Assessing the Frequency and Association of Risk Factors with Gestational Diabetes in Women Reporting to a Tertiary Care Hospital using the American Diabetes Association 2023 Criteri

Najeeb Ullah Khan; Abdus  Sattar; Mariam  Saeed; Muhammad Zeeshan  Rana; Hina  Anwar

doi:10.51253/pafmj.v76i3.10979

Authors

Najeeb Ullah Khan Department of Chemical Pathology, Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan
Abdus Sattar Department of Chemical Pathology, Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan
Mariam Saeed Department of Chemical Pathology, Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan
Muhammad Zeeshan Rana Department of Chemical Pathology, Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan
Hina Anwar Department of Chemical Pathology, Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76i3.10979

Keywords:

American Diabetes Association, Gestational Diabetes Mellitus, Oral Glucose Tolerance Test

Abstract

Objective: To assess the frequency of gestational diabetes mellitus (GDM) using latest criteria of American Diabetes Association (ADA) 2023, and to determine the possible association of risk factors with GDM.

Study Design: Comparative cross-sectional study.

Place and Duration of Study: Department of Pathology, Combined Military Hospital Lahore, Pakistan, from Feb to Aug 2023.

Methodology: A total of 281 pregnant women undergoing an Oral Glucose Tolerance Test (OGTT) between 24-28 weeks of gestation were included. Blood samples were obtained following a ten-hour fasting period, 75g of anhydrous glucose was administered and further samples taken one and two hours after oral glucose load. GDM was then diagnosed using latest criteria of ADA 2023.

Results: Among the 281 pregnant women, 72(25.6%) were diagnosed with GDM, whereas 209 had normal glucose tolerance. The mean age of participants was 27.8±4.6 years. Statistically significant differences were observed between females with and without GDM concerning age (p=0.001), prior history of GDM (p=<0.001), familial history of GDM (p=<0.001), BMI exceeding 30 kg/m2 (0.001), and a history of miscarriages (p=0.006). Whereas no statistically significant association of parity (p=0.093), history of macrosomia (p=0.583), preterm delivery (p=0.484), history of hypertension (p=0.250) or socioeconomic status (0.08).

Conclusion: Frequency of GDM according to ADA 2023 criteria was found to be 25.6%. We have highlighted common occurrence of GDM among women aged over 30, those with a history of previous abortions, prior GDM, familial DM, and overweight individuals.

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References

1. Nhidza G, Mutsaka K, Malunga G, Zhou DT. Diagnosis of Gestational Diabetes Mellitus in Urban Harare, Zimbabwe. Open Public Health J 2018; 11: 1-7.

https://dx.doi.org/10.2174/1874944501811010001

2. Plows JF, Stanley JL, Baker PN, Reynolds CM, Vickers MH. The pathophysiology of gestational diabetes mellitus. Int J Mol Sci 2018; 19(11): 3342.

https://doi.org/10.3390/ijms19113342

3. Khurshid A, Parveen Z, Jan MM, Assad M. Association of causes of type 2 diabetes mellitus and gestational diabetes with the clinical profile in the population of Khyber Pakhtunkhwa Pakistan. Arch Med Sci Civil Dis 2022; 7(1): e44–e52.

https://doi.org/10.5114/amscd

4. Latif M, Ayaz SB, Anwar M, Manzoor M, Aamir M, Bokhari SARS, et al. Frequency of Gestational diabetes mellitus in Pregnant Women Reporting to a Public Sector Tertiary Care Hospital of Quetta. Pak Armed Forces Med J 2022; 72(6): 2095-2098. https://www.pafmj.org/PAFMJ/article/view/4073

5. Metzger BE, Coustan DR, Trimble ER. Hyperglycemia and Adverse Pregnancy Outcomes. Clin Chem 2019; 65(7): 937-938.

https://doi.org/10.1373/clinchem.2019.303990

6. Vounzoulaki E, Khunti K, Abner SC, Tan BK, Davies MJ, Gillies CL. Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysis. BMJ 2020; 369: m1361.

https://doi.org/10.1136/bmj.m1361

7. Bibi S, Saleem U, Mahsood N. The frequency of Gestational diabetes mellitus and associated risk factors at Khyber teaching hospital Peshawar. J Postgrad Med Inst 2015; 29(1): 43-46.

