Prevalence, Prevention, and Lifestyle Intervention of Gestational Diabetes Mellitus in China

Abstract

Gestational diabetes mellitus (GDM) has become an epidemic and has caused a tremendous healthy and economic burden in China, especially after the “two-child policy” put into effect on October 2015. The prevalence of GDM has continued to increase during the past few decades and is likely to see a further rise in the future. The public health impact of GDM is becoming more apparent in China and it might lead to the development of chronic non-communicable diseases in the long-term for both mothers and their children. Early identification of high-risk individuals could help to take preventive and intervention measures to reduce the risk of GDM and adverse perinatal outcomes. Therefore, a focus on prevention and intervention of GDM in China is of great importance. Lifestyle interventions, including dietary and physical exercise intervention, are effective and first-line preventive strategies for GDM prevention and intervention. The GDM One-day Care Clinic established in 2011, which educates GDM patients on the basic knowledge of GDM, dietary intervention, physical exercise, weight management, and blood glucose self-monitoring methods, sets a good model for group management of GDM and has been implemented throughout the hospitals as well as maternal and child health centers in China. The current review focus on the prevalence, risk factors, as well as prevention and lifestyle intervention of GDM in China for better understanding of the latest epidemiology of GDM in China and help to improve maternal and neonatal pregnancy outcomes and promote long-term health for women with GDM.

The overall plant-based diet index during pregnancy and risk of gestational diabetes mellitus: a prospective cohort study in China

“…Third, the prevalence of GDM in this study was lower than the overall prevalence in China (8•1 % v. 14•8 %) (2) . Previous studies have suggested that women with older age, higher pre-pregnancy BMI and a family history of diabetes are more likely to develop GDM (45,46) . However, participants in our cohort were younger, had lower pre-pregnancy BMI and less family history of diabetes than that in other populations in China (47,48) .…”

Investigation Into the Predictive Potential of Three-Dimensional Ultrasonographic Placental Volume and Vascular Indices in Gestational Diabetes Mellitus

“…All pregnant women were followed up after delivery. Screening for GDM was universally performed at 24–28 gestational weeks according to Guideline for Diagnosis and Treatment of Gestational Diabetes Mellitus (2014) ( 6 ). The GDM is diagnosed if any of the oral glucose tolerance test plasma glucose values meets or exceeds the following cut-off values: 5.1 mmol/L at fasting; 10.0 mmol/L at 1 h; and 8.5 mmol/L at 2 h. The follow-up data were collected as follows: pregnant complications, gestational age, modes of delivery, 1 and 5 min Apgar scores, birth weight, placental weight, and placental volume after delivery.…”

“…GDM affects about 7% of pregnancies, where advanced maternal age, obesity, previous history of GDM, previously giving birth to macrosomic infants, and family history of diabetes mellitus are regarded as major risk factors (2)(3)(4). Oral glucose tolerance test is often used for screening GDM during 24-28 gestational weeks (5,6). However, GDM screening at 24-28 gestational weeks is too late for the physicians to make dietary or pharmacology therapy, which may ultimately affect placental integrity and fetal growth (7,8).…”

Non-insulin agents for the management of gestational diabetes: lack of evidence versus lack of action

“…The prevalence of gestational diabetes mellitus (GDM) has been following an increasing trend during the past few years, with available epidemiological data suggesting that it affects approximately 1 out of 7 pregnancies globally [1]. Intensive glucose control during pregnancy can substantially decrease the risk of adverse maternal, perinatal and neonatal outcomes related to GDM.…”