Gestational diabetes and the incidence of type 2 diabetes: a systematic review.
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TLDR
Differences in rates of progression between ethnic groups was reduced by adjustment for various lengths of follow-up and testing rates, so that women appeared to progress to type 2 diabetes at similar rates after a diagnosis of GDM.Abstract:
OBJECTIVE —To examine factors associated with variation in the risk for type 2 diabetes in women with prior gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS —We conducted a systematic literature review of articles published between January 1965 and August 2001, in which subjects underwent testing for GDM and then testing for type 2 diabetes after delivery. We abstracted diagnostic criteria for GDM and type 2 diabetes, cumulative incidence of type 2 diabetes, and factors that predicted incidence of type 2 diabetes. RESULTS —A total of 28 studies were examined. After the index pregnancy, the cumulative incidence of diabetes ranged from 2.6% to over 70% in studies that examined women 6 weeks postpartum to 28 years postpartum. Differences in rates of progression between ethnic groups was reduced by adjustment for various lengths of follow-up and testing rates, so that women appeared to progress to type 2 diabetes at similar rates after a diagnosis of GDM. Cumulative incidence of type 2 diabetes increased markedly in the first 5 years after delivery and appeared to plateau after 10 years. An elevated fasting glucose level during pregnancy was the risk factor most commonly associated with future risk of type 2 diabetes. CONCLUSIONS —Conversion of GDM to type 2 diabetes varies with the length of follow-up and cohort retention. Adjustment for these differences reveals rapid increases in the cumulative incidence occurring in the first 5 years after delivery for different racial groups. Targeting women with elevated fasting glucose levels during pregnancy may prove to have the greatest effect for the effort required.read more
Citations
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Gestational Diabetes Mellitus and Postpartum Care Practices of Nurse-Midwives
Jean Y. Ko,Patricia M. Dietz,Elizabeth J. Conrey,Loren Rodgers,Cynthia Shellhaas,Sherry L. Farr,Cheryl L. Robbins +6 more
TL;DR: Estimation of the prevalence of postpartum screening for abnormal glucose tolerance and related care by certified nurse-midwives for women with recent histories of GDM and to identify strategies for improvement found providing CNMs with additional training and identifying community resources to support needed lifestyle behavior change may improve care.
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One-year weight losses in the Tianjin Gestational Diabetes Mellitus Prevention Programme: A randomized clinical trial.
Huikun Liu,Leishen Wang,Shuang Zhang,Junhong Leng,Nan Li,Weiqin Li,Jing Wang,Huiguang Tian,Lu Qi,Xilin Yang,Zhijie Yu,Jaakko Tuomilehto,Gang Hu +12 more
TL;DR: To report the weight loss findings after the first year of a lifestyle intervention trial among women with gestational diabetes mellitus (GDM), a large group of women were randomly allocated to receive either a statin or a pill or both.
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Prevalence of glucose intolerance, and associated antenatal and historical risk factors among Malaysian women with a history of gestational diabetes mellitus.
TL;DR: In this study, duration lapse after index GDM, fasting plasma glucose and 2-hour plasma glucose at diagnosis of index G DM were important risk factors for early identification of women at high risk for future glucose intolerance.
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Lactation improves pancreatic β cell mass and function through serotonin production.
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Simulation modelling as a tool for knowledge mobilisation in health policy settings: a case study protocol.
TL;DR: This research will apply and evaluate a simulation modelling approach to understand the complex interrelation of factors that drive GDM rates, test options for screening and interventions, and optimise the use of evidence to inform policy and program decision-making.
References
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William C. Knowler,Elizabeth Barrett-Connor,Sarah E. Fowler,Richard F. Hamman,John M. Lachin,Elizabeth A. Walker,David M. Nathan +6 more
TL;DR: In this paper, the authors compared a lifestyle intervention with metformin to prevent or delay the development of Type 2 diabetes in nondiabetic individuals. And they found that the lifestyle intervention was significantly more effective than the medication.
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TL;DR: Type 2 diabetes can be prevented by changes in the lifestyles of high-risk subjects by means of individualized counseling aimed at reducing weight, total intake of fat, and intake of saturated fat and increasing intake of fiber and physical activity.
Journal ArticleDOI
Effects of Diet and Exercise in Preventing NIDDM in People With Impaired Glucose Tolerance: The Da Qing IGT and Diabetes Study
Xiao Ren Pan,Guang Wei Li,Ying Hua Hu,Ji Xing Wang,Wenying Yang,Zuo Xin An,Ze Xi Hu,Juan Lin,Jian Zhong Xiao,Hui Bi Cao,Ping An Liu,Xi Gui Jiang,Ya Yan Jiang,Jin Ping Wang,Hui Zheng,Hui Zhang,Peter H. Bennett,Barbara V. Howard +17 more
TL;DR: Diet and/or exercise interventions led to a significant decrease in the incidence of diabetes over a 6-year period among those with IGT, and thereby reduce the overall incidence of diabetic complications.
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Guide to clinical preventive services: a challenge to physician resourcefulness
TL;DR: The physician's degree of resourcefulness, i.e., the ability to deal skillfully and promptly with new situations, is important for changing the health behaviors of patients within the constraints of a brief office visit, was in short supply among primary care physicians selected for their interest in preventive medicine.