Determinants Of Gestational Diabetes Mellitus Research Articles

Prevalence and determinants of gestational diabetes mellitus among pregnant women in India: an analysis of National Family Health Survey Data

BackgroundGestational diabetes mellitus (GDM) is a type of diabetes with its first recognition during pregnancy. GDM is a high-risk maternal and neonatal condition which increases the risk of Type 2 diabetes in mothers and their infants. It is essential to detect and treat GDM since its inception when mothers suffer from Type 1 diabetes while carrying the foetus during the gestational period.MethodsThe study analysed individual data from the National Family Health Survey (NFHS) surveyed in 2015–2016 (4th round) and 2019–2021 (5th round) covering a total of approximately 6 lakhs and 7 lakhs women, respectively. Among them, 32,072 women in 2015–2016 and 28,187 in 2019–2021 were pregnant, of whom 180 women in 2014–2015 and 247 women in 2019–2021 had diabetes during their gestational periods, allowing the percentage prevalence calculation of GDM. The analysis of Poisson regression estimates examined the socioeconomic and demographic risk factors for GDM among pregnant women.ResultsThe overall prevalence of GDM in women showed an increase from 0.53% in 2015–16 to 0.80% in 2019–20 at the national level, and a similar increase in many states of India was witnessed, with a few exceptions. The GDM prevalence has shown a gradient over age, with a low prevalence in 15–19- and 25–29-year-olds and the highest prevalence in 40–44-year-olds. Concerning the rural and urban divide, its prevalence in both urban and rural areas has increased from 0.61 to 0.85% and 0.51 to 0.78% between 2015 and 16 and 2019–21. The results of the Poisson regression analysis reveal that older adults with high Body Mass Index (BMI), thyroid disorder, and heart disease have a greater risk of GDM among pregnant women in India. The states of Kerala, Meghalaya, and Goa show a high prevalence of GDM.ConclusionThe low prevalence of GDM may not be clinically significant but has negative repercussions on the mother and her child cannot be overlooked. Thus, it is essential to curb GDM since its inception and save a generation ahead from the risk of diabetes and other diseases.

Factors influencing gestational diabetes self-care among pregnant women in a Syrian Refugee Camp in Jordan.

The main objective of this study is to identify the level of self-care practices and the determinants of Gestational Diabetes Mellitus (GDM) among pregnant women residing in one of the refugee camps in Jordan. A cross-sectional study was conducted on a convenient sample of forty women diagnosed with GDM from the high-risk maternity clinic in one of the Syrian refugee camps in Jordan. The study used the Gestational Diabetes Management Self-Efficacy Scale (GDMSES), Diabetes Knowledge (DMK) assessment, and Diabetes Self-Care Activities Questionnaire (SDSCA) to measure the variables of interest. Descriptive analysis and Multiple logistic regression were used to assess for significant factors. Significant associations were found between the subcategories of diet, exercise, and blood sugar control in both the self-efficacy and self-activity scales (p < 0.01, p < 0.01, p < 0.05), respectively. Two factors were associated with higher GDM self-care: diabetes knowledge and higher self-efficacy toward GDM self-care (p < 0.05). The findings of this study highlight that pregnant women with GDM who have higher levels of self-efficacy and diabetes knowledge are more likely to achieve higher levels of GDM self-care. Beside developing health promotion programs to enhance women's self-efficacy in adhering to GDM care, adequate support and relevant resources to facilitate GDM management among refugee women are recommended. Future research for identifying other potential factors affecting GDM self-care among refugees is highly recommended.

Prevalence and Predictors of Gestational Diabetes Mellitus and Overt Diabetes in Pregnancy: A Secondary Analysis of Nationwide Data from India

Abstract Background: This analysis was conducted to understand prevalence and determinants of gestational diabetes mellitus (GDM) and (overt) diabetes in pregnancy (DIP) in India, and also ascertain their health-seeking behaviour. Materials and Methods: The authors analysed data from the fifth National Family Health Survey of India. Binary logistic regression was used to assess the factors independently associated with GDM and (overt) DIP. Results: The weighted prevalence of GDM was 4.2% (95% confidence interval [CI]: 3.9–4.5), and the age-adjusted prevalence was 5.4% (95% CI: 4.5–6.4). The prevalence of GDM increased with age. The weighted prevalence of (overt) DIP was 0.38% (95% CI: 0.30–0.48), and the age-adjusted prevalence was 1.04% (95% CI: 0.64–1.68). On adjusted analysis, it was found that increasing age and obesity had significantly higher odds of having GDM. Higher odds of access to private facilities were found amongst women with higher education and those who were overweight. Significant regional variation in the prevalence of GDM was observed, with a very low burden observed in northeastern states and a comparatively higher burden in Central, Western and Southern Indian states. Conclusions: There is an increasing prevalence of GDM in India. Strengthening primary health systems to enhance GDM-related service availability, quality and delivery could be logical policy intervention.

