Primary care diabetes最新文献

{"title":"Intermittent fasting versus continuous caloric restriction for glycemic control and weight loss in type 2 diabetes: A traditional review.","authors":"Hairya Ajaykumar Lakhani, Deepanwita Biswas, Mahima Kuruvila, Manisha Sai Chava, Kshitij Raj, Joel Thomas Varghese, N L Swathi","doi":"10.1016/j.pcd.2025.02.006","DOIUrl":"https://doi.org/10.1016/j.pcd.2025.02.006","url":null,"abstract":"<p><p>Type 2 Diabetes Mellitus (T2DM) represents a major global health issue, with its incidence anticipated to increase markedly in the forthcoming decades. Efficient non-pharmacological therapies, especially dietary approaches, are essential for regulating glycemic control and facilitating weight reduction. Intermittent Fasting (IF) and Continuous Caloric Restriction (CCR) are two well researched methodologies, but their relative effectiveness and enduring advantages continue to be topics of active discussion. This review systematically assesses and contrasts the impacts of intermittent fasting (IF) and continuous calorie restriction (CCR) on glycemic regulation and weight reduction in persons with type 2 diabetes mellitus (T2DM), highlighting their short-term and long-term effects, safety profiles, and adherence rates. A thorough literature analysis was performed utilizing PubMed and Google Scholar, concentrating on papers published from 2000 to 2024. The review encompassed randomized controlled trials and observational studies that investigated the effects of intermittent fasting (IF) and continuous calorie restriction (CCR) on glycemic indicators (HbA1c, fasting glucose) and body weight. IF shown substantial short-term advantages, encompassing marked decreases in HbA1c levels, fasting glucose, and body weight. Mechanistic discoveries emphasized better insulin sensitivity, augmented fat metabolism, and autophagy as key aspects. In contrast, CCR was linked to enduring metabolic enhancements, including decreased visceral fat and improved insulin sensitivity. Nevertheless, both dietary approaches demonstrated constraints.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The perspectives of healthcare professionals in providing care to women with GDM in high-income nations: A qualitative systematic review.","authors":"Mary-Ellen Hooper, Ella Kurz, Cathy Knight-Agarwal, Mary-Jessimine Bushell, Elyse Ladbrook, Deborah Davis","doi":"10.1016/j.pcd.2024.11.005","DOIUrl":"https://doi.org/10.1016/j.pcd.2024.11.005","url":null,"abstract":"<p><strong>Background: </strong>Gestational Diabetes Mellitus (GDM) represents a growing challenge worldwide, with significant risks to both women and their babies that extend beyond the duration of the pregnancy and immediate post-partum period. Healthcare professionals (HCPs) play important roles in the screening, diagnosis, treatment and management of women with GDM.</p><p><strong>Methods: </strong>For this qualitative systematic review, a comprehensive search strategy explored the electronic databases Web of Science, CINAHL, Medline, and Scopus, as well as the reference lists of the included papers, for primary studies investigating the experiences, perspectives and practices of HCPs providing care to women with GDM in high-income healthcare settings. Studies were assessed with the Crowe Critical Appraisal Tool, and findings were synthesised using the approach described by Thomas and Harden.</p><p><strong>Results: </strong>This review included 33 articles - 26 qualitative and seven mixed method studies, representing ten high-income nations. The total number of HCP participants represented across the studies is 989. This figure is constituted by medical professionals (n = 226), nurses and midwives (n = 583), allied health (n = 40) and other or not numerically specified HCPs (n = 140). From 149 findings, four major themes and 10 subthemes were constructed. The four major themes are: multidisciplinary collaboration; healthcare practice; organizational factors; and working with women.</p><p><strong>Discussion and conclusion: </strong>There are barriers to providing optimal care to women with GDM. Including, time and resource constraints, a lack of consensus in practice guidelines, and variable multidisciplinary collaboration. Moving forward, there needs to be a focus on more explicit guidelines, multidisciplinary collaboration, and appropriate resources to support HCPs in providing care to women to manage the short-term and longer-term risks that are associated with a pregnancy affected by GDM.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Td2Ast project: A pragmatic intervention on diet and physical activity for patients with type 2 diabetes mellitus.","authors":"Maria Del Mar Fernandez-Alvarez, Cristina Papín-Cano, Shelini Surendran, Ruben Martin-Payo","doi":"10.1016/j.pcd.2025.02.003","DOIUrl":"https://doi.org/10.1016/j.pcd.2025.02.003","url":null,"abstract":"<p><strong>Aim: </strong>The purpose of this study was to assess the efficacy of an educational intervention based on the Behavior Change Wheel (BCW) framework for individuals with type 2 diabetes mellitus (T2DM) on dietary and physical activity recommendations in a Spanish region.