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24.02.2024 | Original Article

Incidence of overt diabetes in pregnancy among women with 50-g glucose challenge test ≥ 200 mg/dL

verfasst von: Dittakarn Boriboonhirunsarn, Amporn Robkhonburi, Dawrueng Gusonkhum

Erschienen in: Diabetology International

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Abstract

Objectives

To determine the incidence of overt diabetes in pregnancy (ODIP) among women with 50-g GCT results ≥ 200 mg/dL and compare characteristics and pregnancy outcomes between women with and without gestational diabetes (GDM).

Methods

A retrospective cohort study was conducted in 212 pregnant women whose 50-g GCT results ≥ 200 mg/dL. ODIP was diagnosed from 75-g OGTT if fasting plasma glucose ≥ 126 and/or 2-h plasma glucose ≥ 200 mg/dL. Various characteristics and pregnancy outcomes were compared between ODIP and those with and without GDM.

Results

Incidence of ODIP was 1.9% of all pregnant women and 23.6% of women with 50-g GCT ≥ 200 mg/dL. Women with ODIP and GDM were more likely to be overweight or obese than those without GDM (52%, 39.6%, and 18.2%, p < 0.001). Women with ODIP had significantly higher 50-g GCT results, lower gestational weight gain, and were less likely to deliver vaginally. Insulin therapy was significantly more common in women with ODIP compared to GDM (70.2% vs. 15.4%, p < 0.001). Rates of LGA, macrosomia, and other neonatal outcomes were comparable. BMI ≥ 25 kg/m2 and 50-g GCT ≥ 240 mg/dL independently increased the risk of any abnormal glucose tolerance [adjusted OR 3.22 (95% CI 1.55–6.70) and 2.28 (95% CI 1.14–4.58)] and ODIP [adjusted OR 9.43 (95% CI 2.15–41.38) and 6.36 (95% CI 2.85–14.18)], respectively.