Prevalence of Gestational Diabetes and Associated Maternal Factor

The prevalence of gestational diabetes is rising all over the world. Maternal and neonatal complications are associated with gestational diabetes Mellitus. Objective: To investigate the prevalence of gestational diabetes and associated maternal factors in outpatients of Jinnah Hospital Lahore. Methods: The descriptive cross-sectional study design was used to assess the prevalence of gestational diabetes and associated maternal factors with a 200-population size that is deliberated from Slovin’s formula for the pregnant women of the Gynae outpatient’s department at Jinnah Hospital Lahore. The convenient sampling technique is used to collect the data from pregnant women. The study took approximately 9 months. The questionnaire asked about sociodemographic factors, family history, and medical history. Results: The prevalence of gestational diabetes mellitus was 36.8% in Pakistan. Positive family history (41.4%), increased BMI (46.6%), parity (83.5%), and obesity (59.2%) were determinants of gestational diabetes mellitus. Maternal complications like pre-eclampsia (8.3%), pregnancy-induced hypertension (20.1%), cesarean (48.9%), and antepartum hemorrhage (20.2%) were higher in GDM women. Conclusions: The study finding reveals that gestational diabetes mellitus was discovered to be highly prevalent in Pakistani women and they were at higher risk of developing maternal complications. Women with advanced maternal age, low monthly income, obesity, a family history of diabetes, parity number, and increased BMI are risk factors for Gestational diabetes mellitus.

A systematic review and meta-analysis of the prevalence and determinants of gestational diabetes mellitus in Nigeria

A systematic review and meta-analysis of the prevalence and determinants of gestational diabetes mellitus in Nigeria

Previous adverse pregnancy events as a predictor of gestational diabetes mellitus in Southern Ethiopia: a case control study

Introduction Gestational diabetes mellitus is a type of glucose intolerance that first manifests itself during pregnancy. A pregnant woman and her unborn child are at an increased risk of pregnancy complications and poor neonatal outcomes. Pregnancy diabetes affects one out of every 200 women. Therefore, this study aims to identify the determinants of gestational diabetes mellitus among pregnant women attending an antenatal care service in Gedeo Zone, Ethiopia. Methods A facility-based case-control study design was employed from 25 January 2020 through 25 April 2020. The study included 80 cases and 240 control groups of pregnant women. Face-to-face interviews with structured questionnaires were used to collect data. For analyses, data was entered into Epidata version 3.1 and exported to the Statistical Package for the Social Sciences (SPSS) version 23.0. Variables with p .25 or lower in bivariate analysis were fitted to multivariable analysis. A multivariable logistic regression model with a 95% confidence interval and a p-Value of .05 was used. Results Family history of diabetes mellitus [AOR 1.837; 95% CI (1.06–3.18)], history of spontaneous abortion [AOR 2.39; 95% CI 1.33–4.31), history of still birth [AOR 2.240 (1.222–4.105)], and history of delivery of a macrocosmic baby in the previous pregnancy [AOR 1.99 (1.157–3.43)] were found to be predictors of GDM. Conclusion Previous adverse pregnancy outcomes were found to be the main predictors of GDM. Women with gestational diabetes mellitus should be followed after delivery in order to monitor hyper-glycemic status.

A systematic review and meta-analysis of the prevalence and determinants of gestational diabetes mellitus in Nigeria.