</p><p><strong>Methods: </strong>A two-arm pragmatic randomized pilot trial was developed. The intervention consisted of a 6-month period with three components: face-to-face counseling, a phone call, and specially designed written guidelines focusing on dietary and physical activity recommendations The primary outcome was changes in dietary and physical activity recommendations. The secondary outcome, the impact of the intervention on HbA1c levels, body mass index, and the frequency of consultations to primary care.</p><p><strong>Results: </strong>n=208 patients were recruited. Individuals in the intervention experienced a significative improvement in adherence to dietary recommendations (+0.52; p-value<0.001), physical activity (+0.79; p-value<0.001), and a decrease in HbA1c levels (0.11 %; p-value=0.04).</p><p><strong>Conclusion: </strong>The 6-month intervention, designed for T2DM patients and based on the BCW model, has demonstrated effectiveness in improving adherence to healthy dietary and physical activity recommendations, as well as reducing HbA1c levels.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing quality of diabetes care between immigrants and non-immigrants within dimensions of marginalization: A population-based cohort study.","authors":"Shadia Adekunte, Yu Qing Bai, Gillian L Booth, Ghazal Fazli, Calvin Ke, Lorraine L Lipscombe, Sarah M Mah, Laura C Rosella, Walter P Wodchis, Baiju R Shah","doi":"10.1016/j.pcd.2025.02.007","DOIUrl":"https://doi.org/10.1016/j.pcd.2025.02.007","url":null,"abstract":"<p><strong>Aims: </strong>Immigrants in western countries face an increased risk of developing diabetes and have been shown to receive lower quality of diabetes care. However, it is uncertain whether this disparity in care persists when comparing immigrants and non-immigrants with similar levels of marginalization with respect to the social determinants of health.</p><p><strong>Methods: </strong>Using population-based healthcare administrative data linked to immigration and neighbourhood census data, we conducted a retrospective cohort study of all people aged ≥ 40 years with diabetes in Ontario, Canada on 1 April 2019. Process measures (testing for HbA1c, LDL-cholesterol and urine albumin-creatinine ratio; eye examinations; and appropriate prescriptions) and outcome measures (achieving guideline-recommended targets for laboratory tests) over the following year were ascertained. They were compared between immigrants and non-immigrants overall and within the highest and lowest quintiles of three measures of marginalization: material deprivation, residential instability and dependency.</p><p><strong>Results: </strong>There were 1,449,589 people with diabetes included in the study (22.6 % immigrants). Immigrants were less likely than non-immigrants to achieve many of the process quality indicators and were less likely to achieve both HbA1c and LDL-cholesterol targets. These findings were similar when stratified within the highest and lowest quintiles of material deprivation, residential instability and dependency.</p><p><strong>Conclusions: </strong>Even within similar levels of marginalization, immigrants were less likely to achieve many quality indicators for diabetes care than non-immigrants. This finding suggests that the gap in quality of care between immigrants and non-immigrants is not simply due to differences in these social determinants of health, and highlights the intersecting impact of immigration and marginalization. However, the disparities were relatively small, so the greater issue is the overall low achievement of these quality indicators among all people with diabetes.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of onset of chronic kidney disease in type 2 diabetes mellitus (ROCK-DM): Development and validation of a 4-variable prediction model.","authors":"Jie Ming Nigel Fong, Serena Low, Yang Xu, Pek Siang Edmund Teo, Gek Hsiang Lim, Huili Zheng, Keven Ang, Ngiap Chuan Tan, Cheng Boon Poh, Hui Boon Tay, Allen Yan Lun Liu, Choong Meng Chan, Chieh Suai Tan, Su Chi Lim, Yong Mong Bee, Jia Liang Kwek","doi":"10.1016/j.pcd.2025.02.005","DOIUrl":"https://doi.org/10.1016/j.pcd.2025.02.005","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this study was to develop and validate a prediction model for incident chronic kidney disease (CKD) in type 2 diabetes mellitus (T2DM), defined as eGFR < 60 ml/min/1.73m2 and/or urine albumin:creatinine ratio (UACR) > 3 mg/mmol in ≥ 2 consecutive readings ≥ 3 months apart.</p><p><strong>Methods: </strong>Model derivation was performed in the SingHealth Diabetes Registry, including patients aged ≥ 21 years diagnosed with T2DM without pre-existing CKD. External validation was performed in a single-center prospective observational cohort. Cox Proportional Hazard model was created to evaluate predictors associated with time-to-onset of incident CKD. Increasingly parsimonious models were assessed for discrimination and calibration. Models underwent external validation, benchmarking against existing models, and decision curve analysis.