Abstract

Objective: To evaluate the associations of gestational diabetes (GDM) history with dietary intake, nutritional status, insulin resistance, demographic, and anthropometrical data. Materials & Methods: This cross-sectional study used data from the National Health and Nutrition Examination Survey for the years 2000-2010. Data analysis was based on 290 women who reported a history of GDM compared to 4239 women who denied a GDM history. Insulin resistance [HOMA_IR = (fasting insulin in mU/mL × fasting glucose in mmol/L)/405] was calculated. Pearson correlation, Wilcoxon rank sum tests, Student’s t-tests, and chi-square analysis were used while linear regression assessed independent associations. Results: The median time-lapse from the diagnosis of GDM was 15 years. Women with a GDM history had significantly higher body mass index (BMI), other anthropometric measurements, diastolic blood pressures and insulin resistance. They were also more likely to be Hispanic, have delivered macrosomic infants, and delivered via cesarean. Previous GDM history compared to non-GDM subjects had significantly higher dietary intakes of energy calories, protein, total fat, saturated fatty acids, mono-saturated fatty acids, and cholesterol. Within the entire cohort, increasing insulin resistance was also associated with lower income, less college education, Hispanic or African American ethnicity, obesity, higher systolic and diastolic blood pressures, and with higher dietary cholesterol but lower intake of dietary fiber and micronutrients. Regression analyses showed that GDM history, Hispanic ethnicity, BMI, dietary intake of cholesterol and decreasing income were independently predictive of insulin resistance. Conclusion: The data confirm that even many years after a pregnancy associated with GDM, women with a history of GDM still report significantly higher dietary intakes of energy calories, protein, and fat with no corresponding increase in consumption of dietary fiber or minerals and vitamins. Consequently, the increased calorie and food consumption of women with previous GDM are associated with obesity, insulin resistance and higher blood pressures. These observations may suggest the need to target high-risk groups who may need more resources and awareness of the benefits of quality nutrition.

Highlights

  • Gestational diabetes mellitus (GDM) is currently defined as carbohydrate intolerance with onset or recognition during pregnancy [1]

  • The National Health and Nutrition Examination Survey (NHANES) is a nationally representative survey conducted by the National Center for Health Statistics (NCHS), Center of Disease Control and Prevention (CDC) to assess the health and nutritional status among civilian, non-institutionalized US population

  • NHANES data consisted of a total of 290 women who self-reported having a history of GDM and 4238 women who self-reported no history of GDM

Read more

Summary

Introduction

Gestational diabetes mellitus (GDM) is currently defined as carbohydrate intolerance with onset or recognition during pregnancy [1]. Insulin resistance in pregnancy is associated with GDM [2]. Women with a history of GDM have an increased risk for long-term morbidity. A recent large meta-analysis reported a composite 7-fold increase in risk for type 2 diabetes mellitus (T2DM) [3]. A higher incidence of metabolic syndrome, which includes features such as obesity, insulin resistance, dyslipidemia, and hypertension, has been found in women with previous GDM [4]-[6]. Previous studies have shown that GDM is an independent risk factor for long-term cardiovascular morbidity [4]

Methods
Results
Conclusion

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.