Risk Factors for Gestational Diabetes in Black Population

Bell, David S.H.; Barger, Bruce O.; Go, Rodney C.P.; Goldenberg, Robert L.; Perkins, Laura; Vanichanan, Chotip; Roseman, Jeffrey M.; Acton, Ronald T.

doi:10.2337/diacare.13.11.1196

Cited by 20 publications

(9 citation statements)

References 20 publications

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“…Very little is known of the relation of MA to other CVD risk factors in AfricanAmerican women, a group at high risk for cardiovascular events (32)(33)(34); nothing is reported in African-American women with a history of gestational diabetes (GDM) who are at high risk of both diabetes and hypertension (35). Also, the prevalence of MA in this latter high-risk group is unknown.…”

Section: Diabetes Care 24:1764 -1769 2001mentioning

confidence: 99%

“…RESEARCH DESIGN AND METHODS -The original cohort of 664 African-American women who had their first prenatal visit at any of the eight Jefferson County Health Department Clinics between 1981 and 1988 and who were screened and diagnosed with GDM was described previously (35). During 1992-1995, 450 women in this original cohort were still enrolled in the study, and were contacted in 1996 -1999 to assess MA.…”

Section: Diabetes Care 24:1764 -1769 2001mentioning

confidence: 99%

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Prevalence and Risk Factors of Microalbuminuria in a Cohort of African-American Women With Gestational Diabetes

Desmond

Roseman

et al. 2001

Diabetes Care

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OBJECTIVE -To study the prevalence of microalbuminuria (MA) in African-American women with a history of gestational diabetes (GDM) who are at high risk for insulin resistance and renal dysfunction and to study MA's relation to insulin resistance, type 2 diabetes, and hypertension.RESEARCH DESIGN AND METHODS -MA was assessed using 24-h, timed, and/or random urine samples in a cross-sectional sample (n ϭ 289) from a cohort of African-American women with a history of GDM and followed for a median of 11 years (range 3.0 -18.4) since their diabetic pregnancy. Subjects with a urine albumin excretion rate of 30 -300 g/24 h or 30 -300 g/mg creatinine in a random sample were classified as having MA if two of three samples over a 3-to 6-month period were positive. These women were evaluated for family history of diabetes, smoking and alcohol use, BMI, diabetes, hypertension, and lipid abnormalities. Insulin sensitivity was determined using the homeostasis model assessment (HOMA) estimates, which used fasting insulin and glucose measurements obtained at the same time as the MA urine sample.RESULTS -At MA assessment, the women ranged in age from 22 to 57 years, with a median of 39 years. The overall prevalence of MA was 20%; 36% in those with diabetes. Those women with MA had higher rates of diabetes (63.8 vs. 28.6%, odds ratio [OR] ϭ 4.4, P Ͻ 0.05), hypertension (82.8 vs. 42.9%, OR ϭ 6.4, P Ͻ 0.05), and family history of diabetes (85.7 vs. 61.7%, OR ϭ 3.7, P Ͻ 0.05). The proportion of subjects with MA with a family history of hypertension was nonsignificantly increased (92.9 vs. 82.4%). Subjects with MA were more obese (BMI 37.2 Ϯ 8.9 vs. 34.4 Ϯ 8.6 kg/m 2 ) and had higher levels of HbA 1c (8.8 Ϯ 3.3 vs. 6.6 Ϯ 1.8%, P Ͻ 0.001) and systolic (144.3 Ϯ 25.9 vs. 122.8 Ϯ 17.2 mmHg, P Ͻ 0.0001) and diastolic (95.1 Ϯ 15.4 vs. 82.5 Ϯ 11.9 mmHg, P Ͻ 0.0001) blood pressures. Lipid fractions were similar in those with and without MA. Although fasting glucose was much higher in subjects with MA (10.3 Ϯ 5.8 vs. 7.1 Ϯ 4.2 mmol/l, P ϭ 0.0002), insulin levels were not significantly higher in subjects with MA (17.4 Ϯ 21.2 vs. 15.2 Ϯ 12.4 pmol/l). Insulin sensitivity, as measured using log HOMA, was similar (1.5 Ϯ 0.6 vs. 1.6 Ϯ 0.6) in women with and without MA, respectively. Multivariable logistic regression analyses indicated that HbA 1c , OR ϭ 1.16 (1.07, 1.27), and systolic blood pressure, OR ϭ 1.27 (1.14, 1.41), were independent risk factors for MA. In those with diabetes, the subjects with MA had higher rates of hypertension-83.8 vs. 56.1%, OR ϭ 4.1 (1.5, 11.10)-which was reflected by their higher systolic and diastolic blood pressures, 146.1 mmHg (P ϭ 0.001) and 94.8 mmHg (P ϭ 0.002), respectively, and lower levels of VLDL (0.45 Ϯ 0.22 vs. 0.61 Ϯ 0.33 mmol/l, P ϭ 0.021). In the multivariable analyses of those with diabetes, the two independent risk factors for MA were similar: HbA 1c , OR ϭ 1.13 (1.01, 1.28), and systolic blood pressure, OR ϭ 1.21 (1.04, 1.41).CONCLUSIONS -African-American women with a history of GDM have one of the h...

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Section: Diabetes Care 24:1764 -1769 2001mentioning

confidence: 99%

Section: Diabetes Care 24:1764 -1769 2001mentioning

confidence: 99%

Prevalence and Risk Factors of Microalbuminuria in a Cohort of African-American Women With Gestational Diabetes

Desmond

Roseman

et al. 2001

Diabetes Care

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“…Clinical risk factors are similar to risk factors for T2DM and include family history of T2DM, obesity, older age, hypertension, heart disease [8], waisthip ratio, and waist circumference (Table 1) [9]. Ethnicity also contributes, with African-American, Hispanic, Asian, and Native-American women at higher risk [10,11].…”

Section: Similarities Between Gdm and T2dmmentioning

confidence: 94%

Prevention of T2DM in women with a previous history of GDM

Strehlow

Mestman

2005

Curr Diab Rep

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Women with a history of gestational diabetes mellitus (GDM) have a high risk of progression to type 2 diabetes mellitus (T2DM). Risk factors are similar for GDM and T2DM and include, among others, obesity, family history, and ethnic background. GDM is also associated with the metabolic syndrome. Women with impaired glucose tolerance or "prediabetes" postpartum have the highest risk of progression. In women with impaired glucose tolerance, lifestyle modification or pharmacologic therapy may prevent or delay the onset of T2DM.

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“…Construct‐valid measures of personality traits and attributes have wide application in clinical research, mainly as measures used to predict differences in behavior, or to explain the differences between individual responses to therapeutic or behavioral interventions. The constructs of social support (14), locus of control (15, 16), and anxiety (17) are some of several constructs that have been widely used in clinical studies, as researchers try to influence behaviors in order to improve health outcomes.…”

Section: Validitymentioning

confidence: 99%

Evaluation of research studies Part IV: Validity and reliability—Concepts and application

Fullerton

1993

Journal of Nurse-Midwifery

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Risk Factors for Gestational Diabetes in Black Population

Cited by 20 publications

References 20 publications

Prevalence and Risk Factors of Microalbuminuria in a Cohort of African-American Women With Gestational Diabetes

Prevalence and Risk Factors of Microalbuminuria in a Cohort of African-American Women With Gestational Diabetes

Prevention of T2DM in women with a previous history of GDM

Evaluation of research studies Part IV: Validity and reliability—Concepts and application

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