8. Lee KW, Ching SM, Ramachandran V, Yee A, Hoo FK, Chia YC, et al. Prevalence and Risk Factors of Gestational Diabetes Mellitus in Asia: A Systematic Review and Meta-Analysis. BMC Pregnancy Childbirth 2018; 18(1): 1–20.

https://doi.org/10.1186/s12884-018-2131-4

9. Zakir A, Shehzad F, Nazli R. Frequency and association of risk factors in development of gestational diabetes mellitus. Khyber Med Univ J 2017; 9(3): 126-129.

10. Fu Q, Chen R, Xu S, Ding Y, Huang C, He B, et al. Assessment of potential risk factors associated with gestational diabetes mellitus: evidence from a Mendelian randomization study. Front Endocrinol 2024; 14: 1276836.

https://doi.org/10.3389/fendo.2023.1276836

11. Munir SI, Khalil N, Khokhar SJ, and Sayyed B. Frequency of Uncontrolled Diabetes Mellitus in Late 3rd Trimester and Its Association with Maternal Outcome. Pak Euro J Med Life Sci 2022; 5(1): 93-100.

https://doi.org/10.31580/pjmls.v5i1.2452

12. Riaz M, Nawaz A, Masood SN, Fawwad A, Basit A, Shera A. Frequency of gestational diabetes mellitus using DIPSI criteria, a study from Pakistan. Clin Epidemiol Glob Health 2019; 7(2): 218–221. https://doi.org/10.1016/j.cegh.2018.06.003

13. Beyene FY, Kassa BG, Mihretie GN, Ayele AD. Gestational diabetes mellitus and its associated factors in Ethiopia: a systematic review and meta-analysis. Eur J Med Res 2023; 28(1): 125. https://doi.org/10.1186/s40001-023-01088-5

14. Dahiya V, Goyal P, Sharma S. Descriptive study to detect rate of gestational diabetes mellitus by DIPSI and IADPSG criteria. Int J Gynaecol 2018; 5(3): 35-37. https://doi.org/10.26611/1012532

15. Ali U, Cure L, Lewis RK, Rattani A, Hill T, Woods NK. Examining rurality and social determinants of health among women with GDM: a 15-year comprehensive population analysis. BMC Womens Health 2024; 24(1): 467.

https://doi.org/10.1186/s12905-024-03306-6

16. Zhou T, Du S, Sun D, Li X, Heianza Y, Hu G, et al. Prevalence and Trends in Gestational Diabetes Mellitus Among Women in the United States, 2006-2017: A Population-Based Study. Front Endocrinol 2022; 13: 868094.

https://doi.org/10.3389/fendo.2022.868094

17. Sharma AK, Singh S, Singh H, Mahajan D, Kolli P, Mandadapu G. Deep Insight of the Pathophysiology of Gestational Diabetes Mellitus. Cells 2022; 11(17): 2672.

https://doi.org/10.3390/cells11172672

18. Liu B, Lamerato LE, Misra DP. A retrospective analysis of the relationship between race/ethnicity, age at delivery and the risk of gestational diabetes mellitus. J Matern Fetal Neonatal Med 2020; 33(17): 2961-2969.

https://doi.org/10.1080/14767058.2019.1566310

19. Monod C, Kotzaeridi G, Linder T, Eppel D, Rosicky I, Filippi V. Prevalence of gestational diabetes mellitus in women with a family history of type 2 diabetes in first- and second-degree relatives. Acta Diabetol 2023; 60(3): 345-351.

https://doi.org/10.1007/s00592-022-02011-w

20. Abera DA, Larbie C, Abugri J, Ofosu M, Mutocheluh M, Dongsogo J. Prevalence and Predictors of Gestational Diabetes Mellitus in Sub-Saharan Africa: A 10-Year Systematic Review. Endocrinol Diabetes Metab 2024; 7(3): e00478.

https://doi.org/10.1002/edm2.478