diabetestalk.net

Gestational Diabetes And The Incidence Of Type 2 Diabetes: A Systematic Review.

Potential Protective Effect Of Lactation Against Incidence Of Type 2 Diabetes Mellitus In Women With Previous Gestational Diabetes Mellitus: A Systematic Review And Metaanalysis

Potential Protective Effect Of Lactation Against Incidence Of Type 2 Diabetes Mellitus In Women With Previous Gestational Diabetes Mellitus: A Systematic Review And Metaanalysis

Potential protective effect of lactation against incidence of type 2 diabetes mellitus in women with previous gestational diabetes mellitus: A systematic review and metaanalysis Division of Maternal Medicine, Center for MaternalFetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan Naoko Arata, Division of Maternal Medicine, Center for MaternalFetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 101 Okura 2chome, Setagaya, Tokyo, Japan 1578535. Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan Department of Global Health Nursing, Graduate School of Nursing Sciences, St. Luke's International University, Tokyo, Japan Division of Maternal Medicine, Center for MaternalFetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan Naoko Arata, Division of Maternal Medicine, Center for MaternalFetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 101 Okura 2chome, Setagaya, Tokyo, Japan 1578535. Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan Department of Global Health Nursing, Graduate School of Nursing Sciences, St. Luke's International University, Tokyo, Japan Please review our Terms and Conditions of Use and check box below to share full-text version of article. I have read and accept the Wiley Online Library Terms and Conditions of Use. Use the link below to share a full-text version of this article with your friends and colleagues. Learn more. Lactation may protect women with previous gestational diabetes mellitus (GDM) from developing type 2 diabetes mellitus, but the results of existing studies are inconsistent, Continue reading >>

A Systematic Review Of The Literature Associating Breastfeeding With Type 2 Diabetes And Gestational Diabetes

A Systematic Review Of The Literature Associating Breastfeeding With Type 2 Diabetes And Gestational Diabetes

A Systematic Review of the Literature Associating Breastfeeding with Type 2 Diabetes and Gestational Diabetes Get access/doi/full/10.1080/07315724.2005.10719480?needAccess=true As diabetes becomes more prevalent in younger women, diabetes and maternal-child health issues such as breastfeeding co-exist with increasing frequency. We sought to determine the relationship between breastfeeding and both type 2 diabetes and gestational diabetes (GDM) in a variety of clinical contexts, with a focus on prevention. The Medline database from 19662003, relevant references of selected articles, the Cochrane database, and the NIH Clinical Trials website were searched. Search terms included breastfeeding, infant nutrition, and diabetes. The search was restricted to the English language and human subjects. Each study was reviewed by at least two of the authors and included if it pertained to the relationship between type 2 diabetes or GDM and breastfeeding. Twelve of 15 identified studies (80%) met selection criteria. All studies were observational. Specific maternal-child health populations varied by study. Two of the authors abstracted information from each article on 1) study design, 2) target population, 3) sample size/power, 4) definition of breastfeeding, 5) definition of diabetes, and 6) confounders. Higher rates of pregnancy and neonatal complications among women with type 2 or gestational diabetes can pose significant challenges to breastfeeding. Low estrogen levels in breastfeeding women may have a protective effect on glucose metabolism and subsequent risk of diabetes. Having been breastfed for at least 2 months may lower the risk of diabetes in children. Initial research has begun on the long-term effects of diabetes during pregnancy on children. Breastfeeding may lower bo Continue reading >>

Periodontitis And Type 2 Diabetes Among Women With Previous Gestational Diabetes: Epidemiological And Immunological Aspects In A Follow-up Of Three Years

Periodontitis And Type 2 Diabetes Among Women With Previous Gestational Diabetes: Epidemiological And Immunological Aspects In A Follow-up Of Three Years

