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Latest & greatest articles for gestational diabetes
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External validation of prognostic models to predict risk of gestationaldiabetes mellitus in one Dutch cohort: prospective multicentre cohort study. To perform an external validation and direct comparison of published prognostic models for early prediction of the risk of gestationaldiabetes mellitus, including predictors applicable in the first trimester of pregnancy. External validation of all published prognostic models in large scale, prospective, multicentre cohort study. 31 independent (...) midwifery practices and six hospitals in the Netherlands. Women recruited in their first trimester (<14 weeks) of pregnancy between December 2012 and January 2014, at their initial prenatal visit. Women with pre-existing diabetes mellitus of any type were excluded. Discrimination of the prognostic models was assessed by the C statistic, and calibration assessed by calibration plots. 3723 women were included for analysis, of whom 181 (4.9%) developed gestationaldiabetes mellitus in pregnancy. 12
Lactation and Progression to Type 2 Diabetes Mellitus After GestationalDiabetes Mellitus 27538169 2017 12 07 2018 12 02 1539-3704 165 4 2016 08 16 Annals of internal medicine Ann. Intern. Med. Lactation and Progression to Type 2 Diabetes Mellitus After GestationalDiabetes Mellitus. 299-300 10.7326/L16-0106 Gunderson Erica P EP Study of Women, Infant Feeding and Type 2 Diabetes After GDM Pregnancy Investigators eng R01 HD050625 HD NICHD NIH HHS United States Journal Article Comment United (...) States Ann Intern Med 0372351 0003-4819 AIM IM Ann Intern Med. 2015 Dec 15;163(12):889-98 26595611 Ann Intern Med. 2016 Aug 16;165(4):299 27538168 Breast Feeding Diabetes Mellitus, Type 2 Diabetes, Gestational Disease Progression Female Humans Lactation Pregnancy 2016 8 19 6 0 2016 8 19 6 0 2017 12 8 6 0 ppublish 27538169 2544588 10.7326/L16-0106 PMC5613933 NIHMS906750 Am J Psychiatry. 2001 Jun;158(6):848-56 11384888 Matern Child Health J. 2009 May;13(3):334-42 18473131 BMC Public Health. 2011 Dec
Different intensities of glycaemic control for women with gestationaldiabetes mellitus. Gestationaldiabetes mellitus (GDM) has major short- and long-term implications for both the mother and her baby. GDM is defined as a carbohydrate intolerance resulting in hyperglycaemia or any degree of glucose intolerance with onset or first recognition during pregnancy from 24 weeks' gestation onwards and which resolves following the birth of the baby. Rates for GDM can be as high as 25% depending (...) diagnosed with GDM. Data from 171 of the 180 women were published as a conference abstract and no full report has been identified. The overall risk of bias of the single included study was judged to be unclear.The included trial did not report on any of this review's primary outcomes. For the mother, these were hypertension disorders of pregnancy or subsequent development of type 2 diabetes. For the infant, our primary outcomes were (perinatal (fetal and neonatal) mortality; large-for-gestational age
Short-term risk of cancer among women with previous gestationaldiabetes: a population-based study To evaluate the relationship between gestationaldiabetes (GDM) and incidence of cancer in women within the first decade postpartum.This population-based retrospective cohort study compared the risk of cancer in women with GDM with that of a matched control group comprising pregnant women without diabetes. We included women from Ontario, Canada aged 20-50 years with no history of cancer who had (...) given birth between 1995 and 2008 (N = 149 049). Women with GDM (N = 49 684) were matched on age and year of giving birth, in a ratio of 1:2, to pregnant women without diabetes (N = 99 365).Over a median 8-year follow-up, there were a total of 2927 (1.5%) cancers. After adjustment for covariates, we found no significant difference in overall risk of cancer between women with GDM and matched control subjects; however, GDM was associated with a significantly greater risk of thyroid cancer (adjusted
