Recurrence of Gestational Diabetes Mellitus A systematic review

Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Diabetes care (Impact Factor: 8.42). 06/2007; 30(5):1314-9. DOI: 10.2337/dc06-2517
Source: PubMed


The purpose of this study was to examine rates and factors associated with recurrence of gestational diabetes mellitus (GDM) among women with a history of GDM.
We conducted a systematic literature review of articles published between January 1965 and November 2006, in which recurrence rates of GDM among women with a history of GDM were reported. Factors abstracted included recurrence rates, time elapsed between pregnancies, race/ethnicity, diagnostic criteria, and, when available, maternal age, parity, weight or BMI at the initial and subsequent pregnancy, weight gain at the initial or subsequent pregnancy and between pregnancies, insulin use, gestational age at diagnosis, glucose tolerance test levels, baby birth weight and presence of macrosomia, and breast-feeding.
Of 45 articles identified, 13 studies were eligible for inclusion. After the index pregnancy, recurrence rates varied between 30 and 84%. Lower rates were found in non-Hispanic white (NHW) populations (30-37%), and higher rates were found in minority populations (52-69%). Exceptions to observed racial/ethnic variations in recurrence were found in cohorts that were composed of a significant proportion of both NHW and minority women or that included women who had subsequent pregnancies within 1 year. No other risk factors were consistently associated with recurrence of GDM across studies. The rates of future preexisting diabetes in pregnancy, socioeconomic status, postpartum diabetes screening rates after the index pregnancy, and the average length of time between pregnancies were generally not reported.
Recurrence of GDM was common and may vary most significantly by NHW versus minority race/ethnicity.

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    • "An increase in GDM prevalence in Europe of ~10% using the new diagnostic criteria as compared to 2-6% appreciated through classic criteria was reported. Numerous risk factors have been incriminated for the occurrence of GDM (Kim et al., 2007), but only maternal obesity and excess weight gain can be corrected. The estimate of the real prevalence of GDM and the identification of some susceptible to influence risk factors provide useful data for the establishment of prevention programs. "

    Archives of Biological Sciences 01/2015; 67(00):20-20. DOI:10.2298/ABS140903020T · 0.72 Impact Factor
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    • "The rate of pregnancy outcomes also differs between Caucasian and Asian ethnicity. For example, preterm birth and macrosomia (Wong et al., 2008), recurrence of GDM in subsequent pregnancies (Kim et al., 2007) and later development of type 2 diabetes (Baptiste-Roberts et al., 2009) are all seen with higher frequency among Asian women with GDM. These facts strengthen the hypothesis that any approaches for the prevention and management of GDM may have greater impact in Asian populations. "
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    ABSTRACT: Abstract This review aims to evaluate the effectiveness of low glycemic index (GI) dietary intervention for the treatment of gestational diabetes mellitus (GDM), specifically from the Asian perspective. A systematic review of the literature using multiple databases without time restriction was conducted. Three studies were retrieved based upon a priori inclusion criteria. While there was a trend towards improvement, no significant differences were observed in overall glycemic control and pregnancy outcomes in GDM women. However, a tendency for lower birth weight and birth centile if the intervention began earlier was noted. Low GI diets were well accepted and had identical macro-micronutrient compositions as the control diets. However, due to genetic, environment and especially food pattern discrepancies between Western countries and Asians, these results may not be contributed to Asian context. Clearly, there are limited studies focusing on the effect of low GI dietary intervention in women with GDM, particularly in Asia.
    International Journal of Food Sciences and Nutrition 03/2014; 65(2):144-50. DOI:10.3109/09637486.2013.845652 · 1.21 Impact Factor
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    • "Peters et al. [45] reported that for every 4.5 kg increase in weight postpartum, there was a 2-fold increase in the risk of type 2 diabetes, even after adjustment for other factors including postpartum BMI, OGTT results, and breastfeeding. While this finding was not consistent across all older reports [57], more recent reports suggest that maternal weight gain in the United States between pregnancies might play a larger role in postpartum glucose intolerance, perhaps due to the aforementioned steady increase in BMI over the past decade among women of reproductive age [2]. In one recent examination of 22,351 women in a multiethnic population in northern California, women had a significant increase in their odds of GDM in their subsequent pregnancy with each unit of BMI gained between pregnancies [58]. "
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    ABSTRACT: Gestational diabetes mellitus (GDM) reflects defects in insulin secretion in response to the metabolic demands of pregnancy. While GDM is increasingly common worldwide due in large part to the obesity epidemic, its frequency is relatively low in Korean women. In this report, the prevalence and risk factors for GDM, perinatal outcomes, and postpartum course are compared in non-Korean and Korean women. While Koreans and non-Koreans with GDM share pathophysiology and complications, there may be differences in the role of obesity and thus the effectiveness of interventions targeting obesity in GDM women. Further investigations of the effectiveness of weight loss interventions and pharmacotherapy specifically among Korean women are needed. Dietary and other lifestyle data from Korean populations could inform prevention and treatment strategies in other countries which suffer from significantly higher prevalences of GDM.
    Diabetes & metabolism journal 02/2014; 38(1):1-12. DOI:10.4093/dmj.2014.38.1.1
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