PrintversionISSN 1678-7757On-lineversionISSN 1678-7765 J. Appl. Oral Sci.vol.25no.2BauruMar./Apr.2017 Periodontitis and type 2 diabetes among women with previous gestational diabetes: epidemiological and immunological aspects in a follow-up of three years 1Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Periodontologia e Patologia, Belo Horizonte, MG, Brasil. 2Universidade de Taubat, Centro de Pesquisa Periodontal, Taubat, SP, Brasil. Periodontitis can contribute to the development of insulin resistance. Gestational diabetes is a risk factor for type 2 diabetes. Therefore, periodontitis, when associated with gestational diabetes, could increase the risk for the development of type 2 diabetes after pregnancy. The aim of this study was to verify the incidence on the development of type 2 diabetes in women with previous gestational diabetes with and without periodontitis after a three-year time interval. Initial sample of this follow-up study consisted of 90 women diagnosed with gestational diabetes who underwent periodontal examination. After three years, 49 women were subjected to new periodontal examination and biological, behavioral, and social data of interest were collected. Additionally, the quantification of the C-reactive protein in blood samples was performed. Fasting glucose and glycated hemoglobin levels were requested. Saliva samples were collected for quantification of interleukin 6 and 10, tumor necrosis factor , matrix metalloproteinase 2 and 9. The incidence of type 2 diabetes mellitus was 18.4% and of periodontitis was 10.2%. There was no significant difference in the incidence of type 2 diabetes mellitus among women with and without periodontitis. It was observed impact of C-reactive protein in the development of type 2 d Continue reading >>

Gestational Diabetes And The Incidence Of Type 2 Diabetes: A Systematic Review.

Gestational Diabetes And The Incidence Of Type 2 Diabetes: A Systematic Review.

Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Division of General Internal Medicine, University of Michigan, Ann Arbor, Michigan 48109, USA. [email protected] To examine factors associated with variation in the risk for type 2 diabetes in women with prior gestational diabetes mellitus (GDM). 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. 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. 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. Continue reading >>

Diabetes Mellitus - Gestational Diabetes Mellitus

Diabetes Mellitus - Gestational Diabetes Mellitus

Diabetes mellitus - Gestational diabetes mellitus Globally the incidence of diabetes is likely to exceed 250 million people by 2025 that is a measure of the scale of the problem this condition is likely to present in the future. It is evidence of how diabetes will be one of the foremost public health challenges facing the world in the decades ahead. Accordingly diabetes belongs at the top of the healthcare agenda, it has yet to be afforded that position. Throughout 2006, this Continuing Education module has dealt with the causes and complications of diabetes mellitus, and the management of type 1 and type 2 in the various patient groups. Last months article discussed the importance of pre-pregnancy care for women with diabetes. This month will focus on gestational diabetes. Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. This does not exclude the possibility that unrecognised glucose intolerance may have antedated or begun concomitantly with the pregnancy.1 The prevalence of GDM depends on the population being studied, ranging from 1% to 14%.2 Currently there is no national register for diabetes in Ireland however figures from annual reports of maternity hospitals suggest that the prevalence of GDM in Ireland is 1% to 2%. As with type 2 diabetes, the incidence of GDM is increasing rapidly worldwide. Those with GDM have an increased risk of developing type 2 diabetes in later life. In a systematic review of 28 studies covering 28 years (2000) a cumulative incidence of type 2 diabetes ranging from 2.6% to 70% of women who had GDM was ascertained.3 The first report of the Irish Diabetes Prevalence Working Group has found that 4.3% of the adult population in Ireland have type 2 diabetes. Continue reading >>

