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Dutta D, Sharma M, Nagendra L, Bhattacharya S, Mohindra R, Yajnik CS. Long-Term Impact on Offspring (5 to 11 Years of Age) of Metformin Use in Pregnancy in Mothers With Diabetes: A Systematic Review and Meta-Analysis. Endocr Pract 2024:S1530-891X(24)00559-7. [PMID: 38876183 DOI: 10.1016/j.eprac.2024.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVE Data are scant on the impact of metformin use in gestational diabetes mellitus/diabetes in pregnancy on long-term outcomes in children and mothers beyond 5 years of childbirth. This systematic review and meta-analysis aimed to evaluate the long-term impact of metformin use in pregnancy on children and their mothers. METHODS Electronic databases were searched for studies evaluating metformin compared with insulin for managing gestational diabetes mellitus/diabetes in pregnancy. The primary outcome was the change in body mass index (BMI) in children at the ages of 5 to 11 years. The secondary outcomes were alterations in other anthropometric measures, obesity, and changes in the levels of lipids and adipocytokines in children and mothers. RESULTS Children at the age of 9 years born to mothers who were treated with metformin during pregnancy had similar BMI (mean difference [MD], 1.09 kg/m2 [95% confidence interval {CI}, -0.44 to 2.62]; P = .16; I2 = 16%), waist circumference-to-height ratio (MD, 0.13 [95% CI, -0.05 to 0.30]; P = .16; I2 = 94%), dual-energy X-ray absorptiometry (DXA) total fat mass (MD, 0.68 kg [95% CI, -2.39 to 3.79]; P = .66; I2 = 70%), DXA total fat percent (MD, 0.04% [95% CI, -3.44 to 3.51]; P = .98; I2 = 56%), DXA total fat-free mass (MD, 0.81 kg [95% CI, -0.96 to 2.58]; P = .37; I2 = 55%), magnetic resonance imaging visceral adipose tissue volume (MD, 80.97 cm3 [95% CI, -136.47 to 298.41]; P = .47; I2 = 78%), and magnetic resonance spectroscopy liver fat percentage (MD, 0.27% [95% CI, -1.26 to 1.79]; P = .73; I2 = 0%) to those born to mothers who were treated with insulin. Serum adiponectin, leptin, alanine aminotransferase, and ferritin were comparable among groups. In children between the ages of 9 and 11 years, the occurrence of obesity, diabetes, or challenges in motor and social development were comparable between the 2 groups. After 9 years of childbirth, BMI and the risk of developing diabetes were similar between the 2 groups of women. CONCLUSION Metformin use in pregnancy did not show any adverse effects compared with insulin on long-term outcomes in children and their mothers.
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Affiliation(s)
- Deep Dutta
- Department of Endocrinology, Center for Endocrinology, Diabetes, Arthritis & Rheumatism Superspeciality Healthcare, Dwarka, New Delhi, India.
| | - Meha Sharma
- Department of Rheumatology, Center for Endocrinology, Diabetes, Arthritis & Rheumatism Superspeciality Healthcare, Dwarka, New Delhi, India
| | - Lakshmi Nagendra
- Department of Endocrinology, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, India
| | | | - Ritin Mohindra
- Department of Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Bakhsh E. Impact of Replacement Therapy on Pregnancy Outcomes in Hemophilia Carriers: A Historical Cohort Study in Saudi Arabia. Life (Basel) 2024; 14:623. [PMID: 38792643 PMCID: PMC11122275 DOI: 10.3390/life14050623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
This retrospective cohort study evaluates the safety and efficacy of replacement therapy with regard to pregnancy outcomes in hemophilia carriers. Hemophilia carriers face elevated bleeding risks during pregnancy, necessitating meticulous management, including replacement therapy with clotting factors. This research examines the records of 64 pregnant hemophilia carriers at King Fahad Medical City, Riyadh, from January 2010 to December 2023, analyzing their demographic details, hemophilia type and severity, replacement therapy specifics, and pregnancy outcomes. The study found that 62.5% of the participants had hemophilia A, with 43.8% categorized as severe. Most subjects (87.5%) received recombinant factor VIII at a median dosage of 30 IU/kg weekly. Adverse pregnancy outcomes included gestational hypertension (15.6%), preterm labor (18.8%), and postpartum hemorrhage (12.5%). The cesarean section rate was 28.1%. Neonatal outcomes were generally favorable, with median birth weights at 3100 g and mean Apgar scores of 8.2 and 9.1 at 1 and 5 min, respectively. Logistic regression analysis revealed no significant association between adverse events and therapy type or dosage, though a trend towards significance was noted with once-weekly administration (p = 0.082). The study concludes that replacement therapy is a viable method for managing hemophilia in pregnant carriers, leading to generally favorable maternal and neonatal outcomes. However, it underscores the importance of individualized treatment plans and close monitoring to effectively manage the risks associated with hemophilia during pregnancy.
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Affiliation(s)
- Ebtisam Bakhsh
- Internal Medicine Department, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11564, Saudi Arabia
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Ghamri K. Prevalence and Risk Factors of Confirmed Gestational Diabetes Mellitus Among Pregnant Women With Prior Positive Screening: A Case-Control Study. Cureus 2024; 16:e61216. [PMID: 38939238 PMCID: PMC11208977 DOI: 10.7759/cureus.61216] [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: 05/27/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Saudi Arabia has a higher rate of gestational diabetes mellitus (GDM) than most other countries. There is a paucity of data on the risk factors for GDM, particularly positive screening for diabetes in the initial period of pregnancy. OBJECTIVES The aim of this study was to determine the prevalence of confirmed GDM in pregnant women who initially screened positive for GDM, as well as to identify its association with age, nationality, and clinical risk factors. PATIENTS AND METHODS This case-control study was conducted retrospectively at a tertiary referral center in Jeddah, Saudi Arabia. It included pregnant women who were referred between January 2019 and December 2022 after having tested positive on a 50 g oral glucose tolerance test (OGTT). They subsequently underwent a 75 g or 100 g confirmatory OGTT at our center. The sociodemographic and clinical characteristics of those with confirmed GDM (cases) and those with negative confirmatory OGTT (controls) were compared. RESULTS The majority of participants (75.4%) had confirmed GDM. However, there were no significant differences between cases and controls with regard to age, nationality, or clinical or pregnancy-related factors. Of note, the cohort was characterized by high gravidity and high parity, which may indicate susceptibility to GDM. CONCLUSION The study findings support the usefulness of the 50 g OGTT for the screening of pregnant women at high risk for GDM. In addition, high gravidity and parity may also be risk factors for GDM, warranting closer monitoring for GDM and further research in a high-natality population such as that of Saudi Arabia.
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Affiliation(s)
- Kholoud Ghamri
- Internal medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
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Almazyad NS, Jahan S. Awareness of Gestational Diabetes Mellitus Maternal and Neonatal Outcomes Among Women Attending Primary Healthcare Centers in Qassim, Saudi Arabia. Cureus 2024; 16:e59345. [PMID: 38817476 PMCID: PMC11137627 DOI: 10.7759/cureus.59345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2024] [Indexed: 06/01/2024] Open
Abstract
Background Gestational diabetes mellitus (GDM), diagnosed during pregnancy, can harm both mothers and neonates. GDM awareness among women varies among various countries. Understanding the level of awareness is vital for designing effective health interventions. Objectives This study aimed to evaluate GDM awareness among married females at primary healthcare centers (PHCCs) in Qassim, Saudi Arabia, focusing on knowledge regarding adverse maternal and fetal outcomes of GDM. Methods An observational cross-sectional study was conducted among married females at PHCCs in Qassim, from June 2023 to October 2023. A two-stage cluster sampling method was used. Four PHCCs were selected in the first stage, and study participants were selected from these centers in the second stage. A self-administered questionnaire was used. Statistical Product and Service Solutions (SPSS, version 23; IBM SPSS Statistics for Windows, Armonk, NY) was used for statistical analysis. Results Of the 270 participants, the majority (72.2%) demonstrated 'poor' knowledge about GDM adverse outcomes for both mothers and neonates, 17.8% demonstrated a 'fair' level, and only 10% displayed a 'good' knowledge. Participants' educational level, personal history of diabetes, and age were associated with knowledge levels. Awareness of specific outcomes related to GDM, both maternal and neonatal, varied among participants. Information on GDM was mainly obtained from mass media and personal networks, while healthcare providers were reported as the least common source. Conclusion Based on the results of our study, we conclude that educational interventions, especially involving healthcare providers, are essential to improve awareness about GDM adverse outcomes. Strategies involving educational sessions by healthcare providers and health education materials at PHCCs can improve awareness leading to effective management of GDM and improved maternal and neonatal outcomes.
