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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From screening to postpartum follow-up - the determinants and barriers for gestational diabetes mellitus (GDM) services, a systematic review.
TL;DR: Investigation of determinants and barriers to GDM care from initial screening and diagnosis to prenatal treatment and postpartum follow-up reveals that sense of self-efficacy and social support are key determinants.
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Prepregnancy obesity prevalence in the United States, 2004-2005.
TL;DR: This prevalence makes maternal obesity and its resulting maternal morbidities (e.g., gestational diabetes mellitus) a common risk factor for a complicated pregnancy.
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Increased risk of ischemic heart disease, hypertension, and type 2 diabetes in women with previous gestational diabetes mellitus, a target group in general practice for preventive interventions: A population-based cohort study.
Barbara Daly,Konstantinos A Toulis,Neil Thomas,Krishna Gokhale,James Martin,Jonathan Webber,Deepi Keerthy,Kate Jolly,Ponnusamy Saravanan,Krishnarajah Nirantharakumar +9 more
TL;DR: Women diagnosed with GDM were at very high risk of developing type 2 diabetes and had a significantly increased incidence of hypertension and IHD.
Journal ArticleDOI
Lifestyle interventions for the treatment of women with gestational diabetes
Julie Brown,Nisreen A Alwan,Jane West,Stephen Brown,Christopher J. D. McKinlay,Diane Farrar,Caroline A Crowther +6 more
TL;DR: The effects of combined lifestyle interventions with or without pharmacotherapy in treating women with gestational diabetes were evaluated, with no clear evidence of a difference between lifestyle intervention and control groups.
Journal ArticleDOI
Risk Perception for Diabetes Among Women With Histories of Gestational Diabetes Mellitus
Catherine Kim,Laura N. McEwen,John D. Piette,Jennifer Goewey,Assiamira Ferrara,Elizabeth A. Walker +5 more
TL;DR: In this article, the authors examined risk perception for diabetes among women with histories of gestational diabetes mellitus (GDM) among 217 women who were enrolled in a managed care plan and who did not currently have diabetes.
References
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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.
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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.