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Clinical Care/Education
Pregnancy Outcomes of Women Additionally Diagnosed as Gestational Diabetes by the International Association of the Diabetes and Pregnancy Study Groups Criteria
Min Hyoung Kim, Soo Heon Kwak, Sung-Hoon Kim, Joon Seok Hong, Hye Rim Chung, Sung Hee Choi, Moon Young Kim, Hak C. Jang
Diabetes Metab J. 2019;43(6):766-775.   Published online February 28, 2019
DOI: https://doi.org/10.4093/dmj.2018.0192
  • 5,959 View
  • 89 Download
  • 26 Web of Science
  • 28 Crossref
AbstractAbstract PDFPubReader   
Background

We investigated the pregnancy outcomes in women who were diagnosed with gestational diabetes mellitus (GDM) by the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria but not by the Carpenter-Coustan (CC) criteria.

Methods

A total of 8,735 Korean pregnant women were identified at two hospitals between 2014 and 2016. Among them, 2,038 women participated in the prospective cohort to investigate pregnancy outcomes. Diagnosis of GDM was made via two-step approach with 50-g glucose challenge test for screening followed by diagnostic 2-hour 75-g oral glucose tolerance test. Women were divided into three groups: non-GDM, GDM diagnosed exclusively by the IADPSG criteria, and GDM diagnosed by the CC criteria.

Results

The incidence of GDM was 2.1% according to the CC criteria, and 4.1% by the IADPSG criteria. Women diagnosed with GDM by the IADPSG criteria had a higher body mass index (22.0±3.1 kg/m2 vs. 21.0±2.8 kg/m2, P<0.001) and an increased risk of preeclampsia (odds ratio [OR], 6.90; 95% confidence interval [CI], 1.84 to 25.87; P=0.004) compared to non-GDM women. Compared to neonates of the non-GDM group, those of the IADPSG GDM group had an increased risk of being large for gestational age (OR, 2.39; 95% CI, 1.50 to 3.81; P<0.001), macrosomia (OR, 2.53; 95% CI, 1.26 to 5.10; P=0.009), and neonatal hypoglycemia (OR, 3.84; 95% CI, 1.01 to 14.74; P=0.049); they were also at an increased risk of requiring phototherapy (OR, 1.57; 95% CI, 1.07 to 2.31; P=0.022) compared to the non-GDM group.

Conclusion

The IADPSG criteria increased the incidence of GDM by nearly three-fold, and women diagnosed with GDM by the IADPSG criteria had an increased risk of adverse pregnancy outcomes in Korea.

Citations

Citations to this article as recorded by  
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Review
Genetics
Maturity-Onset Diabetes of the Young: What Do Clinicians Need to Know?
Sung-Hoon Kim
Diabetes Metab J. 2015;39(6):468-477.   Published online December 11, 2015
DOI: https://doi.org/10.4093/dmj.2015.39.6.468
  • 6,491 View
  • 125 Download
  • 67 Web of Science
  • 78 Crossref
AbstractAbstract PDFPubReader   

Maturity-onset diabetes of the young (MODY) is a monogenic form of diabetes that is characterized by an early onset, autosomal dominant mode of inheritance and a primary defect in pancreatic β-cell function. MODY represents less than 2% of all diabetes cases and is commonly misdiagnosed as type 1 or type 2 diabetes mellitus. At least 13 MODY subtypes with distinct genetic etiologies have been identified to date. A correct genetic diagnosis is important as it often leads to personalized treatment for those with diabetes and enables predictive genetic testing for their asymptomatic relatives. Next-generation sequencing may provide an efficient method for screening mutations in this form of diabetes as well as identifying new MODY genes. In this review, I discuss a current update on MODY in the literatures and cover the studies that have been performed in Korea.

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Original Articles
Maternal and Neonatal Outcomes in Korean Women with Type 1 and Type 2 Diabetes
Hee-Sook Kim, Hye-Jung Jang, Jeong-Eun Park, Moon-Young Kim, Sun-Young Ko, Sung-Hoon Kim
Diabetes Metab J. 2015;39(4):316-320.   Published online August 17, 2015
DOI: https://doi.org/10.4093/dmj.2015.39.4.316
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AbstractAbstract PDFPubReader   
Background

The purpose of this study was to evaluate maternal and neonatal outcomes in Korean women with type 1 diabetes and type 2 diabetes.

Methods

We performed a retrospective survey of 163 pregnancies in women with type 1 diabetes (n=13) and type 2 diabetes (n=150) treated from 2003 to 2010 at Cheil General Hospital & Women's Healthcare Center, Korea. We compared maternal characteristics as well as maternal and neonatal outcomes between groups.