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Affiliation(s)
- Nouf S Almazyad
- Family Medicine Academy, Qassim Health Cluster, Buraidah, SAU
| | - Saulat Jahan
- Family Medicine Academy, Qassim Health Cluster, Buraidah, SAU
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Kotzaeridi G, Monod C, Linder T, Eppel D, Seidel V, Feichtinger M, Mosimann B, Filippi V, Wegener S, Henrich W, Tura A, Göbl CS. The impact of regional origin on the incidence of gestational diabetes mellitus in a multiethnic European cohort. Front Public Health 2024; 11:1286056. [PMID: 38312137 PMCID: PMC10834617 DOI: 10.3389/fpubh.2023.1286056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/28/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Women with migration background present specific challenges related to risk stratification and care of gestational diabetes mellitus (GDM). Therefore, this study aims to investigate the role of ethnic origin on the risk of developing GDM in a multiethnic European cohort. Methods Pregnant women were included at a median gestational age of 12.9 weeks and assigned to the geographical regions of origin: Caucasian Europe (n = 731), Middle East and North Africa countries (MENA, n = 195), Asia (n = 127) and Sub-Saharan Africa (SSA, n = 48). At the time of recruitment maternal characteristics, glucometabolic parameters and dietary habits were assessed. An oral glucose tolerance test was performed in mid-gestation for GDM diagnosis. Results Mothers with Caucasian ancestry were older and had higher blood pressure and an adverse lipoprotein profile as compared to non-Caucasian mothers, whereas non-Caucasian women (especially those from MENA countries) had a higher BMI and were more insulin resistant. Moreover, we found distinct dietary habits. Non-Caucasian mothers, especially those from MENA and Asian countries, had increased incidence of GDM as compared to the Caucasian population (OR 1.87, 95%CI 1.40 to 2.52, p < 0.001). Early gestational fasting glucose and insulin sensitivity were consistent risk factors across different ethnic populations, however, pregestational BMI was of particular importance in Asian mothers. Discussion Prevalence of GDM was higher among women from MENA and Asian countries, who already showed adverse glucometabolic profiles at early gestation. Fasting glucose and early gestational insulin resistance (as well as higher BMI in women from Asia) were identified as important risk factors in Caucasian and non-Caucasian patients.
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Affiliation(s)
- Grammata Kotzaeridi
- Department of Obstetrics and Gynaecology, Medical University of Vienna, Vienna, Austria
| | - Cécile Monod
- Department of Obstetrics and Gynaecology, University Hospital Basel, Basel, Switzerland
| | - Tina Linder
- Department of Obstetrics and Gynaecology, Medical University of Vienna, Vienna, Austria
| | - Daniel Eppel
- Department of Obstetrics and Gynaecology, Medical University of Vienna, Vienna, Austria
| | - Vera Seidel
- Clinic of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | | | - Beatrice Mosimann
- Department of Obstetrics and Gynaecology, University Hospital Basel, Basel, Switzerland
| | - Valeria Filippi
- Department of Obstetrics and Gynaecology, University Hospital Basel, Basel, Switzerland
| | - Silke Wegener
- Clinic of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Wolfgang Henrich
- Clinic of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Andrea Tura
- Metabolic Unit, CNR Institute of Neuroscience, Padova, Italy
| | - Christian S. Göbl
- Department of Obstetrics and Gynaecology, Medical University of Vienna, Vienna, Austria
- Department of Obstetrics and Gynaecology, Division of Obstetrics, Medical University of Graz, Graz, Austria
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Alwash SM, Huda MM, McIntyre HD, Mamun AA. Time trends and projections in the prevalence of gestational diabetes mellitus in Queensland, Australia, 2009-2030: Evidence from the Queensland Perinatal Data Collection. Aust N Z J Obstet Gynaecol 2023; 63:811-820. [PMID: 37435791 DOI: 10.1111/ajo.13734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 06/26/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is the fastest-growing type of diabetes in Australia. We aimed to assess the time trends during 2009-2018 and projections of GDM in Queensland, Australia up to 2030. MATERIALS AND METHODS The study data were from the Queensland Perinatal Data Collection (QPDC) and included data on 606 662 birth events with the births reported from at least 20 weeks gestational age or birth weight at least 400 g. Bayesian regression model was used to assess the trends in the prevalence of GDM. RESULTS The prevalence of GDM increased from 5.47 to 13.62% from 2009 to 2018 (average annual rate of change, AARC = +10.71%). If the trend remains the same, the projected prevalence will increase to 42.04% (95% uncertainty interval = 34.77-48.96) by 2030. Observing AARC across different subpopulations, we found that the trend of GDM increased markedly among women living in inner regional areas (AARC = +12.49%), were non-Indigenous (AARC = +10.93%), most disadvantaged (AARC = +11.84%), aged either of two age groups (AARC = +18.45% and + 15.17% for <20 years and 20-24 years, respectively), were with obesity (AARC = +11.05%) and smoked during pregnancy (AARC = +12.26%). CONCLUSIONS Overall, the prevalence of GDM has sharply increased in Queensland, and if this trend continues, about 42% of pregnant women will experience GDM by 2030. The trends vary across different subpopulations. Therefore, targeting the most vulnerable subpopulations is vital to prevent the development of GDM.
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Affiliation(s)
- Sura M Alwash
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Queensland, Australia
| | - M Mamun Huda
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Queensland, Australia
- ARC Centre of Excellence for Children and Families Over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
| | - H David McIntyre
- Mater Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Abdullah A Mamun
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Queensland, Australia
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Ringvoll H, Kolberg M, Rangul V, Hafskjold I, Haug EB, Blomhoff R, Henriksen HB, Horn J. Postpartum lifestyle behaviour among women with prior gestational diabetes mellitus: evidence from the HUNT study. BMJ Nutr Prev Health 2023; 6:173-181. [PMID: 38618544 PMCID: PMC11009551 DOI: 10.1136/bmjnph-2022-000612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 09/19/2023] [Indexed: 04/16/2024] Open
Abstract
Introduction Women with a history of gestational diabetes mellitus (GDM) are at increased risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Recommendations for postpartum follow-up include targeted lifestyle advice to lower the risk.The aim of this study was to compare postpartum lifestyle behaviours and perceptions among women with and without a history of GDM. In addition, we examined whether lifestyle behaviours of women with a history of GDM participating in a lifestyle intervention study differed from lifestyle behaviours of women with a history of GDM in the general population. Research design and methods We linked data from the fourth survey of the population-based Trøndelag Health Study (HUNT4) to information from the Medical Birth Registry of Norway for women with registered births between 2000 and 2019. Using logistic regression, we compared lifestyle behaviours in women with and without GDM. In secondary analyses, lifestyle behaviours in women with GDM participating in a postpartum lifestyle intervention study were compared with HUNT participants with GDM using Fisher's exact tests/t-tests. Results A high proportion of the women in our population, regardless of GDM history, reported several unhealthy lifestyle behaviours. We found no significant association between history of GDM and lifestyle behaviours. The lifestyle intervention study for women with a history of GDM appeared to recruit women with more favourable lifestyle behaviours. Conclusions Women, regardless of GDM history, could potentially benefit from further support for lifestyle improvement, but it may be especially important in women with a history of GDM given their increased risk of T2DM and CVD. Interventions targeting women with GDM might not reach the women with the unhealthiest lifestyle behaviours, and measures to reach out to all women should be further investigated.