Background:Gestational diabetes mellitus (GDM) is any degree of glucose intolerance with onset or first diagnosis in pregnancy. GDM has numerous potential complications and it is important to estimate its burden and risk factors. The objective of the meta-analysis was to determine the pooled prevalence of GDM in Nigeria and identify its determinants.Methods:The study design was a meta-analysis; therefore the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Electronic databases (African Journal Online, PubMed, SCOPUS, and Google Scholar) and the gray literature were systematically searched. Statistical analysis was done with MetaXL using the random effect model. Heterogeneity was determined using the I2 statistic and the publication bias was checked with the Doi plot.Results:The total sample size was 46 210. The prevalence of GDM in Nigeria was 0.5 – 38% and the pooled prevalence was 11.0% (95% CI 8-13). The I2 statistic was 99%. The Doi plot suggested some degree of bias. The most frequently reported determinants of GDM were previous macrosomic babies, maternal obesity, family history of diabetes, previous miscarriage, and advanced maternal age.Conclusion:The prevalence of GDM in Nigeria is high and efforts should be geared at modifying its risk factors so as to reduce its prevalence and prevent the associated complications.

The Prevalence and Determinants of GDM among Pregnant Women’s in Obstetric Clinics at MCH Makkah City 2019

Gestational diabetes mellitus (GDM) used to be defined as any degree of glucose intolerance with onset or first recognition during pregnancy. Gestational Diabetes Mellitus (GDM) is the most common metabolic disorder during pregnancy. It is associated with maternal and fetal complications. Screening for GDM and its risk factors is essential for the early diagnosis and management. Recently, the definition has evolved to distinguish women whose condition is a transient manifestation of pregnancy-related insulin resistance from those with probable preexisting diabetes that is first recognized during pregnancy. The physiological and hormonal change during pregnancy can lead to increase insulin resistance and production of glucose, if pancreas cannot secrete sufficient insulin to maintain blood glucose can cause impaired glucose tolerance or gestational diabetes. Aim of the study: This study aimed to evaluate the prevalence of GDM among pregnant women's in the obstetric clinics in MCH at Makkah city. Methodology: analytic cross sectional study was conducted among (147) pregnant women who attend obstetric clinics in the one-month using the simple has been random technique using random table generator. Maternal and children's hospital is the biggest hospital in Makkah and has 3 clinic per day. Results: A total of (170) participated in the study. Regarding age of these Only(46.5%)of the participated were(>35)years, the weight(current) the data ranged from(40to136)by mean +SD(72.905±16.167). While the weight before pregnancy the data ranged from (39to1727)by mean +SD(67.985±15.082). The age a significant relation between diabetic mellitus and age were P-value=0.001and X2(8.860) increase in >35years answer YES were(71.4%). Gravida show a significant relation between diabetic mellitus were P-value=0.036 and X2(10.255) increase in more than 4 answer YES were (57.1%). the gravida/para/abortus (GPA) results show a significant relation between diabetic mellitus and GPA were P-value=0.026 and X2(11.008) increase in zero answer NO were (64.7%). Conclusion: The prevalence of of GDM among pregnant women's in obstetric clinics at MCH Makkah city 2019 was high. Previous history of GDM, antenatal family history of diabetes, low physical activity, overweight and/or obesity and inadequate dietary diversity were significantly associated with GDM. Routine screening of pregnant women and healthy lifestyle are strongly recommended.

Determinants of Gestational Diabetes Mellitus at Tertiary Care Hospital of Lahore

Gestational Diabetes Mellitus (GDM) is defined as glucose intolerance of varying degree with onset or first recognition during pregnancy. Prevalence of GDM is known to vary widely depending on the region of the country, dietary habits, and socio-economic status.

Determinants of gestational diabetes mellitus: a hospital-based case–control study in coastal South India

A public health problem that has been on the rise in the twenty-first century is gestational diabetes mellitus (GDM). There are serious adverse effects on both maternal and fetal health following GDM. Potential complications can be reduced by early detection of risk factors, which predispose women to GDM. This study aims to identify the risk factors associated with GDM. A case–control study was carried out among antenatal women admitted to hospitals affiliated to Kasturba Medical College, Mangalore. The study population consisted of cases, who were GDM patients, and controls, who were age-matched, non-GDM patients. Statistical Package for Social Sciences (SPSS) version 25.0 was used for entering and analysing data. Both univariate and multivariate analysis was done for determining the factors responsible for GDM. The mean age of cases was 29.54 (± 4.3) years and of controls was also 29.54 (± 4.2). There was no significant difference while comparing the socioeconomic status across the study groups. Irregular menstrual cycle (OR = 2.78, CI = 0.94–08.4, P = 0.06) and history of type 2 diabetes mellitus in first-degree relatives (OR = 5.26, CI = 2.13–12.99, P ≤ 0.001) were found to be significant risk factors. It was found in our study that irregular menstrual history, history of GDM in previous pregnancy, history of type 2 diabetes mellitus in first-degree relative and history of GDM in first-degree relative are all independent risk factors of GDM.

