Gestational Diabetes After Delivery

Kitzmiller, John L.; Dang-Kilduff, Leona; Taslimi, M. Mark

doi:10.2337/dc07-s221

Cited by 141 publications

(91 citation statements)

References 158 publications

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“…The differentiation of this study from our study and other studies and the reason for the low DM prevalence in this study was probably the exclusion of cases with normal results on the first glycemic status evaluation at the sixth week after delivery (9). Despite the presence of studies reporting that ethnic origin does not have primary importance, there are studies associating the prevalence of postpartum type 2 DM they determined following GDM, directly with de novo type 2 DM development rates in the population study (5,(12)(13)(14). In our country, there is no specific screening program for DM except for the pregnancy period.…”

Section: Discussioncontrasting

confidence: 45%

Incidence of diabetes mellitus at postpartum six to twelve months following the diagnosis of gestational diabetes mellitus

Kerimoğlu¹,

Yalvaç²,

Karçaaltıncaba³

et al. 2010

J Turkish German Gynecol Assoc

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Objective:The aim of this study was to research the rates of diabetes mellitus (DM) and the risk factors that may play a role in the prediction of this condition by evaluating patients with the diagnosis of gestational diabetes mellitus (GDM) at the 6 th -12 th postpartum months. Material and Method:Among 109 cases who had been invited to the hospital for oral glucose tolerance test (OGTT) at the 6 th -12 th postpartum months, 84 cases (77%) were enrolled in the study. To the 78 patients that were found to be appropriate according to the study criteria, 75 gr OGTT was administered. Patients who had new pregnancies during the period of postpartum screening, and those with previously diagnosed DM were excluded from the study. Results:While the results of 23 cases (29.5%) included in the study were normal, 27 cases (34.6%) were diagnosed with DM and 28 cases (35.9%) were diagnosed as having an impaired glucose tolerance and /or impaired fasting glucose (IGT/IFG). Among patients diagnosed with DM, the history of DM in the first degree relatives (n=21, 77.8%, p=0.018), body mass index before pregnancy (mean=30.1±4.4, p=0.009) and insulin requirement for the treatment of GDM (n=25, 92.6%, p<0.05) were determined at higher rates. In the logistic regression analysis, multiparity (OR=2) and insulin requirement during pregnancy (OR: 7.27) were found to be the predictive factors in the development of postpartum DM. Discussion:In this study, the determination of high rates of DM development in the postpartum period after GDM demonstrates the necessity of augmentation in efforts to increase the screening rates after delivery and to increase the patients' acknowledgement of this topic. (J Turkish-German Gynecol Assoc 2010; 11: 89-94) Key words: Gestational diabetes mellitus, postpartum, OGTT Received: 20 February, 2010 Accepted: 11 April, 2010 Amaç: Bu çalışmada gestasyonel diyabetes mellitus (GDM) tanısı alan hastaların postpartum 6-12.aylar arasında değerlendirilmesi sonucunda diyabetes mellitus (DM) saptanma oranları ve bu durumun öngörülmesine katkısı olabilecek risk faktörlerini araştırmak amaç-lanmıştır. Gereç ve Yöntemler:Postpartum 6-12. aylar arasında oral glikoz tolerans testi (OGTT) için hastaneye davet edilen 109 hastadan 84 (%77) olgu çalışmaya başvurdu, çalışma kriterlerine uygun 78 hastaya 75 gr OGTT uygulandı. Postpartum tarama zamanında tekrar gebelik tespit edilen veya daha önce DM tanısı alan hastalar çalışma dışı bırakıldı. Bulgular:Çalışma kapsamındaki hastalardan 23 (%29.5) olgunun sonuçları normalken; 27 olguya (%34.6) DM, 28 (%35.9) olguya bozulmuş glikoz toleransı ve/veya bozulmuş açlık glikozu tanısı konuldu. DM tanısı alan hasta grubunda 1.derece akrabalarda DM öyküsü (n=21, %77.8, p=0.018), gebelik öncesi vücut kitle indeksi (ortalama=30.1±4.4, p=0.009) ve GDM tedavisi için insülin gereksinimi (n=25, %92.6, p<0.05) daha fazla oranda tespit edildi. Yapılan lojistik regresyon analizi sonucunda multiparite (OR=2) ve gebelikte insülin tedavisi gereksiniminin (OR: 7.27) postpartum DM gelişimi iç...