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Affiliation(s)
- Hanne Ringvoll
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Trondheim, Norway
| | - Marit Kolberg
- Center for Oral Health Services and Research, Trondheim, Norway
| | - Vegar Rangul
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Trondheim, Norway
- Nord University, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Ingrid Hafskjold
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Trondheim, Norway
| | - Eirin Beate Haug
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Rune Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Clinic Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Hege Berg Henriksen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Julie Horn
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Trondheim, Norway
- Department of Obstetrics and Gynecology, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
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Khogali HI, Al-Bluwi GSM, Guy Pedo V, Al Dhanhani AM. Maternal and fetal health outcomes in systemic lupus erythematosus pregnancies in the Emirati population: A comparative study. Lupus 2023; 32:1453-1461. [PMID: 37786253 DOI: 10.1177/09612033231204650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
OBJECTIVES To evaluate adverse pregnancy outcomes in patients with systemic lupus erythematosus (SLE), compare their maternal and fetal outcomes with those of age-matched pregnant women without SLE, and identify factors linked to increased risks of adverse outcomes. METHODS Medical records from Tawam Hospital were reviewed retrospectively to identify patients with SLE and a history of pregnancy. Demographics, clinical variables, and maternal and fetal outcomes were obtained. A one-to-one age-matched healthy control group was randomly selected. The outcomes and odd ratios of women with and without SLE were compared, and factors associated with adverse pregnancy outcomes were examined. RESULTS The outcomes of 78 SLE pregnancies in 39 women were analyzed. Adverse maternal outcomes, such as gestational diabetes mellitus (GDM), occurred in 32% of pregnancies, whereas adverse fetal outcomes, such as low-birth weight and preterm deliveries, occurred in 51% of pregnancies. Pregnant women with SLE had a 5-fold higher risk of GDM, had higher odds of maternal hypertension, and were more likely to deliver through cesarean section than those without SLE. Preterm deliveries and low-birth weight were also more common in SLE pregnancies. Steroid use during pregnancy was significantly associated with an increased risk of GDM development. Lupus nephritis, maternal hypertension, pre-eclampsia, and GDM were linked to preterm deliveries. CONCLUSION Pregnant women with SLE were at a higher risk for adverse maternal and fetal outcomes than age-matched pregnant women without SLE. These findings can guide clinical management and emphasize the need for close monitoring of SLE pregnancies.
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Affiliation(s)
| | - Ghada S M Al-Bluwi
- Internal Medicine Department, College of Medicine & Health Sciences, UAE University, Al Ain, UAE
| | - Virgie Guy Pedo
- Internal Medicine Department, College of Medicine & Health Sciences, UAE University, Al Ain, UAE
| | - Ali M Al Dhanhani
- Internal Medicine Department, College of Medicine & Health Sciences, UAE University, Al Ain, UAE
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Hakim R, Alqerafi A, Malibari W, Allhybi A, Al Aslab B, Hafez A, Bin Sawad M, Almalky N. Comprehension and Understanding of Gestational Diabetes Mellitus Among Pregnant Women Attending Primary Health Care Facilities in Jeddah, Saudi Arabia. Cureus 2023; 15:e46937. [PMID: 37841992 PMCID: PMC10572680 DOI: 10.7759/cureus.46937] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2023] [Indexed: 10/17/2023] Open
Abstract
Background and objective Gestational diabetes mellitus (GDM) is a form of diabetes that develops during pregnancy and can negatively affect both the mother and the fetus. This study aimed to assess the knowledge and awareness of GDM among pregnant women in primary care centers. By enhancing their understanding of the risks and symptoms of GDM, we can potentially mitigate adverse outcomes. Methods A cross-sectional study was conducted in the National Guard's primary healthcare facilities in Jeddah, Saudi Arabia. The study employed a validated 12-item questionnaire to collect data from 489 participants. The questionnaire items covered the identification of risk factors, diagnostic approach, treatment options, and complications related to GDM, considering maternal and fetal health implications. Results The study participants had a mean age of 30.9 years. Among these participants, 53.6% demonstrated a thorough understanding of GDM, 35.2% had moderate knowledge scores, and 11.2% had low knowledge scores. Higher levels of awareness were strongly associated with higher levels of education, gravidity, and prior knowledge of GDM. Conclusion The study highlights the importance of early detection and management strategies for GDM during pregnancy to minimize its negative impacts. The findings suggest the need for individually tailored antenatal education programs by healthcare professionals that address the needs of different populations. This is particularly relevant for women with lower education levels and those who are pregnant for the first time or have no prior knowledge of GDM.
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Affiliation(s)
- Reema Hakim
- Family Medicine, Bahra Primary Healthcare Center, King Abdulaziz Medical City, Jeddah, SAU
| | - Ahmed Alqerafi
- Medical School, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Waleed Malibari
- Medical School, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Abdulaziz Allhybi
- Medical School, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Bader Al Aslab
- Medical School, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Alwalied Hafez
- Medical School, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Muhannad Bin Sawad
- Medical School, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Nawwaf Almalky
- Medical School, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
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10
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Alduayji MM, Selim M. Risk Factors of Gestational Diabetes Mellitus Among Women Attending an Antenatal Care Clinic in Prince Sultan Military Medical City (PSMMC), Riyadh, Kingdom of Saudi Arabia: A Case-Control Study. Cureus 2023; 15:e44200. [PMID: 37767263 PMCID: PMC10521585 DOI: 10.7759/cureus.44200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a serious health issue for both mother and child. As GDM is common worldwide, healthcare providers pay attention while screening and managing pregnant women to ensure good outcomes for both mother and child. OBJECTIVE This study aims to identify the risk factors associated with developing GDM in pregnant women attending antenatal care clinics in Prince Sultan Military Medical City (PSMMC) in Riyadh, Saudi Arabia. METHODS This is a case-control study that utilized patients' medical records for data collection. The study included 317 pregnant Saudi women who attended antenatal care clinics and antenatal diabetic clinics in PSMMC from May 2022 to May 2023. Cases were defined as women who met the inclusion and exclusion criteria and had a positive oral glucose tolerance test (OGTT) result, while controls were defined as women in the same age group and gravidity who had negative OGTT. Analysis was conducted using SPSS Statistics version 29.0 (IBM Corp. Released 2021. IBM SPSS Statistics for Windows, Version 29.0. Armonk, NY: IBM Corp.) Results: The total number of cases was 132 out of 313 total samples, representing 42.2% of the total sample. Three factors were associated with an increased risk of developing GDM, including a family history of diabetes (p-value <0.001), a history of GDM (p-value <0.001), and macrosomia (p-value = 0.020). The study also found higher BMI and advanced maternal age were risk factors for GDM (p-value = 0.004, 0.007), respectively. However, the study did not find a significant association between GDM and other factors, such as chronic disease prevalence, history of miscarriage, or history of fetal death. CONCLUSION The study identified several risk factors associated with an increased risk of GDM including family history of diabetes, history of GDM, macrosomia, overweight/obesity, and advanced maternal age. It is recommended that antenatal care providers screen for GDM risk factors and closely monitor overweight, obese, or older women. Education and counseling on healthy lifestyle habits, such as maintaining a healthy weight and engaging in physical activity, may also be beneficial for preventing GDM. Further research is needed to confirm and identify additional risk factors for GDM.
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Affiliation(s)
- Maha M Alduayji
- Preventive Medicine Division, Family and Community Medicine Administration, Prince Sultan Military Medical City (PSMMC), Riyadh, SAU
| | - Mohie Selim
- Preventive Medicine Division, Family and Community Medicine Administration, Prince Sultan Military Medical City (PSMMC), Riyadh, SAU
- Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Assiut, EGY
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Khalil WJ, Akeblersane M, Khan AS, Moin ASM, Butler AE. Environmental Pollution and the Risk of Developing Metabolic Disorders: Obesity and Diabetes. Int J Mol Sci 2023; 24:ijms24108870. [PMID: 37240215 DOI: 10.3390/ijms24108870] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/25/2023] [Accepted: 05/13/2023] [Indexed: 05/28/2023] Open
Abstract
To meet the increased need for food and energy because of the economic shift brought about by the Industrial Revolution in the 19th century, there has been an increase in persistent organic pollutants (POPs), atmospheric emissions and metals in the environment. Several studies have reported a relationship between these pollutants and obesity, and diabetes (type 1, type 2 and gestational). All of the major pollutants are considered to be endocrine disruptors because of their interactions with various transcription factors, receptors and tissues that result in alterations of metabolic function. POPs impact adipogenesis, thereby increasing the prevalence of obesity in exposed individuals. Metals impact glucose regulation by disrupting pancreatic β-cells, causing hyperglycemia and impaired insulin signaling. Additionally, a positive association has been observed between the concentration of endocrine disrupting chemicals (EDCs) in the 12 weeks prior to conception and fasting glucose levels. Here, we evaluate what is currently known regarding the link between environmental pollutants and metabolic disorders. In addition, we indicate where further research is required to improve our understanding of the specific effects of pollutants on these metabolic disorders which would enable implementation of changes to enable their prevention.