Genetic determinants of gestational diabetes mellitus: a case-control study in two independent populations.

Genetic risk score (GRS) is more informative to identify the complicated associations between variants of genes and disease. Considering similar pathogenesis and shared genetic predispositions between gestational diabetes mellitus (GDM) and type 2 diabetes/obesity, we conducted this study to explore whether the GRS model integrating variants related to type 2 diabetes/obesity is also associated with GDM risk. A population-based case-control study that included 1429 subjects was conducted to investigate the association between the GRS model and GDM risk, which were analyzed employing stratified logistic regression analysis with the adjustment for age, BMI, parity and family history of diabetes. We have screened 23 SNPs and further filtered six SNPs that were significantly associated with the risk of GDM: four risk SNPs (MTNR1B: rs10830963, rs1387153, rs2166706; MC4R: rs2229616) and two protective SNPs (MTNR1B: rs1447352 and rs4753426). The GRS model with a higher score indicated a higher genetic predisposition to develop GDM, especially in the highest quartile of GRS (all P < 0.001) and the strata of advanced maternal age (all P < 0.001) and obesity (all P = 0.005). In this study, six SNPs were explored and further identified to be associated with GDM risk, which suggested GRSs including these polymorphisms might participate in facilitating GDM risk. These findings offer the potential to improve our understanding of the etiology of GDM.

The socio-demographic determinants of gestational diabetes mellitus among postnatal women from Palakkad district, Kerala: comparative study

Background: The prevalence of diabetes is increasing all over the world and it is associated with different genetic factors as well as environmental factors. The increasing prevalence of type 2 diabetes among young people has led to an increase in number of pregnancies with this complication. As the incidence of diabetes is more in Kerala, the present study was undertaken to compare the socio-demographic determinants among pregnant mothers with normal gestation and mothers with GDM.Methods: A hospital based cross-sectional study was carried out and sample size was calculated using the formulae of (Zα + Zβ) 2 × 2 × P × Q/d2. The calculated sample size was 108 and consecutive sampling technique was used for data collection. A semi-structured questionnaire containing socio-demographic and obstetrics details were used as a study tool and an interview schedule was used for data collection.Results: Out of total 111 postnatal mothers, majority 80 (72.1%) belongs to the age group of 21-30 years, and more than half 64(57.66%) of mothers belongs to Hindu religion. When the socio-demographic and obstetrics details of mothers were compared among GDM and normal mothers it was found that there was statistically significant difference between religion, family history of diabetes and occurrence of GDM (p=0.001). Among obstetric details history of abortion, BMI of mothers and birth weight show statistically significant difference among two groups (p&lt;0.001).Conclusions: The study reveals that the socio demographic factors and obstetric factors influence the occurrence of GDM.

Maternal overweight is not an independent risk factor for increased birth weight, leptin and insulin in newborns of gestational diabetic women: observations from the prospective \u2018EaCH\u2019 cohort study

