Lankan population was 18% 5 . Expected sensitivity for this study was 75% and expected specificity was 95%.…”

Section: Methodsmentioning

confidence: 84%

“…According to the world diabetes report published by the WHO in 2016, second highest prevalence of GDM is reported among the south East Asian countries including Sri Lanka 4 . Prevalence of GDM in Sri Lanka, in year 2014 was 18% 5 in 2016 prevalence of GDM in urban and suburban areas of Sri Lanka was reported as 13.8% 6 .…”

Section: Introductionmentioning

confidence: 99%

Prediction of Gestational diabetes: Role of neutrophil to lymphocyte ratio at booking visit

Fahim

Silva

Abeykoon³

2021

Sri Lanka J Obstet & Gynae

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Introduction: Gestational Diabetes Mellitus (GDM) affect up to approximately 10% of all pregnancies. Various markers of inflammation have been shown to predict the future diabetes risk and Neutrophil Lymphocyte Ratio (NLR) level is significantly correlated with metabolic syndrome criteria. However, very few studies investigated any possible association between NLR and development of GDM. Objectives• To compare the NLR among GDM group and control group.• To identify an optimal cut-off value of NLR in predicting GDM.Methods: A longitudinal observational study in all pregnant women who are in their first trimester at antenatal clinic, Teaching Hospital, Kandy for six months was carried out with a Full Blood Count at the first trimester and Oral Glucose Tolerance Test (OGTT) at the 24-28 weeks of gestation. Sample size was 361 and non-probability convenient sampling technique was applied.Results: Mean NLR value was 3.16 (SD=1.84) and the difference between GDM and non GDM mothers was not significant. Left upper most value for NLR of the ROC curve is 1.32 and when it is used as the cut off value the sensitivity is 99.6% and the specificity is 21.2%. Conclusions and recommendations:NLR positively correlates with the OGTT values done at 24-28 weeks of gestation, which can be used as a predictor at early booking visit. There is no significant difference between the mean value of participants with or without GDM. Prediction of GDM by NLR should be further studied in a well-targeted study population with wide methodology.

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“…However, majority of patients in our study (88.8%) underwent post prandial blood sugar (PPBS) during the booking visit. A previous study conducted in Anuradhapura district in 2012 (8), used urinary sugar level which is not very reliable or accurate as the screening test. Compared to that we observed a marked improvement in diagnostic practice in our cohort.…”

Section: Discussionmentioning

confidence: 99%

“…IADPSG (the international association of the diabetes and pregnancy study groups) criteria had a good predictive value for macrosomia in a Sri Lankan study (7). A study conducted in Anuradhapura district found that random urine sugar tests were done as the screening test for hyperglycaemia in pregnancy in 93% and blood sugar levels were done in less than 41% (8). However random urine sugar test and fasting blood sugar test were found to be unreliable in another Sri Lankan study and they suggested that 2-hour blood sugar level after 75 g of oral glucose had better sensitivity and speci city for diagnosis of diabetes mellitus in early pregnancy (9).…”

mentioning

confidence: 99%

Diagnosis, Management and Maternal, Neonatal Outcomes of Hyperglycaemia in Pregnancy Among Pregnant Women in a Rural District of Sri Lanka: A Cross Sectional Descriptive Study

Amarawardena

Silva

Weerasena

et al. 2022

Preprint

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Background Prevalence of hyperglycaemia in pregnancy is on the rise. Both gestational diabetes mellitus and pre-existing diabetes mellitus are linked to several maternal and foetal/neonatal complications. We describe the diagnosis, management and maternal, neonatal outcomes of hyperglycaemia in pregnancy and compare these variables between mothers with gestational diabetes mellitus and mothers with pre- existing diabetes mellitus in a rural district of Sri Lanka recovering from the effects of decades of civil war. Methods A retrospective cross sectional descriptive study was conducted among mothers with gestational or pre-existing diabetes with a singleton pregnancy, who delivered in the obstetric ward of district general hospital of Vavuniya from 01/10/2018 to 31/10/2019. Consecutive sampling was used. Results Mean age of the participants (n = 324) was 30.07 ± 4.63 (± SD) years. Post prandial blood glucose was checked in 88.8% during the booking visit. Pre-existing diabetes mellitus was detected in 13.5% of mothers. Medical nutrition therapy alone was used in the management of 54.01% of mothers. Addition of metformin alone was needed in 36.7% and 9.2% required combination therapy with metformin and insulin. There were no maternal deaths, intra uterine deaths or still births. Operative delivery was required in 46.3% of mothers. Birth weight > 3.5kg was observed in 13.3% of newborns. Low birth weight (birth weight < 2.5 kg) was noted in 5.2%. There were no cases of shoulder dystocia. Sixteen (4.93%) babies had minor complications. Post-partum complications were noted only in 7 (2.16%) mothers. Post-partum blood sugar levels were performed in 86.7% mothers. Neonatal complications and low birth weight were significantly higher among mothers with pre-existing diabetes. Conclusions We observed low rates of maternal and neonatal complications among mothers with hyperglycaemia in pregnancy. Re-establishment of public health system in these rural areas in the post-war period probably contributed to this. Mothers with pre-existing diabetes had significantly higher rates of low birth weight and neonatal complications compared to mothers with gestational diabetes mellitus. A significant number of mothers missed post-partum blood sugar testing which is an area that could be improved.

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Diabetes in pregnancy among Sri Lankan women: gestational or pre-gestational?

Abstract: Background

Cited by 10 publications

References 16 publications

Pre-gestational versus gestational diabetes: A population based study on clinical and demographic differences

Pre-gestational versus gestational diabetes: A population based study on clinical and demographic differences

Prediction of Gestational diabetes: Role of neutrophil to lymphocyte ratio at booking visit

Diagnosis, Management and Maternal, Neonatal Outcomes of Hyperglycaemia in Pregnancy Among Pregnant Women in a Rural District of Sri Lanka: A Cross Sectional Descriptive Study

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