Gestational Diabetes Mellitus Among Asians – A Systematic Review From a Population Health Perspective

Hu, Lihua; Tobias, Deirdre K; Zhang, Cuilin

doi:10.3389/fendo.2022.840331

Cited by 13 publications

(9 citation statements)

References 104 publications

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“…The incidence rate of T2D after GDM is highly variable across countries and it is relatively higher among Asian populations than among Western populations ( 34 , 35 ). Furthermore, T2D in Asian populations is characterized by a younger age and lower BMI of onset than in the Western populations ( 36 ).…”

Section: Discussionmentioning

confidence: 99%

A holistic approach to preventing type 2 diabetes in Asian women with a history of gestational diabetes mellitus: a feasibility study and pilot randomized controlled trial

Liew,

Soon,

Chooi

et al. 2023

Front. Clin. Diabetes Healthc.

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BackgroundGestational Diabetes Mellitus (GDM) exposes women to future risk of Type 2 Diabetes. Previous studies focused on diet and physical activity, less emphasis was given to tackle intertwined risk factors such as sleep and stress. Knowledge remains scarce in multi-ethnic Asian communities. This study explored the: (1) feasibility of a holistic digital intervention on improving diet, physical activity (PA), sleep and stress of Asian women with a history of GDM, and (2) preliminary efficacy of the holistic intervention on women’s physical and mental well-being via a pilot randomized controlled trial.MethodsFemale volunteers with a history of GDM but without pre-existing diabetes were recruited from multi-ethnic Singaporean community. Each eligible woman was given a self-monitoring opportunity using Oura Ring that provided daily feedback on step counts, PA, sleep and bedtime heart rate. Intervention group additionally received personalized recommendations aimed to reinforce healthy behaviors holistically (diet, PA, sleep and stress). Dietary intake was evaluated by a research dietitian, while step counts, PA, sleep and bedtime heart rate were evaluated by health coaches based on Oura Ring data. Perceived physical and mental health and well-being were self-reported. Clinical outcomes included glycemic status determined by HbA1c and OGTT tests, body mass index, blood pressures and lipid profile.ResultsOf 196 women from the community, 72 women completed diabetes screening, 61 women were eligible and 56 women completed the study. The 56 completers had mean age of 35.8 ± 3.7 years, predominantly Chinese, majority had their first GDM diagnosed at least 2 years ago and had two GDM-affected pregnancies. After intervention period, more women in the Intervention group achieved at least 8,000 steps/day and had at least 6 hours of sleep per night. Noticeable reduction of added sugar in their food and beverages were observed after the dietary intervention. Changes in body weight and mental well-being were observed but group differences were not statistically significant.ConclusionsThe holistic approach appeared feasible for personalizing lifestyle recommendations to promote physical and mental well-being among women with a history of GDM. Larger studies with sufficient assessment timepoints and follow-up duration are warranted to improve the evaluation of intervention effects on clinical outcomes.Clinical trial registration numberhttps://clinicaltrials.gov/show/NCT05512871, NCT05512871.

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Section: Discussionmentioning

confidence: 99%

A holistic approach to preventing type 2 diabetes in Asian women with a history of gestational diabetes mellitus: a feasibility study and pilot randomized controlled trial

Liew,

Soon,

Chooi

et al. 2023

Front. Clin. Diabetes Healthc.

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“…4 Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China. 5 Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China. 6 Duke-NUS Medical School, Singapore, Singapore.…”

Section: Abbreviationsmentioning

confidence: 99%

“…GDM affects from 1% to > 30% of pregnancies worldwide and is exceptionally prevalent in Asian populations such as Saudi Arabia, India, and Singapore [5]. GDM is also important for public health awareness for two reasons.…”

Section: Introductionmentioning

confidence: 99%

Exploring preconception signatures of metabolites in mothers with gestational diabetes mellitus using a non-targeted approach

