Risk Factors For Gestational Diabetes Mellitus Research Articles

ASSOCIATION OF RISK FACTORS WITH PREVALENCE OF GESTATIONAL DIABETES MELLITUS

Objective: Gestational diabetes mellitus (GDM) is among the most common complications of pregnancy associated with adverse maternal and perinatal outcomes. There is an increased risk of gestational hypertension, preeclampsia, and operative delivery and their associated potential morbidities in women with GDM, especially in India, with increasing obesity, lifestyle, and dietary changes. Hence, this study was undertaken to study the prevalence of GDM and evaluate its maternal and neonatal outcomes. Methods: This study was conducted on 200 pregnant women between 26 and 28 weeks of gestation who were screened for GDM and diagnosed to have GDM based on WHO criteria. Risk factors associated with GDM and neonatal complications were studied. Results: Most of the GDM cases were significantly associated with body mass index (BMI) >25 kg/m2, family history of diabetes, previous macrosomia/ large for gestational age (LGA) babies, and history of GDM with p<0.001. The incidence of preeclampsia and polyhydramnios was significantly higher among GDM cases. Operative delivery and assisted (forceps) delivery had a strongly significant association with GDM (p<0.001). Hypoglycemia was the most common complication noted in neonates of GDM women. The incidence of complications was also significantly higher among neonates born with GDM. Conclusion: Our study concluded that BMI, family history of diabetes, past GDM, and previous LGA babies were important risk factors for GDM. The study emphasizes the need to screen all pregnant women for GDM so that timely diagnosis and intervention will reduce both maternal and perinatal complications.

Serum betaine and dimethylglycine in mid-pregnancy and the risk of gestational diabetes mellitus: a case-control study.

To investigate the associations of choline, betaine, dimethylglycine (DMG), L-carnitine, and Trimethylamine-N-oxide (TMAO) with the risk of Gestational diabetes mellitus (GDM) as well as the markers of glucose homeostasis. We performed a case-control study including 200 diagnosed GDM cases and 200 controls matched by maternal age (±2 years) and gestational age (±2 weeks). Concentrations of serum metabolites were measured by the high-performance liquid chromatography - tandem mass spectrometry (HPLC-MS/MS). Compared to the control group, GDM group had significantly lower serum betaine concentration and betaine/choline ratio, and higher DMG concentration. Furthermore, decreased betaine concentration and betaine/choline ratio, increased DMG concentration showed significant association with the risk of GDM. In addition, serum betaine concentrations were negatively associated with blood glucose levels at 1-h post-glucose load (OGTT-1h), and both betaine and L-carnitine concentrations were positively associated with 1,5-anhydroglucitol levels. Betaine/choline ratio was negatively associated with OGTT-1h and blood glucose levels at 2-h post-glucose load (OGTT-2h) and serum choline concentrations were negatively associated with fasting blood glucose and positively associated with OGTT-2h. Decreased serum betaine concentrations and betaine/choline ratio, and elevated DMG concentrations could be significant risk factors for GDM. Furthermore, betaine may be associated with blood glucose regulation and short-term glycemic fluctuations.

Promoting healthy eating in early pregnancy in individuals at risk of gestational diabetes mellitus: does it improve glucose homeostasis? A study protocol for a randomized control trial.

Healthy eating during pregnancy has favorable effects on glycemic control and is associated with a lower risk of gestational diabetes mellitus (GDM). According to Diabetes Canada, there is a need for an effective and acceptable intervention that could improve glucose homeostasis and support pregnant individuals at risk for GDM. This unicentric randomized controlled trial (RCT) aims to evaluate the effects of a nutritional intervention initiated early in pregnancy, on glucose homeostasis in 150 pregnant individuals at risk for GDM, compared to usual care. Population: 150 pregnant individuals ≥18 years old, at ≤14 weeks of pregnancy, and presenting ≥1 risk factor for GDM according to Diabetes Canada guidelines. Intervention: The nutritional intervention initiated in the first trimester is based on the health behavior change theory during pregnancy and on Canada's Food Guide recommendations. It includes (1) four individual counseling sessions with a registered dietitian using motivational interviewing (12, 18, 24, and 30 weeks), with post-interview phone call follow-ups, aiming to develop and achieve S.M.A.R.T. nutritional objectives (specific, measurable, attainable, relevant, and time-bound); (2) 10 informative video clips on healthy eating during pregnancy developed by our team and based on national guidelines, and (3) a virtual support community via a Facebook group. Control: Usual prenatal care. Protocol: This RCT includes three on-site visits (10-14, 24-26, and 34-36 weeks) during which a 2-h oral glucose tolerance test is done and blood samples are taken. At each trimester and 3 months postpartum, participants complete web-based questionnaires, including three validated 24-h dietary recalls to assess their diet quality using the Healthy Eating Food Index 2019. Primary outcome: Difference in the change in fasting blood glucose (from the first to the third trimester) between groups. This study has been approved by the Ethics Committee of the Centre de recherche du CHU de Québec-Université Laval. This RCT will determine whether a nutritional intervention initiated early in pregnancy can improve glucose homeostasis in individuals at risk for GDM and inform Canadian stakeholders on improving care trajectories and policies for pregnant individuals at risk for GDM. https://clinicaltrials.gov/study/NCT05299502, NCT05299502.