Csiro Publishing | Australian Journal Of Primary Health

Csiro Publishing | Australian Journal Of Primary Health

A Department of General Practice, University of Melbourne, 200 Berkeley Street, Carlton, Vic. 3053, Australia. B Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Highway, Burwood, Vic. 3125, Australia. C Population Health Strategic Research Centre, Deakin University, 221 Burwood Highway, Burwood, Vic. 3125, Australia. D Corresponding author. Email: [email protected] Australian Journal of Primary Health 23(1) 66-74 Submitted: 22 November 2015 Accepted: 10 February 2016 Published: 25 July 2016 This paper investigates factors influencing womens engagement with diabetes preventative care after a pregnancy with gestational diabetes (GDM) from the perspectives of GPs and women and explores the role of the GP in that care. Qualitative research using semi-structured interviews with women who had experienced GDM (n=16) and GPs (n=18) were conducted and a thematic content analysis conducted. Womens interviews explored their experience of GDM, factors influencing, and engagement with, follow-up care for diabetes prevention and role of the GP in that care. GP interviews explored postnatal care provided to women with GDM, the role of the GP in that care and perceived factors influencing a mothers engagement in her self-care. Three themes were identified: (1) advice and testing; (2) role of the GP; and (3) barriers and enablers to care. Significant consensus about the role of the GP and barriers and enablers to care existed. Both groups believed post GDM follow-up is best done by GPs and suggested recall and reminders would improve care. GPs gave consistent exercise advice, but lacked consensus on follow-up testing, dietary and weight-loss advice. Womens health literacy influenced how they viewed their GPs role. Consensus guidelines o Continue reading >>

Gestational Diabetes From A To Z

Gestational Diabetes From A To Z

Number of Hits and Downloads for This Article Dec 15, 2017 (publication date) through Apr 26, 2018 Baishideng Publishing Group Inc, 7901 Stoneridge Drive, Suite 501, Pleasanton, CA 94588, USA Copyright The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. World J Diabetes.Dec 15, 2017;8(12): 489-511 Published online Dec 15, 2017.doi: 10.4239/wjd.v8.i12.489 AbdelHameed Mirghani Dirar, Prince Abdel Aziz Bin Musaad Hospital, Diabetes and Endocrinology Center, Arar 91421, North Zone Province, Saudi Arabia John Doupis, Iatriko Paleou Falirou Medical Center, Division of Diabetes and Clinical Research Center, Athens 17562, Greece John Doupis, Postgraduate Diabetes Education, Institute of Molecular and Experimental Medicine, Cardiff University School of Medicine, Cardiff CF14 4XN, United Kingdom ORCID number: AbdelHameed Mirghani Dirar ( 0000-0002-3374-4829 ). Author contributions: Mirghani Dirar A and Doupis J contributed equally to this work; Mirghani Dirar A and Doupis J designed the format; Mirghani Dirar A wrote the paper; Doupis J revised and approved the paper; this paper is a part of Mirghani Dirar As MSc Dissertation in Postgraduate Diabetes Education, Institute of Molecular and Experimental Medicine, Cardiff University School of Medicine; the MSc dissertation was supervised by Doupis J. Conflict-of-interest statement: The authors declare that they have no conflict of interest for this paper. Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license Continue reading >>

Global Aetiology And Epidemiology Of Type 2 Diabetes Mellitus And Its Complications

Global Aetiology And Epidemiology Of Type 2 Diabetes Mellitus And Its Complications

Global aetiology and epidemiology of type 2 diabetes mellitus and its complications Nature Reviews Endocrinology volume 14, pages 8898 (2018) | Download Citation Globally, the number of people with diabetes mellitus has quadrupled in the past three decades, and diabetes mellitus is the ninth major cause of death. About 1 in 11 adults worldwide now have diabetes mellitus, 90% of whom have type 2 diabetes mellitus (T2DM). Asia is a major area of the rapidly emerging T2DM global epidemic, with China and India the top two epicentres. Although genetic predisposition partly determines individual susceptibility to T2DM, an unhealthy diet and a sedentary lifestyle are important drivers of the current global epidemic; early developmental factors (such as intrauterine exposures) also have a role in susceptibility to T2DM later in life. Many cases of T2DM could be prevented with lifestyle changes, including maintaining a healthy body weight, consuming a healthy diet, staying physically active, not smoking and drinking alcohol in moderation. Most patients with T2DM have at least one complication, and cardiovascular complications are the leading cause of morbidity and mortality in these patients. This Review provides an updated view of the global epidemiology of T2DM, as well as dietary, lifestyle and other risk factors for T2DM and its complications. Globally, about 1 in 11 adults have diabetes mellitus (90% have type 2 diabetes mellitus (T2DM)), and Asia is the epicentre of this global T2DM epidemic. The major driving factors of the global T2DM epidemic include overweight and obesity, sedentary lifestyle and increased consumption of unhealthy diets containing high levels of red meat and processed meat, refined grains and sugar-sweetened beverages. Given its global influence, it i Continue reading >>

