1
|
Pan SC, Huang CC, Chen BY, Chin WS, Guo YL. Risk of type 2 diabetes after diagnosed gestational diabetes is enhanced by exposure to PM2.5. Int J Epidemiol 2023; 52:1414-1423. [PMID: 37229603 DOI: 10.1093/ije/dyad071] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 05/11/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Air pollution and gestational diabetes mellitus (GDM) are both associated with increased diabetes mellitus (DM) occurrence. However, whether air pollutants modify the effects of GDM on the occurrence of DM has been unknown. This study aims to determine whether the effect of GDM on DM development can be modified by exposure to ambient air pollutants. METHODS Women with one singleton birth delivery during 2004-14 according to the Taiwan Birth Certificate Database (TBCD) were included as the study cohort. Those newly diagnosed as having DM 1 year or later after childbirth were identified as DM cases. Controls were selected among women without DM diagnosis during follow-up. Personal residence was geocoded and linked with interpolated concentrations of air pollutants into township levels. Conditional logistic regression was used to determine the odds ratio (OR) of pollutant exposure and GDM, adjusting for age, smoking and meteorological variables. RESULTS There were 9846 women who were newly diagnosed as having DM over a mean follow-up period of 10.2 years. We involved them and the 10-fold matching controls involved in our final analysis. The OR (odds ratio) (95% confidence interval, 95% CI) of DM occurrence per interquartile range increased in particulate matter (PM) smaller than or equal to 2.5 µm (PM2.5) and ozone (O3) was 1.31 (1.22-1.41) and 1.20 (1.16-1.25), respectively. The effects of PM exposure on DM development were significantly higher in the GDM group (OR: 2.46, 95% CI: 1.84-3.30) than in the non-GDM group (OR: 1.30, 95% CI: 1.21-1.40). CONCLUSIONS Exposure to high levels of PM2.5 and O3 elevates the risk of DM. GDM acted synergistically in DM development with exposure to PM2.5 but not with that to O3.
Collapse
Affiliation(s)
- Shih-Chun Pan
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Ching-Chun Huang
- Environmental and Occupational Medicine, College of Medicine, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan
- Environmental and Occupational Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Bing-Yu Chen
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Wei-Shan Chin
- School of Nursing, College of Medicine, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan
| | - Yue Leon Guo
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
- Environmental and Occupational Medicine, College of Medicine, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| |
Collapse
|
2
|
Ikoh Rph CL, Tang Tinong R. The Incidence and Management of Type 2 Diabetes Mellitus After Gestational Diabetes Mellitus. Cureus 2023; 15:e44468. [PMID: 37664380 PMCID: PMC10471197 DOI: 10.7759/cureus.44468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2023] [Indexed: 09/05/2023] Open
Abstract
Gestational diabetes mellitus (GDM) refers to a transient state of impaired glucose tolerance that develops during pregnancy, affecting a significant proportion of expectant mothers globally. This review aimed to comprehensively examine the subsequent incidence and management of type 2 diabetes mellitus (T2DM) in women who have previously experienced GDM. The transition from GDM to T2DM is a well-recognized continuum, with affected women facing an increased risk of developing T2DM postpartum. Several studies have demonstrated that women with a history of GDM face a substantially higher risk of developing T2DM compared to normoglycemic pregnant women. The long-term consequences of developing T2DM following GDM are significant, as it not only affects the health of the mother but also poses risks to the offspring. The most common risk factors associated with the progression of GDM to T2DM include pregnancy at an advanced age, insulin treatment during pregnancy, and delivering an overweight baby. As GDM women are at higher risk of developing T2DM, effective management strategies such as lifestyle changes, postpartum care, breastfeeding, screening tests, and gaining awareness of risk are crucial to mitigate the risk of T2DM in this population. The current review was conducted to guide healthcare providers and women with a history of GDM about the potential risks of T2DM and management strategies to prevent the condition. This review provides a summary of evidence on the incidence rate of T2DM in GDM patients, its associated risk factors, and approaches to mitigate this challenge.