Pre-pregnancy potato consumption and risk of gestationaldiabetes mellitus: prospective cohort study. What is the association between potato consumption before pregnancy and the risk of gestationaldiabetes mellitus (GDM)?This prospective cohort study included 15,632 women from the Nurses' Health Study II (1991-2001). They had no previous GDM or chronic diseases before pregnancy. Consumption of potatoes and other foods was assessed every four years. Incident first time GDM was ascertained from (...) % lower risk of GDM. Consumption and diabetes were self reported, and severity of diabetes was unknown. More than 90% of women were white. A causal association cannot be assumed.Higher levels of potato consumption before pregnancy are associated with greater risk of GDM, and substitution of potatoes with other vegetables, legumes, or whole grain foods might lower the risk.Funding was received from the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health
The Comparative Effectiveness of Diabetes Prevention Strategies to Reduce Postpartum Weight Retention in Women With GestationalDiabetes Mellitus: The GestationalDiabetes' Effects on Moms (GEM) Cluster Randomized Controlled Trial To compare the effectiveness of diabetes prevention strategies addressing postpartum weight retention for women with gestationaldiabetes mellitus (GDM) delivered at the health system level: mailed recommendations (usual care) versus usual care plus a Diabetes (...) Prevention Program (DPP)-derived lifestyle intervention.This study was a cluster randomized controlled trial of 44 medical facilities (including 2,280 women with GDM) randomized to intervention or usual care. The intervention included mailed gestational weight gain recommendations plus 13 telephone sessions between 6 weeks and 6 months postpartum. Primary outcomes included the following: proportion meeting the postpartum goals of 1) reaching pregravid weight if pregravid BMI <25.0 kg/m(2) or 2) losing 5
The role of obesity and overweight as a factor of gestationaldiabetes mellitus: a systematic review The role of obesity and overweight as a factor of gestationaldiabetes mellitus: a systematic review | Kapustin | Journal of obstetrics and women's diseases Journal of obstetrics and women's diseases ISSN 1684-0461 (Print) ISSN 1683-9366 (Online) User Username Password Remember me Notifications Subscription Login to verify subscription Article Tools Email this article (Login required) Email (...) of a systematic review, clarify the role of overweight and obesity as a predictor of gestationaldiabetes mellitus (GDM). Materials and methods: an analysis of the literature data of the leading bibliographic sources - MEDLINE, Cochrane col., EMBASE. To evaluate the body mass index and standards of weight gain during pregnancy used the WHO guidelines and criteria of the Institute of Medicine (2009). The frequency and the odds ratio (OR) of developing GDM was estimated separately for each of the three groups
Large-for-Gestational-Age Ultrasound Diagnosis and Risk for Cesarean Delivery in Women With GestationalDiabetes Mellitus To assess the accuracy of a large-for-gestational-age (LGA) ultrasound diagnosis and the subsequent risk for cesarean delivery associated with ultrasound diagnosis of LGA among women with gestationaldiabetes mellitus.This was a retrospective cohort study of 903 women with GDM who delivered after 36 weeks of gestation with an ultrasound-estimated fetal weight within 31 days (...) delivery (adjusted odds ratio [OR] 3.13, 95% confidence interval [CI] 2.10-4.67, P<.001) after adjusting for relevant covariates. Stratified analyses demonstrated that ultrasound diagnosis of LGA was associated with an increased risk for cesarean delivery whether the birth weight was between 2,500 and 3,499 g (OR 2.82, 95% CI 1.62-4.84, P<.001) or between 3,500 and 4,500 g (OR 3.47, 95% CI 2.06-5.88, P<.001).Ultrasonography significantly overestimates the prevalence of LGA in women with gestational
Lifestyle intervention for gestationaldiabetes mellitus prevention: AÂ cluster-randomized controlled study The study was to examine whether gestationaldiabetes mellitus (GDM) can be prevented by early trimester lifestyle counseling in a high-risk population.From September 2012 to January 2013, 1664 pregnancies in the Department of Obstetrics and Gynecology of First Hospital of Peking University were enrolled in the study during their first prenatal care visit before the 8 gestational weeks (...) on maternal anthropometrics were offered. Both groups were followed until 75 g oral glucose tolerance test (OGTT) testing at 24-28 gestational weeks. The weight gain after intervention and the prevalence of GDM were used to evaluate the effect.(1) According to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria, the positive rate of GDM for the intervention group was 17.16% (23/134), lower than the control group which was 23.91% (33/138), P = 0.168. (2) The weight gain