The Prevalence Of Gestational Diabetes: A Population-based Analysis Of A Nationwide Screening Program

The Prevalence Of Gestational Diabetes: A Population-based Analysis Of A Nationwide Screening Program

Kleinwechter H, Schfer-Graf U, Buhrer C, et al.: Gestational diabetes mellitus (GDM) diagnosis, therapy and follow-up care: practice guideline of the German Diabetes Association (DDG) and the German Association for Gynaecology and Obstetrics (DGGG). Exp Clin Endocrinol Diabetes 2014; 122: 395405 CrossRef MEDLINE American Diabetes Association: Classification and diagnosis of diabetes. Diabetes Care 2016; 39 (Suppl 1): S13S22 CrossRef MEDLINE Crowther CA, Hiller JE, Moss JR, et al.: Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med 2005; 352: 247786 CrossRef MEDLINE Metzger BE, Lowe LP, Dyer AR, et al.: Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 2008; 358: 19912002 CrossRef MEDLINE Landon MB, Spong CY, Thom E, et al.: A multicenter, randomized trial of treatment for mild gestational diabetes. N Engl J Med 2009; 361: 133948 CrossRef MEDLINE PubMed Central Bellamy L, Casas JP, Hingorani AD, Williams D: Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet 2009; 373: 17739 CrossRef Kim C, Newton KM, Knopp RH: Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care 2002; 25: 18628 CrossRef Lbner K, Knopff A, Baumgarten A, et al.: Predictors of postpartum diabetes in women with gestational diabetes mellitus. Diabetes 2006; 55: 7927 CrossRef MEDLINE Rayanagoudar G, Hashi AA, Zamora J, Khan KS, Hitman GA, Thangaratinam S: Quantification of the type 2 diabetes risk in women with gestational diabetes: a systematic review and meta-analysis of 95,750 women. Diabetologia 2016; 59: 140311 CrossRef MEDLINE PubMed Central Gemeinsamer Bundesausschuss: Richtlinien ber die rztliche Betreuung whrend der Schwangerschaft und nach der Entbindung (Mutterscha Continue reading >>

Gestational Diabetes

Gestational Diabetes

Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy.[2] Gestational diabetes generally results in few symptoms;[2] however, it does increase the risk of pre-eclampsia, depression, and requiring a Caesarean section.[2] Babies born to mothers with poorly treated gestational diabetes are at increased risk of being too large, having low blood sugar after birth, and jaundice.[2] If untreated, it can also result in a stillbirth.[2] Long term, children are at higher risk of being overweight and developing type 2 diabetes.[2] Gestational diabetes is caused by not enough insulin in the setting of insulin resistance.[2] Risk factors include being overweight, previously having gestational diabetes, a family history of type 2 diabetes, and having polycystic ovarian syndrome.[2] Diagnosis is by blood tests.[2] For those at normal risk screening is recommended between 24 and 28 weeks gestation.[2][3] For those at high risk testing may occur at the first prenatal visit.[2] Prevention is by maintaining a healthy weight and exercising before pregnancy.[2] Gestational diabetes is a treated with a diabetic diet, exercise, and possibly insulin injections.[2] Most women are able to manage their blood sugar with a diet and exercise.[3] Blood sugar testing among those who are affected is often recommended four times a day.[3] Breastfeeding is recommended as soon as possible after birth.[2] Gestational diabetes affects 3–9% of pregnancies, depending on the population studied.[3] It is especially common during the last three months of pregnancy.[2] It affects 1% of those under the age of 20 and 13% of those over the age of 44.[3] A number of ethnic groups including Asians, American Indians, Indigenous Australians, and Pacific Continue reading >>

