Prevalence of gestational diabetes mellitus among women born in Greenland: measuring the effectiveness of the current screening procedure

Abstract

Objectives. To estimate the prevalence of gestational diabetes mellitus (GDM) among Greenlanders and to evaluate the quality of the current screening procedure for gestational diabetes. Study design. Observational retrospective study of consecutive birth-log data and medical records on pregnant women who had given birth in Nuuk during 2008. Methods. Information about maternal weight, weight gain in pregnancy, height, blood pressure, result of oral glucose tolerance test, family history of diabetes, smoking and alcohol habits, ethnicity, delivery and birth weight and length was collected for women who had given birth in Nuuk, Greenland, during 2008. Results. A total of 233 women born in Greenland who had given birth to a singleton in Nuuk 2008 were included in the study. Of those, 37% were defined as having a high risk for GDM and thus met the screening criteria for GDM used in Greenland. However, only 54% of those women were screened. The prevalence of gestational diabetes was calculated to be 4.3% among high-risk Greenlandic pregnant women (2/46) (95% CI 0-10.0%). Conclusions. Despite a suboptimal screening rate, the prevalence of GDM among Greenlanders seems to be relatively low and Greenlanders may thus be less prone to develop GDM. However, diabetes mellitus is a relatively new disease in Greenland, and glucose intolerance in pregnancy is more likely to affect the next generation. The screening rate is suboptimal, and it is recommended that the screening procedure be optimized in order to find and treat all women with GDM. The number of screened women compared to the number of births occurring annually could be used as an indicator of screening efficacy. Diabetes prevention initiatives should be given high priority to avoid high rates of GDM in the future, as increasing prevalence of the disease is now seen worldwide, regardless of race. (Int J Circumpolar Health 2010;69(x):352-360)

Gestational diabetes and macrosomia among Greenlanders. Time to change diagnostic strategy?

“…It was stated that plasma calibrated handheld glucometers is acceptable to use for the diagnosis of glucose intolerance in pregnancy in locations where laboratory support is either unavailable or at a site remote to the point of care [20]. The prevalence of WHO 2013 GDM at 6.8% reported in this study is the highest prevalence of GDM reported in Greenland until now [10]. This may be a result of the increasing prevalence of overweight and obesity observed among Greenlandic women within the last 2 decades [21].…”

“…Globally, the prevalence of GDM has increased within the last 20 years [8,9]. The first study of GDM performed in Greenland reported a very low prevalence of GDM among women from Nuuk who gave birth in 2008 [10]. However, only 54% of eligible women was actually tested with an oral glucose tolerance test (OGTT) for GDM [10].…”

“…The first study of GDM performed in Greenland reported a very low prevalence of GDM among women from Nuuk who gave birth in 2008 [10]. However, only 54% of eligible women was actually tested with an oral glucose tolerance test (OGTT) for GDM [10]. A later study including all women who gave birth to a singleton in all Greenland 2014 reported a higher testing rate at 85% in Nuuk indicating improved testing rate in Nuuk compared to 2008 [11].…”

Gestational Diabetes Mellitus in Iranian Women: a rising rate

“…Oral glucose challenge test (OGCT), a tolerance test to 50 grams glucose, and oral glucose tolerance test (OGTT), a tolerance test to 75 or 100 grams glucose, were suggested as screening and diagnostic tests for GDM, respectively (9, 10). The incidence of GDM was reported between 1 to 14% of all pregnancies in various regions of the world (11)(12)(13)(14)(15) and its incidence in Iran was estimated about 4.5% of all pregnancies (16,17), but it has indicated that the rate of GDM is increasing in different countries and it is going to become an important public health problem, mainly among women aged 35-39 years (18)(19)(20)(21). So the current study was done as a preliminary study to compare the current rate of GDM in Urmia city, a northwest province in Iran with previously reported rate.…”

Obesity and diabetes — an Arctic challenge

“…This may potentially reduce diabetes prevalence among people born after the 1950's. Pedersen et al (3) suggest that the unexpected low prevalence of gestational diabetes found in Greenland -despite a very high prevalence of diabetes in the adult population in Greenland -could be the beginning of a decrease in diabetes prevalence as a consequence of lower rates of low birth weight over the last decades. If the risk of diabetes associated with birth weight has decreased, as the study indicates, this has adverse implications for the future incidence of diabetes.…”