</p><p><strong>Results: </strong>25,142 (59 %) of 42,552 patients in the derivation cohort developed CKD over a median 4.0 years (IQR 2.1-7.7) follow up. An 18-variable model, 12-variable model, and 4-variable model (including age, duration of T2DM, eGFR, and previous non-persistent albuminuria) was developed. The 4-variable model had a C-statistic of 0.78 and good calibration on plots of observed-versus-predicted risk. The 12-variable and 18-variable models performed similarly. In the external validation cohort of 2249 patients, of whom 1035 (46 %) developed incident CKD, the 4-variable model had a C-statistic of 0.87. All models had better discrimination than existing benchmarks. Decision curve analysis of the 4-variable model showed positive net benefit for any threshold probability above 16 % for 2-year and 28 % for 5-year CKD risk.</p><p><strong>Conclusion: </strong>The 4-variable model for prediction of incident CKD in T2DM demonstrates good performance, predicts both eGFR and albuminuria endpoints, and is simple-to-use. This may guide personalized care, resource allocation and population health.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuity of care across sectors in patients with type 2 diabetes: A nationwide register study in Denmark.","authors":"Anne Sofie Baymler Lundberg, Claus Høstrup Vestergaard, Annelli Sandbæk, Anders Prior","doi":"10.1016/j.pcd.2025.02.004","DOIUrl":"https://doi.org/10.1016/j.pcd.2025.02.004","url":null,"abstract":"<p><strong>Aims: </strong>Our aims were to describe health care utilisation patterns across sectors in patients with type 2 diabetes(T2D), and to identify patient characteristics associated with low continuity of care.</p><p><strong>Methods: </strong>A nationwide register-based cohort study including all Danish citizens recorded with a diagnosis of T2 diabetes in 2017. The outcome was continuity of care as measured by three different indices: the Continuity of Care Index (COCI), the Usual Provider of Care Index (UPC), and the Sequential Continuity Index (SECON).</p><p><strong>Results: </strong>The median of patients with T2D had 75 % of their contacts to their usual health care provider. The strongest association with low continuity of care was the number of comorbidities, showing a dose response trend. Other patient characteristics associated with low continuity of care were duration of T2 diabetes (>10.3 years), lower age group (40-49 years), having a high education level (>15 years) and having a cancer comorbidity.</p><p><strong>Conclusions: </strong>Our study was the first step to flag patients at potential risk of fragmented care due to many transitions between providers. This is of importance for the general practitioners, who are the coordinators of the patients with T2D and their various health conditions and contacts.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep well, but be active. Effect of sleep and sedentariness on incidence of diabetes.","authors":"Keyuan Liu, P. Marques-Vidal","doi":"10.1093/eurjpc/zwad125.106","DOIUrl":"https://doi.org/10.1093/eurjpc/zwad125.106","url":null,"abstract":"AIMS\u0000We aimed to determine the individual effect of long/short sleep and of inactivity on diabetes risk using data from a population-based prospective study in Switzerland.\u0000\u0000\u0000METHODS\u0000Prospective study with a median (min-max) follow-up of 9 (2.4-11.5) years. Incident diabetes was defined based on 1) fasting plasma glucose (FPG), 2) glycated hemoglobin (HbA1c), or 3) any diagnostic criterion (FPG, HbA1c or medical diagnosis). Sleep and sedentary levels were assessed by questionnaire. Sleep was categorized into short (<7 h/day), adequate (7-9 h/day) and long (>9 h/day).\u0000\u0000\u0000RESULTS\u0000Data from 3355 participants (57.6% women, mean age years 56.6 ± 10.3) was analyzed. There were 136, 110 and 142 incident cases of diabetes defined by FPG, HbA1c or any criterion, respectively. Participants who developed diabetes had a higher sedentariness but no differences were found regarding sleep duration. Similar results were obtained after adjusting for age, gender, education, smoking and body mass index: hazard ratio (95% confidence interval) for sedentariness 1.61 (1.11-2.35), 1.40 (0.93-2.12) and 1.39 (1.04-1.87) for diabetes defined by FPG, HbA1c or any diagnostic criterion, respectively.\u0000\u0000\u0000CONCLUSION\u0000Being sedentary, but not being a long or a short sleeper, increases the risk of developing diabetes.","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42061845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of Enhanced Primary Healthcare (EnPHC) interventions on Type 2 diabetes management in Malaysia: Difference-in-differences (DID) analysis.","authors":"M. Husin, X. Teh, S. M. Ong, Y. Lim, Swee Hung Ang, C. Chan, M. Lim, S. Shanmugam, Noraziani Khamis, Faeiz Syezri Adzmin Jaafar, Norliza Ibrahim, N. Nasir, D. Kusuma, A. Wagner, D. Ross-Degnan, R. Atun, S. Sivasampu","doi":"10.21203/RS.3.RS-154502/V1","DOIUrl":"https://doi.org/10.21203/RS.3.RS-154502/V1","url":null,"abstract":"AIMS\u0000To evaluate the effectiveness of the Enhanced Primary Healthcare (EnPHC) interventions on process of care and intermediate clinical outcomes among type 2 diabetes patients.