Social Contributors to Glycemic Control in Gestational Diabetes Mellitus

Colicchia, Laura C.; Parviainen, Kristiina; Chang, Judy C.

doi:10.1097/aog.0000000000001740

Cited by 20 publications

(25 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The observation that glycemic control modified the risk for type 2 diabetes mellitus and dyslipidemia after adjusting for OGTT values, which reflect the fasting glucose and the pancreatic response to a glucose load without being affected by patient compliance or treatment, might point to this direction. A study that examined the effect of social contributors to glycemic control in GDM observed that poor glycemic control was associated with a chaotic lifestyle, the receipt of food stamps, being non married and no regular exercise [36]. Those results, in turn, imply that glycemic control might be associated with modifiable factors and does not simply reflect the severity of the underlying disease and that this hypothesis should be further evaluated in prospective trials.…”

Section: Discussionmentioning

confidence: 99%

Good glycemic control of gestational diabetes mellitus is associated with the attenuation of future maternal cardiovascular risk: a retrospective cohort study

Yefet

Schwartz

Sliman

et al. 2019

Cardiovasc Diabetol

View full text Add to dashboard Cite

Background To examine whether glycemic control of gestational diabetes mellitus (GDM) could modify the risk for future maternal metabolic and cardiovascular morbidities. Methods A retrospective cohort study of women with a first diagnosis of GDM who delivered between 1991 and 2011. Women were divided into groups of good and poor glycemic control, defined as a mean daily glucose of up to 95 mg/dL (N = 230) and more than 95 mg/dL (N = 216), respectively. In addition, a control group of women without GDM (N = 352) was also analyzed. The primary outcomes were the development of type 2 diabetes mellitus (T2DM), obesity, hypertension, or dyslipidemia. Results Mean follow-up time was 15.8 ± 5.1 years. Assessment was performed at a maternal age of 45 ± 7 years. The rates of the study outcomes in the control, GDM with good glycemic control and GDM with poor glycemic control were as follows: T2DM [19 (5.4%), 87 (38%), 127 (57%)]; hypertension [44 (13%), 42 (18%), 44 (20%)]; obesity [111 (32%), 112 (48%), 129 (58%)]; and dyslipidemia [49 (14%), 67 (29%), 106 (48%)]. Glycemic control was an independent risk factor for T2DM in multivariate Cox regression analysis (hazard ratio (HR) for poor glycemic control vs. controls 10.7 95% CI [6.0–19.0], good glycemic control vs. control HR 6.0 [3.3–10.8], and poor glycemic control vs. good glycemic control HR 1.8 [1.3–2.4]). Glycemic control was also an independent risk factor for dyslipidemia (poor glycemic control vs. controls HR 3.7 [2.3–5.8], good glycemic control vs. controls HR 2.0 [1.2–3.2], and poor glycemic control vs. good glycemic control HR 1.8 1.8 [1.3–2.6]). The fasting glucose level during oral glucose tolerance test (OGTT) was also an independent risk factor for these complications. The interaction term between glycemic control and the fasting value of the OGTT was not statistically significant, suggesting that the effect of glycemic control on the rate of future T2DM and dyslipidemia was not modified by the baseline severity of GDM. Conclusion GDM and especially poor glycemic control are associated with T2DM and dyslipidemia. Strict glycemic control for reducing that risk should be evaluated in prospective trials.

show abstract

Section: Discussionmentioning

confidence: 99%

Good glycemic control of gestational diabetes mellitus is associated with the attenuation of future maternal cardiovascular risk: a retrospective cohort study

Yefet

Schwartz

Sliman

et al. 2019

Cardiovasc Diabetol

View full text Add to dashboard Cite

show abstract

“…Prior work has asserted that several social, psychological, behavioral, and economic factors influence a woman's glycemic control. Factors such as inadequate food security, psychosocial deprivation, and chaotic lifestyle are all thought to influence blood glucose control (5)(6)(7). Moreover, women with diabetes experience added logistical, educational, and knowledge-based burdens that can influence pregnancy outcomes.…”

mentioning

confidence: 99%

Health Care Providers’ Perspectives on Barriers and Facilitators to Care for Low-Income Pregnant Women With Diabetes