Collapse
Affiliation(s)
- Chinyere L Ikoh Rph
- Endocrinology, Diabetes and Metabolism, John F. Kennedy University of Medicine Curacao, Willemstad, CUW
| | | |
Collapse
|
3
|
Pathirana MM, Lassi Z, Ali A, Arstall M, Roberts CT, Andraweera PH. Cardiovascular risk factors in women with previous gestational diabetes mellitus: A systematic review and meta-analysis. Rev Endocr Metab Disord 2021; 22:729-761. [PMID: 33106997 DOI: 10.1007/s11154-020-09587-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/26/2020] [Indexed: 12/16/2022]
Abstract
This systematic review and meta-analysis aimed to synthesize evidence on conventional cardiovascular disease (CVD) risk factors among women with previous Gestational Diabetes Mellitus (GDM). The review protocol is registered with PROSPERO (CRD42019118149). PubMed, CINAHL, SCOPUS, and EMBASE databases were searched. Studies reporting on CVD risk factors in women with previous GDM compared to women without previous GDM were selected. A total of 139 studies were eligible, of which 93 were included in the meta-analysis. Women with previous GDM have significantly higher systolic blood pressure (2.47 mmHg 95% CI 1.74 to 3.40, n = 48, 50,118 participants) diastolic blood pressure (1.89 mmHg 95% CI 1.32 to 2.46, n = 48, 49,495 participants), BMI (1.54 kg/m2 95% CI 1.32 to 2.46, n = 78, 255,308 participants), total cholesterol (0.26 SMD 95% CI 0.15 to 0.37, n = 48, 38,561 participants), LDL cholesterol (0.19 SMD 95% CI 0.08 to 0.30, n = 44, 16,980 participants), triglycerides (0.56 SMD 95% CI 0.42 to 0.70, n = 46, 13,175 participants), glucose (0.69 SMD 95% CI 0.56 to 0.81, n = 55, 127,900 participants), insulin (0.41 SMD 95% CI 0.23 to 0.59, n = 32, 8881 participants) and significantly lower HDL cholesterol (-0.28 SMD 95% CI -0.39 to -0.16, n = 56, 35,882 participants), compared to women without previous GDM. The increased blood pressure, total cholesterol, triglycerides and glucose are seen as early as <1 year post-partum.Women with previous GDM have a higher risk of CVD based on significant increases in conventional risk factors. Some risk factors are seen as early as <1 year post-partum. Women with GDM may benefit from early screening to identify modifiable CVD risk factors.
Collapse
Affiliation(s)
- Maleesa M Pathirana
- Adelaide Medical School and The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Zohra Lassi
- Adelaide Medical School and The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Anna Ali
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Basil Hetzel Institute, The Queen Elizabeth Hospital, Woodville, SA, Australia
- Adelaide G-TRAC Centre & CRE Frailty & Healthy Ageing Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Margaret Arstall
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia
| | - Claire T Roberts
- Adelaide Medical School and The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, Australia
| | - Prabha H Andraweera
- Adelaide Medical School and The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia.
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia.
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia.
