Seshiah V, Balaji V, Balaji Madhuri S, Paneerselvam A, Arthi T, Thamizharasi M, Datta Manjula
Diabetes Care and Research Institute, Chennai 600 010.
J Assoc Physicians India. 2008 May;56:329-33.
Women diagnosed to have Gestational Diabetes Mellitus (GDM) are at increased risk of developing diabetes in future. Thus, diagnosis of GDM is an important public health issue. In a random survey 16.2% of pregnant women were found to have GDM in the Chennai urban population. Hence we undertook a planned community based study to ascertain the prevalence of GDM.
We conducted a prospective screening for GDM in the urban, semi urban and rural areas. All pregnant women irrespective of gestational weeks underwent a 75 g glucose challenge test in the fasting state. Diagnosis of GDM was made if the 2 hr plasma glucose was > or = 140 mg/dl (WHO criteria).
A total of 4151, 3960 and 3945 pregnant women were screened in urban, semi urban and rural areas, respectively. GDM was detected in 739 (17.8%) women in urban, 548 (13.8%) in semi urban and 392 (9.9%) in rural areas. Out of 1679 GDM women, 1204 (72%) were detected in first visit and the remaining 28% in subsequent visits. A significant increase (P < 0.0001) in the prevalence of GDM was observed with family history of diabetes, increased maternal age and BMI. A trend for increased prevalence of GDM was observed in women with less physical activity, however, not statistically significant.
In this community based study, the prevalence of GDM varied in the urban, semi urban and rural areas. Age > or = 25 years, BMI > or = 25 and family history of diabetes were found to be risk factors for GDM.
被诊断为妊娠期糖尿病(GDM)的女性未来患糖尿病的风险会增加。因此,GDM的诊断是一个重要的公共卫生问题。在一项随机调查中,钦奈城市人口中16.2%的孕妇被发现患有GDM。因此,我们开展了一项有计划的社区研究,以确定GDM的患病率。
我们在城市、半城市和农村地区对GDM进行前瞻性筛查。所有孕妇,无论孕周如何,均在空腹状态下接受75克葡萄糖耐量试验。如果2小时血浆葡萄糖≥140毫克/分升(世界卫生组织标准),则诊断为GDM。
城市、半城市和农村地区分别筛查了4151名、3960名和3945名孕妇。城市地区739名(17.8%)女性、半城市地区548名(13.8%)女性和农村地区392名(9.9%)女性被检测出患有GDM。在1679名GDM女性中,1204名(72%)在首次就诊时被检测出,其余28%在后续就诊时被检测出。观察到糖尿病家族史、孕妇年龄增加和体重指数增加会使GDM患病率显著升高(P<0.0001)。体力活动较少的女性中GDM患病率有上升趋势,但无统计学意义。
在这项基于社区的研究中,GDM的患病率在城市、半城市和农村地区有所不同。年龄≥25岁、体重指数≥25以及糖尿病家族史被发现是GDM的危险因素。