Assessment of potential risk factors associated with gestational diabetes mellitus: evidence from a Mendelian randomization study.

Previous research on the association between risk factors and gestational diabetes mellitus (GDM) primarily comprises observational studies with inconclusive results. The objective of this study is to investigate the causal relationship between 108 traits and GDM by employing a two-sample Mendelian randomization (MR) analysis to identify potential risk factors of GDM. We conducted MR analyses to explore the relationships between traits and GDM. The genome-wide association studies (GWAS) for traits were primarily based on data from the UK Biobank (UKBB), while the GWAS for GDM utilized data from FinnGen. We employed a false discovery rate (FDR) of 5% to account for multiple comparisons. The inverse-variance weighted (IVW) method indicated that the genetically predicted 24 risk factors were significantly associated with GDM, such as "Forced expiratory volume in 1-second (FEV1)" (OR=0.76; 95% CI: 0.63, 0.92), "Forced vital capacity (FVC)" (OR=0.74; 95% CI: 0.64, 0.87), "Usual walking pace" (OR=0.19; 95% CI: 0.09, 0.39), "Sex hormone-binding globulin (SHBG)" (OR=0.86; 95% CI: 0.78, 0.94). The sensitivity analyses with MR-Egger and weighted median methods indicated consistent results for most of the trats. Our study has uncovered a significant causal relationship between 24 risk factors and GDM. These results offer a new theoretical foundation for preventing or mitigating the risks associated with GDM.

New perspective on first-trimester serum uric acid level in predicting the risk of gestational diabetes mellitus

This study aimed to investigate the correlation between serum uric acid (UA) and gestational diabetes mellitus (GDM) during the first trimester and provide a new perspective for the prevention and treatment of GDM. Based on the diagnostic criteria of gestational diabetes of the International Association of Diabetes and Pregnancy Study Groups, 1744 and 4256 patients were enrolled in the GDM and normal glucose tolerance (NGT) groups. Four groups were constituted based on the quartile of first-trimester serum UA (UA) level, and the differences in each indicator between groups were compared. Logistic regression was used to analyze the effects of UA level on GDM risk. The rate of GDM in the UA quartile changed from low to high. Significant differences were also observed in fasting plasma glucose level, 1 h post glucose and 2 h post glucose levels, in all the groups (P < 0.05), which increased with the UA level. UA level were independent risk factors for GDM. The best threshold of GDM predicted by the first-trimester UA level was 226.55 μmol/L. The first-trimester UA level in patients with GDM was relatively higher and was an independent risk factor for GDM.

Getting a "SMART START" to gestational diabetes mellitus education: a mixed-methods pilot evaluation of a knowledge translation tool in primary care.

South Asian people living in Canada face higher rates of gestational diabetes mellitus (GDM) compared to national trends. The objective of this study was to design and pilot test a knowledge translation (KT) tool to support GDM prevention counselling in primary care. This study is a mixed-methods pilot evaluation of the "SMART START" KT tool involving 2 family physicians in separate practices and 20 pregnant South Asians in Ontario, Canada. We conducted the quantitative and qualitative components in parallel, developing a joint display to illustrate the converging and diverging elements. Between January and July 2020, 20 South Asian pregnant people were enrolled in this study. A high level of acceptability was received from patients and practitioners for timing, content, format, language, and interest in the interventions delivered. Quantitative findings revealed gaps in patient knowledge and behaviour in the following areas: GDM risk factors, the impact of GDM on the unborn baby, weight gain recommendations, diet, physical activity practices, and tracking of weight gain. From the qualitative component, we found that physicians valued and were keen to engage in GDM prevention counselling. Patients also expressed personal perceptions of healthy active living during pregnancy, experiences, and preferences with gathering and searching for information, and key preventative behaviours. Building on this knowledge can contribute to the design and implementation of other research opportunities or test new hypotheses as they relate to GDM prevention among South Asian communities.

