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03-01-2018 | Gestational diabetes | Article

Prenatal counseling on type 2 diabetes risk, exercise, and nutrition affects the likelihood of postpartum diabetes screening after gestational diabetes

Journal: Journal of Perinatology

Authors: Kai E. Jones, Yan Yan, Graham A. Colditz, Cynthia J. Herrick

Publisher: Nature Publishing Group US

Abstract

Objective

Screening rates for type 2 diabetes after a pregnancy with gestational diabetes are inadequate. We aimed to determine how prenatal counseling on exercise, nutrition, and type 2 diabetes risk affects postpartum screening for diabetes.

Methods

Using Pregnancy Risk Assessment Monitoring System data from Colorado (2009–2011) and Massachusetts (2012–2013), we performed multivariable logistic regression to examine the relationship between prenatal counseling and postpartum screening.

Results

Among 556 women, prenatal counseling was associated with increased postpartum diabetes screening, after adjusting for age; parity; and receipt of Women, Infants, and Children (WIC) benefits (adjusted odds ratio (AOR) 3.0 [95% CI 1.4–6.5]). This effect was modified by race/ethnicity. Primiparity (AOR 2.2 [95% CI 1.2–4.1]) and advanced maternal age (AOR 2.2 [95% CI 1.2–3.8]) were associated with increased screening, and receiving WIC benefits was associated with decreased screening (AOR 0.5 [95% CI 0.3–0.9]).

Conclusions

In women with gestational diabetes, culturally appropriate counseling on future diabetes risk, nutrition, and exercise may enhance postpartum diabetes screening.

Lavery JA, Friedman AM, Keyes KM, Wright JD, Ananth CV. Gestational diabetes in the United States: temporal changes in prevalence rates between 1979 and 2010. BJOG. 2017;124:804–813.CrossRefPubMed

DeSisto CL, Kim SY, Sharma AJ. Prevalence estimates of gestational diabetes mellitus in the United States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2007-2010. Prev Chronic Dis. 2014;11:130415.CrossRef

American Diabetes Association. 13. Management of diabetes in pregnancy. Diabetes Care. 2017;40:S114–S119.CrossRef

Yogev Y, Ben-Haroush A, Chen R, Rosenn B, Hod M, Langer O. Undiagnosed asymptomatic hypoglycemia: diet, insulin, and glyburide for gestational diabetic pregnancy. Obstet Gynecol. 2004;104:88–93.CrossRefPubMed

Dabelea D, Hanson RL, Lindsay RS, Pettitt DJ, Imperatore G, Gabir mM, et al. Intrauterine exposure to diabetes conveys risks for type 2 diabetes and obesity: a study of discordant sibships. Diabetes. 2000;49:2208–11.CrossRefPubMed

Dabelea D, Mayer-Davis EJ, Lamichhane AP, D’Agostino RB Jr., Liese AD, Vehik KS, et al. Association of intrauterine exposure to maternal diabetes and obesity with type 2 diabetes in youth: the SEARCH Case-Control Study. Diabetes Care. 2008;31:1422–6.CrossRefPubMedPubMedCentral

Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009;373:1773–9.CrossRefPubMed

Ratner RE. Prevention of type 2 diabetes in women with previous gestational diabetes. Diabetes Care. 2007;30:S242–S245.CrossRefPubMed

Aroda VR, Christophi CA, Edelstein SL, Zhang P, Herman WH, Barrett-Connor E, et al. The effect of lifestyle intervention and metformin on preventing or delaying diabetes among women with and without gestational diabetes: the Diabetes Prevention Program Outcomes Study 10 year Follow-up. J Clin Endocrinol Metab. 2015;100:1646–53.CrossRefPubMedPubMedCentral

10.

Blumer I, Hadar E, Hadden DR, Jovanovič L, Mestman JH, Murad MH, et al. Diabetes and pregnancy: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2013;98:4227–49.CrossRefPubMed

11.

Gabbe SG, Landon MB, Warren-Boulton E, Fradkin J. Promoting health after gestational diabetes: a national diabetes education program call to action. Obstet Gynecol. 2012;119:171–6.CrossRefPubMedPubMedCentral

12.

American College of Obstetricians and Gynecologists. Practice bulletin: gestational diabetes mellitus. Obstet Gynecol. 2013;122:406–16.CrossRef

13.

Hale NL, Probst JC, Liu J, Martin AB, Bennett KJ, Glover S. Postpartum screening for diabetes among Medicaid-eligible South Carolina women with gestational diabetes. Women’s Health Issues. 2012;22:e163–169.CrossRefPubMed

14.

Ferrara A, Peng T, Kim C. Trends in post-partum diabetes screening and subsequent diabetes and impaired fasting glucose among women with histories of gestational diabetes mellitus: a report from the Translating Research into Action for Diabetes (TRIAD) Study. Diabetes Care. 2009;32:269–74.CrossRefPubMedPubMedCentral

15.

Lawrence JM, Black MH, Hsu JW, Chen W, Sacks DA. Prevalence and timing of postpartum glucose testing and sustained glucose dysregulation after gestational diabetes mellitus. Diabetes Care. 2010;33:569–76.CrossRefPubMed

16.

Tovar A, Chasan-Taber L, Eggleston E, Oken E. Postpartum screening for diabetes among women with a history of gestational diabetes mellitus. Prev Chronic Dis. 2011;8:A124.PubMedPubMedCentral

17.

Symons Downs D, Ulbrecht JS. Understanding exercise beliefs and behaviors in women with gestational diabetes mellitus. Diabetes Care. 2006;29:236–40.CrossRefPubMed

18.