| |
Collapse
|
4
|
Vounzoulaki E, Khunti K, Abner SC, Tan BK, Davies MJ, Gillies CL. Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysis. BMJ 2020; 369:m1361. [PMID: 32404325 PMCID: PMC7218708 DOI: 10.1136/bmj.m1361] [Citation(s) in RCA: 447] [Impact Index Per Article: 111.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To estimate and compare progression rates to type 2 diabetes mellitus (T2DM) in women with gestational diabetes mellitus (GDM) and healthy controls. DESIGN Systematic review and meta-analysis. DATA SOURCES Medline and Embase between January 2000 and December 2019, studies published in English and conducted on humans. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Observational studies investigating progression to T2DM. Inclusion criteria were postpartum follow-up for at least 12 months, incident physician based diagnosis of diabetes, T2DM reported as a separate outcome rather than combined with impaired fasting glucose or impaired glucose tolerance, and studies with both a group of patients with GDM and a control group. RESULTS This meta-analysis of 20 studies assessed a total of 1 332 373 individuals (67 956 women with GDM and 1 264 417 controls). Data were pooled by random effects meta-analysis models, and heterogeneity was assessed by use of the I2 statistic. The pooled relative risk for the incidence of T2DM between participants with GDM and controls was estimated. Reasons for heterogeneity between studies were investigated by prespecified subgroup and meta-regression analyses. Publication bias was assessed by funnel plots and, overall, studies were deemed to have a low risk of bias (P=0.58 and P=0.90). The overall relative risk for T2DM was almost 10 times higher in women with previous GDM than in healthy controls (9.51, 95% confidence interval 7.14 to 12.67, P<0.001). In populations of women with previous GDM, the cumulative incidence of T2DM was 16.46% (95% confidence interval 16.16% to 16.77%) in women of mixed ethnicity, 15.58% (13.30% to 17.86%) in a predominantly non-white population, and 9.91% (9.39% to 10.42%) in a white population. These differences were not statistically significant between subgroups (white v mixed populations, P=0.26; white v non-white populations, P=0.54). Meta-regression analyses showed that the study effect size was not significantly associated with mean study age, body mass index, publication year, and length of follow-up. CONCLUSIONS Women with a history of GDM appear to have a nearly 10-fold higher risk of developing T2DM than those with a normoglycaemic pregnancy. The magnitude of this risk highlights the importance of intervening to prevent the onset of T2DM, particularly in the early years after pregnancy. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019123079.
Collapse
Affiliation(s)
- Elpida Vounzoulaki
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
- National Institute for Health Research Applied Research Collaboration-East Midlands, Leicester Diabetes Centre, Leicester LE5 4PW, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
- National Institute for Health Research Applied Research Collaboration-East Midlands, Leicester Diabetes Centre, Leicester LE5 4PW, UK
| | - Sophia C Abner
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
- National Institute for Health Research Applied Research Collaboration-East Midlands, Leicester Diabetes Centre, Leicester LE5 4PW, UK
| | - Bee K Tan
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Melanie J Davies
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
| | - Clare L Gillies
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
- National Institute for Health Research Applied Research Collaboration-East Midlands, Leicester Diabetes Centre, Leicester LE5 4PW, UK
| |
Collapse
|
5
|
Benhalima K, Lens K, Bosteels J, Chantal M. The Risk for Glucose Intolerance after Gestational Diabetes Mellitus since the Introduction of the IADPSG Criteria: A Systematic Review and Meta-Analysis. J Clin Med 2019; 8:jcm8091431. [PMID: 31510081 PMCID: PMC6780861 DOI: 10.3390/jcm8091431] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 08/29/2019] [Accepted: 09/04/2019] [Indexed: 12/13/2022] Open
Abstract
The aim of the study was to assess the postpartum risk for glucose intolerance since the introduction of the ‘International Association of Diabetes and Pregnancy Study Groups’ (IADPSG) criteria for gestational diabetes mellitus (GDM). Studies published since 2010 were included, which evaluated the risk for type 2 diabetes mellitus (T2DM), impaired glucose tolerance (IGT), and cardiovascular (CV) events in women with previous GDM compared to normal glucose tolerant women. We included forty-three studies, evaluating 4,923,571 pregnant women of which 5.8% (284,312) had a history of GDM. Five studies used IADPSG criteria (n = 6174 women, 1314 with GDM). The overall pooled relative risk (RR) for postpartum T2DM was 7.42 (95% CI: 5.99–9.19) and the RR for postpartum T2DM with IADPSG criteria was 6.45 (95% CI: 4.74–8.77) compared to the RR of 9.08 (95% CI: 6.96–11.85; p = 0.17) for postpartum T2DM based on other diagnostic criteria. The RR for postpartum IGT was 2.45 (95% CI: 1.92–3.13), independent of the criteria used. None of the available studies with IADPSG criteria evaluated the risk for CV events. Women with a history of GDM based on the IADPSG criteria have a similarly increased risk for postpartum glucose intolerance compared to GDM based on other diagnostic criteria. More studies with GDM based on the IADPSG criteria are needed to increase the quality of evidence concerning the long-term metabolic risk.
