Trends and predictors of gestational diabetes mellitus in Chile

Abstract

ObjectiveTo examine the temporal trends in gestational diabetes mellitus (GDM) prevalence in Chile, and to determine the main predictors of GDM.MethodsA secondary analysis was conducted of all birth records at Hospital Dr. Sótero del Río, Chile, from January 1, 2002, to December 31, 2015. We excluded those women with pre‐existing type 2 diabetes, those with missing data, and those with unlikely data. GDM was defined as fasting glucose levels >5.55 mmol/L [>100 mg/dL] or >7.77 mmol/L [>140 mg/dL] 2 hours after glucose load in the oral glucose tolerance test. Potential predictors were selected based on prior research and ease of evaluation.ResultsFrom the original database of 100 758 records, 86 362 women were included in the final cohort. The mean GDM prevalence was 7.6% (95% CI [confidence interval] 7.5%–7.8%), increasing from 4.4% (95% CI 4.0%–4.9%) in 2002 to 13.0% (95% CI 12.0%–13.9%) in 2015. Age, education, marital status, parity, family history of type 2 diabetes, personal history of GDM, hypertension and pre‐eclampsia, alcohol consumption, smoking, and pre‐gestational nutritional status performed well in the prediction of GDM.ConclusionOne out of eight Chilean pregnant women of medium‐ to low socio‐economic status were found to develop GDM. We identified a set of easy‐to‐capture predictors in the primary health care system that may allow for the early identification of women at high‐risk for the development of GDM.

Early pregnancy levels of gingival crevicular fluid matrix metalloproteinases‐8 and ‐9 are associated with the severity of periodontitis and the development of gestational diabetes mellitus

“…According to these arguments, coordinated efforts are required to provide better perinatal management and postpartum preventive strategies to modify these trends and to evade the ''vicious cycle'' in which diabetes causes more diabetes 2,46 . In this sense, countries with high rates of obesity are related to the highest rates of diabetes and our country is not an exception, in which the prevalence of GDM has increased from 4.4% in 2012 to 13% in 2015 47 …”

Gestational Diabetes Mellitus and Preeclampsia: Correlation and Influencing Factors

“…PE also affects the occurrence of GDM; a retrospective cohort study in Korea showed that a history of PE in first pregnancy is a risk factor for the development of GDM in subsequent pregnancies ( 50 ). However, a retrospective study in Chile suggested that the history of PE in previous pregnancies is negatively associated with the occurrence of GDM in the next pregnancy ( 13 ). Whether PE associated with the occurrence of GDM should be further confirmed in large sample studies.…”

Impact of Remote Monitoring Technologies for Assisting Patients With Gestational Diabetes Mellitus: A Systematic Review

“…GDM is currently the most common medical complication of pregnancy and the prevalence of undiagnosed hyperglycemia and even overt diabetes in young women is increasing ( McIntyre et al, 2019 ). In Chile, 1 in 8 pregnant women of middle socioeconomic status has GDM ( Garmendia et al, 2020 ), and 5–10% of women with GDM develop type 2 diabetes after delivery, maintaining a linear growth ( Auvinen et al, 2020 ).…”

“…GDM in the health care system has tripled over a 14-years period, which could be explained by changes in the trend of risk factors during this period ( Garmendia et al, 2020 ), such as the increased prevalence of obesity, along with later fertility which has been associated with higher risk gestation. All this results in an increased burden of care and demand for specialized services ( Ministerio de Salud, 2014 ).…”