How Do We Reduce the Number of Cases of Missed Postpartum Diabetes in Women With Recent Gestational Diabetes Mellitus?

Schaefer-Graf, Ute M.; Klavehn, Silke; Hartmann, Reinhard; Kleinwechter, Helmut; Demandt, Norbert; Sorger, M.; Kjos, Siri L.; Vetter, K.; Abou-Dakn, Michael

doi:10.2337/dc09-0627

Cited by 70 publications

(47 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The rate of lactation is low in European women, and this needs to be addressed. Similarly, uptake rates of post partum OGTT after GDM remain low internationally (5,34). Electronic alerts via text message or email, automated letters, and nurse phone contact may increase uptake.…”

Section: Discussionmentioning

confidence: 99%

Atlantic DIP: high prevalence of abnormal glucose tolerance post partum is reduced by breast-feeding in women with prior gestational diabetes mellitus

O’Reilly

Avalos

Dennedy

et al. 2011

European Journal of Endocrinology

View full text Add to dashboard Cite

Objective: Gestational diabetes (GDM) is associated with adverse fetal and maternal outcomes, and identifies women at risk of future type 2 diabetes mellitus (T2DM). Breast-feeding may improve post partum maternal glucose tolerance. Our objective was to identify the prevalence of post partum dysglycemia after GDM, to delineate associated factors and to examine the effect of lactation on post partum glucose tolerance. Design: We compared post partum 75 g oral glucose tolerance test (OGTT) results from 300 women with GDM and 220 controls with normal gestational glucose tolerance (NGT) in five regional centers. Breast-feeding data was collected at time of OGTT. Methods: Post partum OGTT results were classified as normal (fasting plasma glucose (FPG) !5.6 mmol/l, 2 h !7.8 mmol/l) and abnormal (impaired fasting glucose (IFG), FPG 5.6-6.9 mmol/l; impaired glucose tolerance (IGT), 2 h glucose 7.8-11 mmol/l; IFGCIGT; T2DM, FPG R7 mmol/lG2 h glucose R11.1 mmol/l). Binary logistic regression was used to identify factors predictive of persistent hyperglycemia. Results: Five hundred and twenty women were tested; six (2.7%) with NGT in pregnancy had post partum dysglycemia compared with 57 (19%) with GDM in index pregnancy (P!0.001). NonEuropean ethnicity (odds ratio (OR) 3.40; 95% confidence interval (CI) 1.45-8.02, PZ0.005), family history of T2DM (OR 2.14; 95% CI 1.06-4.32, PZ0.034), and gestational insulin use (OR 2.62; 95% CI 1.17-5.87, PZ0.019) were associated with persistent dysglycemia. The prevalence of persistent hyperglycemia was significantly lower in women who breast-fed vs bottle-fed post partum (8.2 vs 18.4%, P!0.001). Conclusions: Non-European ethnicity, gestational insulin use, family history of T2DM, and elevated body mass index were associated with persistent dysglycemia after GDM. Breast-feeding may confer beneficial metabolic effects after GDM and should be encouraged. European Journal of Endocrinology 165 953-959

show abstract

Section: Discussionmentioning

confidence: 99%

Atlantic DIP: high prevalence of abnormal glucose tolerance post partum is reduced by breast-feeding in women with prior gestational diabetes mellitus

O’Reilly

Avalos

Dennedy

et al. 2011

European Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…This is also expressed in our study. The study has also shown that high levels of blood sugar in pregnant women can risk developing diabetes or impaired glucose tolerance after pregnancy because, in women who have experienced a higher level of FBS during pregnancy, there has been impaired fasting glucose after pregnancy or diabetes; thus, this relationship proved significant (21).…”

Section: Discussionmentioning

confidence: 96%

“…The reasons for this difference can be due to the smaller sample size of our study compared with this study and having a control group in this study (20). Schaefer-Graf et al conducted another study that examines the factors involved in postpartum diabetes and how to reduce its patients (21). This study has shown that BMI is closely associated with the incidence of postpartum diabetes.…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Evaluation of Predictive Factors of Development of Type 2 Diabetes Mellitus (T2dm) in Patients With Gestational Diabetes Mellitus (Gdm)