Collapse
Affiliation(s)
- Katrien Benhalima
- Department of Endocrinology, University hospital Gasthuisberg, KU Leuven, Herestraat 49, 3000 Leuven, Belgium.
| | - Karen Lens
- Medical school, University hospital Gasthuisberg, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Jan Bosteels
- Department of Obstetrics & Gynecology, Imelda ziekenhuis, Imeldalaan 9, 2820 Bonheiden, Belgium
| | - Mathieu Chantal
- Department of Endocrinology, University hospital Gasthuisberg, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| |
Collapse
|
6
|
Kearney M, Perron J, Marc I, Weisnagel SJ, Tchernof A, Robitaille J. Association of prenatal exposure to gestational diabetes with offspring body composition and regional body fat distribution. Clin Obes 2018; 8:81-87. [PMID: 29239129 DOI: 10.1111/cob.12237] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 11/14/2017] [Indexed: 12/21/2022]
Abstract
The aim of this cohort study was to compare body composition and regional body fat distribution between children exposed (GDM+) or unexposed (GDM-) in utero to gestational diabetes mellitus (GDM) and to investigate the association with the glycaemic and the insulin profile. Data from 56 GDM+ and 30 GDM- were analysed. Height, weight and waist circumference were measured. Total and regional body composition was measured by dual-energy X-ray absorptiometry. Insulin, glucose and HbA1c were obtained from a fasting plasma sample, and the HOMA-IR index was calculated. anova was performed to compare adiposity measures between GDM+ and GDM-. Associations between the glycaemic and insulin profile and adiposity measures were studied using partial Pearson correlations. Mean age was 6.6 ± 2.3 years. Waist circumference, fat mass percentage, android fat mass, android fat mass percentage and android-to-gynoid fat mass ratio were higher among GDM+, and lean mass percentage was lower (P < 0.05). Among GDM+ children, body mass index (BMI) z score, waist circumference, fat mass percentage, android fat mass percentage and android-to-gynoid fat mass ratio were all positively correlated with HbA1C (r = 0.32-0.43, P < 0.05). Prenatal exposure to GDM is associated with increased total and abdominal adiposity. This increased adiposity observed among GDM+ children is associated with an altered glycaemic profile. This study is registered in the Clinical Trials.gov registry (NCT01340924).
Collapse
Affiliation(s)
- M Kearney
- School of Nutrition, Laval University, Québec, Canada
- Institute of Nutrition and Functional Foods (INAF), Laval University, Québec, Canada
| | - J Perron
- Institute of Nutrition and Functional Foods (INAF), Laval University, Québec, Canada
| | - I Marc
- Endocrinology and Nephrology Axis, CHU de Québec Research Center, Québec, Canada
| | - S J Weisnagel
- Endocrinology and Nephrology Axis, CHU de Québec Research Center, Québec, Canada
- Diabetes Research Unit, Laval University Medical Research Center, Québec, Canada
| | - A Tchernof
- School of Nutrition, Laval University, Québec, Canada
- Institute of Nutrition and Functional Foods (INAF), Laval University, Québec, Canada
- Endocrinology and Nephrology Axis, CHU de Québec Research Center, Québec, Canada
| | - J Robitaille
- School of Nutrition, Laval University, Québec, Canada
- Institute of Nutrition and Functional Foods (INAF), Laval University, Québec, Canada
- Endocrinology and Nephrology Axis, CHU de Québec Research Center, Québec, Canada
| |
Collapse
|
7
|