Prevalence Of Gestational Diabetes Mellitus In Eastern And Southeastern Asia: A Systematic Review And Meta-analysis

Prevalence Of Gestational Diabetes Mellitus In Eastern And Southeastern Asia: A Systematic Review And Meta-analysis

Prevalence of Gestational Diabetes Mellitus in Eastern and Southeastern Asia: A Systematic Review and Meta-Analysis 1School of Public Health, Curtin University, Perth, WA, Australia 2National Institute of Hygiene and Epidemiology, Hanoi, Vietnam 3Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam 4United Nations Population Fund, Hanoi, Vietnam Correspondence should be addressed to Ngoc Minh Pham Received 30 August 2017; Accepted 16 December 2017; Published 20 February 2018 Copyright 2018 Cong Luat Nguyen et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Aim. To review the prevalence of gestational diabetes mellitus (GDM) in Eastern and Southeastern Asia. Methods. We systematically searched for observational studies on GDM prevalence from January 2000 to December 2016. Inclusion criteria were original English papers, with full texts published in peer-reviewed journals. The quality of included studies was evaluated using the guidelines of the National Health and Medical Research Council, Australia. Fixed effects and random effects models were used to estimate the summary prevalence of GDM and the corresponding 95% confidence intervals (CI). Results. A total of 4415 papers were screened, and 48 studies with 63 GDM prevalence observations were included in the final review. The pooled prevalence of GDM was 10.1% (95% CI: 6.5%15.7%), despite substantial variations across nations. The prevalence of GDM in lower- or upper-middle income countries was about 64% higher than in their high-income counterparts. Moreover, the one-step screening method was twice more likely to be used in diagnosi Continue reading >>

Prevalence Of Gestational Diabetes Mellitus In Eastern And Southeastern Asia: A Systematic Review And Meta-analysis

Prevalence Of Gestational Diabetes Mellitus In Eastern And Southeastern Asia: A Systematic Review And Meta-analysis

Prevalence of Gestational Diabetes Mellitus in Eastern and Southeastern Asia: A Systematic Review and Meta-Analysis 1School of Public Health, Curtin University, Perth, WA, Australia 2National Institute of Hygiene and Epidemiology, Hanoi, Vietnam 3Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam 4United Nations Population Fund, Hanoi, Vietnam Correspondence should be addressed to Ngoc Minh Pham ; [email protected] Received 30 August 2017; Accepted 16 December 2017; Published 20 February 2018 Copyright 2018 Cong Luat Nguyen et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. American Diabetes Association, 2. Classification and diagnosis of diabetes, Diabetes Care, vol. 38, Supplement 1, pp. S8S16, 2015. View at Publisher View at Google Scholar View at Scopus L. Guariguata, U. Linnenkamp, J. Beagley, D. R. Whiting, and N. H. Cho, Global estimates of the prevalence of hyperglycaemia in pregnancy, Diabetes Research and Clinical Practice, vol. 103, no. 2, pp. 176185, 2014. View at Publisher View at Google Scholar View at Scopus D. Farrar, M. Simmonds, M. Bryant et al., Hyperglycaemia and risk of adverse perinatal outcomes: systematic review and meta-analysis, BMJ, vol. 354, article i4694, 2016. View at Google Scholar C. Kim, K. M. Newton, and R. H. Knopp, Gestational diabetes and the incidence of type 2 diabetes: a systematic review, Diabetes Care, vol. 25, no. 10, pp. 18621868, 2002. View at Publisher View at Google Scholar Y. Yogev, E. M. J. Xenakis, and O. Langer, The association between preeclampsia and the severity of gestational diabetes: the impact of glycemic control, American Continue reading >>

Time To Think About Preventing Type 2 Diabetes After Gestational Diabetes?