Razmpoor¹,

Kheirandish²,

Zare³

2017

Acta Healthmedica

View full text Add to dashboard Cite

Introduction: Several groups have been considered as the population at risk for diabetes, one of which is women with a history of gestational diabetes. Women with gestational diabetes are likely to develop type 2 diabetes mellitus (T2DM) and cardiovascular disease. Given the great importance of controlling risk factors for T2DM following gestational diabetes, it was decided to conduct a study to investigate predictive factors of the development of T2DM in patients with gestational diabetes mellitus (GDM). Methods: This cross-sectional study had been conducted on pregnant women with gestational diabetes in 2015. All pregnant women underwent screening for gestational diabetes at the first visit. At six to 12 weeks after parturition, they were put under oral glucose tolerance test (OGTT) again. Follow-up was done in all cases where there was an abnormality in diagnostic test or symptoms of hyperglycemia, glycosuria, and abnormal weight gain. All blood samples were centrifuged, and plasma samples obtained were transferred to measure glucose. Chi-square test was used for data analysis with IBM SPSS 21.0 statistical software. P-value less than 0.05 was considered as the significance level. Results: A total of approximately 185 patients were included in this study with a mean age of 27.7 ± 4.8 years. Among 185 patients who were followed-up for six to 12 weeks after parturition, 10% of patients were with type 2 diabetes after pregnancy. In addition, 10% of postpartum patients have had impaired glucose tolerance test (IGT), but diabetes was not found. Also, 30.27% (n = 56) of the patients have had impaired fasting glucose (IFG). Finally, about 44.32% (n = 82) of the patients had abnormal blood glucose test (AGT). After analyzing the data, it was found that, of 185 patients, two patients had a BMI less than 20, three people with a BMI between 20-24.9, seven patients with a BMI between 25-29.9, and three patients with BMI between 30-40 had diabetes, according to GTT test. Risk factors such as cholesterol, history of hyperthyroidism, history of hypothyroidism, polycystic ovarian syndrome, obesity, acanthosis nigricans, and family history of diabetes had no significant relationship with development of diabetes after pregnancy (p>0.05). Conclusion: About 10% of patients after parturition clearly had diabetes, according to the tests carried out. Our study showed that BMI and FBS play a significant role in predicting the development of diabetes, but factors such as history of miscarriage, stillbirth, macrosomia, death without cause and medical records such as hypertension, obesity, hyperthyroidism, and hypothyroidism have not played a significant role in this prediction.

show abstract

“…In this study, the rate of incidence of postpartum DM development in the first year among patients treated with insulin for GDM was found to be higher than that of other patients (p<0.05 OR=7.27). The necessity of insulin use during pregnancy was also defined as a factor with high predictive value for the development of DM in the future in the literature (9,21,(28)(29)(30). The total number of hospitalisation days and polyclinic control were evaluated since they consequently show poor glycemic control and the necessity of more common assessment, but there was no significant difference between patients diagnosed with DM and those not diagnosed with DM.…”

Section: Discussionmentioning

confidence: 99%

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

View full text Add to dashboard Cite

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...

show abstract

How Do We Reduce the Number of Cases of Missed Postpartum Diabetes in Women With Recent Gestational Diabetes Mellitus?

Cited by 70 publications

References 23 publications

Atlantic DIP: high prevalence of abnormal glucose tolerance post partum is reduced by breast-feeding in women with prior gestational diabetes mellitus

Atlantic DIP: high prevalence of abnormal glucose tolerance post partum is reduced by breast-feeding in women with prior gestational diabetes mellitus

Evaluation of Predictive Factors of Development of Type 2 Diabetes Mellitus (T2dm) in Patients With Gestational Diabetes Mellitus (Gdm)

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

Contact Info

Product

Resources

About