Gestational Diabetes Mellitus in Primigravidae: a Mild Disease

Abstract

This prospective observational study was done to analyse the prevalence of gestational diabetes mellitus (GDM) among primigravidae and its outcome. All healthy primigravidae with singleton pregnancies were offered universal glucose tolerance testing between 16 and 28 weeks gestation. GDM and non GDM groups were managed according to hospital protocol. The antenatal features and pregnancy outcomes were analysed. Out of 616 primigravidae, 113 (18.34 %) were GDM with slightly older (27.9 ± 4.2 versus 26.32 ± 3.3, p < 0.001) age. The mean fasting and two hours postprandial blood glucose in both groups were 4.99 ± 1.08 mmol/l, 8.86 ± 1.41 mmol/l(GDM) and 4.36 ± 0.43 mmol/l, 5.71 ± 1.11 mmol/l (Non GDM), respectively. Maternal family history of diabetes mellitus, weight exceeding 80 Kg, polyhydramnios (2.65 % versus 0.2 %, p=0.028) and neonatal hyperbilirubinaemia (9.73 % versus 2.98 %, p=0.01) occurred significantly more frequent in the GDM group compared to normal. There was no significant difference in other pregnancy outcomes and complications between the two groups. In conclusion GDM in primigravidae was detected at a relatively young age with more frequent maternal family history of DM, weight exceeding 80 Kg, polyhydromnions and neonatal hyperbilirubinaemia. The degree of disease was mild and treatment led to no significant complication.

Gestational Diabetes in Malaysia: A Systematic Review of Prevalence, Risk Factors and Outcomes

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Effect of Probiotics on the Glucose Levels of Pregnant Women: A Meta-Analysis of Randomized Controlled Trials

“…Women who are not diabetic or obese before pregnancy can develop insulin resistance due to changes in hormones or intestinal flora or weight gain during pregnancy, and the condition may even develop into GDM. Studies have shown that the incidence rate of GDM can be as high as 14% [ 45 ]. The composition changes of the intestinal flora during pregnancy may affect the metabolic function of the host.…”

Gut Microbiota and Gestational Diabetes Mellitus: A Review of Host-Gut Microbiota Interactions and Their Therapeutic Potential

“…The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study involving 15 multinational centers reported the prevalence of GDM between 9.3 and 25.5% in the global population (Sacks et al, 2012). GDM has become a major health burden, as it is associated with poor fetal-maternal outcomes, including polyhydramnios, higher cesarean section rate, preeclampsia, shoulder dystocia, and macrosomia (Beucher et al, 2010;Ismail et al, 2011;Catalano et al, 2012;Kc et al, 2015). Furthermore, Ehrlich et al (2011) reported an increased risk of GDM by 38% in future pregnancies in women diagnosed with GDM during their first pregnancies compared to only 3.5% in women without GDM.…”