Time To Think About Preventing Type 2 Diabetes After Gestational Diabetes?

You may have risk factors which contributed to you being diagnosed with gestational diabetes which may also make you higher risk for developing Type 2 diabetes. But even if you didn't have ANY risk factors for gestational diabetes, you still need to think about preventing Type 2 diabetes after gestational diabetes, as having gestational diabetes itself is a risk factor for Type 2. Having gestational diabetes gives you a seven-fold increased risk of developing type 2 diabetes. It also gives your baby a six-fold increased risk of developing type 2 diabetes and obesity later in life, meaning it is best to not only think of your own diet and lifestyle choices, but also your family's. Risk of developing Type 2 diabetes after gestational diabetes for the mother Gestational diabetes increases your risk of developing type 2 diabetes after the pregnancy. Statistics from Diabetes UK state that there is a seven-fold increased risk in women with gestational diabetes developing type 2 diabetes in later life. NICE state that up to 50% of women diagnosed with gestational diabetes develop type 2 diabetes within 5 years of the birth. and a meta-analysis published in March 2014 state: In a systematic review conducted in 2009, body fat measures had the most consistent associations with diabetes risk compared with other types of factors including age, parity and family history of diabetes. Specifically, pre-pregnancy BMI was associated with significantly increased risk of future diabetes after a gestational diabetes delivery; for every 1 kg increase in pre-pregnancy weight, there was a 40% increase in odds of developing Type 2 diabetes (odds ratio 1.40, 95% CI 1.20–1.60). Intra-partum and post-partum weight measures were also associated with increased diabetes risk A 2002 publication fro Continue reading >>

Gestational Diabetes And The Incidence Of Type 2 Diabetes

Gestational Diabetes And The Incidence Of Type 2 Diabetes

A systematic review 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. Gestational diabetes mellitus (GDM), or impaired glucose intolerance first diagnosed during pregnancy (1), affects Continue reading >>

Risk Factors For Type 2 Diabetes Mellitus

Risk Factors For Type 2 Diabetes Mellitus

INTRODUCTION Type 2 diabetes mellitus is characterized by hyperglycemia, insulin resistance, and relative impairment in insulin secretion. Its pathogenesis is poorly understood, but is heterogeneous and both genetic factors affecting insulin release and responsiveness and environmental factors, such as obesity, are important. The prevalence of and risk factors for type 2 diabetes will be reviewed here. The pathogenesis, including genetic susceptibility, and the diagnostic criteria for diabetes are discussed elsewhere. (See "Pathogenesis of type 2 diabetes mellitus" and "Clinical presentation and diagnosis of diabetes mellitus in adults".) LIFETIME RISK/PREVALENCE It is estimated that diabetes affects 387 million people worldwide [1]. Among adults in the United States, the estimated overall prevalence of diabetes ranges from 12 to 14 percent, depending on the criteria used [2]. An analysis of data from the National Health Interview Survey found a doubling in the prevalence of type 2 diabetes from 1990 to 2008, with no significant change during 2008 to 2012 [3]. Other national databases, such as the National Health and Nutrition Examination Survey (NHANES), have reported an increase in the prevalence of diabetes over two decades (from 9.8 to 12.4 percent), but have confirmed the relatively stable (approximately 12 percent) prevalence between 2008 and 2012 [2,4]. Given the marked increase in childhood obesity, there is concern that the prevalence of diabetes will continue to increase substantially. (See "Definition; epidemiology; and etiology of obesity in children and adolescents", section on 'Epidemiology'.) The prevalence of diabetes is higher in certain populations. Using data from a national survey for people aged 20 years or older, the prevalence of type 2 diabetes i Continue reading >>

More in insulin