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Section: Discussioncontrasting

confidence: 45%

Incidence of diabetes mellitus at postpartum six to twelve months following the diagnosis of gestational diabetes mellitus

Kerimoğlu¹,

Yalvaç²,

Karçaaltıncaba³

et al. 2010

J Turkish German Gynecol Assoc

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“…2 GDM is associated with increased perinatal risks, while long-term consequences include development of type 2 diabetes and increased cardiovascular risk. 3 Although research to date has varied in estimates of future type 2 diabetes risk, one recent Australian study reported a 9.6 times greater risk of type 2 diabetes in women with previous GDM and a cumulative risk of 25% after 15 years. 4 Research demonstrates that intensive lifestyle interventions are effective in the prevention of type 2 diabetes, 5 hence, the diagnosis of GDM provides an opportunity for early intervention in an at-risk group.…”

Section: Introductionmentioning

confidence: 99%

Postpartum diet quality in Australian women following a gestational diabetes pregnancy

et al. 2012

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BACKGROUND/OBJECTIVES:To describe the diet quality of a national sample of Australian women with a recent history of gestational diabetes mellitus (GDM) and determine factors associated with adherence to national dietary recommendations. SUBJECTS/METHODS: A postpartum lifestyle survey with 1499 Australian women diagnosed with GDM p3 years previously. Diet quality was measured using the Australian recommended food score (ARFS) and weighted by demographic and diabetes management characteristics. Multinominal logistic regression analysis was used to determine the association between diet quality and demographic characteristics, health seeking behaviours and diabetes-related risk factors. RESULTS: Mean (±s.d.) ARFS was 30.9±8.1 from a possible maximum score of 74. Subscale component scores demonstrated that the nuts/legumes, grains and fruits were the most poorly scored. Factors associated with being in the highest compared with the lowest ARFS quintile included age (odds ratio (OR) 5-year increase ¼ 1.40; 95% (confidence interval) CI:1.16-1.68), tertiary education (OR ¼ 2.19; 95% CI:1.52-3.17), speaking only English (OR ¼ 1.92; 95% CI:1.19-3.08), being sufficiently physically active (OR ¼ 2.11; 95% CI:1.46-3.05), returning for postpartum blood glucose testing (OR ¼ 1.75; 95% CI:1.23-2.50) and receiving risk reduction advice from a health professional (OR ¼ 1.80; 95% CI:1.24-2.60). CONCLUSIONS: Despite an increased risk of type 2 diabetes, women in this study had an overall poor diet quality as measured by the ARFS. Women with GDM should be targeted for interventions aimed at achieving a postpartum diet consistent with the guidelines for chronic disease prevention. Encouraging women to return for follow-up and providing risk reduction advice may be positive initial steps to improve diet quality, but additional strategies need to be identified.

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“…Type 2 diabetes ultimately develops in about one-half of all women who have GDM (9). In 2007, GDM in mothers of ;180,000 delivered newborns was associated with $636 million in increased medical costs (10).…”

mentioning

confidence: 99%

The Economic Burden of Elevated Blood Glucose Levels in 2012: Diagnosed and Undiagnosed Diabetes, Gestational Diabetes Mellitus, and Prediabetes

et al. 2014

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OBJECTIVE To update estimates of the economic burden of undiagnosed diabetes, prediabetes, and gestational diabetes mellitus in 2012 in the U.S. and to present state-level estimates. Combined with published estimates for diagnosed diabetes, these statistics provide a detailed picture of the economic costs associated with elevated glucose levels. RESEARCH DESIGN AND METHODS This study estimated health care use and medical expenditures in excess of expected levels occurring in the absence of diabetes or prediabetes. Data sources that were analyzed include Optum medical claims for ∼4.9 million commercially insured patients who were continuously enrolled from 2010 to 2012, Medicare Standard Analytical Files containing medical claims for ∼2.6 million Medicare patients in 2011, and the 2010 Nationwide Inpatient Sample containing ∼7.8 million hospital discharge records. The indirect economic burden includes reduced labor force participation, missed workdays, and reduced productivity. State-level estimates reflect geographic variation in prevalence, risk factors, and prices. RESULTS The economic burden associated with diagnosed diabetes (all ages) and undiagnosed diabetes, gestational diabetes, and prediabetes (adults) exceeded $322 billion in 2012, consisting of $244 billion in excess medical costs and $78 billion in reduced productivity. Combined, this amounts to an economic burden exceeding $1,000 for each American in 2012. This national estimate is 48% higher than the $218 billion estimate for 2007. The burden per case averaged $10,970 for diagnosed diabetes, $5,800 for gestational diabetes, $4,030 for undiagnosed diabetes, and $510 for prediabetes. CONCLUSIONS These statistics underscore the importance of finding ways to reduce the burden of prediabetes and diabetes through prevention and treatment.

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Gestational Diabetes After Delivery

Cited by 141 publications

References 158 publications

Incidence of diabetes mellitus at postpartum six to twelve months following the diagnosis of gestational diabetes mellitus

Incidence of diabetes mellitus at postpartum six to twelve months following the diagnosis of gestational diabetes mellitus

Postpartum diet quality in Australian women following a gestational diabetes pregnancy

The Economic Burden of Elevated Blood Glucose Levels in 2012: Diagnosed and Undiagnosed Diabetes, Gestational Diabetes Mellitus, and Prediabetes

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