Department of Ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
PLoS One. 2022 Jun 15;17(6):e0267663. doi: 10.1371/journal.pone.0267663. eCollection 2022.
To report the prevalence of total diabetes in pregnancy (TDP) and diabetes-related microvascular complications among Indonesian pregnant women.
We conducted a community-based cross-sectional study with multi-stage, cluster random sampling to select the participating community health centers (CHC) in Jogjakarta, Indonesia between July 2018-November 2019. All pregnant women in any trimester of pregnancy within the designated CHC catchment area were recruited. Capillary fasting blood glucose (FBG) and blood glucose (BG) at 1-hour (1-h), and 2-hour (2-h) post oral glucose tolerance test (OGTT) were measured. TDP was defined as the presence of pre-existing diabetes or diabetes in pregnancy (FBG ≥7.0 mmol/L, or 2-h OGTT ≥11.1 mmol/L, or random BG ≥11.1 mmol/L with diabetes symptoms). Disc and macula-centered retinal photographs were captured to assess diabetic retinopathy (DR). Blood pressure, HbA1c and serum creatinine levels were also measured.
A total of 631/664 (95%) eligible pregnant women were included. The median age was 29 (IQR 26-34) years. The prevalence of TDP was 1.1% (95%CI 0.5, 2.3). It was more common in women with chronic hypertension (p = 0.028) and a family history of diabetes (p = 0.015). Among the TDP group, 71% had a high HbA1c, but no DR nor nephropathy were observed.
Although a very low prevalence of TDP and no diabetes-related microvascular complications were documented in this population, there is still a need for a screening program for diabetes in pregnancy. Once diabetes has been identified, appropriate management can then be provided to prevent adverse outcomes.
报告印度尼西亚孕妇的总体妊娠糖尿病（TDP）患病率和与糖尿病相关的微血管并发症。
我们进行了一项基于社区的横断面研究，采用多阶段、集群随机抽样的方法，于 2018 年 7 月至 2019 年 11 月在印度尼西亚日惹选择参与的社区卫生中心（CHC）。在指定的 CHC 集水区内，任何孕龄的孕妇都被招募。测量毛细血管空腹血糖（FBG）和口服葡萄糖耐量试验（OGTT）后 1 小时（1-h）和 2 小时（2-h）的血糖（BG）。TDP 的定义为存在既往糖尿病或妊娠糖尿病（FBG≥7.0mmol/L，或 2-hOGTT≥11.1mmol/L，或随机 BG≥11.1mmol/L 伴糖尿病症状）。拍摄盘状和黄斑中心视网膜照片以评估糖尿病视网膜病变（DR）。还测量了血压、HbA1c 和血清肌酐水平。
共有 631/664（95%）名符合条件的孕妇入选。中位年龄为 29（IQR 26-34）岁。TDP 的患病率为 1.1%（95%CI 0.5,2.3）。在患有慢性高血压（p=0.028）和糖尿病家族史的女性中更为常见（p=0.015）。在 TDP 组中，71%的患者 HbA1c 升高，但未观察到 DR 或肾病。
尽管在该人群中记录到 TDP 的患病率非常低，且无与糖尿病相关的微血管并发症，但仍需要开展妊娠糖尿病筛查计划。一旦发现糖尿病，即可提供适当的管理，以预防不良结局。
