The absolute and relative risk of type 2 diabetes after gestational diabetes: A systematic review and meta-analysis of 129 studies

Dennison, Rebecca A; Chen, Eileen S.; Green, Madeline E.; Legard, Chloe; Kotecha, Deeya; Farmer, George; Sharp, Stephen J.; Ward, Rebecca J; Usher‐Smith, Juliet A.; Griffin, Simon J.

doi:10.1016/j.diabres.2020.108625

Cited by 108 publications

(106 citation statements)

References 41 publications

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“…In the long-term, the mother is in a high likelihood of recurrence of GDM in successive pregnancies above 48% [ 305 , 306 ]. Also, a robust body of literature supports GDM hyperglycemia predisposes mothers to developing T2DM and cardiovascular diseases years after delivery [ 10 , 307 , 308 , 309 , 310 , 311 ]. Although the proportion of GDM women who develop T2DM is highly variable, a recent meta-analysis indicates a relative risk of 8-fold (95% IC: 6.5–10.6) [ 10 ].…”

Section: Adverse Perinatal Outcomes Related To Gdmmentioning

confidence: 99%

“…Also, a robust body of literature supports GDM hyperglycemia predisposes mothers to developing T2DM and cardiovascular diseases years after delivery [ 10 , 307 , 308 , 309 , 310 , 311 ]. Although the proportion of GDM women who develop T2DM is highly variable, a recent meta-analysis indicates a relative risk of 8-fold (95% IC: 6.5–10.6) [ 10 ]. Subsequently, this increases the chance of developing cardiovascular disease and metabolic syndrome up to threefold [ 308 ].…”

Section: Adverse Perinatal Outcomes Related To Gdmmentioning

confidence: 99%

“…These two hits lead to GDM development because of inadequate compensatory changes in β-cell mass activity and proliferation due to a more pronounced insulin resistance condition, particularly during the second and third trimester of pregnancy [ 8 , 9 ]. This transient metabolic stress on the pancreas during pregnancy, partially explains why GDM is associated with a higher risk of post-partum development of Type 2 Diabetes Mellitus (T2DM) in the mother and fetus [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Immunoendocrine Dysregulation during Gestational Diabetes Mellitus: The Central Role of the Placenta

Olmos-Ortíz

Flores-Espinosa

Díaz

et al. 2021

IJMS

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Gestational Diabetes Mellitus (GDM) is a transitory metabolic condition caused by dysregulation triggered by intolerance to carbohydrates, dysfunction of beta-pancreatic and endothelial cells, and insulin resistance during pregnancy. However, this disease includes not only changes related to metabolic distress but also placental immunoendocrine adaptations, resulting in harmful effects to the mother and fetus. In this review, we focus on the placenta as an immuno-endocrine organ that can recognize and respond to the hyperglycemic environment. It synthesizes diverse chemicals that play a role in inflammation, innate defense, endocrine response, oxidative stress, and angiogenesis, all associated with different perinatal outcomes.

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Section: Adverse Perinatal Outcomes Related To Gdmmentioning

confidence: 99%

Section: Adverse Perinatal Outcomes Related To Gdmmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Immunoendocrine Dysregulation during Gestational Diabetes Mellitus: The Central Role of the Placenta

Olmos-Ortíz

Flores-Espinosa

Díaz

et al. 2021

IJMS

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“… 3 Although hyperglycaemia typically resolves after delivery, women with GDM are approximately eight times more likely to develop T2DM than unaffected women, and one-third of women with GDM have been diagnosed with T2DM by 15 years postpartum. 4 …”

Section: Introductionmentioning

confidence: 99%

Barriers to postpartum diabetes screening: a qualitative synthesis of clinicians’ views

et al. 2021

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Background: Gestational diabetes (GDM) is an important risk factor for developing type 2 diabetes (T2DM) later in life. Postpartum screening provides an opportunity for early detection and management of T2DM, but uptake is poor. Aim: To explore barriers to screening from clinicians’ perspectives to guide future interventions to increase uptake. Design and Setting: Systematic review and qualitative synthesis. Method: We assessed qualitative studies included in a previous review, then searched five electronic databases from 2013 to May 2019 for qualitative studies reporting clinicians’ perspectives on postpartum glucose screening after GDM. Study quality was assessed against the Critical Appraisal Skills Programmes checklist. Qualitative data from the studies were analysed using thematic synthesis. Results: We included nine studies, containing views from 187 clinicians from both community and hospital care. Three main themes were identified: difficulties in handover between primary and secondary care (ambiguous roles and communication difficulties), short-term focus in clinical consultations (underplaying risk so as not to overwhelm patients and competing priorities) and patient-centric barriers. Conclusion: We identified barriers to diabetes screening at both system and individual levels. At the system level, clarification of responsibility for testing among healthcare professionals and better systems for recall are needed. These could be achieved through registers, improved clinical protocols, and automatic flagging and prompts within electronic medical records. At the individual level, clinicians should be supported to prioritise the importance of screening within consultations and better educational resources made available for women. Making it more convenient for women to attend may also facilitate screening.

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“…Universidade Vila Velha (UVV), Vila Velha -ES 4. Faculdade de Minas (FAMINAS), Belo Horizonte -MG 5. Universidade Nilton Lins (UNL), Manaus -AM 6.…”

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A importância do pré-natal na prevenção de complicações materno-fetais do diabetes mellitus gestacional

et al. 2021

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Objetivo: Revisar e demonstrar métodos de prevenção de complicações do Diabetes Mellitus Gestacional, por meio de intervenções e tratamentos para o controle glicêmico. Revisão bibliográfica: O alto índice glicêmico durante o período gestacional poderá culminar em Diabetes Mellitus do tipo 2, o qual é originado por variados fatores, tais como mudanças hormonais, conjuntamente aos hábitos de vida da gestante. Tal patologia poderá gerar complicações para o feto se não diagnosticada e tratada precocemente. Destaca-se que o feto pode nascer com variadas complicações, sendo a mais frequente a macrossomia fetal, promovida pelo estímulo de uma maior produção e secreção de insulina, em decorrência do aporte elevado de glicose ao feto. Ademais, evidencia-se que a mãe poderá apresentar lesões durante o parto em consequência da macrossomia, além de um alto risco de desenvolvimento de Diabetes do tipo 2, doenças cardiovasculares, dentre outras. Sendo assim, nota-se a necessidade de um rastreamento das pacientes com diabetes gestacional, além de uma mudança no estilo de vida (MEV) da grávida. Considerações finais: Considera-se que o pré-natal é de suma importância para o rastreamento, diagnóstico e tratamento de pacientes com diabetes gestacional ou pré-disposição a patologia, evitando possíveis complicações.

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The absolute and relative risk of type 2 diabetes after gestational diabetes: A systematic review and meta-analysis of 129 studies

Cited by 108 publications

References 41 publications

Immunoendocrine Dysregulation during Gestational Diabetes Mellitus: The Central Role of the Placenta

Immunoendocrine Dysregulation during Gestational Diabetes Mellitus: The Central Role of the Placenta

Barriers to postpartum diabetes screening: a qualitative synthesis of clinicians’ views

A importância do pré-natal na prevenção de complicações materno-fetais do diabetes mellitus gestacional

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