Prevalence Of Pre-existing Diabetes Research Articles

Trends in epidemiology of hyperglycemia in pregnancy in Taiwan, 2008-2017.

Hyperglycemia in pregnancy (HIP) increases the risk of adverse pregnancy outcomes. The increasing prevalence of overweight or obesity and the increasing proportion of pregnant women with advanced maternal age (AMA) in the recent decade may affect its prevalence. We analyzed the secular trend of HIP prevalence in 2008-2017 in Taiwan and investigated the impact of AMA in this study. This cross-sectional study used data from Health and Welfare Data Science Center. Pregnant women who registered their data in the Birth Certificate Application in 2008-2017 were recruited. Diagnosis of HIP was defined by ICD-9-CM and ICD-10-CM codes. In 2008-2017, 151,306-211,768 pregnant women were recruited in different years. The proportion of women with AMA increased from 15.8% to 32.1%. Meanwhile, the prevalence increased from 0.5% to 0.9% for preexisting diabetes, 0.2% to 0.4% for undiagnosed diabetes, and 11.4% to 14.5% for GDM. Maternal age was significantly associated with the prevalence of HIP. For women aged <30 years, 30-34 years and ≥35 years, the prevalence of preexisting diabetes were 0.51%, 0.75% and 1.24%, respectively (p<0.05); the prevalence of undiagnosed diabetes were 0.18%, 0.24% and 0.37%, respectively (p<0.05); and the prevalence of GDM were 10.57%, 14.77% and 18.13%, respectively (p<0.05). In all age groups, the prevalence of HIP increased over time in 2008-2017. The prevalence of HIP increased in Taiwan in 2008-2017, which may result from the increasing proportion of pregnant women with AMA and the change in the diagnostic criteria for GDM.

Trends in prevalence of pre-existing diabetes and perinatal outcomes: a large, population-based study in Catalonia, Spain, 2006–2015

IntroductionThis study aims to assess trends in the prevalence of pre-existing diabetes and whether the risk of adverse perinatal outcomes decreased in women between 2006 and 2015 in Catalonia, Spain.Research...

Maternal and infant outcomes in sarcoidosis pregnancy: a Swedish population-based cohort study of first births

BackgroundIt is unclear whether sarcoidosis, a multisystem inflammatory disease, is associated with adverse pregnancy outcomes. We aimed to assess the risk of adverse maternal and infant outcomes in sarcoidosis pregnancies, focused on first births.MethodsUsing a population-based cohort study design and Swedish national registers (2002–2013), we identified 182 singleton first pregnancies in the Medical Birth Register with at least two maternal ICD-coded sarcoidosis visits prior to pregnancy in the National Patient Register. Modified Poisson regression models estimated relative risks (RR) of adverse outcomes in sarcoidosis pregnancies compared to the general population adjusted for maternal age at delivery, calendar year and educational level. Some models were additionally adjusted for maternal body mass index and smoking status.ResultsThe prevalence of pre-existing diabetes and hypertension was higher in mothers with sarcoidosis than those without sarcoidosis. Mothers with sarcoidosis had an increased risk of preeclampsia/eclampsia (RR 1.6; 95%CI 1.0, 2.6) and cesarean delivery (RR 1.3; 95%CI 1.0, 1.6). There were < 5 stillbirths and cases of infection and no cases of placental abruption, venous thromboembolism, cardiac arrest or maternal death. Newborns of first-time mothers with sarcoidosis had a 70% increased risk of preterm birth (RR 1.7; 95%CI 1.1, 2.5). There was an increased risk of birth defects (RR 1.6; 95%CI 0.9, 2.8) the majority of which were non-cardiac.ConclusionsSarcoidosis is associated with increased risks for preeclampsia/eclampsia, cesarean delivery, preterm birth and some birth defects. Awareness of these conditions may prevent possible pregnancy complications in mothers with sarcoidosis and their newborns.

Prevalence of diabetes in Japanese patients with cancer.

Cancer patients with diabetes experience a poorer prognosis, yet the population burden of this multimorbidity remains unknown. This study aimed to estimate the latest incidence and prevalence of cancer with diabetes mellitus in Japan. We used projection of cancer incidence and latest survival data from population‐based cancer registries. The incidence of cancer associated with diabetes was estimated separately for patients with pre‐existing diabetes and those without diabetes, and used to estimate the 5‐year cancer prevalence for those with and without diabetes. The prevalence of pre‐existing diabetes in cancer patients at any cancer site was estimated to be 20.7% (647,160 men and women). Among cancer sites, diabetes prevalence was high in patients with liver and pancreatic cancers in both sexes. In conclusion, our study shows a large burden of diabetes in cancer patients in Japan, which warrants further attention by health practitioners and policy‐makers.

Diabetes and Pregnancy

Diabetes and Pregnancy

PWE-159 Diabetes and Pancreatic Cancer – Cause or Association?