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Affiliation(s)
- William Junior Khalil
- School of Medicine, Royal College of Surgeons in Ireland Bahrain, Busaiteen 15503, Bahrain
| | - Meriem Akeblersane
- School of Medicine, Royal College of Surgeons in Ireland Bahrain, Busaiteen 15503, Bahrain
| | - Ana Saad Khan
- School of Medicine, Royal College of Surgeons in Ireland Bahrain, Busaiteen 15503, Bahrain
| | - Abu Saleh Md Moin
- Research Department, Royal College of Surgeons in Ireland Bahrain, Busaiteen 15503, Bahrain
| | - Alexandra E Butler
- Research Department, Royal College of Surgeons in Ireland Bahrain, Busaiteen 15503, Bahrain
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Al-Shahrani AM. Predictors of Neonatal Intensive Care Unit Admission and Adverse Outcomes Related to Gestational Diabetes. Cureus 2023; 15:e38579. [PMID: 37153839 PMCID: PMC10161799 DOI: 10.7759/cureus.38579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a type of diabetes that manifests itself in pregnant women. It poses a significant risk to the mother's health as well as the health of the infant, including more babies being brought to the neonatal intensive care unit (NICU). It puts both the mother's and the child's health at serious risk, increasing the likelihood that newborns may need to be treated in a neonatal critical care unit. This study aimed to determine the factors that predict GDM-related NICU admission and other adverse newborn outcomes. METHODS The study was a cross-sectional analysis of 175 pregnant women who presented with gestational diabetes at the Maternity and Children's Hospital in Bisha (MCH-Bisha), Saudi Arabia, between January 1 and December 31, 2022. A logistic regression model was used to analyze the data to predict adverse outcomes for newborns and NICU admissions and identify associations between maternal variables and outcomes. RESULTS Maternal characteristics highly associated with adverse neonatal outcomes included advanced maternal age (greater than 30 years), a family history of DM, and a history of greater than or equal to four previous pregnancies. Logistic regression models revealed that newborns delivered to mothers older than 30 years were 7.17 times more likely to be admitted to the NICU than newborns born to mothers younger than 30 years. Saudi nationality, urban residence, and cesarean section delivery factors account for nearly all adverse neonatal outcomes (91%, 75%, and 91%, respectively). Newborns delivered by cesarean section were 3.38 times more likely to be admitted to NICU, and the association was significant. CONCLUSIONS Maternal age greater than 30 years and a history of more than or equal to four pregnancies were the strongest indicators of infant adverse outcomes and NICU admittance among women with gestational diabetes. These findings highlight the need for approaches to GDM management that are efficient, thorough, and multidisciplinary.
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Alshammary AF, Ansar S, Farzan R, Alsobaie SF, Alageel AA, Al-Hakeem MM, Ali Khan I. Dissecting the Molecular Role of ADIPOQ SNPs in Saudi Women Diagnosed with Gestational Diabetes Mellitus. Biomedicines 2023; 11:biomedicines11051289. [PMID: 37238960 DOI: 10.3390/biomedicines11051289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/12/2023] [Accepted: 04/19/2023] [Indexed: 05/28/2023] Open
Abstract
The traditional definition of gestational diabetes mellitus (GDM) is the leading cause of carbohydrate intolerance in hyperglycemia of varying severity, with onset or initial detection during pregnancy. Previous studies have reported a relationship among obesity, adiponectin (ADIPOQ), and diabetes in Saudi Arabia. ADIPOQ is an adipokine that is produced and secreted by adipose tissue involved in the regulation of carbohydrate and fatty acid metabolism. This study investigated the molecular association between rs1501299, rs17846866, and rs2241766 single-nucleotide polymorphisms (SNPs) in ADIPOQ and GDM in Saudi Arabia. Patients with GDM and control patients were selected, and serum and molecular analyses were performed. Statistical analyses were performed on clinical data, Hardy Weinberg Equilibrium, genotype and allele frequencies, multiple logistic regression, ANOVA, haplotype, linkage disequilibrium, as well as MDR and GMDR analyses. The clinical data showed significant differences in various parameters between the GDM and non-GDM groups (p < 0.05). In GDM women with alleles, genotypes, and different genetic models, the rs1501299 and rs2241766 SNPs showed a strong association (p < 0.05). Multiple logistic regression analysis revealed a negative correlation (p > 0.05). This study concluded that rs1501299 and rs2241766 SNPs were strongly associated with GDM in women in Saudi Arabia.
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Affiliation(s)
- Amal F Alshammary
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Sabah Ansar
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Raed Farzan
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Sarah F Alsobaie
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Arwa A Alageel
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Malak Mohammed Al-Hakeem
- Department of Obstetrics and Gynecology, College of Medicine, King Khalid University Hospital, Riyadh 11451, Saudi Arabia
| | - Imran Ali Khan
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
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14
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Alshammary AF, Al-Hakeem MM, Ali Khan I. Saudi Community-Based Screening Study on Genetic Variants in β-Cell Dysfunction and Its Role in Women with Gestational Diabetes Mellitus. Genes (Basel) 2023; 14:924. [PMID: 37107681 PMCID: PMC10137495 DOI: 10.3390/genes14040924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/07/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Diabetes (hyperglycemia) is defined as a multifactorial metabolic disorder in which insulin resistance and defects in pancreatic β-cell dysfunction are two major pathophysiologic abnormalities that underpin towards gestational diabetes mellitus (GDM). TCF7L2, KCNQ1, and KCNJ11 genes are connected to the mechanism of β-cell dysfunction. The purpose of this study was to investigate the genes associated with β-cell dysfunction and their genetic roles in the rs7903146, rs2237892, and rs5219 variants in Saudi women diagnosed with type 2 diabetes mellitus and GDM. MATERIALS AND METHODS In this case-control study, 100 women with GDM and 100 healthy volunteers (non-GDM) were recruited. Genotyping was performed using polymerase chain reaction (PCR), followed by restriction fragment length analysis. Validation was performed using Sanger sequencing. Statistical analyses were performed using multiple software packages. RESULTS Clinical studies showed a β-cell dysfunction positive association in women with GDM when compared to non-GDM women (p < 0.05). Both rs7903146 (CT vs. CC: OR-2.12 [95%CI: 1.13-3.96]; p = 0.01 & T vs. C: (OR-2.03 [95%CI: 1.32-3.11]; p = 0.001) and rs5219 SNPs (AG vs. AA: OR-3.37 [95%CI: 1.63-6.95]; p = 0.0006 & G vs. A: OR-3.03 [95%CI: 1.66-5.52]; p = 0.0001) showed a positive association with genotype and allele frequencies in women with GDM. ANOVA analysis confirmed that weight (p = 0.02), BMI (p = 0.01), and PPBG (p = 0.003) were associated with rs7903146 and BMI (p = 0.03) was associated with rs2237892 SNPs. CONCLUSIONS This study confirms that the SNPs rs7903146 (TCF7L2) and rs5219 (KCNJ11) are strongly associated with GDM in the Saudi population. Future studies should address the limitations of this study.
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Affiliation(s)
- Amal F. Alshammary
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Malak Mohammed Al-Hakeem
- Department of Obstetrics and Gynecology, College of Medicine, King Khalid University Hospital, Riyadh 11451, Saudi Arabia
| | - Imran Ali Khan
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
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15
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Aldahmash W, Harrath AH, Aljerian K, Sabr Y, Alwasel S. Expression of Glucose Transporters 1 and 3 in the Placenta of Pregnant Women with Gestational Diabetes Mellitus. Life (Basel) 2023; 13:life13040993. [PMID: 37109521 PMCID: PMC10143906 DOI: 10.3390/life13040993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/29/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The annual prevalence of gestational diabetes mellitus-characterized by an increase in blood glucose in pregnant women-has been increasing worldwide. The goal of this study was to evaluate the expression of glucose transporter 1 (GLUT1) and glucose transporter 3 (GLUT3) in the placenta of women with gestational diabetes mellitus. METHODS Sixty-five placentas from women admitted to the King Saud University Medical City, Riyadh, Saudi Arabia, were analyzed; 34 and 31 placentas were from healthy pregnant women and women with gestational diabetes, respectively. The expressions of GLUT1 and GLUT3 were assessed using RT-PCR, Western blotting, and immunohistochemical methods. The degree of apoptosis in the placental villi was estimated via a TUNEL assay. RESULTS The results of the protein expression assays and immunohistochemical staining showed that the levels of GLUT1 and GLUT3 were significantly higher in the placentas of pregnant women with gestational diabetes than those in the placentas of healthy pregnant women. In addition, the findings showed an increase in apoptosis in the placenta of pregnant women with gestational diabetes compared to that in the placenta of healthy pregnant women. However, the results of gene expression assays showed no significant difference between the two groups. CONCLUSIONS Based on these results, we conclude that gestational diabetes mellitus leads to an increased incidence of apoptosis in the placental villi and alters the level of GLUT1 and GLUT3 protein expressions in the placenta of women with gestational diabetes. Understanding the conditions in which the fetus develops in the womb of a pregnant woman with gestational diabetes may help researchers understand the underlying causes of the development of chronic diseases later in life.