Conclusion

Incidence of ODIP was 23.6% of women with 50-g GCT ≥ 200 mg/dL. BMI ≥ 25 kg/m2 and 50-g GCT ≥ 240 mg/dL independently increased the risk of GDM and ODIP. Neonatal complications were comparable between ODIP and those with and without GDM.
Literatur
1.
Zurück zum Zitat ACOG Practice Bulletin No. 201: Pregestational diabetes mellitus. Obstet Gynecol. 2018;132(6):e228–48.CrossRef ACOG Practice Bulletin No. 201: Pregestational diabetes mellitus. Obstet Gynecol. 2018;132(6):e228–48.CrossRef
2.
Zurück zum Zitat American Diabetes Association. Classification and diagnosis of diabetes: standards of medical care in diabetes. Diabetes Care. 2023;46(Suppl 6):S19–40. American Diabetes Association. Classification and diagnosis of diabetes: standards of medical care in diabetes. Diabetes Care. 2023;46(Suppl 6):S19–40.
3.
Zurück zum Zitat Hod M, Kapur A, Sacks DA, Hadar E, Agarwal M, Di Renzo GC, et al. The international federation of gynecology and obstetrics (FIGO) Initiative on gestational diabetes mellitus: a pragmatic guide for diagnosis, management, and care. Int J Gynaecol Obstet. 2015;131(Suppl 3):S173-211.CrossRefPubMed Hod M, Kapur A, Sacks DA, Hadar E, Agarwal M, Di Renzo GC, et al. The international federation of gynecology and obstetrics (FIGO) Initiative on gestational diabetes mellitus: a pragmatic guide for diagnosis, management, and care. Int J Gynaecol Obstet. 2015;131(Suppl 3):S173-211.CrossRefPubMed
4.
Zurück zum Zitat World Health Organization. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: a world health organization guideline. Diabetes Res Clin Pract. 2014;103(3):341–63.CrossRef World Health Organization. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: a world health organization guideline. Diabetes Res Clin Pract. 2014;103(3):341–63.CrossRef
6.
Zurück zum Zitat International Association of Diabetes and Pregnancy Study Groups Consensus Panel, Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33(3):676–82.CrossRefPubMedCentral International Association of Diabetes and Pregnancy Study Groups Consensus Panel, Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33(3):676–82.CrossRefPubMedCentral
7.
Zurück zum Zitat Oppermann ML, Campos MA, Hirakata VN, Reichelt AJ. Overt diabetes imposes a comparable burden on outcomes as pregestational diabetes: a cohort study. Diabetol Metab Syndr. 2022;14(1):177.CrossRefPubMedPubMedCentral Oppermann ML, Campos MA, Hirakata VN, Reichelt AJ. Overt diabetes imposes a comparable burden on outcomes as pregestational diabetes: a cohort study. Diabetol Metab Syndr. 2022;14(1):177.CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Lee D, Booth GL, Ray JG, Ling V, Feig DS. Undiagnosed type 2 diabetes during pregnancy is associated with increased perinatal mortality: a large population-based cohort study in Ontario. Canada Diabet Med. 2020;37(10):1696–704.CrossRefPubMed Lee D, Booth GL, Ray JG, Ling V, Feig DS. Undiagnosed type 2 diabetes during pregnancy is associated with increased perinatal mortality: a large population-based cohort study in Ontario. Canada Diabet Med. 2020;37(10):1696–704.CrossRefPubMed
9.
Zurück zum Zitat Murphy HR, Howgate C, O’Keefe J, Myers J, Morgan M, Coleman MA, et al. Characteristics and outcomes of pregnant women with type 1 or type 2 diabetes: a 5-year national population-based cohort study. Lancet Diabetes Endocrinol. 2021;9(3):153–64.CrossRefPubMed Murphy HR, Howgate C, O’Keefe J, Myers J, Morgan M, Coleman MA, et al. Characteristics and outcomes of pregnant women with type 1 or type 2 diabetes: a 5-year national population-based cohort study. Lancet Diabetes Endocrinol. 2021;9(3):153–64.CrossRefPubMed
10.
Zurück zum Zitat Wong T, Ross GP, Jalaludin BB, Flack JR. The clinical significance of overt diabetes in pregnancy. Diabet Med. 2013;30(4):468–74.CrossRefPubMed Wong T, Ross GP, Jalaludin BB, Flack JR. The clinical significance of overt diabetes in pregnancy. Diabet Med. 2013;30(4):468–74.CrossRefPubMed
11.
Zurück zum Zitat Mane L, Flores-Le Roux JA, Benaiges D, Chillaron JJ, Prados M, Pedro-Botet J, et al. Impact of overt diabetes diagnosed in pregnancy in a multi-ethnic cohort in Spain. Gynecol Endocrinol. 2019;35(4):332–6.CrossRefPubMed Mane L, Flores-Le Roux JA, Benaiges D, Chillaron JJ, Prados M, Pedro-Botet J, et al. Impact of overt diabetes diagnosed in pregnancy in a multi-ethnic cohort in Spain. Gynecol Endocrinol. 2019;35(4):332–6.CrossRefPubMed
12.
Zurück zum Zitat Sampaio Y, Porto LB, Lauand TCG, Marcon LP, Pedrosa HC. Gestational diabetes and overt diabetes first diagnosed in pregnancy: characteristics, therapeutic approach and perinatal outcomes in a public healthcare referral center in Brazil. Arch Endocrinol Metab. 2021;65(1):79–84.PubMed Sampaio Y, Porto LB, Lauand TCG, Marcon LP, Pedrosa HC. Gestational diabetes and overt diabetes first diagnosed in pregnancy: characteristics, therapeutic approach and perinatal outcomes in a public healthcare referral center in Brazil. Arch Endocrinol Metab. 2021;65(1):79–84.PubMed