Estradiol-to-follicle ratio on human chorionic gonadotropin day is a novel predictor of gestational diabetes mellitus in women receiving fresh embryo transfer.

To assess the predictive value of estradiol (E2) related parameters on the incidence of gestational diabetes mellitus (GDM) in women undergoing fresh embryo transfer. A Post-hoc analysis of a prospective cohort study. We identified an optimal E2/follicle (E2/F) ratio threshold of 246.03 pg/ml on the day of human chorionic gonadotropin (hCG) administration. Women with an E2/F ratio exceeding this threshold had significantly lower rates of GDM (12.75% vs. 20.41%, P < 0.001) and ovarian hyperstimulation syndrome (OHSS) (11.75% vs. 15.48%, P = 0.03). Additional E2 parameters were also evaluated: baseline E2, E2 on hCG day, E2 increase, and E2 fold change. Lower GDM rates were observed in women with baseline E2 above 31.50 pg/ml (13.51% vs. 19.42%, P <0.01), E2 on hCG day above 3794.50 pg/ml (12.26% vs. 19.32%, P < 0.001), and E2 increase above 3771.50 pg/ml (12.24% vs. 19.28%, P < 0.001). There were no significant differences in OHSS rates for these additional E2 parameters. After adjusting for confounders, lower E2/F ratio (OR: 1.626, 95% CI: 1.229-2.150, P <0.01), E2 on hCG day (OR: 1.511, 95% CI: 1.133-2.016, P = 0.01), and E2 increase (OR: 1.522, 95% CI: 1.141-2.031, P <0.01) were identified as risk factors for GDM. This study demonstrates that an E2/F ratio over 246.03 pg/ml is significantly associated with a reduced risk of both GDM and OHSS in women undergoing fresh embryo transfer, highlighting the E2/F ratio as a superior predictive biomarker compared to other E2-related parameters.

Identifying gestational diabetes mellitus and assessing risk factors in affected women: a comprehensive study.

Gestational diabetes mellitus (GDM) is a prevalent pregnancy complication associated with adverse health outcomes for both mothers and offspring. This study aimed to identify risk factors for GDM, a condition with a rapidly increasing global prevalence. We conducted a study involving 474 pregnant women who attended the obstetrics outpatient clinic of Kafkas University Faculty of Medicine Hospital between January 2022 and June 2023. Risk factors for GDM were assessed based on criteria recommended by the American Diabetes Association and the Committee on Practice of the American College of Obstetricians and Gynecologists. Statistical analyses, including descriptive statistics, Chi-square tests, Mann-Whitney U tests, and multivariate logistic regression. Individuals with GDM (mean age: 31.26±6.09 years) were significantly older than those without GDM (mean age: 28.36±4.89 years; p<0.001). Obesity prevalence was higher in the GDM group (32.5%) compared to the non-GDM group (14.3%; p<0.001). Individuals with GDM had higher rates of pre-diabetes (3.3% vs. 0.3%; p=0.007), a history of gestational diabetes (25.2% vs. 5.7%; p<0.001), high blood sugar in previous pregnancies (13.8% vs. 1.4%; p<0.001), and diabetes mellitus in 1st-degree relatives (40.7% vs. 20.3%; p<0.001). GDM was associated with increased pregnancies (p<0.001), preterm births (p<0.001), macrosomic babies (p=0.026), congenital anomalies (p=0.011), high cholesterol (p=0.036), and polyhydramnios (p=0.001) in previous pregnancies, as well as polyhydramnios in the index pregnancy (p=0.008). Regular exercise in previous pregnancies differed significantly based on GDM presence (p=0.037). Recognizing modifiable risk factors is crucial for preventing GDM and reducing associated health risks. Healthcare providers should be vigilant, especially among those with a family history of GDM, previous GDM, advanced maternal age, and other risk factors. Early lifestyle interventions show promise. Further research is needed for accurate GDM prediction.