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Affiliation(s)
- Waleed Aldahmash
- Zoology Department, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia
| | - Abdel Halim Harrath
- Zoology Department, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia
| | - Khaldoon Aljerian
- Pathology Department, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
| | - Yasser Sabr
- Obstetrics and Gynaecology Department, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
| | - Saleh Alwasel
- Zoology Department, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia
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Alazwari A, Johnstone A, Tafakori L, Abdollahian M, AlEidan AM, Alfuhigi K, Alghofialy MM, Albunyan AA, Al Abbad H, AlEssa MH, Alareefy AKH, Alshamrani MA. Predicting the development of T1D and identifying its Key Performance Indicators in children; a case-control study in Saudi Arabia. PLoS One 2023; 18:e0282426. [PMID: 36857368 PMCID: PMC9977054 DOI: 10.1371/journal.pone.0282426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 02/15/2023] [Indexed: 03/02/2023] Open
Abstract
The increasing incidence of type 1 diabetes (T1D) in children is a growing global concern. It is known that genetic and environmental factors contribute to childhood T1D. An optimal model to predict the development of T1D in children using Key Performance Indicators (KPIs) would aid medical practitioners in developing intervention plans. This paper for the first time has built a model to predict the risk of developing T1D and identify its significant KPIs in children aged (0-14) in Saudi Arabia. Machine learning methods, namely Logistic Regression, Random Forest, Support Vector Machine, Naive Bayes, and Artificial Neural Network have been utilised and compared for their relative performance. Analyses were performed in a population-based case-control study from three Saudi Arabian regions. The dataset (n = 1,142) contained demographic and socioeconomic status, genetic and disease history, nutrition history, obstetric history, and maternal characteristics. The comparison between case and control groups showed that most children (cases = 68% and controls = 88%) are from urban areas, 69% (cases) and 66% (control) were delivered after a full-term pregnancy and 31% of cases group were delivered by caesarean, which was higher than the controls (χ2 = 4.12, P-value = 0.042). Models were built using all available environmental and family history factors. The efficacy of models was evaluated using Area Under the Curve, Sensitivity, F Score and Precision. Full logistic regression outperformed other models with Accuracy = 0.77, Sensitivity, F Score and Precision of 0.70, and AUC = 0.83. The most significant KPIs were early exposure to cow's milk (OR = 2.92, P = 0.000), birth weight >4 Kg (OR = 3.11, P = 0.007), residency(rural) (OR = 3.74, P = 0.000), family history (first and second degree), and maternal age >25 years. The results presented here can assist healthcare providers in collecting and monitoring influential KPIs and developing intervention strategies to reduce the childhood T1D incidence rate in Saudi Arabia.
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Affiliation(s)
- Ahood Alazwari
- School of Science, RMIT University, Melbourne, Victoria, Australia
- School of Science, Al-Baha University, Al-Baha, Saudi Arabia
- * E-mail:
| | - Alice Johnstone
- School of Science, RMIT University, Melbourne, Victoria, Australia
| | - Laleh Tafakori
- School of Science, RMIT University, Melbourne, Victoria, Australia
| | - Mali Abdollahian
- School of Science, RMIT University, Melbourne, Victoria, Australia
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Bashir MM, Ahmed LA, Elbarazi I, Loney T, Al-Rifai RH, Alkaabi JM, Al-Maskari F. Incidence of gestational diabetes mellitus in the United Arab Emirates; comparison of six diagnostic criteria: The Mutaba'ah Study. Front Endocrinol (Lausanne) 2022; 13:1069477. [PMID: 36578957 PMCID: PMC9791114 DOI: 10.3389/fendo.2022.1069477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022] Open
Abstract
Background For more than half a century, there has been much research and controversies on how to accurately screen for and diagnose gestational diabetes mellitus (GDM). There is a paucity of updated research among the Emirati population in the United Arab Emirates (UAE). The lack of a uniform GDM diagnostic criteria results in the inability to accurately combine or compare the disease burden worldwide and locally. This study aimed to compare the incidence of GDM in the Emirati population using six diagnostic criteria for GDM. Methods The Mutaba'ah study is the largest multi-center mother and child cohort study in the UAE with an 18-year follow-up. We included singleton pregnancies from the Mutaba'ah cohort screened with the oral glucose tolerance test (OGTT) at 24-32 weeks from May 2017 to March 2021. We excluded patients with known diabetes and with newly diagnosed diabetes. GDM cumulative incidence was determined using the six specified criteria. GDM risk factors were compared using chi-square and t-tests. Agreements among the six criteria were assessed using kappa statistics. Results A total of 2,546 women were included with a mean age of 30.5 ± 6.0 years. Mean gravidity was 3.5 ± 2.1, and mean body mass index (BMI) at booking was 27.7 ± 5.6 kg/m2. GDM incidence as diagnosed by any of the six criteria collectively was 27.1%. It ranged from 8.4% according to the EASD 1996 criteria to 21.5% according to the NICE 2015 criteria. The two most inclusive criteria were the NICE 2015 and the IADPSG criteria with GDM incidence rates of 21.5% (95% CI: 19.9, 23.1) and 21.3% (95% CI: 19.8, 23.0), respectively. Agreement between the two criteria was moderate (k = 0.66; p < 0.001). The least inclusive was the EASD 1996 criteria [8.4% (95% CI: 7.3, 9.6)]. The locally recommended IADPSG/WHO 2013 criteria had weak to moderate agreement with the other criteria, with Cohen's kappa coefficient ranging from (k = 0.51; p < 0.001) to (k = 0.71; p < 0.001). Most of the GDM risk factors assessed were significantly higher among those with GDM (p < 0.005) identified by all criteria. Conclusions The findings indicate discrepancies among the diagnostic criteria in identifying GDM cases. This emphasizes the need to unify GDM diagnostic criteria in this population to provide accurate and reliable incidence estimates for healthcare planning, especially because the agreement with the recommended criteria was not optimal.
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Affiliation(s)
- Maryam M. Bashir
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Luai A. Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Rami H. Al-Rifai
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Juma M. Alkaabi
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Fatma Al-Maskari
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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18
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Dłuski DF, Ruszała M, Rudziński G, Pożarowska K, Brzuszkiewicz K, Leszczyńska-Gorzelak B. Evolution of Gestational Diabetes Mellitus across Continents in 21st Century. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15804. [PMID: 36497880 PMCID: PMC9738915 DOI: 10.3390/ijerph192315804] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/07/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
Over the last few decades, several definitions of gestational diabetes mellitus (GDM) have been described. There is currently not enough research to show which way is the best to diagnose GDM. Opinions differ in terms of the optimal screening and diagnostic measures, in part due to the differences in the population risks, the cost-effectiveness considerations, and the lack of an evidence base to support large national screening programs. The basic method for identifying the disease is the measurement of glucose plasma levels which may be determined when fasting, two hours after a meal, or simply at any random time. The currently increasing incidence of diabetes in the whole population, the altering demographics and the presence of lifestyle changes still require better methods of screening for hyperglycemia, especially during pregnancy. The main aim of this review is to focus on the prevalence and modifications to the screening criteria for GDM across all continents in the 21st century. We would like to show the differences in the above issues and correlate them with the geographical situation. Looking at the history of diabetes, we are sure that more than one evolution in GDM diagnosis will occur, due to the development of medicine, appearance of modern technologies, and the dynamic continuation of research.