et al. 2020

View full text Add to dashboard Cite

OBJECTIVE | Treatment of gestational diabetes mellitus and type 2 diabetes during pregnancy can improve maternal and neonatal outcomes; yet, self-care burdens for pregnant women with diabetes are high, particularly for low-income and minority women. Although prior studies have investigated patient-perceived barriers and facilitators to diabetes selfmanagement during pregnancy, little work investigates the perspectives of health care providers (HCPs) on these factors. The objective of this study was to investigate HCPs' perspectives on patient barriers and facilitators to diabetes care during pregnancy.METHODS | In this qualitative investigation, focus groups were conducted using a semistructured interview guide designed to elicit HCPs' perceptions of patient barriers and facilitators to successful diabetes-related self-care. HCPs included physicians, nurses, health educators, and other personnel who care for low-income pregnant women with diabetes. Interviews were transcribed verbatim. Transcripts were analyzed using the constant comparative technique to identify themes and subthemes, using the Social Ecological Model as a theoretical framework.RESULTS | Participants (n 5 29) identified barriers and facilitators to women's achievement of optimal diabetes self-care according to six levels (environment, access, institution, interpersonal, knowledge, and individual). Example subthemes included inflexible work schedule, poor access to medication and supplies, overburdened clinic, perceived patient "policing," and low health literacy. Individual factors included self-efficacy, motivation, and engagement. HCPs identified barriers, but not facilitators, for each theme.CONCLUSION | HCPs described facilitators and barriers to diabetes care at all levels of the Social Ecological Model. These data can inform interventions to dismantle barriers patients face and thus create meaningful health care interventions to improve outcomes for low-income pregnant women with diabetes.

show abstract

“…Diabetic mothers, especially for those with complications, are linked to low SES because those women might have limited ability to work and have lower disposable income, resulting in a relatively deprived environment for children. Apart from socioeconomic deprivation, lifestyle, access to health food, regular physical activity, public insurance, etc, are also linked to glycemic control 25. Overall, it is recommended to record social factors and consider them as confounders when examining the true effect of maternal diabetes on ADHD in children.…”

Section: Discussionmentioning

confidence: 99%

<p>The association of maternal diabetes with attention deficit and hyperactivity disorder in offspring: a meta-analysis</p>

Zhao¹,

Li²,

Liu³

et al. 2019

NDT

View full text Add to dashboard Cite

ObjectiveRecent controversial evidence suggests that maternal diabetes may increase the risk of attention deficit and hyperactivity disorder (ADHD) in offspring. To examine this potential association, a systematic literature search and meta-analysis was performed.MethodsOR or risk ratio (RR) from each study was obtained and combined for evaluating the risk. Six cohort studies and three case-control studies were included in the present study.ResultsThe meta-analysis of the highly heterogeneous case-control studies did not find significant association between maternal diabetes and ADHD risk (OR: 1.20, 95% CI: 0.96–1.49). The combining of the cohort studies demonstrated that offspring of diabetic mothers were at higher risk of ADHD (RR: 1.40, 95% CI: 1.27–1.54); however, publication bias was identified. When exposure was specified as gestational diabetes mellitus (GDM), GDM exposure increased the risk of ADHD for children by 164% (95% CI: 1.25–5.56) in a Caucasian population. Neither heterogeneity nor publication bias was detected.ConclusionMaternal diabetes, especially GDM, is probably a risk factor for ADHD in the Caucasian population. More studies based on large sample size and different ethnicities are needed to confirm this association.

show abstract

Social Contributors to Glycemic Control in Gestational Diabetes Mellitus

Abstract: Social factors are associated with glycemic control in GDM and may be modifiable to improve glucose control.

Cited by 20 publications

References 19 publications

Good glycemic control of gestational diabetes mellitus is associated with the attenuation of future maternal cardiovascular risk: a retrospective cohort study

Good glycemic control of gestational diabetes mellitus is associated with the attenuation of future maternal cardiovascular risk: a retrospective cohort study

Health Care Providers’ Perspectives on Barriers and Facilitators to Care for Low-Income Pregnant Women With Diabetes

<p>The association of maternal diabetes with attention deficit and hyperactivity disorder in offspring: a meta-analysis</p>

Contact Info

Product

Resources

About