Rising prevalence of gestational diabetes mellitus and its associated risk factors in Makurdi, North-Central Region of Nigeria.

The disease burden of gestational diabetes mellitus (GDM) in sub-Saharan African region have been on the rise. Proper assessment of current prevalence of GDM may inform policy changes and management approach for improved care delivery. To determine the current prevalence of Gestational Diabetes Mellitus (GDM) and evaluate its major risk factors amongst pregnant women in Makurdi, North-Central Nigeria. This was a multi-center hospital-based prospective observational study. Maternal characteristics and clinical risk factors for GDM in a cohort of 281 pregnant women at 9 to 16 weeks gestational age was evaluated. The one-step 75g oral glucose tolerance test (OGTT) was carried out at 24 to 28 weeks of gestation. Of the 356 women recruited, 281 (79.8%) completed the study. The GDM prevalence in the cohort was 16.7%. Increased early pregnancy BMI (adjusted OR = 1.154, 95% CI = 1.080 - 1.233, p<0.001) and presence of family history of diabetes mellitus (adjusted OR = 0.482, 95% CI = 0.233 - 0.997, P<0.05) were independent risk factors for GDM in the cohort. Increasing maternal age and early pregnancy BMI amongst other possible reasons, may account for the rising prevalence of GDM in the region.

Establishment of gestational diabetes risk prediction model and clinical verification

ObjectiveThe present study aimed to evaluate the risk factors for gestational diabetes mellitus (GDM) and build and validate an early risk prediction model of GDM by comparing the differences in the indicators of the first trimester of pregnancy between pregnant women with GDM and non-gestational diabetes mellitus (NGDM). Thus, this study provided a theoretical basis for early intervention of GDM.MethodsA total of 6000 pregnant women who underwent a routine prenatal examination in Qinhuangdao Maternal and Child Health Hospital (Qinhuangdao City, Hebei Province, China) from January 2016–2022 were retrospectively selected and randomly divided into a modeling cohort (4200 cases) and validation cohort (1800 cases) at a ratio of 3:7. According to the results of oral glucose tolerance test (OGTT), they were divided into NGDM and GDM groups. The modeling cohort consisted of 2975 NGDM and 1225 GDM cases, while the validation cohort consisted of 1281 NGDM and 519 GDM cases. The differences in general conditions and laboratory indicators between different groups were compared, and logistic regression analysis was further used to establish a risk prediction model for GDM in the first trimester. The receiver operating characteristic curve (ROC) and Hosmer–Lemeshow (HL) tests were used to evaluate the prediction of the model efficacy.ResultsAge, pre-pregnancy body mass index (BMI), glycosylated hemoglobin (HbA1c), blood uric acid (UA), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) in the first trimester were independent risk factors for GDM (P < 0.05). The model equation was Y = 1/{1 + exp[− (− 18.373 + age × 0.065 + BMI × 0.030 + first-trimester HbA1c × 2.519 + UA × 0.014 + TG × 0.224-HDL-C × 0.635)]}. The area under the ROC curve (AUC) of the model cohort was 0.803 (0.788–0.817), the sensitivity was 72.0%, and the specificity was 73.5%. The AUC of the validation cohort was 0.782 (0.759–0.806), the sensitivity was 68.6%, and the specificity was 73.8%. The P values of the HL test in both the training and validation sets were > 0.05, indicating a satisfactory model fit.ConclusionAge, pre-pregnancy BMI, HbA1C in early pregnancy, blood UA, TG, and HDL-C are independent risk factors for GDM. The risk prediction model established by combining age, pre-pregnancy BMI, and laboratory indicators in the first trimester can provide a theoretical basis for early screening, monitoring, and intervention of GDM high-risk pregnant women.

Awareness of Gestational Diabetes Mellitus Among Women in the Al-Baha Region, Saudi Arabia.

