Prevalence and risk factors of gestational diabetes in Punjab, North India: results from a population screening program

TY - JOUR

T1 - Prevalence and risk factors of gestational diabetes in Punjab, North India

T2 - results from a population screening program

AU - Arora, Geeti P

AU - Thaman, Richa G

AU - Prasad, Rashmi B

AU - Almgren, Peter

AU - Brøns, Charlotte

AU - Groop, Leif C

AU - Vaag, Allan A

N1 - © 2015 European Society of Endocrinology.

PY - 2015/8/1

Y1 - 2015/8/1

N2 - OBJECTIVE: The World Health Organization (WHO) has in 2013 changed the diagnostic criteria for gestational diabetes mellitus (GDM) to acknowledge the putative effect of mildly elevated fasting plasma glucose (FPG) levels on pregnancy outcomes. We aimed to determine the prevalence and risk factors of GDM comparing the previous WHO 1999 criteria to the WHO 2013 criteria in North India.METHODS: In a population-based screening programme, 5100 randomly selected North Indian women were studied using a cross-sectional design with a questionnaire, venous FPG and 2-h capillary plasma glucose (PG) after a 75 g oral glucose tolerance test performed between 24 and 28 weeks of pregnancy.RESULTS: The prevalence of GDM was 35% using WHO 2013 criteria vs 9% using WHO 1999 criteria. FPG measurements identified 94% of WHO 2013 GDM cases as opposed to 11% of WHO 1999 GDM cases. In contrast, 2-h PG measurements identified only 13% of WHO 2013 GDM cases compared with 96% of the WHO 1999 GDM cases. Using logistic regression with backward elimination, urban habitat, illiteracy, non-vegetarianism, increased BMI, Hindu religion and low adult height were all independent risk factors of GDM using the 1999 criteria, whereas only urban habitat, low adult height and increased age were independent risk factors of GDM using the 2013 criteria.CONCLUSIONS: Intervention studies are needed to justify the WHO 2013 GDM criteria increasing the prevalence four fold to include more than one third of North Indian pregnant women.

AB - OBJECTIVE: The World Health Organization (WHO) has in 2013 changed the diagnostic criteria for gestational diabetes mellitus (GDM) to acknowledge the putative effect of mildly elevated fasting plasma glucose (FPG) levels on pregnancy outcomes. We aimed to determine the prevalence and risk factors of GDM comparing the previous WHO 1999 criteria to the WHO 2013 criteria in North India.METHODS: In a population-based screening programme, 5100 randomly selected North Indian women were studied using a cross-sectional design with a questionnaire, venous FPG and 2-h capillary plasma glucose (PG) after a 75 g oral glucose tolerance test performed between 24 and 28 weeks of pregnancy.RESULTS: The prevalence of GDM was 35% using WHO 2013 criteria vs 9% using WHO 1999 criteria. FPG measurements identified 94% of WHO 2013 GDM cases as opposed to 11% of WHO 1999 GDM cases. In contrast, 2-h PG measurements identified only 13% of WHO 2013 GDM cases compared with 96% of the WHO 1999 GDM cases. Using logistic regression with backward elimination, urban habitat, illiteracy, non-vegetarianism, increased BMI, Hindu religion and low adult height were all independent risk factors of GDM using the 1999 criteria, whereas only urban habitat, low adult height and increased age were independent risk factors of GDM using the 2013 criteria.CONCLUSIONS: Intervention studies are needed to justify the WHO 2013 GDM criteria increasing the prevalence four fold to include more than one third of North Indian pregnant women.

KW - Adolescent

KW - Cross-Sectional Studies

KW - Diabetes, Gestational

KW - Female

KW - Humans

KW - India

KW - Population Surveillance

KW - Pregnancy

KW - Prevalence

KW - Risk Factors

KW - Young Adult

U2 - 10.1530/eje-14-0428

DO - 10.1530/eje-14-0428

M3 - Journal article

C2 - 26012589

SN - 0804-4643

VL - 173

SP - 257

EP - 267

JO - European Journal of Endocrinology

JF - European Journal of Endocrinology

IS - 2

ER -