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Affiliation(s)
- Dominik Franciszek Dłuski
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-954 Lublin, Poland
| | - Monika Ruszała
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-954 Lublin, Poland
| | - Gracjan Rudziński
- Faculty of Medicine, Medical University of Lublin, 20-059 Lublin, Poland
| | - Kinga Pożarowska
- Faculty of Medicine, Medical University of Lublin, 20-059 Lublin, Poland
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Chahed S, Lassouad L, Dardouri M, Mtiraoui A, Maaroufi A, Khairi H. Impact of a tailored-care education programme on maternal and neonatal outcomes in pregnant women with gestational diabetes: a randomized controlled trial. Pan Afr Med J 2022; 43:128. [PMID: 36762155 PMCID: PMC9883796 DOI: 10.11604/pamj.2022.43.128.34084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 10/22/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction patient education is a key component of positive pregnancy and childbearing experiences, especially in women with gestational diabetes (GDM). Scant studies assessed the impact of tailored self-care education on pregnancy outcomes in pregnant women with gestational diabetes mellitus (GDM). This study aimed to assess the effect of a tailored-care education programme on maternal and neonatal outcomes in pregnant women with GDM during pregnancy and at birth. Methods this was a randomized controlled trial conducted in a university hospital in the centre of Tunisia, from October 2020 to May 2021. The intervention group (n=61) received a self-care education programme with the usual care plan for GDM, while the control group received only the usual care plan (n=60). This trial was registered in the Pan African Clinical Trials Registry under the registration number PACTR202106591503674. Results at baseline, there was no significant difference between groups in terms of sociodemographic and clinical characteristics. The findings showed that the intervention significantly reduced maternal and neonatal hospitalizations (p=0.000), caesarean section (p=0.002), preterm labour (p=0.002), macrosomia (p=0.000), foetal distress (p=0.001), newborn respiratory complication (p=0.01) and hypoglycaemia (p=0.000). Conclusion implementing a tailored-care education for pregnant women with GDM had a positive impact on mother and infant clinical outcomes. Midwives and endocrinologists should use this programme to reduce maternal and neonatal complications during and after pregnancy.
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Affiliation(s)
- Sihem Chahed
- Université de Sousse, Faculté de Médecine de Sousse, Laboratoire de Recherche LR12ES03 “Qualité des Soins et Management des Services de Santé Maternelle”, Sousse, Tunisia,,Université de Monastir, Ecole Supérieure des Sciences et Techniques de la Santé de Monastir, Monastir, Tunisia,,Corresponding author: Sihem Chahed, Université de Sousse, Faculté de Médecine de Sousse, Laboratoire de Recherche LR12ES03 “Qualité des Soins et Management des Services de Santé Maternelle”, Sousse, Tunisia.
| | - Latifa Lassouad
- Université de Sousse, Faculté de Médecine de Sousse, Laboratoire de Recherche LR12ES03 “Qualité des Soins et Management des Services de Santé Maternelle”, Sousse, Tunisia,,Hôpital Universitaire Farhat Hached, Service de Gynécologie-Obstétrique, Sousse, Tunisia
| | - Maha Dardouri
- Université de Sousse, Faculté de Médecine de Sousse, Laboratoire de Recherche LR12ES03 “Qualité des Soins et Management des Services de Santé Maternelle”, Sousse, Tunisia
| | - Ali Mtiraoui
- Université de Sousse, Faculté de Médecine de Sousse, Laboratoire de Recherche LR12ES03 “Qualité des Soins et Management des Services de Santé Maternelle”, Sousse, Tunisia
| | - Amel Maaroufi
- Hôpital Universitaire Farhat Hached, Service d´Endocrinologie et Diabétologie, Sousse, Tunisia
| | - Hedi Khairi
- Université de Sousse, Faculté de Médecine de Sousse, Laboratoire de Recherche LR12ES03 “Qualité des Soins et Management des Services de Santé Maternelle”, Sousse, Tunisia,,Hôpital Universitaire Farhat Hached, Service de Gynécologie-Obstétrique, Sousse, Tunisia
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Juber NF, Abdulle A, AlJunaibi A, AlNaeemi A, Ahmad A, Leinberger-Jabari A, Al Dhaheri AS, AlZaabi E, Mezhal F, Al-Maskari F, AlAnouti F, Alsafar H, Alkaabi J, Wareth LA, Aljaber M, Kazim M, Weitzman M, Al-Houqani M, Ali MH, Oumeziane N, El-Shahawy O, Sherman S, AlBlooshi S, Shah SM, Loney T, Almahmeed W, Idaghdour Y, Ali R. Maternal Early-Life Risk Factors and Later Gestational Diabetes Mellitus: A Cross-Sectional Analysis of the UAE Healthy Future Study (UAEHFS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10339. [PMID: 36011972 PMCID: PMC9408157 DOI: 10.3390/ijerph191610339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/10/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
Limited studies have focused on maternal early-life risk factors and the later development of gestational diabetes mellitus (GDM). We aimed to estimate the GDM prevalence and examine the associations of maternal early-life risk factors, namely: maternal birthweight, parental smoking at birth, childhood urbanicity, ever-breastfed, parental education attainment, parental history of diabetes, childhood overall health, childhood body size, and childhood height, with later GDM. This was a retrospective cross-sectional study using the UAE Healthy Future Study (UAEHFS) baseline data (February 2016 to April 2022) on 702 ever-married women aged 18 to 67 years. We fitted a Poisson regression to estimate the risk ratio (RR) for later GDM and its 95% confidence interval (CI). The GDM prevalence was 5.1%. In the fully adjusted model, females with low birthweight were four times more likely (RR 4.04, 95% CI 1.36-12.0) and females with a parental history of diabetes were nearly three times more likely (RR 2.86, 95% CI 1.10-7.43) to report later GDM. In conclusion, maternal birthweight and parental history of diabetes were significantly associated with later GDM. Close glucose monitoring during pregnancy among females with either a low birth weight and/or parental history of diabetes might help to prevent GDM among this high-risk group.
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Affiliation(s)
- Nirmin F. Juber
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi P.O. Box 129188, United Arab Emirates
| | - Abdishakur Abdulle
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi P.O. Box 129188, United Arab Emirates
| | - Abdulla AlJunaibi
- Department of Pediatrics, Zayed Military Hospital, Abu Dhabi P.O. Box 72763, United Arab Emirates
| | - Abdulla AlNaeemi
- Department of Cardiology, Zayed Military Hospital, Abu Dhabi P.O. Box 72763, United Arab Emirates
| | - Amar Ahmad
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi P.O. Box 129188, United Arab Emirates
| | - Andrea Leinberger-Jabari
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi P.O. Box 129188, United Arab Emirates
| | - Ayesha S. Al Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences, UAE University, Al-Ain P.O. Box 15551, United Arab Emirates
| | - Eiman AlZaabi
- Department of Pathology, Sheikh Shakhbout Medical City, Abu Dhabi P.O. Box 11001, United Arab Emirates
| | - Fatima Mezhal
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi P.O. Box 129188, United Arab Emirates
| | - Fatma Al-Maskari
- Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al-Ain P.O. Box 15551, United Arab Emirates
- Zayed Center for Health Sciences, UAE University, Al-Ain P.O. Box 15551, United Arab Emirates
| | - Fatme AlAnouti
- College of Natural and Health Sciences, Zayed University, Abu Dhabi P.O. Box 144534, United Arab Emirates
| | - Habiba Alsafar
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi P.O. Box 127788, United Arab Emirates
- Department of Genetics and Molecular Biology, Khalifa University of Science and Technology, Abu Dhabi P.O. Box 127788, United Arab Emirates
- Department of Biomedical Engineering, Khalifa University of Science and Technology, Abu Dhabi P.O. Box 127788, United Arab Emirates
| | - Juma Alkaabi
- Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Al-Ain P.O. Box 15551, United Arab Emirates
| | - Laila Abdel Wareth
- The National Reference Laboratory, Abu Dhabi P.O. Box 92323, United Arab Emirates
| | - Mai Aljaber
