Progression of pregnancy induced diabetes mellitus to type two diabetes mellitus, an ambidirectional cohort study.

B. Feleke, Teferi Elfu Feleke, M. Kassahun, Wondemu Gebrekirose Adane, Desalegn Achenefe, Abere Genetu, Azezu Asres Nigussie, Hailemariam Awoke Engedaw
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Abstract

INTRODUCTION Diabetes mellitus (DM) is a metabolic disorder characterized by elevated level of blood glucose. It affects more than 422 million people globally. In resource limited settings, the progression of gestational diabetes (GDM) to DM was not well investigated and this research work was conducted to estimate the incidence of DM after GDM and their predictors in resource limited settings. METHODS A retrospective and prospective cohort studies were used from January 2010 until December 2019. The data were collected using patients chart review, interview and collecting blood sample. Initially, baseline data were collected from GDM and GDM free women and update data were collected every 3 month. Clinical nurses were used to extract the necessary data from medical charts and to collect the data using patient interview. Laboratory technologists were used to measure the blood glucose level of the study participants. The study was conducted in pregnant women presenting themselves in the referral hospitals of Amhara regional state. The sample size was calculated using Epi-info software. Descriptive statistics were used to describe the profile of study participants. Kaplan Meier survival curve and life-table were used to estimate the survivals of study participants. Incidence density was used to estimate the incidence of DM. Cox regression was used to identify the predictors DM. RESULTS A total of 4892 women were followed giving for the response rate of 88.62%. The mean age of study participants at the start of the study was 28.34 years with standard deviation [SD] ±7.48 years. DM was associated with gestational diabetes mellitus [AHR (adjusted hazard ratio); 2.53, 95% CI: 2.14-2.99], frequency of breastfeeding [AHR; 0.72, 95% CI: 0.69-0.74], age [AHR; 1.04, 95% CI: 1.03-1.05], parity [AHR; 1.14, 95% CI: 1.07-1.21], regular physical exercise [AHR; 0.45, 95% CI: 0.37-0.55], family history of DM [AHR; 2.04, 95% CI: 1.76-2.37], stillbirth [AHR; 1.67: 95% CI: 1.34-2.07], abortion [AHR; 2.64, 95% CI: 2.25-3.09]. CONCLUSION The progression of GDM to DM was very high and special follow up should be implemented for women with a history of abortion, stillbirth, and family history of DM.
妊娠期糖尿病向2型糖尿病的进展,一项双向队列研究。
引言糖尿病是一种以血糖升高为特征的代谢紊乱。它影响着全球超过4.22亿人。在资源有限的环境中,妊娠期糖尿病(GDM)发展为糖尿病的情况没有得到很好的调查,本研究工作旨在评估GDM后糖尿病的发病率及其在资源有限环境中的预测因素。方法从2010年1月至2019年12月进行回顾性和前瞻性队列研究。数据是通过患者病历回顾、访谈和采集血样收集的。最初,从GDM和无GDM的女性中收集基线数据,每3个月收集一次更新数据。临床护士被用来从病历中提取必要的数据,并通过患者访谈收集数据。实验室技术人员被用来测量研究参与者的血糖水平。这项研究是在阿姆哈拉州转诊医院的孕妇中进行的。使用Epi-info软件计算样本量。描述性统计用于描述研究参与者的概况。Kaplan-Meier生存曲线和生命表用于估计研究参与者的生存率。发病率密度用于估计糖尿病的发病率。Cox回归用于确定糖尿病的预测因素。对4892名女性进行了随访,有效率为88.62%。研究开始时,研究参与者的平均年龄为28.34岁,标准差[SD]±7.48岁。糖尿病与妊娠期糖尿病相关[AHR(调整后的危险比);2.53,95%CI:2.14-2.99],母乳喂养频率[AHR;0.72,95%CI:0.69-0.74],年龄[AHR;1.04,95%CI:1.03-1.05],产次[AHR;1.14,95%CI:1.07-1.21],定期体育锻炼[AHR;0.45,95%CI:0.37-0.55],糖尿病家族史[AHR;2.04,95%CI+1.76-2.37],死产[AHR;1.67:95%CI:1.34-2.07],流产[AHR;2.64,95%CI:2.25-3.09]。结论GDM向DM的进展非常高,对有流产史、死产史和DM家族史的妇女应进行特殊随访。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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