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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Oral anti‐diabetic pharmacological therapies for the treatment of women with gestational diabetes
TL;DR: There was no evidence of a difference in the risk of being born large-for-gestational age (LGA) between infants whose mothers had been treated with glibenclamide and those in the placebo group for GDM, and the overall risk of bias was 'unclear' due to inadequate reporting of methodology.
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Health Behaviors Among Women of Reproductive Age With and Without a History of Gestational Diabetes Mellitus
TL;DR: In this paper, the prevalence of several health-related behaviors among women of reproductive age with and without a history of gestational diabetes mellitus (hGDM) was estimated using a cross-sectional study using the 2001-2003 Behavioral Risk Factor Surveillance System, a national population-based random sample telephone survey.
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Screening for type 2 diabetes following gestational diabetes Family physician and patient perspectives
TL;DR: This follow-up survey demonstrates that PCPs and patients value the importance of screening for diabetes, identify the PCP as pivotal to screening, and appreciate a reminder strategy.
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Exercise for pregnant women with gestational diabetes for improving maternal and fetal outcomes
TL;DR: Exercise for pregnant women with gestational diabetes for improving maternal and fetal outcomes in women with GDM was evaluated and there was no clear evidence of a difference between groups for a mortality and morbidity composite.
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Promoting health after gestational diabetes: a National Diabetes Education Program call to action.
TL;DR: The National Diabetes Education Program joins the American College of Obstetricians and Gynecologists to promote opportunities for obstetrician-gynecologists and other primary care providers to better meet the long-term health needs of women with prior gestational diabetes mellitus and their children.
References
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Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.
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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Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance.
Jaakko Tuomilehto,Jon Lindstrom,Johan G. Eriksson,Valle Tt,Helena Hämäläinen,Pirjo Ilanne-Parikka,Keinänen-Kiukaanniemi S,Mauri Laakso,Anne Louheranta,Rastas M,Salminen,Matti Uusitupa +11 more
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.