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Diabetes in pregnancy


Epidemiology

Prevalence of gestational diabetes and risk of progression to type 2 diabetes: A global perspective

This review provides an overview of the global prevalence of gestational diabetes mellitus based on data published in the past decade and discusses the methodological challenges in estimating the global burden.

Summary points
  • Gestational diabetes mellitus (GDM) has been related to substantial short- and long-term adverse health outcomes.
  • However, easily accessible and systematically organized data on estimates of global prevalence of GDM are lacking.
  • A review of publications during the past decade demonstrates large variations of the prevalence of GDM worldwide, with it being higher among Middle East and North Africa, Southeast Asia, and Western Pacific regions, whereas it is lowest in Europe.
  • Direct comparisons across countries are challenging, however, at least partly due to varied screening approaches, diagnostic criteria, and underlying population characteristics.
  • Data on the risk of progression from GDM to type 2 diabetes are still limited and little is known about modifiable factors that may lower the risk.
  • Collaborative and continuing efforts to acquire global GDM prevalence data within and across countries are needed.

Zhu Y, Zhang C. Curr Diab Rep 2016; 16: 7. doi: 10.1007/s11892-015-0699-x

Trends in the incidence of diabetes, its clinical sequelae, and associated costs in pregnancy

The aim of this retrospective claims analysis was to evaluate health outcomes, medical costs, risks and types of complications associated with diabetes in pregnancy for mothers and newborns.

Summary points
  • Increasing diabetes prevalence affects a substantial number of pregnant women in the United States.
  • Complications known to arise from the effects of maternal diabetes during the first trimester primarily include miscarriage and congenital malformation; complications that arise during the second and third trimesters primarily include stillbirth and macrosomia.
  • Maternal complications occur more commonly in women with diabetes and include hypoglycemia, gestational hypertension/preeclampsia and Cesarean delivery, among other comorbidities.
  • The aim of this study was to evaluate costs, risk and types of complications associated with diabetes in pregnancy via a large claims database analysis.
  • Adverse pregnancy outcomes, maternal complications and neonatal complications appear significantly more frequently in association with diabetes.
  • Costs of healthcare, including pharmacy, inpatient and outpatient expenses, are also higher in pregnancies complicated by diabetes.

Jovanovič L et al. Diabetes Metab Res Rev 2015; 31: 707–716. doi: 10.1002/dmrr.2656

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