Gestational diabetes mellitus

Introduction: Gestational diabetes mellitus (GDM) is defined as glucose intolerance ofvariable severity with onset or first recognition during pregnancy. Approximately 1–14% ofall pregnancies are complicated by GDM. Although most women with GDM have anormalglucose tolerance (NGT) when tested several weeks postpartum, impaired insulin secretionand/or increased insulin resistance has been reported in these women, and a substantialproportion of the women with previous GDM will eventually develop type 2 diabetes. GDMis associated with adverse perinatal outcomes and potential adverse maternal and neonatalsequelae. The objective of this study was to determine the incidence of gestational diabetesmellitus in the pregnant women that referred to prenatalcare clinic in the Kosar Hospital.Methods and materials: In a prospective cohort study, universal screening for gestationaldiabetes mellitus was performed for 850 pregnant women who were referred from privateclinics and community health care centers to Kosar Hospital in Qazvin City during March2008 to March 2012. Screening was performed with a 50 g oral Glucose Challenge Test(GCT) with 130 mg/dl cut-off point, then a diagnostic 100 g Oral Glucose Tolerance Test(OGTT) was done according to Carpenter and Coustan criteria. Both descriptive andstatistical analysis methods were applied.Results: During the study period a total of 850 pregnant women (mean age 31.1±/4.7 years,range: 15_/40 years) were referred. A positive history of diabetes in first degree relatives wasreported in 18.1% of cases. Pre-pregnancy body weight and BMI were 62.8±/8.7 kg (range37.8_/121 kg) and 23.5±/3.6 kg/m2 (range 16.5_/47.8 kg/m2), respectively. A positive GCTwas found in 272 women (32%).Based on oral glucose tolerance test (100 g OGTT), 58(6.8%) of women had GDM.Conclusion: we have found that the incidence of GDM in our population is similar to otherparts and the commonly recognized risk factors are valid for our population. Women withGDM had a higher rate of pregnancy complications and there was a high incidence ofpersistent glucose intolerance post-partum. Our findings lead us to recommend universalscreening for GDM in pregnant women, though further evaluation of the cost benefits need tobe conducted. With improved detection, the next challenge we face is to improve theoutcomes of GDM pregnancy.

کلیدواژه ها:

Gestational ، Diabetes mellitus