Maternal and Dietary Factors Are Associated with Metabolic Syndrome in Women with a Previous History of Gestational Diabetes Mellitus (original) (raw)
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Journal of Medical Science And clinical Research, 2019
Aim: To study the incidence of metabolic syndrome in postnatal women with history of gestational diabetes mellitus in the index pregnancy when compared to a women without the history of gestational diabetes mellitus To study the socio-demographic factors affecting the development of metabolic syndrome in postnatal women with history of gestational diabetes mellitus in the index pregnancy Materials and Methods: The recruitment of the postnatal women to the study was started after obtaining clearance from the Ethical committee conducted in Sree Avittom Thirunal Hospital, Government Medical College, Thiruvananthapuram and study period was for one year. This was a Prospective cohort study Results: In our study we included only women >19 years and <35 years and majority of the women in the GDM group belonged to the age group 26-30 and women in the non GDM group who belonged to 25. In the present study 49.7% of the women in the GDM group belonged to Class IV when compared to 64.6% in the non GDM group also belonged to the same socioeconomic status. Majority of the women belonged to the Hindu religion both in the GDM and the non GDM group.60% of the multipara belonged to the GDM group when compared to 40% of the primipara belonged to the GDM group.24.6% of the patients in the GDM group had a history of gestational hypertension, when compared to 8% of the non GDM group.20% of the women in the GDM group had a past history of GDM in their previous pregnancies.23.4% of the women in the GDM group had a family history of diabetes in father when compared to 5.1% of the non GDM group. Majority of the women in the study did not have any family history of diabetes in the siblings.45.1% of the women belonging to the GDM group had a birth weight between 2.6 to 3.5kg.28% of the women belonging to the GDM group had a pre pregnancy BMI > = 25 when compared to 13.1% of the women in the non GDM group.69% of the women belonging to the GDM group had BMI >= 25 when compared to 48% of the women belonging to the non GDM group. In our study, we included only women >19 yrs and <35 yrs and the percentage of metabolic syndrome was higher in either ends of the range that is 55.6% and 44% respectively. Majority of the subjects were booked at our hospital but the percentage of metabolic syndrome was found to be slightly higher in the referral subjects, p value was 0.4 and it was not
Effect of Lifestyle and Diet on Gestational Diabetes GDM in South Asian Women a Systematic Review
Henry Publishing Groups, 2020
Background: Evidence suggests that all forms of diabetes are on the increase, especially Gestational Diabetes Mellitus (GDM), which increases the risk of maternal and neonatal morbidities. However, the global effect of diet (HA) and lifestyle (PA) of GDM in the South Asian (SA) population remain uncertain. The study aimed to examine the global burden of gestational diabetes mellitus in the SA population living in UK. Methods: A systematic review of the studies reporting the effect of diet and lifestyle on pregnant women who were a high risk of GDM was conducted. Cochrane (Central), PubMed, Scopus, JBI, Medline, EMBASE and reference lists of retrieved studies were searched from inception to December 2019. Publications on the effect of diet and lifestyle on GDM in the SA population were included in the study. Studies were limited to the English language and women aged between 18 and above inclusive. Results: Though there are some studies on the management of GDM outside the UK covering from ethnic groups in the sample, in the context of UK there are not enough studies published to date. Twelve studies met the inclusion criteria for this review. The included studies collectively reported GDM rates of 13,450 pregnant women immigrants from 9 countries. The diagnostic criteria used in the studies were the World Health Organisation (WHO) 1985 and 1999, International Association of Diabetes, Pregnancy Study Group (IAD-PSG), National Diabetes Data Group (NDDG), Carpenter-Coustan (C&C) and O'Sullivan's criteria. Of 12 studies presented, 2 indicated diet restrictions specifically for SA GDM patients. 8 of the 12 studies showed physical activity in early pregnancy and post-operative monitoring and recommended food choices as well for the prevention of Type II Diabetes Mellitus (T2DM).Of the 12 studies reviewed, 2 indicated that dietary restrictions and physical activity through a smart phone APP is beneficial for reducing birth complications and T2DM in the near future. Conclusion: This review suggests that dietary restrictions (healthy eating) and mild to moderate physical activity pre-pregnancy and continued throughout could help prevent GDM. Evidence also suggested that SA women, especially immigrants, with a low level of knowledge, low awareness and education, a language barrier, and cultural practices are more at risk of GDM than immigrants and non-GDM women as well.