Jacques S, Lemieux S, Lamarche B, Laramée C, Corneau L, Lapointe A, Tessier-Grenier M, Robitaille J. Development of a Web-Based 24-h Dietary Recall for a French-Canadian Population. Nutrients 2016; 8:nu8110724. [PMID: 27854276 PMCID: PMC5133109 DOI: 10.3390/nu8110724] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 10/26/2016] [Accepted: 11/08/2016] [Indexed: 01/04/2023] Open
Abstract
Twenty-four-hour dietary recalls can provide high-quality dietary intake data, but are considered expensive, as they rely on trained professionals for both their administration and coding. The objective of this study was to develop an automated, self-administered web-based 24-h recall (R24W) for a French-Canadian population. The development of R24W was inspired by the United States Department of Agriculture (USDA) Automated Multiple-Pass Method. Questions about the context of meals/snacks were included. Toppings, sauces and spices frequently added to each food/dish were suggested systematically. A list of frequently forgotten food was also suggested. An interactive summary allows the respondent to track the progress of the questionnaire and to modify or remove food as needed. The R24W prototype was pre-tested for usability and functionality in a convenience sample of 29 subjects between the ages of 23 and 65 years, who had to complete one recall, as well as a satisfaction questionnaire. R24W includes a list of 2865 food items, distributed into 16 categories and 98 subcategories. A total of 687 recipes were created for mixed dishes, including 336 ethnic recipes. Pictures of food items illustrate up to eight servings per food item. The pre-test demonstrated that R24W is easy to complete and to understand. This new dietary assessment tool is a simple and inexpensive tool that will facilitate diet assessment of individuals in large-scale studies, but validation studies are needed prior to the utilization of the R24W.
Collapse
Affiliation(s)
- Simon Jacques
- Institute of Nutrition and Functional Foods, Laval University, 2440 Hochelaga Boulevard, Quebec City, QC G1V 0A6, Canada.
- School of Nutrition, Pavillon Paul-Comtois, Laval University, 2425 rue de l'Agriculture, local 2412, Quebec City, QC G1V 0A6, Canada.
| | - Simone Lemieux
- Institute of Nutrition and Functional Foods, Laval University, 2440 Hochelaga Boulevard, Quebec City, QC G1V 0A6, Canada.
- School of Nutrition, Pavillon Paul-Comtois, Laval University, 2425 rue de l'Agriculture, local 2412, Quebec City, QC G1V 0A6, Canada.
| | - Benoît Lamarche
- Institute of Nutrition and Functional Foods, Laval University, 2440 Hochelaga Boulevard, Quebec City, QC G1V 0A6, Canada.
- School of Nutrition, Pavillon Paul-Comtois, Laval University, 2425 rue de l'Agriculture, local 2412, Quebec City, QC G1V 0A6, Canada.
| | - Catherine Laramée
- Institute of Nutrition and Functional Foods, Laval University, 2440 Hochelaga Boulevard, Quebec City, QC G1V 0A6, Canada.
| | - Louise Corneau
- Institute of Nutrition and Functional Foods, Laval University, 2440 Hochelaga Boulevard, Quebec City, QC G1V 0A6, Canada.
| | - Annie Lapointe
- Institute of Nutrition and Functional Foods, Laval University, 2440 Hochelaga Boulevard, Quebec City, QC G1V 0A6, Canada.
| | - Maude Tessier-Grenier
- Institute of Nutrition and Functional Foods, Laval University, 2440 Hochelaga Boulevard, Quebec City, QC G1V 0A6, Canada.
- School of Nutrition, Pavillon Paul-Comtois, Laval University, 2425 rue de l'Agriculture, local 2412, Quebec City, QC G1V 0A6, Canada.
| | - Julie Robitaille
- Institute of Nutrition and Functional Foods, Laval University, 2440 Hochelaga Boulevard, Quebec City, QC G1V 0A6, Canada.
- School of Nutrition, Pavillon Paul-Comtois, Laval University, 2425 rue de l'Agriculture, local 2412, Quebec City, QC G1V 0A6, Canada.
| |
Collapse
|