GestationalDiabetes Mellitus Can Be Prevented by Lifestyle Intervention: The Finnish GestationalDiabetes Prevention Study (RADIEL): A Randomized Controlled Trial To assess whether gestationaldiabetes mellitus (GDM) can be prevented by a moderate lifestyle intervention in pregnant women who are at high risk for the disease.Two hundred ninety-three women with a history of GDM and/or a prepregnancy BMI of ≥30 kg/m(2) were enrolled in the study at <20 weeks of gestation and were randomly (...) % in the intervention group and 21.6% in the control group ([95% CI 0.40-0.98%]; P = 0.044, after adjustment for age, prepregnancy BMI, previous GDM status, and the number of weeks of gestation). Gestational weight gain was lower in the intervention group (-0.58 kg [95% CI -1.12 to -0.04 kg]; adjusted P = 0.037). Women in the intervention group increased their leisure time physical activity more and improved their dietary quality compared with women in the control group.A moderate individualized lifestyle
Guideline Supplement: Gestationaldiabetes mellitus Maternity and Neonatal C linical G uideline Department of Health Supplement: Gestationaldiabetes mellitus Queensland Clinical Guideline Supplement: Gestationaldiabetes mellitus Refer to online version, destroy printed copies after use Page 2 of 12 Table of Contents 1 Introduction 3 1.1 Funding 3 1.2 Conflict of interest 3 1.3 Guideline review 3 2 Methodology 4 2.1 Topic identification 4 2.2 Scope 4 2.3 Clinical questions 4 2.4 Exclusions 4 (...) ) 3234 1479. Queensland Clinical Guideline Supplement: Gestationaldiabetes mellitus Refer to online version, destroy printed copies after use Page 3 of 12 1 Introduction This document is a supplement to the Queensland Clinical Guideline Gestationaldiabetes mellitus (GDM). It provides supplementary information regarding guideline development, makes summary recommendations, suggests measures to assist implementation and quality activities and summarises changes (if any) to the guideline since
Flowchart: Gestationaldiabetes mellitus postpartum care Document Number: F15.33-3-V1-R20 Department of Health Queensland Clinical Guidelines State of Queensland (Queensland Health) 2015 http://creativecommons.org/licenses/by-nc-nd/3.0/au/deed.en Queensland Clinical Guidelines, Guidelines@health.qld.gov.au Postpartum care for all GDM Cease Metformin and/or Insulin immediately after birth (vaginal or CS) BGL monitoring • Target BGL = 7.0 mmol/L • Monitor BGL QID for 24 hours (preprandial (...) and before bed) • If all preprandial BGL between 4-7 mmol/L, cease monitoring 24 hours after birth BGL 7.0 mmol/L • If any preprandial BGL > 7.0 mmol/L o Seek medical review o Continue BGL monitoring • Insulin rarely required postpartum o If indicated, prescribe lower dose than required during pregnancy IV therapy (if any) • If BGL = 4.0 mmol/L and diet tolerated cease mainline IV fluids after birth All GDM Pharmacological therapy? Insulin or Metformin Queensland Clinical Guideline: Gestationaldiabetes
Flowchart: Intrapartum management for gestationaldiabetes mellitus requiring Insulin and/or Metformin Document Number: F15.33--2-V1-R20 Department of Health Queensland Clinical Guidelines State of Queensland (Queensland Health) 2015 http://creativecommons.org/licenses/by-nc-nd/3.0/au/deed.en Queensland Clinical Guidelines, Guidelines@health.qld.gov.au Intrapartum management for GDM requiring Insulin and/or Metformin Metformin • Cease when labour established Insulin • Cease when labour
Flowchart: Gestationaldiabetes mellitus, screening and Diagnosis Document Number: F15.33-1-V1-R20 Department of Health Queensland Clinical Guidelines State of Queensland (Queensland Health) 2015 http://creativecommons.org/licenses/by-nc-nd/3.0/au/deed.en Queensland Clinical Guidelines, Guidelines@health.qld.gov.au Screening and diagnosis of GDM 24-28 weeks gest 2 hour 75 g OGTT Routine antenatal care Risk factors? OGTT normal? BGL: Blood glucose level BMI: Body Mass Index DM: Diabetes Mellitus (...) GDM: GestationalDiabetes Mellitus gest: gestational age HbA1c: Glycated haemoglobin OGTT: Oral glucose tolerance test =: greater than or equal to : greater than Queensland Clinical Guideline: Gestationaldiabetes mellitus. Guideline No: MN15.33-V1-R20 Assess all women for risk factors GDM care GDM diagnosis OGTT (preferred test for diagnosis) One or more of: • Fasting = 5.1 mmol/L • 1 hour = 10 mmol/L • 2 hour = 8.5 mmol/L HbA1c (if OGTT not suitable) • 1st trimester only • Result = 41 mmol/mol