European Journal of Clinical Nutrition, 2006
Objective: This study aims to identify lifestyle predictors of gestational diabetes mellitus (GDM) in South Asian women. Pregravid body mass index, body composition, rate of weight gain during pregnancy, physical activity (PA) and dietary intake were studied. Design: Prospective cohort study (n ¼ 611) of South Asian women at Aga Khan University Hospital antenatal clinic in Karachi, Pakistan. Weight, height and body fat % were measured and data on PA, diet and socioeconomic covariates were collected at baseline. A glucose screen was performed at 29.872.6 weeks. Results: Using logistic regression analysis for the full cohort, the risk of GDM increased with older maternal age (odds ratio (OR) 1.13, confidence interval (CI) 1.06-1.21), increased body fat % (OR 1.07, CI 1.03-1.13) and the risk was inversely associated with PA (100 kcal) (OR 0.79-0.99, CI 0.89). Using a nested case (n ¼ 49) control (n ¼ 98) design to study dietary intake, the risk of GDM decreased with increasing protein (% energy) in the diet (OR 0.75, CI 0.60-0.95). Conclusions: Body fat %, physical inactivity and, possibly, diet quality are important modifiable risk factors for GDM.
Scientific Reports
Metabolic syndrome (MetS) in pregnancy shows epigenetic associations with intergenerational inheritance of metabolic diseases. The presence of different diagnostic criteria influences MetS prevalence estimates. We evaluated MetS and metabolic derangements to determine the utility of its assessment in early pregnancy. A cross-sectional analysis of metabolic derangements in pregnant women with period of gestation (POG) ≤ 12 weeks was done among Rajarata Pregnancy Cohort participants in Sri Lanka. 2682 women with mean age 27.9 year (SD-5.5) and median POG 8.0wk (IQR-3) were analyzed. Mean levels of triglycerides (TG), total cholesterol (TC), high-density-lipoprotein (HDL), low-density-lipoprotein (LDL), fasting plasma glucose, and 2 h oral glucose tolerance test were 87.71 (SD 38.7), 172.2 (SD 34.7), 49.6 (SD 11.5), 122.6 (SD 32.3), 82.2 (SD 12.8) and 120.3 (SD 11.5) respectively. All serum lipids except LDL increase significantly from 6 to 12 weeks, with TG by 23 and TC by 8 units. Hi...
Malaysian journal of nutrition, 2013
Gestational diabetes mellitus (GDM) increases risks for type 2 diabetes and cardiovascular diseases. Low glycaemic index (GI) diets improve cardio-metabolic outcomes in insulin-resistant individuals. We examined the feasibility of lowering GI through GI-based-education among Asian post-GDM women. A 3-month investigation was carried out on 60 Malaysian women with a mean age of 31.0 +/- 4.5 years and a history of GDM. Subjects were randomised into two groups: LGIE and CHDR. The CHDR group received conventional healthy dietary recommendations only. The LGIE group received GI based-education in addition to conventional healthy dietary recommendations. At baseline and after 3-months, dietary intake of energy and macronutrient intakes including GI diet and glycaemic load was assessed using 3-day food records. Diabetes-Diet and GI-concept scores and physical activity levels were assessed using a questionnaire. Adherence to dietary instructions was measured at the end of 3 months. At the en...
PubMed, 2012
Introduction: Women with previous gestational diabetes mellitus (PGDM) are at increased risk of future glucose intolerance. This study aimed to determine the prevalence of prediabetes and type 2 diabetes mellitus (T2DM), and the associated antenatal and historical risk factors among women with PGDM. Methods: This was a cross-sectional study conducted at University Malaya Medical Centre, Kuala Lumpur, Malaysia. A 75-g 2-hour oral glucose tolerance test was performed in a cohort of multiethnic women with PGDM. Body mass index, waist and hip circumferences, fasting lipid profile and blood pressure were obtained. Data pertaining to the index gestational diabetes mellitus (GDM) were obtained from medical records and interviews. Results: 448 women were enrolled in the study. The prevalence of prediabetes and T2DM was 26.2% and 35.5%, respectively. On multinomial logistic regression analysis, fasting plasma glucose at diagnosis of index GDM and duration lapse after index GDM were shown to be significantly higher in women with isolated impaired fasting glucose (IFG), combined IFG/impaired glucose tolerance and T2DM, as compared to women with normal glucose tolerance (p < 0.05). 2-hour plasma glucose at diagnosis of index GDM was significantly higher only in women who progressed to T2DM when compared to those that remained normal glucose tolerant (p < 0.05). Conclusion: In this study, duration lapse after index GDM, fasting plasma glucose and 2-hour plasma glucose at diagnosis of index GDM were important risk factors for early identification of women at high risk for future glucose intolerance. These may be useful for developing potential preventive strategies.
