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J Diabetes Complications. 2014 Jan-Feb;28(1):29-34. doi: 10.1016/j.jdiacomp.2013.08.009. Epub 2013 Oct 4.

Pre-gestational versus gestational diabetes: a population based study on clinical and demographic differences.

Author information

1
Department of Obstetrics and Gynecology, University of California, Irvine Medical Center, Orange, CA. Electronic address: alexf@hs.uci.edu.
2
Department of Obstetrics and Gynecology, University of California, Irvine Medical Center, Orange, CA.
3
Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA.
4
Charles Drew University of Medicine and Science, Research Life Sciences Institute, Los Angeles, CA.
5
David Geffen School of Medicine, Los Angeles, CA.

Abstract

AIMS:

To assess the clinical and demographic differences in patients with pre-gestational diabetes mellitus (PGDM) compared to those with gestational diabetes (GDM).

METHODS:

Using the 2001-2007 California Health Discharge Database, we identified 22,331 cases of PGDM and 147,097 cases of GDM via ICD-9-CM codes after excluding cases which were missing race or age data or with extremes of age. Data analyzed included demographics, pre-existing medical conditions, antepartum complications, and intrapartum complications. Logistic regression was used to adjust for potential confounders.

RESULTS:

Both PGDM and GDM incidences increased during the study period. Advancing age was associated with increased prevalence of both diseases. Although Asians were found to have the highest prevalence of GDM, they, along with Caucasians, were found have the lowest prevalence of PGDM. Conditions with increased frequency in PGDM versus GDM included chronic hypertension, renal disease, thyroid dysfunction, fetal CNS malformation, fetal demise, pyelonephritis, and eclampsia. Subjects with PGDM were more likely than those with GDM to have a shoulder dystocia, failed induction of labor, or undergo cesarean delivery.

CONCLUSIONS:

We have demonstrated clinical morbidities and demographic factors which differ in patients with PGDM compared to patients with GDM. Our findings suggest PGDM to be associated with significantly higher morbidity when compared to GDM. Our findings also suggest that races with the highest tendency for GDM during pregnancy may not necessarily have the highest tendency for PGDM outside of pregnancy.

KEYWORDS:

Demographics; Gestational diabetes; Pregestational diabetes; Risk factors

PMID:
24094665
PMCID:
PMC3887473
DOI:
10.1016/j.jdiacomp.2013.08.009
[Indexed for MEDLINE]
Free PMC Article

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