13.
Zurück zum Zitat Milln J, Nakabuye B, Natamba BK, Sekitoleko I, Mubiru M, Namara AA, et al. Antenatal management and maternal/fetal outcomes associated with hyperglycaemia in pregnancy (HIP) in Uganda; a prospective cohort study. BMC Pregnancy Childbirth. 2021;21(1):386.CrossRefPubMedPubMedCentral Milln J, Nakabuye B, Natamba BK, Sekitoleko I, Mubiru M, Namara AA, et al. Antenatal management and maternal/fetal outcomes associated with hyperglycaemia in pregnancy (HIP) in Uganda; a prospective cohort study. BMC Pregnancy Childbirth. 2021;21(1):386.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Sugiyama T, Saito M, Nishigori H, Nagase S, Yaegashi N, Sagawa N, et al. Comparison of pregnancy outcomes between women with gestational diabetes and overt diabetes first diagnosed in pregnancy: a retrospective multi-institutional study in Japan. Diabetes Res Clin Pract. 2014;103(1):20–5.CrossRefPubMed Sugiyama T, Saito M, Nishigori H, Nagase S, Yaegashi N, Sagawa N, et al. Comparison of pregnancy outcomes between women with gestational diabetes and overt diabetes first diagnosed in pregnancy: a retrospective multi-institutional study in Japan. Diabetes Res Clin Pract. 2014;103(1):20–5.CrossRefPubMed
15.
Zurück zum Zitat Park S, Kim SH. Women with rigorously managed overt diabetes during pregnancy do not experience adverse infant outcomes but do remain at serious risk of postpartum diabetes. Endocr J. 2015;62(4):319–27.CrossRefPubMed Park S, Kim SH. Women with rigorously managed overt diabetes during pregnancy do not experience adverse infant outcomes but do remain at serious risk of postpartum diabetes. Endocr J. 2015;62(4):319–27.CrossRefPubMed
16.
Zurück zum Zitat Kannawat S, Chawanpaiboon S, Boriboonhirunsarn D. Pregnancy and neonatal adverse outcomes in women with gestational diabetes mellitus diagnosed by a 50-g glucose challenge test level ≥ 200 mg/dl compared with test results using the 100-g oral glucose tolerance test and Carpenter-Coustan criteria. Thai J Obstet Gynaecol. 2021;29(3):142–50. Kannawat S, Chawanpaiboon S, Boriboonhirunsarn D. Pregnancy and neonatal adverse outcomes in women with gestational diabetes mellitus diagnosed by a 50-g glucose challenge test level ≥ 200 mg/dl compared with test results using the 100-g oral glucose tolerance test and Carpenter-Coustan criteria. Thai J Obstet Gynaecol. 2021;29(3):142–50.
17.
Zurück zum Zitat Kaewsrinual S, Boriboonhirunsarn D. Risk factors for insulin therapy in gestational diabetes mellitus. Thai J Obstet Gynaecol. 2022;30(1):51–9. Kaewsrinual S, Boriboonhirunsarn D. Risk factors for insulin therapy in gestational diabetes mellitus. Thai J Obstet Gynaecol. 2022;30(1):51–9.
18.
Zurück zum Zitat Phattanachindakun B, Watananirun K, Boriboonhirunsarn D. Early universal screening of gestational diabetes in a university hospital in Thailand. J Obstet Gynaecol. 2022;42(6):2001–7.CrossRefPubMed Phattanachindakun B, Watananirun K, Boriboonhirunsarn D. Early universal screening of gestational diabetes in a university hospital in Thailand. J Obstet Gynaecol. 2022;42(6):2001–7.CrossRefPubMed
19.
Zurück zum Zitat Rasmussen KM, Yaktine AL, editors. Weight gain during pregnancy: Reexamining the guidelines. Washington, DC: The National Academies Press; 2009. Rasmussen KM, Yaktine AL, editors. Weight gain during pregnancy: Reexamining the guidelines. Washington, DC: The National Academies Press; 2009.
20.
Zurück zum Zitat Gestational hypertension and preeclampsia. ACOG practice bulletin, number 222. Obstet Gynecol. 2020;135(6):e237–60.CrossRef Gestational hypertension and preeclampsia. ACOG practice bulletin, number 222. Obstet Gynecol. 2020;135(6):e237–60.CrossRef
21.
Zurück zum Zitat Mikolajczyk RT, Zhang J, Betran AP, Souza JP, Mori R, Gulmezoglu AM, Merialdi M. A global reference for fetal-weight and birthweight percentiles. Lancet. 2011;377(9780):1855–61.CrossRefPubMed Mikolajczyk RT, Zhang J, Betran AP, Souza JP, Mori R, Gulmezoglu AM, Merialdi M. A global reference for fetal-weight and birthweight percentiles. Lancet. 2011;377(9780):1855–61.CrossRefPubMed
Metadaten
Titel
Incidence of overt diabetes in pregnancy among women with 50-g glucose challenge test ≥ 200 mg/dL
verfasst von
Dittakarn Boriboonhirunsarn
Amporn Robkhonburi
Dawrueng Gusonkhum
Publikationsdatum
24.02.2024
Verlag
Springer Nature Singapore
Erschienen in
Diabetology International
Print ISSN: 2190-1678
Elektronische ISSN: 2190-1686
DOI
https://doi.org/10.1007/s13340-024-00694-w

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