Introduction Diabetes is an established risk factor for pancreatic cancer. 1 However, there is still limited evidence around predictors of pancreatic cancer diagnosis and severity in patients with pre-existing diabetes. In this retrospective observational study, we assess the relationship between pre-existing diabetes and pancreatic cancer in a UK patient cohort. In particular, we investigate the association of pre-diagnosis blood glucose levels with onset and severity of pancreatic cancer to determine whether there is a role for screening in diabetic patients. Methods Between 2012 and 2014, a total of 188 patients were diagnosed with pancreatic cancer at our regional oncology centre. Data was available for 116 of these patients. Detailed information on pre-diagnosis diabetic status, plasma glucose levels and cancer severity were retrieved systematically from their clinical notes and cancer services database, using standardised forms and procedures. Multivariate logistic regression analysis was used to investigate the association of blood glucose levels 5 years pre-diagnosis with age of cancer diagnosis and TNM staging of the cancer. Results Overall, the mean age of diagnosis was 70.8 years and 30% of these patients had pre-existing diabetes, compared to the UK national prevalence of 16.3% (men) and 9.4% (women) for a similar age range (65–74 years). 2 Among those who had died by the time of analysis (n = 37), the age at diagnosis of cancer was 2.4 years younger in patients with pre-existing diabetes than those without. Mean highest blood glucose level 5 years before diagnosis (n = 93) was 7.17 mmol/l in non-diabetics and 15.14 mmol/l in patients with diabetes. Each 1 unit increase of log-transformed blood glucose, regardless of diabetes status, was associated with a 2 year earlier age of diagnosis (p = 0.32) and 4 fold increase of having TNM stage T4/N1/M1 or greater (p = 0.22). Conclusion Our study suggests that pancreatic cancer patients had a much higher prevalence of pre-existing diabetes compared with the general population. Raised blood glucose levels appeared to be associated with earlier age of onset, worse staging and prognosis of pancreatic cancer. This study highlights the need for further UK studies to investigate the relationship between high pre-diagnosis blood glucose levels and pancreatic cancer in order to further examine the role of screening in diabetic patients. References 1 Muniraj T, Chari ST. Diabetes and pancreatic cancer. Minerva Gastroenterol Dietol . 2012 December; 58 (4):331–345. 2 Health Survey for England 2011. HSE 2011: Vol 1, Chapter 4: Diabetes and Hyperglycaemia. Disclosure of Interest None Declared

Gestational diabetes mellitus: an opportunity of a lifetime

Gestational diabetes mellitus is defined as carbohydrate intolerance of any degree that begins or is first recognised during pregnancy. 1 American Diabetes AssociationDiagnosis and classification of diabetes mellitus. Diabetes Care. 2006; 29: 43-48 Google Scholar It complicates about 4% of all pregnancies in the USA 1 American Diabetes AssociationDiagnosis and classification of diabetes mellitus. Diabetes Care. 2006; 29: 43-48 Google Scholar and 3–5% in the UK, 2 Ben-Haroush A Yogev Y Hod M Epidemiology of gestational diabetes mellitus and its association with type 2 diabetes. Diabet Med. 2004; 21: 103-113 Crossref PubMed Scopus (612) Google Scholar although reported US prevalence rates vary between 1–14% 1 American Diabetes AssociationDiagnosis and classification of diabetes mellitus. Diabetes Care. 2006; 29: 43-48 Google Scholar —attributable to factors such as differences in diagnostic criteria used to define both gestational diabetes and type 2 diabetes mellitus, 3 Carpenter MW Coustan DR Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol. 1982; 144: 768-773 Summary Full Text PDF PubMed Scopus (1490) Google Scholar , 4 National Diabetes Data GroupClassification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes. 1979; 18: 1039-1057 Crossref Scopus (5478) Google Scholar , 5 American Diabetes AssociationGestational diabetes mellitus. Diabetes Care. 2000; 23: 77-79 Google Scholar , 6 World Health OrganizationWorld Health Organization: definition, diagnosis and classification of diabetes mellitus and its complications. WHO, Geneva1999 Google Scholar and the heterogeneous ethnic origins of populations studied. 7 Lawrence JM Contreras R Chen W Sacks DA Trends in the prevalence of pre-existing diabetes and gestational diabetes mellitus among a racially/ethnically diverse population of pregnant women, 1999–2005. Diabetes Care. 2008; 31: 899-904 Crossref PubMed Scopus (471) Google Scholar Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysisIncreased awareness of the magnitude and timing of the risk of type 2 diabetes after gestational diabetes among patients and clinicians could provide an opportunity to test and use dietary, lifestyle, and pharmacological interventions that might prevent or delay the onset of type 2 diabetes in affected women. Full-Text PDF

Trends in the Prevalence of Preexisting Diabetes and Gestational Diabetes Mellitus Among a Racially/Ethnically Diverse Population of Pregnant Women, 1999–2005

The purpose of this study was to assess changes in the prevalence of preexisting diabetes (diabetes antedating pregnancy) and gestational diabetes mellitus (GDM) from 1999 through 2005. In this retrospective study of 175,249 women aged 13-58 years with 209,287 singleton deliveries of >or=20 weeks' gestation from 1999 through 2005 in all Kaiser Permanente hospitals in southern California, information from clinical databases and birth certificates was used to estimate the prevalence of preexisting diabetes and GDM. Preexisting diabetes was identified in 2,784 (1.3%) of all pregnancies, rising from an age- and race/ethnicity-adjusted prevalence of 0.81 per 100 in 1999 to 1.82 per 100 in 2005 (P(trend) < 0.001). Significant increases were observed in all age-groups and all racial/ethnic groups. After women with preexisting diabetes were excluded, GDM was identified in 15,121 (7.6%) of 199,298 screened pregnancies. The age- and race/ethnicity-adjusted GDM prevalence remained constant at 7.5 per 100 in 1999 to 7.4 per 100 in 2005 (P(trend) = 0.07). Among all deliveries to women with either form of diabetes, 10% were due to preexisting diabetes in 1999, rising to 21% in 2005, with GDM accounting for the remainder. The stable prevalence of GDM and increase in the prevalence of preexisting diabetes were independent of changes in the age and race/ethnicity of the population. The increase in preexisting diabetes, particularly among younger women early in their reproductive years, is of concern.