- Healthpoint Hospital, Abu Dhabi P.O. Box 112308, United Arab Emirates
| | - Marina Kazim
- Abu Dhabi Blood Bank Services, SEHA, Abu Dhabi P.O. Box 109090, United Arab Emirates
| | - Michael Weitzman
- Department of Environmental Medicine, New York University of Medicine, New York, NY 10016, USA
| | - Mohammad Al-Houqani
- Department of Medicine, College of Medicine and Health Sciences, UAE University, Al-Ain P.O. Box 15551, United Arab Emirates
| | - Mohammed Hag Ali
- Faculty of Health Sciences, Higher Colleges of Technology, Abu Dhabi P.O. Box 25026, United Arab Emirates
| | - Naima Oumeziane
- Abu Dhabi Blood Bank Services, SEHA, Abu Dhabi P.O. Box 109090, United Arab Emirates
| | - Omar El-Shahawy
- Department of Population Health, New York University School of Medicine, New York, NY 10016, USA
| | - Scott Sherman
- Department of Population Health, New York University School of Medicine, New York, NY 10016, USA
| | - Sharifa AlBlooshi
- College of Natural and Health Sciences, Zayed University, Dubai P.O. Box 19282, United Arab Emirates
| | - Syed M. Shah
- Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al-Ain P.O. Box 15551, United Arab Emirates
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates
| | - Wael Almahmeed
- Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi P.O. Box 112412, United Arab Emirates
| | - Youssef Idaghdour
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi P.O. Box 129188, United Arab Emirates
| | - Raghib Ali
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi P.O. Box 129188, United Arab Emirates
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 1TN, UK
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21
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Bashir MM, Ahmed LA, Alshamsi MR, Almahrooqi S, Alyammahi T, Alshehhi SA, Alhammadi WI, Alhosani HA, Alhammadi FH, Al-Rifai RH, Al-Maskari F. Gestational Diabetes Mellitus: A Cross-Sectional Survey of Its Knowledge and Associated Factors among United Arab Emirates University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148381. [PMID: 35886231 PMCID: PMC9321366 DOI: 10.3390/ijerph19148381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 12/01/2022]
Abstract
Gestational diabetes mellitus (GDM) burden is burgeoning globally. Correct knowledge about GDM among young people is paramount for timely prevention. This study assesses GDM knowledge and identifies factors associated with it among United Arab Emirates (UAE) University students. A validated self-administered questionnaire collected data from the university students. We analyzed the data for GDM knowledge status (ever heard of GDM) and GDM knowledge levels (poor, fair, and good) and conducted ordinal logistic regressions to assess for associated factors. A total of 735 students were surveyed with a mean age of 21.0 years. Of these, 72.8% had heard of GDM, and 52.9% of males versus 20.3% of female students had never heard of the condition before. Higher age (p = 0.019) and being a postgraduate student (p = 0.026) were associated with higher GDM knowledge status in males. GDM knowledge level analysis showed that 24.0%, 58.5%, and 17.5% had poor, fair, and good knowledge. The mean GDM-knowledge score was 6.3 ± 2.4 (out of 12). Being married [aOR-1.82 (95%CI 1.10–3.03)] and knowing someone who had GDM [aOR-1.78 (95%CI 1.23–2.60)] were independently associated with higher GDM knowledge levels among students. Students’ primary source of GDM knowledge was family/friends. There is an observed knowledge gap related to GDM among the students, especially males. This study urges the need to accelerate targeted GDM awareness campaigns among university students and the general population in the UAE.
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Affiliation(s)
- Maryam M. Bashir
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (M.M.B.); (L.A.A.); (M.R.A.); (S.A.); (T.A.); (S.A.A.); (W.I.A.); (H.A.A.); (F.H.A.); (R.H.A.-R.)
| | - Luai A. Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (M.M.B.); (L.A.A.); (M.R.A.); (S.A.); (T.A.); (S.A.A.); (W.I.A.); (H.A.A.); (F.H.A.); (R.H.A.-R.)
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Meera R. Alshamsi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (M.M.B.); (L.A.A.); (M.R.A.); (S.A.); (T.A.); (S.A.A.); (W.I.A.); (H.A.A.); (F.H.A.); (R.H.A.-R.)
| | - Sara Almahrooqi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (M.M.B.); (L.A.A.); (M.R.A.); (S.A.); (T.A.); (S.A.A.); (W.I.A.); (H.A.A.); (F.H.A.); (R.H.A.-R.)
| | - Taif Alyammahi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (M.M.B.); (L.A.A.); (M.R.A.); (S.A.); (T.A.); (S.A.A.); (W.I.A.); (H.A.A.); (F.H.A.); (R.H.A.-R.)
| | - Shooq A. Alshehhi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (M.M.B.); (L.A.A.); (M.R.A.); (S.A.); (T.A.); (S.A.A.); (W.I.A.); (H.A.A.); (F.H.A.); (R.H.A.-R.)
| | - Waad I. Alhammadi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (M.M.B.); (L.A.A.); (M.R.A.); (S.A.); (T.A.); (S.A.A.); (W.I.A.); (H.A.A.); (F.H.A.); (R.H.A.-R.)
| | - Hind A. Alhosani
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (M.M.B.); (L.A.A.); (M.R.A.); (S.A.); (T.A.); (S.A.A.); (W.I.A.); (H.A.A.); (F.H.A.); (R.H.A.-R.)
| | - Fatima H. Alhammadi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (M.M.B.); (L.A.A.); (M.R.A.); (S.A.); (T.A.); (S.A.A.); (W.I.A.); (H.A.A.); (F.H.A.); (R.H.A.-R.)
| | - Rami H. Al-Rifai
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (M.M.B.); (L.A.A.); (M.R.A.); (S.A.); (T.A.); (S.A.A.); (W.I.A.); (H.A.A.); (F.H.A.); (R.H.A.-R.)
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Fatma Al-Maskari
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (M.M.B.); (L.A.A.); (M.R.A.); (S.A.); (T.A.); (S.A.A.); (W.I.A.); (H.A.A.); (F.H.A.); (R.H.A.-R.)
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Correspondence:
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22
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Zhao R, Zhou L, Lei G, Wang S, Li Y, Yang X, Xiong G, Hao L. Dietary Acid Load Is Positively Associated With Risk of Gestational Diabetes Mellitus in a Prospective Cohort of Chinese Pregnant Women. Front Nutr 2022; 9:892698. [PMID: 35694169 PMCID: PMC9184257 DOI: 10.3389/fnut.2022.892698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/09/2022] [Indexed: 11/16/2022] Open
Abstract
Background Growing evidence suggests that dietary acid load plays an important role in the development of type 2 diabetes. However, prospective studies on the relationship between dietary acid load and gestational diabetes mellitus (GDM) are limited in the pregnant population. This study aimed to investigate the effect of dietary acid load during early pregnancy on the risk of GDM in Chinese pregnant women. Methods A total of 1,327 pregnant women were enrolled from an ongoing prospective study of the Tongji Birth cohort (TJBC) in Wuhan, China. Dietary intake was assessed before 20 weeks using a 74-item semiquantitative food frequency questionnaire (FFQ). The dietary acid load was estimated using potential renal acid load (PRAL), net endogenous acid production (NEAP), and animal protein to potassium ratio (A:P ratio). A 75g 2-h oral glucose tolerance test (OGTT) was performed at 24-28 gestational weeks to diagnose GDM. Results The mean (standard deviation) values for PRAL score, NEAP score, and A:P ratio were 0.8 ± 11.3 mEq/day, 45.3 ± 16.5 mEq/day, and 9.8 ± 6.0, respectively. There was a significant positive correlation of dietary acid load with the intake of red meat, poultry, fish, and eggs, and a negative correlation with the intake of vegetables, fruits, nuts, and legumes (all P < 0.05). Compared to the lowest tertile, the highest tertile of dietary acid load, including PRAL score (odds ratio [OR]: 2.26, 95% confidence interval [CI] = 1.38–3.71, P-trend = 0.002), NEAP score (OR: 2.02, 95% CI = 1.25–3.27, P-trend = 0.009), and A:P ratio (2.08, 95% CI = 1.30–3.31, P-trend = 0.005), significantly increased the risk of GDM. In addition, the dietary acid load was also significantly associated with an increase in 1-h and 2-h post-load blood glucose concentrations (all P-trend < 0.05). Conclusion We found a significant positive association between dietary acid load during early pregnancy and the risk of GDM in a Chinese population, suggesting that the reduction of food sources of dietary acid load may be an effective strategy for preventing the risk of GDM.