BackgroundBoth gestational diabetes mellitus (GDM) as well as overweight/obesity during pregnancy are risk factors for detrimental anthropometric and hormonal neonatal outcomes, identified to ‘program’ adverse health predispositions later on. While overweight/obesity are major determinants of GDM, independent effects on critical birth outcomes remain unclear. Thus, the aim of the present study was to evaluate, in women with GDM, the relative/independent impact of overweight/obesity vs. altered glucose metabolism on newborn parameters.MethodsThe prospective observational ‘Early CHARITÉ (EaCH)’ cohort study primarily focuses on early developmental origins of unfavorable health outcomes through pre- and/or early postnatal exposure to a ‘diabetogenic/adipogenic’ environment. It includes 205 mother-child dyads, recruited between 2007 and 2010, from women with treated GDM and delivery at the Clinic of Obstetrics, Charité – Universitätsmedizin Berlin, Germany. Recruitment, therapy, metabolite/hormone analyses, and data evaluation were performed according to standardized guidelines and protocols. This report specifically aimed to identify maternal anthropometric and metabolic determinants of anthropometric and critical hormonal birth outcomes in ‘EaCH’.ResultsGroup comparisons, Spearman’s correlations and unadjusted linear regression analyses initially confirmed that increased maternal prepregnancy body-mass-index (BMI) is a significant factor for elevated birth weight, cord-blood insulin and leptin (all P < 0.05). However, consideration of and adjustment for maternal glucose during late pregnancy showed that no maternal anthropometric parameter (weight, BMI, gestational weight gain) remained significant (all n.s.). In contrast, even after adjustment for maternal anthropometrics, third trimester glucose values (fasting and postprandial glucose at 32nd and 36th weeks’ gestation, HbA1c in 3rd trimester and at delivery), were clearly positively associated with critical birth outcomes (all P < 0.05).ConclusionsNeither overweight/obesity nor gestational weight gain appear to be independent determinants of increased birth weight, insulin and leptin. Rather, 3rd trimester glycemia seems to be crucial for respective neonatal outcomes. Thus, gestational care and future research studies should greatly consider late pregnancy glucose in overweight/obese women with or without GDM, for evaluation of critical causes and interventional strategies against ‘perinatal programming of diabesity’ in the offspring.

Determinants of gestational diabetes mellitus: A case control study in a district tertiary care hospital in south India

Objective:To study the determinants of Gestational Diabetes Mellitus (GDM).Design:Case-control study. Setting: Sri Avittom Thirunal Hospital, Thiruvananthapuram district, Kerala, South India.Participants:300 GDM women as cases and 300 age-matched controls.Study variables:Sociodemographic characteristics, pre-pregnancy Body Mass Index (BMI), menstrual history, obstetric history, infertility history, family history of diabetes in first degree relatives, recurrent urinary tract infection (UTI), and moniliasis.Statistical analysis:T-test, Fishers Exact Test, Chi square test, Adjusted Odds Ratio with 95% CI. Results: Pre-pregnancy BMI ≥ 25 (P < 0.001, OR = 2.7), irregular menstrual cycle (P = 0.006), treatment for infertility (P = 0.001, OR = 3.3), family history of diabetes (P = 0.001, OR = 4.5), history of diabetes in mother (P = 0.003), previous pregnancy losses (P = 0.04), past GDM (P = 0.035), prematurity (P = 0.01), pre-eclampsia (P = 0.04), polyhydramnios (P < 0.001, OR = 6.0), UTI (P < 0.001, OR = 3.2), and moniliasis (P < 0.001, OR = 7.6) were significantly associated with present GDM.Conclusion:Early identification of women at risk of GDM and prompt treatment is recommended to prevent complications.

Glucose tolerance in pregnant women with vaginal candidiasis

BackgroundThe use of traditional historic risk factors to identify gestational diabetes mellitus (GDM) will miss half of women with gestational diabetes mellitus. Our aim was to evaluate whether impaired glucose tolerance is a risk factor for vaginal candidiasis in pregnant women.Patients and MethodsIn a cross-sectional study, we compared the prevalence of impaired glucose tolerance in 64 pregnant women with vaginal candidiasis (positive microscopy) and 59 Candida-negative control subjects. Subjects underwent standardized 75-gram oral glucose tolerance testing between the 24th and 28th weeks of their pregnancies. Patients were included only if they had no known diabetes mellitus or historic risk factors for gestational diabetes mellitus, and had not been receiving antibiotic or steroid therapy. We compared glucose levels at fasting, 30 minutes, 60 minutes and 120 minutes, and perinatal and neonatal outcomes in the two groups.ResultsThere were no statistical differences between cases and controls in demographic characteristics. Glucose concentrations were higher in pregnant women with vaginal candidiasis than in control subjects at fasting (89 vs. 84 mg/dL, P=0.021), 30 minutes (139 vs. 126 mg/dL, P=0.050), and 60 minutes (124 vs. 106 mg/dL, P=0.018) after intake of 75 gram of glucose. The two groups did not differ in glucose level at 120 minutes after glucose administration. Gestational diabetes prevalence was 3.1% and 3.4% in the study and control group, respectively (P=0.274).ConclusionThe tolerance to glucose in pregnant women with vaginal candidiasis seems discretely impaired.