\u0000\u0000\u0000METHODS\u0000This was a quasi-experimental controlled study conducted in 20 intervention and 20 control public primary care clinics in Malaysia from November 2016 to June 2019. Type 2 diabetes patients aged 30 years and above were selected via systematic random sampling. Outcomes include process of care and intermediate clinical outcomes. Difference-in-differences analyses was conducted.\u0000\u0000\u0000RESULTS\u0000We reviewed 12,017 medical records of patients with type 2 diabetes. Seven process of care measures improved: HbA1c tests (odds ratio (OR) 3.31, 95% CI 2.13, 5.13); lipid test (OR 4.59, 95% CI 2.64, 7.97), LDL (OR 4.33, 95% CI 2.16, 8.70), and urine albumin (OR 1.99, 95% CI 1.12, 3.55) tests; BMI measured (OR 15.80, 95% CI 4.78, 52.24); cardiovascular risk assessment (OR 174.65, 95% CI 16.84, 1810.80); and exercise counselling (OR 1.18, 95% CI 1.04, 1.33). We found no statistically significant changes in intermediate clinical outcomes (i.e. HbA1c, LDL, HDL and BP control).\u0000\u0000\u0000CONCLUSIONS\u0000EnPHC interventions was successful in enhancing the quality of care, in terms of process of care, by changing healthcare providers behaviour.","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45092402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of restricted diet with a plate in patients with type 2 diabetes: A randomized controlled trial.","authors":"Yongwen Zhang, Huanhuan Han, Lanfang Lanfang","doi":"10.22541/au.160552637.79851951/v1","DOIUrl":"https://doi.org/10.22541/au.160552637.79851951/v1","url":null,"abstract":"BACKGROUND\u0000In view of the complexity of dietary and nutritional education for most patients with type 2 diabetes mellitus (T2DM), a simplified approach called the \"restricted diet with a plate\" or \"plate model\" is recommended.\u0000\u0000\u0000PURPOSE\u0000To evaluate whether the plate model can effectively improve glycemic control and cardiovascular risk markers in type 2 diabetes mellitus (T2DM), while reducing the time devoted to education and avoiding weight gain.\u0000\u0000\u0000METHODS\u0000The study was a randomized, multicenter, controlled study, conducted between October 2018 and October 2019, among patients with T2DM living in Nanjing. The study included 419 participants who were randomly divided into a plate group and a counting group. The plate model included three components: a low-literacy, color leaflet containing the explanation and composition of the plate model, health education, and medical visits. Patients in the counting group received health education, group medical visits, and a paper booklet containing traditional carbohydrate counting education. Primary outcomes were glycemic control and weight.\u0000\u0000\u0000RESULTS\u0000Participants in the plate model reduced HbA1c by 0.7% in the first three months, and reduced to a greater extent at six months (1.44%), but this was not sustained, and HbA1c increased slightly over the following six months. Fasting plasma glucose (FPG) and 2-h postprandial glucose (2hPG) values were significantly reduced at the endpoint in the plate model (9.25 ± 1.72% vs. 7.44 ± 0.88%, P = 0.008; 12.07 ± 2.94 vs. 8.35 ± 1.99%; P = 0.004); however, the 2hPG values decreased most significantly. Total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels decreased significantly in the plate group, which occurred at six months and lasted for 12 months. In the first three months, the average weight loss in the plate group was 1.2 kg/month (95% CI 0.92-1.48), and in the fourth to twelfth months, the average weight gain was 0.21 kg/month (95% CI 0.08-0.34). There was significant difference in education time between the groups (17.3 ± 4.42 vs. 38.6 ± 12.63; P < 0.001).\u0000\u0000\u0000CONCLUSIONS\u0000The plate model is at least as effective as the counting model over the short term for glycemic control and perhaps even better for weight and lipid control. Plate model has the potential to improve education of those with low health literacy by reducing reading demands.","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42015834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progression of pregnancy induced diabetes mellitus to type two diabetes mellitus, an ambidirectional cohort study.","authors":"B. Feleke, Teferi Elfu Feleke, M. Kassahun, Wondemu Gebrekirose Adane, Desalegn Achenefe, Abere Genetu, Azezu Asres Nigussie, Hailemariam Awoke Engedaw","doi":"10.21203/rs.3.rs-30572/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-30572/v1","url":null,"abstract":"INTRODUCTION\u0000Diabetes 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.\u0000\u0000\u0000METHODS\u0000A 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.\u0000\u0000\u0000RESULTS\u0000A 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].\u0000\u0000\u0000CONCLUSION\u0000The 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.","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42002517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}