Background Gestational diabetes mellitus (GDM) is a condition characterized by impaired glucose tolerance that develops during pregnancy. The prevalence of GDM is increasing globally, including in the Al-Baha region of Saudi Arabia. However, there needs to be more data on the awareness of women in this region regarding GDM and its associated risks. This research aimed to evaluate the level of awareness among women in the Al-Baha region regarding GDM. Methodology This study followed an observational cross-sectional design conducted from April 2023 to December 2023. A simple random sampling technique was used to select 457 participants from the resident women of reproductive age in the Al-Baha region. Data were collected through a self-administered questionnaire that assessed knowledge and awareness of GDM risk factors, assessment, therapy, and implications. The questionnaire included a 12-item section evaluating GDM awareness, with correct answers receiving a score of 1. Descriptive statistics were used to analyze the data with Statistical Product and Service Solutions (SPSS, version 28) (IBM SPSS Statistics for Windows, Armonk, NY). Results The majority of participants fell into the age group of more than 36 years (n=207, 45.3%), with a significant proportion having completed university/diploma education (n=282, 61.7%), and most of them worked outside the health sector (n=283, 61.9%). Approximately 27.8% correctly identified that the number of pregnancies does not increase the chance of developing GDM. Only (n=48, 10.5%) accurately identified the usual time for diagnosing GDM in the absence of risk factors, which is between weeks 24 and 28 of pregnancy. Similarly, 26.0% (119 participants) correctly recognized a history of a previous pregnancy with a child weighing more than 4.5 kg as a factor that increases the suspicion of developing GDM in the future. However, it is important to note that the majority of participants (n=311, 68.1%) had a poor level of awareness regarding GDM. Conclusion The findings revealed that the overall level of knowledge about GDM was poor, with less than 10% of participants demonstrating adequate awareness. The study also highlighted that over 80% of the participants were unaware of GDM.

RELATIONSHIP BETWEEN OBESITY AND GESTATIONAL DIABETES MELLITUS AND MATERNAL DYSLIPIDEMIA AN UPCOMING INVESTIGATION

Background: Gestational diabetes and maternal dyslipidemia are linked, although obesity’s role is uncertain. InGDM patients, we examined the relationship between maternal obesity at the first prenatal visit and oral glucosetolerance test (OGTT) fasting lipids.Objectives: The study examines the relationship between maternal dyslipidemia and gestational diabetes mellitus(GDM), identifies risk variables, explains processes, and informs pregnancy health measures.Study design: A prospective studyDuration and place of study: from Sep 2021 to March 2022 at Dow University Karachi, PakistanMethods: Dow University Karachi, which graduates around 150 students annually, conducted this prospectiveresearch. Participants 17-20 years old with at least one maternal risk factor for GDM were recruited at their firstprenatal hospital visit. Women with diabetes or multiple pregnancies were excluded. Maternal risk factors and GDMoutcomes were examined by medical records, interviews, and laboratory testing. The research employed descriptivestatistics and logistic regression to find risk variable-GDM relationships. This study examined how risk factors affectGDM incidence in Dow University Karachi’s young women.Results: The study population was classified by GDM status. At the first prenatal session, 150 women accepted theresearch. A substantial correlation was found between maternal factors and gestational diabetes mellitus incidence.GDM risk increased with younger maternal age, averaging late teens. Maternal obesity was a substantial risk factorfor GDM. High fasting cholesterol, especially triglycerides, and total cholesterol were particularly high in the GDMgroup, emphasizing the importance of maternal cholesterol. Family history of diabetes mellitus, previous diagnosis ofGDM, and high BMI were associated with GDM risk. These results emphasize the complexity of GDM developmentand the need for focused prevention.Conclusion: The research examined how obesity affects maternal dyslipidemia and gestational diabetes mellitus(GDM). The abstract describes the study’s aims and procedures, but not its conclusions. The findings may help usunderstand the complex relationships between maternal obesity, dyslipidemia, and GDM. These findings may helpidentify at-risk pregnant women and develop targeted therapies to improve their health and that of their unborn children. More research and a complete report are needed to properly grasp the study’s advantages to maternal healthcare.Keywords: maternal dyslipidemia, gestational diabetes mellitus (GDM), and pregnancy complications

#209 : The Association Between Autoimmune Diseases and Gestational Diabetes Mellitus: A Mendelian Randomization Study