Frontiers in Endocrinology
Introduction: This study aimed to investigate the association between components of metabolic syndrome (MetS) at first trimester and development of Gestational diabetes mellitus (GDM) in 498 Saudi pregnant women. Materials and Methods: Biochemical and anthropometric parameters were determined at the first trimester and MetS components were defined. Participants were screened for GDM at follow up according to International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria. The main outcome measures were development of GDM and GDM risk vs. MetS components at first trimester. Results: One hundred twenty three (24.7%) were diagnosed with GDM according to IADPSG criteria. GDM risk was significantly higher for participants with hypertriglyceridemia at 1st trimester even after adjusting for age, BMI and parity (OR: 1.82; CI: 1.1-3.7, p = 0.04). Furthermore, the odds of hyperglycemia at 1st trimester was significantly higher in GDM than in non-GDM participants even after adjustments (OR: 2.13, 95% CI: 1.1 to 4.3, p = 0.038). The receiver operating characteristic (ROC) for predicting GDM revealed an area under the curve (AUC) of 0.69 (95% CI: 0.64 to 0.74, p < 0.001) and 0.71 (95% CI: 0.65 to 0.77, p < 0.001) for first-trimester hyperglycemia and hypertriglyceridemia respectively. Conclusions: The incidence of GDM in Saudi pregnant women was strongly associated with hyperglycemia and hypertriglyceridemia at first trimester. These findings are of clinical importance, as an assessment of MetS in early pregnancy can identify women at higher risk of developing GDM.
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 2022
Metabolic syndrome (MS) during pregnancy constitutes a serious threat to the mother and child health that will shortly become a major public health issue, especially in developing countries. However, in Cameroon, epidemiological data on MS during pregnancy are still scarce. The aim of this study was to determine the prevalence and determinants of MS among pregnant women followed-up at the Dschang District Hospital (DDH), in the west region of Cameroon. Patients and Methods: This study was a hospital based cross-sectional study, carried out among pregnant women followed-up at the antenatal care unit of the DDH, from September 2019 to June 2020. Participants were assessed on sociodemographic, lifestyle parameters, and dietary habits using standardized and structured questionnaires. Anthropometric parameters, blood pressure, and biochemical markers were measured using standard procedures. Metabolic syndrome was diagnosed using the HNLBI/AHA definition, modified for pregnant women by Chatzi et al. A participant was recorded as having MS if presenting at least three of the following criteria: Pre-gestational BMI >30 kg/m2; triglycerides ≥150 mg/dl; HDL cholesterol <50 mg/dl; SBP ≥130/DBP ≥85 mm/Hg; and fasting blood glucose ≥100 mg/dl. Results: Six hundred and four (604) pregnant women were included in the study. The prevalence of MS was 17.88% (95% CI: 15.03-21.14) and its most frequent individual components were low levels of HDL-cholesterol (66.23% (95% CI: 62.36-69.88)) and hypertriglyceridemia (28% (95% CI: 54.31-62.15)). Grand multiparous shows a higher risk of presenting MS (OR:3.06, 95% CI: 1.24-7.12; p = 0.011) compared to nulliparous. Pregestational BMI appears to be the best predictor of MS during pregnancy even after adjustment on age, parity, lifestyle and dietary habits (OR: 46.46, 95% CI: 15.58-138.49; p ˂ 0.0001). Conclusion: The prevalence of MS on pregnant women in the Dschang health district is 17.88% (95% CI: 15.03-21.14) and its major determinant is pre-gestational obesity. This work provides quality preliminary data for the design and improvement of prevention strategies.
Nutrients
Abnormal glucose tolerance (AGT), which includes type 2 diabetes and pre-diabetes, is highly prevalent in women post gestational diabetes mellitus (post-GDM). Dietary patterns have been associated with the risk of developing AGT in women post-GDM, but evidence in Asian populations is sparse. This study aimed to determine the association between a posteriori dietary patterns and AGT in women post-GDM. This cross-sectional study recruited 157 women post-GDM (mean age 34.8 years) from Seri Kembangan Health Clinic and Universiti Putra Malaysia. AGT was diagnosed according to the Malaysian Clinical Practice Guidelines using a 75 g 2 h oral glucose tolerance test or HbA1c. Food intake was assessed using the 2014 Malaysian Adult Nutrition Survey food frequency questionnaire. Five dietary patterns were derived using principal component analysis: ‘Unhealthy’, ‘Fish-eggs-fruits-vegetables’, ‘Cereals-confectionaries’, ‘Legumes-dairy’, and ‘Meat-sugar-sweetened-beverages’. After adjusting for s...