Outcome of pregnancy in gestational diabetes as compared to overt diabetes

Authors

  • Chirag R. Banker Department of Obstetrics and Gynecology, GMERS Medical College and Hospital, Gandhinagar, Gujarat, India
  • Latika R. Mehta Department of Obstetrics and Gynecology, GMERS Medical College and Hospital, Gandhinagar, Gujarat, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20200349

Keywords:

Gestational diabetes, Overt diabetes, Perinatal outcome

Abstract

Background: Diabetes mellitus is a chronic metabolic disorder characterised by polyuria, polyphagia, polydipsia and glycosuria. Diabetes in pregnancy can be defined as pregestational (pre-existing) diabetes or gestational diabetes have type 1 (T1DM) or type 2 (T2DM) diabetes mellitus. Present study was carried to compare the maternal and perinatal outcome of overt diabetes mellitus as compared to gestational diabetes mellitus (PGDM) with that of gestational diabetes (GDM).

Methods: An observational study was conducted at obstetrics and gynaecology department of a tertiary care center from July 2010 to October 2012 among 23 diabetic women. Seven of them were cases of overt diabetes while 16 were diagnosed during pregnancy. Maternal and fetal outcome were studied. All patients were followed from time of admission to discharge from hospital.

Results: mean age of the participants were 26.71±4.89 in overt diabetes as compared to 27.56±4.41 among gestational diabetes. Illiteracy, low socio-economic status, rural residence, family history of diabetes was also high in overt diabetes mellitus as compared to GDM but none of them was statistically significant (P < 0.05). Intrauterine fetal death was more among GDM (37.5%) as compared to overt diabetes (28.57%). Prematurity and LBW were also high in overt diabetes as compared to GDM but none of them were statistically significant. Oligohydramnios, polyhydramnios and premature rupture of membrane were higher in gestational diabetes mellitus as compared to overt diabetes among women. Rate of LSCS were higher in gestational diabetes.

Conclusions: Diabetes whether over or gestational is responsible for the poor outcome of the pregnancy so tight control is needed.

 

References

Metzger BE, Buchanan TA, Coustan DR, et al. Summary and recommendations of the Fifth International workshop-conference on gestational diabetes mellitus. Diabetes Care. 2007;30(Suppl 2):S251e60.

Anjana RM, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R, et al. Prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: Phase I results of the Indian Council of Medical Research‑India Diabetes (ICMR‑INDIAB) study. Diabetol. 2011;54:3022‑7.

Kayal A, Mohan V, Malanda B, Anjana RM, Bhavadharini B, Mahalakshmi MM, et al. Women in India with gestational diabetes mellitus strategy (WINGS): methodology and development of model of care for gestational diabetes mellitus (WINGS 4). Indian J Endocrinol Metabol. 2016;20(5):707.

Keshavaraz M, Cheung NW, Babaee GR, Moghadam HK, Ajami ME, Shariati M. Gestational diabetes in Iran: incidence, risk factors and pregnancy outcomes. Diab Res Clin Pract. 2005;69:279.

Xiong X, Saunders LD, Wang FL, Demianczuk NN. Gestational diabetes mellitus: prevalence, risk factors, maternal and infants outcomes. Int J Gynecol Obstet. 2001;75:221.

Horvath K, Siebenhofer A, Koch K, Jeitler K, Matyas E, Bastian H, et al. Effects of treatment in women with gestational diabetes mellitus: systematic review and meta-analysis. BMJ. 2010;340:1-18.

Jacqueminet S, Jannot-Lamotte MF. Management of gestational diabetes. J Gynecol Obstet Biol Reprod (Paris). 2010;8S2:S251-S263.

Verier-Mine O. Outcomes in women with history of gestational diabetes mellitus. Screening and prevention of type 2 diabetes mellitus. J Gynecol Obstet Biol Reprod (Paris). 2010;8S2:S299-S321.

Buchanan TA, Xiang AH, Page KA. Gestational diabetes mellitus: risks and management during and after pregnancy. Nature Reviews Endocrinol. 2012;8(11):639.

Alfadhli EM. Gestational diabetes mellitus. Saudi Med J. 2015;36(4):399.

Coustan DR, Lowe LP, Metzger BE, Dyer AR. The Hyperglycemia and adverse pregnancy outcome (HAPO) study: paving the way for new diagnostic criteria for gestational diabetes mellitus. Am J Obstet Gynecol. 2010;202(6):654-e1.

HAPO Study Cooperative Research Group. Hyperglycemia and adverse pregnancy outcomes. New Eng J Med. 2008;358(19):1991-2002.

Mellitus GD. ACOG practice bulletin. 2018;190:49-64.

Clausen TD, Mathiesen E, Ekbom P, Hellmuth E, Mandrup-Poulsen T, Damm P. Poor pregnancy outcome in women with type 2 diabetes. Diabetes Care. 2005;28(2):323-8.

Wahabi HA, Fayed A, Esmaeil SA. Maternal and perinatal outcomes of pregnancies complicated with pre-gestational and gestational diabetes mellitus in Saudi Arabia. J Diabetes Metab. 2014;5(399):2.

Jindal A. Prevalence, clinical profile and outcome of gestational diabetes mellitus. J Obstet Gynaecol. India. 2001;51:46-8.

Buckshee K, Rohatgi TB. Diabetes in pregnancy: current concepts. In: Saraiya UB, Rao KA, Chatterjee A, eds. Principles and practice of obstetrics and gynaecology for postgraduates (2nd edition). New Delhi: FOGSI Publication. Jaypee Publishers; 2003:60.

Mustary F, Chowdhury TA, Begum F, Mahjabeen N. Maternal and perinatal outcome in gestational diabetes mellitus compared to pregestational diabetes mellitus. BIRDEM Med J. 2019;9(2):127-32.

Abu-Heija AT, Al-Bash M, Mathew M. Gestational and pregestational diabetes mellitus in Omani women: comparison of obstetric and perinatal outcomes. Sultan Qaboos University Med J. 2015;15(4):e496.

Shefali AK, Kavitha M, Deepa R, Mohan V. Pregnancy outcomes in pre-gestational and gestational diabetic women in comparison to non-diabetic women: a prospective study in Asian Indian mothers (CURES-35). The J Assoc Phys India. 2006;54(8):613-8.

Downloads

Published

2020-01-28

Issue

Section

Original Research Articles