Wang

Chong

et al. 2023

BMC Med

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Background Metabolomic changes during pregnancy have been suggested to underlie the etiology of gestational diabetes mellitus (GDM). However, research on metabolites during preconception is lacking. Therefore, this study aimed to investigate distinctive metabolites during the preconception phase between GDM and non-GDM controls in a nested case–control study in Singapore. Methods Within a Singapore preconception cohort, we included 33 Chinese pregnant women diagnosed with GDM according to the IADPSG criteria between 24 and 28 weeks of gestation. We then matched them with 33 non-GDM Chinese women by age and pre-pregnancy body mass index (ppBMI) within the same cohort. We performed a non-targeted metabolomics approach using fasting serum samples collected within 12 months prior to conception. We used generalized linear mixed model to identify metabolites associated with GDM at preconception after adjusting for maternal age and ppBMI. After annotation and multiple testing, we explored the additional predictive value of novel signatures of preconception metabolites in terms of GDM diagnosis. Results A total of 57 metabolites were significantly associated with GDM, and eight phosphatidylethanolamines were annotated using HMDB. After multiple testing corrections and sensitivity analysis, phosphatidylethanolamines 36:4 (mean difference β: 0.07; 95% CI: 0.02, 0.11) and 38:6 (β: 0.06; 0.004, 0.11) remained significantly higher in GDM subjects, compared with non-GDM controls. With all preconception signals of phosphatidylethanolamines in addition to traditional risk factors (e.g., maternal age and ppBMI), the predictive value measured by area under the curve (AUC) increased from 0.620 to 0.843. Conclusions Our data identified distinctive signatures of GDM-associated preconception phosphatidylethanolamines, which is of potential value to understand the etiology of GDM as early as in the preconception phase. Future studies with larger sample sizes among alternative populations are warranted to validate the associations of these signatures of metabolites and their predictive value in GDM.

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“…Maternal obesity is characterized by a body mass index (BMI) of 30 or higher, and it impacts roughly 20% of expectant mothers globally. 1 Evidence has demonstrated that the presence of obesity while pregnant escalates the likelihood of experiencing gestational diabetes, high blood pressure, premature delivery, and fetal demise. 2,3 The fetal risks associated with maternal obesity include macrosomia, congenital anomalies, and neonatal hypoglycemia.…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have found that maternal obesity adversely impacts a mother's health and the health of her fetus. In a systematic review and meta-analysis study 1 , maternal obesity was associated with 2.78 times higher risks of gestational diabetes, 2.38 times higher risks of gestational hypertension, and 2.19 times higher risks of preeclampsia. As well as the preterm birth risk, obese women are at 1.8 times higher risk for stillbirth and 1.4 times higher risk for preterm birth.…”

Section: Introductionmentioning

confidence: 99%

Obesity in Pregnancy Maternal and Fetal Outcome

Siddique,

Ahuja,

Sahito

et al. 2023

PJMHS

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Background: The presence of excessive weight in mothers during pregnancy and childbirth can result in significant issues in different stages of pregnancy, delivery, postpartum and also newborn health. The aim of the present study was to examine the influence of maternal obesity on diverse consequences for both the mother and the developing baby. The main objective was to contrast the effects of obesity on outcomes during pregnancy and childbirth for overweight expectant mothers versus those with a healthy weight. Material and Methods: The investigation was carried out on pregnant women who attended the antenatal clinic at Indus Medical College Tando Muhammad Khan. The investigators utilized a sequential sampling technique and handpicked 56 cases and 56 controls. The data was analyzed using IBM SPSS 22.0 software. The chi-square test was used to identify discrepancies in proportions, while the independent t-test and ANOVA were utilized to contrast the means. They also conducted Pearson's correlation to investigate the connection between maternal BMI and birth weight. Results: There were a total of 112 patients included in the study. There were 56 cases (patients) and 56 controls (healthy individuals). Women with gestational diabetes mellitus had a significantly higher proportion of complications compared to those without gestational diabetes mellitus (32.1% vs. 7.14%, p-value=0.02). Regarding the mode of delivery, women who underwent caesarean section had a significantly higher proportion of complications compared to those who had a vaginal delivery (37.5% vs. 62.5%, p-value=0.02). For post-partum complications, the proportion of women with postpartum fever and wound infection was very low, and no statistical comparison was made. Conclusions: The current research provided clear evidence that maternal obesity can result in negative outcomes for both the mother and fetus. In addition, the study showed that there was an increased need for induction of labor and operative interventions in women who were obese. Keywords: Fetal outcome, Maternal outcome, obesity in pregnancy

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Gestational Diabetes Mellitus Among Asians – A Systematic Review From a Population Health Perspective

Cited by 13 publications

References 104 publications

A holistic approach to preventing type 2 diabetes in Asian women with a history of gestational diabetes mellitus: a feasibility study and pilot randomized controlled trial

A holistic approach to preventing type 2 diabetes in Asian women with a history of gestational diabetes mellitus: a feasibility study and pilot randomized controlled trial

Exploring preconception signatures of metabolites in mothers with gestational diabetes mellitus using a non-targeted approach

Obesity in Pregnancy Maternal and Fetal Outcome

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