Results

Differences in glycosylated hemoglobin between type 1 and type 2 diabetes were not significant. Birth weight (3,501±689.6 g vs. 3,366±531.4 g) and rate of major congenital malformations (7.7% vs. 5.6%) were not significantly different. However, women with type 1 diabetes had higher rates of preeclampsia (38.5% vs. 8.2%, P=0.006), large for gestational age (LGA; 46.2% vs. 20.4%, P=0.004), macrosomia (38.5% vs. 13.4%, P=0.032), and admission for neonatal care (41.7% vs. 14.8%, P=0.03) than women with type 2 diabetes.

Conclusion

Maternal and neonatal outcomes for women with type 1 diabetes were poorer than for women with type 2 diabetes, especially preeclampsia, LGA, macrosomia and admission to the neonatal intensive care unit.

Citations

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Prevalence of Chronic Complications in Korean Patients with Type 2 Diabetes Mellitus Based on the Korean National Diabetes Program
Sang Youl Rhee, Suk Chon, Mi Kwang Kwon, Ie Byung Park, Kyu Jeung Ahn, In Ju Kim, Sung-Hoon Kim, Hyoung Woo Lee, Kyung Soo Koh, Doo Man Kim, Sei Hyun Baik, Kwan Woo Lee, Moon Suk Nam, Yong Soo Park, Jeong-taek Woo, Young Seol Kim
Diabetes Metab J. 2011;35(5):504-512.   Published online October 31, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.5.504
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AbstractAbstract PDFPubReader   
Background

The Korean National Diabetes Program (KNDP) cohort study is performing an ongoing large-scale prospective multicenter investigation to discover the pathogenesis of type 2 diabetes in Korean patients. This study was performed to examine the prevalence of chronic complications in patients with type 2 diabetes among those registered in the KNDP cohort within the past 4 years.

Methods

This study was performed between June 2006 and September 2009 at 13 university hospitals and included 4,265 KNDP cohort participants. Among the participants, the crude prevalence of microvascular and macrovascular diseases of those checked for diabetes-related complications was determined, and the adjusted standard prevalence and standardization of the general population prevalence ratio (SPR) was estimated based on the 2005 Korean National Health and Nutrition Examination Survey (KNHANES) population demographics.

Results

Among the KNDP registrants, 43.2% had hypertension, 34.8% had dyslipidemia, 10.8% had macrovascular disease, and 16.7% had microvascular disease. The SPR of the KNDP registrants was significantly higher than that of the KNHANES subjects after adjusting for demographics in the KNHANES 2005 population. However, with the exception of cardiovascular disease in females, the standardized prevalence for the most complicated items in the survey was significantly higher than that in the KNHANES subjects.

Conclusion

The prevalence of macrovascular disease and peripheral vascular disease were significantly higher in Korean patients with type 2 diabetes than in the normal population. However, no significant difference was noted in the prevalence of cardiovascular disease in females.

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A Comparative Study of Eating Habits and Food Intake in Women with Gestational Diabetes according to Early Postpartum Glucose Tolerance Status
You Jeong Hwang, Bo Kyung Park, Sunmin Park, Sung-Hoon Kim
Diabetes Metab J. 2011;35(4):354-363.   Published online August 31, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.4.354
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AbstractAbstract PDFPubReader   
Background

Women with gestational diabetes mellitus (GDM) are at high risk for type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD); continuous life-style intervention, especially diet, is central to managing T2DM and CVD. However, little is known about the dietary patterns of women with GDM after delivery. The goal of this study was to compare the eating habits and food intakes of women diagnosed with GDM during the early postpartum period.

Methods

We performed a 75 g oral glucose tolerance test (OGTT) in 184 women with GDM between 6 and 12 weeks after delivery. Based on the results of the OGTT, the subjects were divided into three groups according to the American Diabetes Association criteria; normal glucose tolerance (NGT) (n=100), pre-diabetes (n=73), and diabetes mellitus (DM) (n=11). Eating habits and usual food intake after delivery were investigated using a questionnaire, based on 24 hour-recall, which was administered by a trained dietitian. The daily intake data were analyzed using CAN Pro 3.0. Blood tests were performed pre- and post-delivery.

Results

Eating habits were not significantly different among the three groups. However, animal fat consumption was significantly different among the three groups. The intake ratio of fat calories to total calories was also significantly higher in the pre-diabetes and DM groups.

Conclusion

Although diet in the period 6 to 12 weeks postpartum did not influence glucose level, it may be important to educate women with GDM about the risks of excessive animal fat intake during pregnancy and the postpartum period in order to prevent later onset of T2DM.

Citations

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