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Affiliation(s)
- Rui Zhao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Leilei Zhou
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Lei
- The Central Hospital of Wuhan, Wuhan, China
| | - Shanshan Wang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuefeng Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guoping Xiong
- The Central Hospital of Wuhan, Wuhan, China
- *Correspondence: Guoping Xiong,
| | - Liping Hao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Liping Hao,
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Chelu S, Bernad E, Craina M, Neamtu R, Mocanu AG, Vernic C, Chiriac VD, Tomescu L, Borza C. Prevalence of Gestational Diabetes in preCOVID-19 and COVID-19 Years and Its Impact on Pregnancy: A 5-Year Retrospective Study. Diagnostics (Basel) 2022; 12:diagnostics12051241. [PMID: 35626396 PMCID: PMC9140441 DOI: 10.3390/diagnostics12051241] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/18/2022] [Accepted: 05/13/2022] [Indexed: 12/17/2022] Open
Abstract
Gestational diabetes mellitus (GDM) affects a total of 3% to 9% of all pregnancies. It has a high impact on both mother and baby, increases the perinatal risks, and predicts the presence of long-term chronic metabolic complications. The aim of our study is to determine the incidence of GDM in tertiary hospitals in the west part of Romania to lay out the risk factors associated with GDM and to observe the evolution of pregnancy among patients with this pathology by emphasizing the state of birth of the fetus, the birth weight, and the way of birth. We also want to compare the prevalence of GDM in preCOVID-19 (Coronavirus disease) versus COVID-19 years. The study took place between January 2017 and December 2021 at the Municipal Emergency Hospital of Timisoara, Romania. The proportion of births with GDM was significantly increased during the COVID-19 period compared to the preCOVID-19 period (chi2 Fisher exact test, p < 0.001). The period 2020−2021 represents a significant risk factor for GDM births (OR = 1.87, with 95% CI = [1.30, 2.67]). COVID years represent a risk period for developing gestational diabetes, which can be explained by reduced physical activity, anxiety, or modified dietary habits, even if the follow-up period was not impacted.
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Affiliation(s)
- Sorina Chelu
- Discipline of Pathophysiology, Victor Babes University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (S.C.); (C.B.)
| | - Elena Bernad
- Discipline of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (E.B.); (M.C.); (R.N.); (A.G.M.); (L.T.)
| | - Marius Craina
- Discipline of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (E.B.); (M.C.); (R.N.); (A.G.M.); (L.T.)
| | - Radu Neamtu
- Discipline of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (E.B.); (M.C.); (R.N.); (A.G.M.); (L.T.)
| | - Adelina Geanina Mocanu
- Discipline of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (E.B.); (M.C.); (R.N.); (A.G.M.); (L.T.)
| | - Corina Vernic
- Computer Science and Medical Biostatistics Discipline, Victor Babes University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
| | - Veronica Daniela Chiriac
- Discipline of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (E.B.); (M.C.); (R.N.); (A.G.M.); (L.T.)
- Correspondence: ; Tel.: +40-722-379-832
| | - Larisa Tomescu
- Discipline of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (E.B.); (M.C.); (R.N.); (A.G.M.); (L.T.)
| | - Claudia Borza
- Discipline of Pathophysiology, Victor Babes University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (S.C.); (C.B.)
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Abdulaziz Khayat A, fallatah N. Knowledge of Gestational Diabetes Mellitus Among Saudi Women in a Primary Health Care Center of Almadinah Almunawarah, Kingdom of Saudi Arabia. Cureus 2022; 14:e22979. [PMID: 35415024 PMCID: PMC8994052 DOI: 10.7759/cureus.22979] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2022] [Indexed: 11/05/2022] Open
Abstract
Background Gestational diabetes mellitus (GDM) is a type of diabetes mellitus known as any stage of glucose intolerance with onset or first recognition during pregnancy. Awareness of GDM is the first step toward its screening in pregnancy. This study was designed to assess knowledge of GDM, its screening, and risk factors among Saudi women attending primary healthcare center in Almadinah Almunawarah, Kingdom of Saudi Arabia. Methods This was an observational cross-sectional study conducted on Saudi women who attended the primary healthcare centers in Almadinah Almunawarah during the study period from January 2021 to June 2021. The sampling technique used was the stratification of primary healthcare centers in Madinah. According to the Epi-Info, version 3.5.1, the minimum sample size was 292. Data collection was done using a valid, Arabic self-administered questionnaire, which was composed of two main parts: general sociodemographic data and a questionnaire to assess GDM knowledge and awareness (12 questions). Data was recorded and analyzed using SPSS version 26. Results In this study, 333 women were enrolled with an age range between 18 and 60 years, with a mean of 34.31±9.21 years. Overall, more than half of the women (53.45%) had a poor level of knowledge related to GDM, whereas only 7.80% had a good level of knowledge. Results of multivariate logistic regression analysis revealed that women living in rural areas were at almost four-fold higher risk of having a poor level of knowledge (adjusted odds ratio (aOR): 3.97; 95% confidence interval (CI): 1.44-41.98, p=0.0031). With a one-year increase in women’s age, the risk of poor knowledge increased by 4% (aOR: 1.38; 95% CI: 1.08-1.48, p=0.001). In comparison to illiterate women, university-graduated and postgraduate women had a significantly lower risk of poor knowledge (aOR: 0.03; 95% CI: 0.01-0.31, p=0.001 and aOR: 0.19; 95% CI: 0.06-0.66, p = 0.011, respectively). Conclusion The GDM knowledge of Saudi adult women was poor, particularly regarding risk factors, diagnosis, and treatment with insulin. However, their knowledge regarding treatment by lifestyle and diet modifications was quite acceptable.
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25
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Paulo MS, Abdo NM, Bettencourt-Silva R, Al-Rifai RH. Gestational Diabetes Mellitus in Europe: A Systematic Review and Meta-Analysis of Prevalence Studies. Front Endocrinol (Lausanne) 2021; 12:691033. [PMID: 34956073 PMCID: PMC8698118 DOI: 10.3389/fendo.2021.691033] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 11/17/2021] [Indexed: 01/14/2023] Open
Abstract
Background Gestational Diabetes Mellitus (GDM) is defined as the type of hyperglycemia diagnosed for the first-time during pregnancy, presenting with intermediate glucose levels between normal levels for pregnancy and glucose levels diagnostic of diabetes in the non-pregnant state. We aimed to systematically review and meta-analyze studies of prevalence of GDM in European countries at regional and sub-regional levels, according to age, trimester, body weight, and GDM diagnostic criteria. Methods Systematic search was conducted in five databases to retrieve studies from 2014 to 2019 reporting the prevalence of GDM in Europe. Two authors have independently screened titles and abstracts and full text according to eligibility using Covidence software. A random-effects model was used to quantify weighted GDM prevalence estimates. The National Heart, Lung, and Blood Institute criteria was used to assess the risk of bias. Results From the searched databases, 133 research reports were deemed eligible and included in the meta-analysis. The research reports yielded 254 GDM-prevalence studies that tested 15,572,847 pregnant women between 2014 and 2019. The 133 research reports were from 24 countries in Northern Europe (44.4%), Southern Europe (27.1%), Western Europe (24.1%), and Eastern Europe (4.5%). The overall weighted GDM prevalence in the 24 European countries was estimated at 10.9% (95% CI: 10.0-11.8, I2 : 100%). The weighted GDM prevalence was highest in the Eastern Europe (31.5%, 95% CI: 19.8-44.6, I2 : 98.9%), followed by in Southern Europe (12.3%, 95% CI: 10.9-13.9, I2 : 99.6%), Western Europe (10.7%, 95% CI: 9.5-12.0, I2 : 99.9%), and Northern Europe (8.9%, 95% CI: 7.9-10.0, I2 : 100). GDM prevalence was 2.14-fold increased in pregnant women with maternal age ≥30 years (versus 15-29 years old), 1.47-fold if the diagnosis was made in the third trimester (versus second trimester), and 6.79- fold in obese and 2.29-fold in overweight women (versus normal weight). Conclusions In Europe, GDM is significant in pregnant women, around 11%, with the highest prevalence in pregnant women of Eastern European countries (31.5%). Findings have implications to guide vigilant public health awareness campaigns about the risk factors associated with developing GDM. Systematic Review Registration PROSPERO [https://www.crd.york.ac.uk/PROSPERO/], identifier CRD42020161857.
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Affiliation(s)
- Marília Silva Paulo
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Noor Motea Abdo
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Rita Bettencourt-Silva
- Department of Endocrinology and Nutrition, Unidade Local de Saúde do Alto Minho, Viana do Castelo, Portugal
- Department of Endocrinology, Hospital Lusíadas Porto, Porto, Portugal
| | - Rami H. Al-Rifai
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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