Background and Aims: As a common complication of pregnancy, gestational diabetes mellitus (GDM) may lead to a serious negative impact on pregnant women and their children. Autoimmune diseases are chronic pathologies triggered by abnormal responses of the human immune system that result in damage and disorders in the body. Recently, several studies have demonstrated that autoimmune diseases could be related to the risk of GDM. However, several other studies of this relationship have yielded conflicting results. We explored the causal relationship between autoimmune diseases and GDM risk through a two-sample Mendelian randomization (2SMR) study. Method: We obtained exposure data for rheumatoid arthritis (RA) from a genome-wide association study (GWAS) pooled dataset, which consisted of 361,194 participants. We selected single-nucleotide polymorphisms (SNPs) that had a relationship with RA and were at a significance level of not only p &lt; 5 × 10[Formula: see text] but also at a low linkage disequilibrium (LD) level (r2 &lt; 0.01). The results included 5,687 GDM cases and 117,892 controls. For detailed Methods, please see the Methods section in this article’s Online Repository at https://www.jacionline.org Results: The results of inverse variance weight (IVW) analysis suggested a positive correlation between RA and GDM risk. In addition, no validity was observed in the statistical models for heterogeneity and pleiotropy. However, for multiple sclerosis (MS), no causal relationship between it and GDM risk was found in our study. Conclusion: Our results suggest a strong casual association between RA and the risk of GDM. The results suggested the importance of enhanced antenatal care and early intervention among pregnant women with RA as well as clues for novel risk factors for GDM.

Factors related to HbA1c in the first trimester of pregnancy

The prevalence of gestational diabetes mellitus (GDM) in the world is 16.2% of live births associated with hyperglycemia in pregnancy, and 7.4% are caused by type 1 or 2 diabetes which is detected for the first-time during pregnancy. The prevalence of GDM in Indonesia reaches 3.6% and the highest rate is found in the Special Province of Yogyakarta (2.6%). One of the risk factors for GDM is excess nutrition which is influenced by daily intake. This study aims to determine the relationship between nutritional intake and body mass index (BMI) with HbA1c levels in first-trimester pregnant women. This study used a cross-sectional design. A simple random sampling with inclusion and exclusion criteria was employed, involving 47 pregnant women as subjects. Nutritional intake was measured with the semi-quantitative food frequency questionnaire (SQ-FFQ). The nutritional status of pregnant women is measured by BMI. HbA1c was measured by the turbidimetric inhibition immunoassay (TINIA) method. Analysis of research data using the Pearson product-moment correlation test and rank Spearman. The results of this study stated that there was a relationship between nutritional intake and BMI with HbA1c levels. Diagnosis of GDM and appropriate intervention can reduce the risk of complications of diabetes mellitus (DM).

Gestational Diabetes Mellitus among women attending antenatal clinic in a Tertiary Hospital in Northern Nigeria

Introduction: Women with gestational diabetes mellitus (GDM) are at an increased risk of adverse perinatal and maternal morbidities and mortalities. Hence, early detection and management of this condition is vital to ensure a good outcome for both mother and baby. Aim: The aim of the study is to determine the prevalence and associated risk factors for GDM among antenatal attendees in Federal Medical Centre Gusau (FMCG), Zamfara state, Nigeria. Methods: A descriptive cross-sectional study was carried out. Screening was done between 24 and 28-weeks gestational age with a 75g oral glucose tolerance test (OGTT). Plasma glucose measurements was performed using the glucose oxidase method. GDM was diagnosed according to the 2013 WHO diagnostic criteria. Data were collected using a proforma and analyzed using the Statistical Package for Social Sciences (SPSS) Version 26. Descriptive data were presented in frequency tables. Statistical testing using Chi-square, and multivariate analysis (Odd ratio and CI) were carried out with a level of significance set as P&lt; 0.05. Results: One hundred and thirty-six women between the gestational ages of 24-28 weeks were recruited. The mean age of the participants was 25.9±5.4 years. The prevalence of GDM was found to be 16.9%. Fasting blood glucose alone correctly diagnosed 87% of the patients. Previous history of macrosomic babies (≥4kg) and history of GDM in previous pregnancies were significantly associated with GDM. Conclusion: The prevalence of GDM is high among antenatal attendees in Federal Medical center, Gusau.