Kim C, McEwen LN, Kerr EA, Piette JD, Chames MC, Ferrara A, et al. Preventive counseling among women with histories of gestational diabetes mellitus. Diabetes Care. 2007;30:2489–95.CrossRefPubMed

19.

Huynh T, Ghaffari N, Bastek J, Durnwald C. Prenatal care in a specialized diabetes in pregnancy program improves compliance with postpartum testing in GDM women. J Matern-Fetal Neonatal Med. 2016;30:1–5.

20.

Stasenko M, Liddell J, Cheng YW, Sparks TN, Killion M, Caughey AB. Patient counseling increases postpartum follow-up in women with gestational diabetes mellitus. Am J Obstet Gynecol. 2011;204:522.e521–522.e526.CrossRef

21.

Centers for Disease Control and Prevention. PRAMS Methodology. [cited 20 Jul 2016]. Available from: https://www.cdc.gov/prams/methodology.htm.

22.

Gilbert BC, Shulman HB, Fischer LA, Rogers MM. The Pregnancy Risk Assessment Monitoring System (PRAMS): methods and 1996 response rates from 11 states. Matern Child Health J. 1999;3:199–209.CrossRefPubMed

23.

Shulman HB, Gilbert BC, Msphbrenda CG, Lansky A. The Pregnancy Risk Assessment Monitoring System (PRAMS): current methods and evaluation of 2001 response rates. Public Health Rep. 2006;121:74–83.CrossRefPubMedPubMedCentral

24.

Lavery JA, Friedman AM, Keyes KM, Wright JD, Ananth CV. Gestational diabetes in the United States: temporal changes in prevalence rates between 1979 and 2010. BJOG. 2016;124:804–13.CrossRefPubMedPubMedCentral

25.

USDA Food and Nutrition Service. WIC income eligibility guidelines. [cited 26 Jun 2017]. Available from: https://www.fns.usda.gov/wic/wic-income-eligibility-guidelines.

26.

Eggleston EM, LeCates RF, Zhang F, Wharam JF, Ross-Degnan D, Oken E. Variation in postpartum glycemic screening in women with a history of gestational diabetes mellitus. Obstet Gynecol. 2016;128:159–67.CrossRefPubMedPubMedCentral

27.

Oza-Frank R. Postpartum diabetes testing among women with recent gestational diabetes mellitus: PRAMS 2009-2010. Matern Child Health J. 2014;18:729–36.CrossRefPubMed

28.

Simmons D, Jelsma JG, Galjaard S, Devlieger R, van Assche A, Jans G, et al. Results from a European multicenter randomized trial of physical activity and/or healthy eating to reduce the risk of gestational diabetes mellitus: the DALI lifestyle pilot. Diabetes Care. 2015;38:1650–6.CrossRefPubMed

29.

Asbee SM, Jenkins TR, Butler JR, White J, Elliot M, Rutledge A. Preventing excessive weight gain during pregnancy through dietary and lifestyle counseling: a randomized controlled trial. Obstet Gynecol. 2009;113:305–12.CrossRefPubMed

30.

Koivusalo SB, Rono K, Klemetti MM, Roine RP, Lindstrom J, Erkkola M, et al. Gestational diabetes mellitus can be prevented by lifestyle intervention: the Finnish gestational diabetes prevention study (RADIEL): a randomized controlled trial. Diabetes Care. 2016;39:24–30.CrossRefPubMed

31.

Vinter CA, Jensen DM, Ovesen P, Beck-Nielsen H, Jorgensen JS. The LiP (Lifestyle in Pregnancy) study: a randomized controlled trial of lifestyle intervention in 360 obese pregnant women. Diabetes Care. 2011;34:2502–7.CrossRefPubMedPubMedCentral

32.

Ferrara A, Hedderson MM, Brown SD, Albright CL, Ehrlich SF, Tsai AL, et al. The comparative effectiveness of diabetes prevention strategies to reduce postpartum weight retention in women with gestational diabetes mellitus: the gestational diabetes’ effects on moms (GEM) cluster randomized controlled trial. Diabetes Care. 2016;39:65–74.CrossRefPubMed

33.

Nicklas JM, Zera CA, England LJ, Rosner BA, Horton E, Levkoff SE, et al. A web-based lifestyle intervention for women with recent gestational diabetes mellitus: a randomized controlled trial. Obstet Gynecol. 2014;124:563–70.CrossRefPubMedPubMedCentral

34.

Rautio N, Jokelainen J, Korpi-Hyovalti E, Oksa H, Saaristo T, Peltonen M, et al. Lifestyle intervention in prevention of type 2 diabetes in women with a history of gestational diabetes mellitus: one-year results of the FIN-D2D project. J Women’s Health (Larchmt). 2014;23:506–12.CrossRef

35.

Philis-Tsimikas A, Fortmann AL, Dharkar-Surber S, Euyoque JA, Ruiz M, Schultz J, et al. Dulce mothers: an intervention to reduce diabetes and cardiovascular risk in Latinas after gestational diabetes. Transl Behav Med. 2014;4:18–25.CrossRefPubMedPubMedCentral

36.

Xiang AH, Li BH, Black MH, Sacks DA, Buchanan TA, Jacobsen SJ, et al. Racial and ethnic disparities in diabetes risk after gestational diabetes mellitus. Diabetologia. 2011;54:3016–21.CrossRefPubMed

37.

Oliveira V, Frazao E. The WIC program: background, trends, and economic issues, 2015 edition. SSRN Electron J 2015, 134. https://doi.org/10.2139/ssrn.2709086.

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