Department of Epidemiology and Biostatistics, University of Bahir Dar, Bahir Dar, Ethiopia.
Department of Pediatrics and Child Health Wolkite University, Butajira General Hospital, Ethiopia.
Prim Care Diabetes. 2021 Jun;15(3):596-600. doi: 10.1016/j.pcd.2020.11.016. Epub 2020 Dec 13.
Diabetes mellitus (DM) is a metabolic disorder characterized by elevated level of blood glucose. It affects more than 422 million people globally. In resource limited settings, the progression of gestational diabetes (GDM) to DM was not well investigated and this research work was conducted to estimate the incidence of DM after GDM and their predictors in resource limited settings.
A retrospective and prospective cohort studies were used from January 2010 until December 2019. The data were collected using patients chart review, interview and collecting blood sample. Initially, baseline data were collected from GDM and GDM free women and update data were collected every 3 month. Clinical nurses were used to extract the necessary data from medical charts and to collect the data using patient interview. Laboratory technologists were used to measure the blood glucose level of the study participants. The study was conducted in pregnant women presenting themselves in the referral hospitals of Amhara regional state. The sample size was calculated using Epi-info software. Descriptive statistics were used to describe the profile of study participants. Kaplan Meier survival curve and life-table were used to estimate the survivals of study participants. Incidence density was used to estimate the incidence of DM. Cox regression was used to identify the predictors DM.
A total of 4892 women were followed giving for the response rate of 88.62%. The mean age of study participants at the start of the study was 28.34 years with standard deviation [SD] ±7.48 years. DM was associated with gestational diabetes mellitus [AHR (adjusted hazard ratio); 2.53, 95% CI: 2.14-2.99], frequency of breastfeeding [AHR; 0.72, 95% CI: 0.69-0.74], age [AHR; 1.04, 95% CI: 1.03-1.05], parity [AHR; 1.14, 95% CI: 1.07-1.21], regular physical exercise [AHR; 0.45, 95% CI: 0.37-0.55], family history of DM [AHR; 2.04, 95% CI: 1.76-2.37], stillbirth [AHR; 1.67: 95% CI: 1.34-2.07], abortion [AHR; 2.64, 95% CI: 2.25-3.09].
The progression of GDM to DM was very high and special follow up should be implemented for women with a history of abortion, stillbirth, and family history of DM.
糖尿病（DM）是一种以血糖水平升高为特征的代谢性疾病。它影响着全球超过 4.22 亿人。在资源有限的环境中，妊娠期糖尿病（GDM）向 DM 的进展情况并未得到充分研究，因此进行了这项研究工作，以评估资源有限环境中 GDM 后 DM 的发病率及其预测因素。
本研究采用回顾性和前瞻性队列研究，时间范围为 2010 年 1 月至 2019 年 12 月。数据通过患者病历回顾、访谈和采集血样收集。最初，从 GDM 和无 GDM 的女性中收集基线数据，并每 3 个月收集一次更新数据。临床护士用于从病历中提取必要的数据，并通过患者访谈收集数据。实验室技术人员用于测量研究参与者的血糖水平。该研究在阿姆哈拉州立转诊医院就诊的孕妇中进行。使用 Epi-info 软件计算样本量。描述性统计用于描述研究参与者的特征。使用 Kaplan-Meier 生存曲线和寿命表估计研究参与者的生存情况。发病率密度用于估计 DM 的发病率。Cox 回归用于确定 DM 的预测因素。
共有 4892 名妇女接受了随访，应答率为 88.62%。研究开始时，研究参与者的平均年龄为 28.34 岁，标准差（SD）为±7.48 岁。DM 与妊娠期糖尿病（AHR；2.53，95%CI：2.14-2.99）、母乳喂养频率（AHR；0.72，95%CI：0.69-0.74）、年龄（AHR；1.04，95%CI：1.03-1.05）、产次（AHR；1.14，95%CI：1.07-1.21）、定期体育锻炼（AHR；0.45，95%CI：0.37-0.55）、DM 家族史（AHR；2.04，95%CI：1.76-2.37）、死胎（AHR；1.67：95%CI：1.34-2.07）、流产（AHR；2.64，95%CI：2.25-3.09）有关。
GDM 向 DM 的进展非常高，对于有流产、死产和 DM 家族史的妇女，应进行特殊的随访。