The impact of socioeconomic deprivation on the prevalence of gestational diabetes: An observational study

Background Approximately 3.5% of pregnancies in the United Kingdom are complicated by gestational diabetes mellitus (GDM). Risk factors for this mirror those contributing to type 2 diabetes (T2DM). Though socioeconomic status (SES) is presumed to contribute to GDM, evidence in the United Kingdom is limited. In this unique study, we explored the impact of SES on GDM prevalence in a London suburb population. Materials and Methods Four thousand one hundred and sixty-three pregnant women who booked between July 2018 and March 2020 at Princess Royal University Hospital were retrospectively analyzed. Associations between GDM prevalence and SES trends (using multiple deprivation deciles (MDD)), and body mass index (BMI), age, ethnicity, screening uptake, birth-weights and birth outcomes, were analyzed. Results Patients with BMI &gt;30 kg/m2, older than 35 years, and non-Caucasian ethnicity have an increased risk of developing GDM ( p &lt; 0.0001, p &lt; 0.0001, p &lt; 0.0001, respectively). No association existed between MDD and GDM prevalence ( p-values over 0.05). Patients with risk factors for GDM were highest in the deprived areas p &lt; 0.0001. MDD 1–4 (most deprived) had the highest percentage of missed screening (15% of patients with risk factors missed screening), compared to 8% in the least deprived group ( p &lt; 0.0001). Discussion Our data surprisingly suggest that low SES did not increase the incidence of GDM, despite a higher proportion of women with risk factors for GDM living in the most deprived postcodes. However this unclear finding may be due to low screening uptake of deprived populations, and therefore lack of GDM diagnosis, or indicate that GDM is a result of a different aetiology to T2DM. Further research is needed to explore if access to screening services, lack of health education or other health inequalities were responsible for the high proportion of missed screening opportunities in deprived areas.

Racial/Ethnic and Nativity Inequalities in Gestational Diabetes Mellitus: The Role of Psychosocial Stressors.

Racial/ethnic and nativity disparities in gestational diabetes mellitus (GDM) persist in the United States. Identified factors associated with these differences do not fully explain them. Research has recognized psychosocial stress as a potentially modifiable risk factor for GDM. We used New York City Pregnancy Risk and Assessment Monitoring System data (2009-2014) linked with birth certificate items (n=7,632) in bivariate and multivariate analyses to examine associations between 12 psychosocial stressors (modeled three ways: individual stressors, grouped stressors, stress constructs) and GDM across race/ethnicity and nativity, and if stressors explain racial/ethnic/nativity differences in GDM. U.S. and foreign-born Black and Hispanic women reported higher stressors relative to U.S.-born White women. In fully adjusted models, the financial stress construct was associated with a 51% increased adjusted risk of GDM, and adding all stressors doubled the risk. Psychosocial stressors did not explain the elevated risk of GDM among foreign-born Black (adjusted risk ratio,2.18; 95% confidence interval, 1.53-3.11), Hispanic (adjusted risk ratio,1.57; 95% confidence interval, 1.10-2.25), or Asian/Pacific Islander (adjusted risk ratio,4.10; 95% confidence interval, 3.04-5.52) women compared with U.S.-born White women. Historically minoritized racial/ethnic and immigrant women have an increased risk of psychosocial stressors and GDM relative to U.S.-born White women. Although financial and all stressors predicted higher risk of GDM, they did not explain the increased risk of GDM among immigrant and minoritized racial/ethnic women. Further examination into racial/ethnic and nativity inequalities in stress exposure and rates of GDM is warranted to promote healthier pregnancies and birth outcomes.

Association between MTHFR gene C677T polymorphism and gestational diabetes mellitus in Chinese population: a meta-analysis.

