Prevalence of gestational diabetes mellitus in a Suburban District in Sri Lanka: a population based study

Abstract

Introduction GDM is a leading metabolic cause of morbidity to mother and offspring. Determining its prevalence is important for health planning and implementation.Objective Assess prevalence of GDM in the District of Gampaha.Method Community based cross-sectional study was conducted in women attending field-based ante-natal clinics in two Medical Officer of Health (MOH) areas between January 2014 to March 2015.Consecutive women were recruited by cluster sampling with probability proportionate to size using strict exclusion criteria. GDM diagnosis was based on fasting 75 g OGTT, WHO 1999. All responders underwent 2 hr PPBS in first trimester->200 mg/dl with symptoms identified as abnormal, probably diabetes in pregnancy (DIP); those >120 and <200 mg/dl proceeded to OGTT before 16 weeks POA; all negatives were tested by OGTT between 24-28 weeks. Negatives for GDM at 24-28 weeks underwent OGTT between 32-36 weeks; venous plasma glucose tested by accredited laboratory.Results Sample consistedof 160, non-response 4.2% (67); 1533 underwent 2 hr PPBS with 40 exceeding 120mg: 4 >200 mg diagnosed as GDM / DIP, 36 (PPBS >120 < 200 mg) underwent OGTT before 16 weeks with 15 GDM. One hundred and thirty four (8.38%) miscarried including one with early abnormal OGTT. Of 1381 eligible for OGTT (24-28 weeks) 150 had GDM (10.86%). Only 344 (27.94% of normal 1231) consented for third trimester OGTT, of whom 25 had GDM-yielding a total of 194 with GDM (13.9%). ConclusionThe current community prevalence of GDM in the suburban Gampaha District, Sri Lanka is high.

The impact of diagnostic criteria for gestational diabetes on its prevalence: a systematic review and meta-analysis

“…A total of 33.3% studies were cross-sectional and 66.6% were prospective or retrospective cohorts published between 1993 and 2017. Thirty-five studies were cohort [8, 16, 23, 25–27, 30–34, 38–40, 42, 43, 45, 46, 48, 50, 51, 54, 55, 57, 60–66, 69, 71, 72] and 16 cross-sectional [24, 28, 29, 35–37, 41, 44, 47, 49, 52, 53, 56, 67, 68, 70]. Fourteen (27.4%) studies, classified as group 1 [16, 33, 35, 37, 39, 42, 49, 59, 60, 62, 68–71] used IADPSG; 6 (11.7%) as group 2 [24, 41, 43, 47, 50, 54], 11 (21.5%) as group 3 [28, 31, 55–58, 63–67], 2 (3.9%) as group 4 [36, 53], 11 (21.5%) as group 5 [23, 27, 30, 32, 38, 40, 44–46, 51, 52], 4 (7.8%) as group 6 [8, 29, 34, 48] and 3 (5.8%) as group 7 [25, 26, 61].…”

“…In addition, 13 studies were conducted in the USA and Canada [8, 25, 29, 30, 32, 34, 38, 44, 46, 48, 51, 57, 60], five in Australia [24, 41, 43, 50, 54], seven in China and Japan [26, 33, 35, 45, 47, 52, 71], 9 in north Europe [31, 36, 42, 53, 55, 59, 61, 62, 68], six in India, Bangladesh and Sri Lanka [37, 49, 56, 64, 65, 67] and 10 were from other countries [23, 27, 28, 39, 40, 58, 63, 66, 69, 70], including Bahrain, Israel, Croatia, Argentina, Brazil, Ethiopia and Saudi Arabia. One study by the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study Cooperative Research Group was originally performed in nine countries [16].…”

Comparing Different Diagnostic Guidelines for Gestational Diabetes Mellitus in Relation to Birthweight in Sri Lankan Women

“…The 10-year incidence of developing T2D among GDM mothers (vs. non-GDM mothers) is as high as 7- to 10-folds ( 7 , 8 ). Even though the prevalence of GDM and Type 2 diabetes (T2D) is known to be historically high in South Asian populations ( 9 – 15 ), none of these studies have addressed the applicability of IADPSG criteria in South Asian populations compared with other diagnostic guidelines, together with its relationship with any birth outcomes. Therefore, it would be important to test the new GDM diagnostic guidelines in a region where the burden of hyperglycaemia is critical ( 13 ).…”

Feasibility of a Lifestyle Intervention Program for Prevention of Diabetes Among Women With Prior Gestational Diabetes Mellitus (LIVING Study) in South Asia: A Formative Research Study

“…This compares with global estimates of one in every six pregnancies (2). In South Asia, the proportion of GDM ranges from 11% in Bangladesh (3), and 13.9% in Sri Lanka (4) to 25% in India (5)(6)(7), and is increasing, especially in developing countries (2). GDM is an established risk factor for future development of type 2 diabetes mellitus (T2DM), with high conversion rates within 5 years of childbirth, underscoring the need for urgent interventions to address risk factors and manage glucose metabolism in this population (8)(9)(10)(11)(12).…”