The relationship of the methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism with the incidence of gestational diabetes mellitus (GDM) in the Chinese population remains controversial. This study aimed to further clarify the effect of the MTHFR gene C677T polymorphism on GDM risk among Chinese pregnant women based on current evidence. Several databases were searched up to July 29, 2023 for relevant case-control studies. The numbers of patients with and without the T allele of the MTHFR gene C677T polymorphism in the GDM and control groups were determined, and all statistical analyses were performed by RevMan 5.3 software and STATA 15.0 software. Trial sequential analysis (TSA) was performed by TSA version 0.9 beta software to determine the required information size. A total of 17 case-control studies involving 12345 Chinese participants were included. The pooled results demonstrated that the T allele of the MTHFR gene C677T polymorphism was significantly associated with an increased risk of GDM, which was manifested by the five gene models of the MTHFR C677T polymorphism [T vs. C: odds ratio (OR)=1.59, P=0.03; TT vs. CC: OR=2.24, P<0.001; TC vs. CC: OR=1.28, P=0.05; (TT+TC) vs. CC: OR=1.55, P=0.003; TT vs. (TC+CC): OR=1.89, P<0.001]. Subgroup analysis based on the regions indicated that the significant relationship between the T allele of the MTHFR gene C677T polymorphism and an increased risk of GDM was detected only among the southern population [T vs. C: OR=1.62, P=0.09; TT vs. CC: OR=2.22, P=0.004; TC vs. CC: OR=1.17, P=0.28; (TT+TC) vs. CC: OR=1.43, P=0.03; TT vs. (TC+CC): OR=1.97, P=0.006]. TSA plots showed that the information sizes for the association between the MTHFR gene C677T polymorphism and GDM risk were sufficient in the homozygote (TT vs. CC) and recessive (TT vs. TC+CC) models. The MTHFR gene C677T polymorphism is closely related to susceptibility to GDM in the southern Chinese population, and the C-T mutation serves as an important genetic risk factor for GDM. More well-designed large case-control studies are needed to further confirm the above findings.

Gestational diabetes

Gestational diabetes mellitus (GDM) is a common disease of pregnancy, affecting approximately 5% of pregnancies in the UK. It has serious health implications for both mother and baby which stretch beyond the antenatal period. Understanding how to recognise and mitigate some of the modifiable risk factors for GDM and its long-term sequelae is important for GPs.

THU317 Study Of Risk Factors For The Development Of Various Subtypes Of Gestational Diabetes Mellitus

Abstract Disclosure: N.I. Volkova: None. I. Davidenko: None. J. Sorokina: None. J. Degtyareva: None. V. Kovalenko: None. Abstract: Gestational diabetes mellitus (GDM) poses a threat to the health of the mother and a high risk of perinatal complications, however, achieving normoglycemia will significantly improve the prognosis in such pregnant women. One of the factors determining the most optimal management tactics is based on the pathophysiological mechanism of GDM formation. According to modern concepts, the processes associated with pancreatic β-cell dysfunction, insulin resistance (IR) or a combination of these factors may prevail in the basis of the formation of GDM, forming various subtypes of GDM. Identification of risk factors for the development of various subtypes of GDM in pregnant women may be important for timely verification and selection of therapy. In order to study risk factors for the development of various subtypes of GDM 130 pregnant women were examined without a history of carbohydrate metabolism disorders. The subjects were divided into: group I - 45 pregnant women with GDM and β-cell dysfunction, group II - 43 pregnant women with GDM and IR, group III - 42 pregnant women without GDM (control). The risk factors, whose contribution to the development of GDM is already well known, and the factors that, in our opinion, can influence the development of GDM, were studied. We conducted a full clinical examination. Carbohydrate metabolism was assessed according to fasting venous plasma glucose, oral glucose tolerance test with 75 g of glucose. The function of β-cells was evaluated and IR was detected. According to the Matsuda index, subtypes of GDM were identified. Statistical processing was carried out using comparative analysis. The data are presented in the form of medians and interquartile intervals of quantitative indicators in the groups, the data were considered reliable at p&amp;lt;0.05. Pregnant women with GDM and IR are characterized by an older age at the onset of pregnancy [32 (29; 35) y.o, p = 0.009], a large body weight [84 (76; 91) kg, p &amp;lt;0.001], signs of acanthosis nigricans (14%, p=0.03), weight of 1 child at birth (p= 0.047), rarer intake of folic acid (p&amp;lt; 0.001), low physical activity before pregnancy (p&amp;lt;0.001). Patients with GDM and β-cell dysfunction are characterized by a younger age [29 (27; 31) y.o.; p= 0.02], lower body weight [59.8 (55.9; 76.4) kg, p &amp;lt;0.001] and BMI [21.9 (20.7; 26.6) kg/m2, p &amp;lt;0.001], absence of regular MC before pregnancy (93%, p=0.02) and more frequent use of folic acid (p=0.048). Both groups of patients were characterized by the absence of pre-gravidar preparation (p=0.03).Thus, we have studied known risk factors for GDM, as well as factors that could potentially cause the development of hyperglycemia during pregnancy. And it turned out that in addition to the influence of the patient's age and body weight before pregnancy, an important contribution to the development of various subtypes of GDM is provided by low physical activity and lack of pregravidar preparation. Presentation: Thursday, June 15, 2023