Format

Send to

Choose Destination
J Clin Endocrinol Metab. 2015 Aug;100(8):2996-3003. doi: 10.1210/jc.2015-1779. Epub 2015 Jun 19.

Epidemiology of Dysglycemia in Pregnant Oklahoma American Indian Women.

Author information

1
Section of Endocrinology, Diabetes, and Metabolism (M.A.), Oklahoma Shared Clinical and Translational Resources (L.S.), University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73014; Department of Biostatistics and Epidemiology (J.A.S., H.D.D.), College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104; Division of Maternal and Fetal Medicine (J.R.G.), Loyola University Medical Center, Maywood, Illinois 60153; Medical Device and Diagnostics Consulting (J.M.), Albuquerque, New Mexico; and Centre for Experimental Medicine (T.J.L.), Queen's University of Belfast, Belfast BT7 1NN, Northern Ireland, United Kingdom.

Abstract

CONTEXT:

Minority communities are disproportionately affected by diabetes, and minority women are at an increased risk for glucose intolerance (dysglycemia) during pregnancy.

OBJECTIVES:

In pregnant American Indian women, the objectives of the study were to use current criteria to estimate the prevalence of first-trimester (Tr1) dysglycemia and second-trimester (Tr2) incidence of gestational diabetes mellitus (GDM) and to explore new candidate measures and identify associated clinical factors.

DESIGN:

This was a prospective cohort study. In Tr1 we performed a 75-g, 2-hour oral glucose tolerance test (OGTT) and glycated hemoglobin (HbA1c) to determine the following: fasting insulin; homeostasis model assessment of insulin resistance; serum 1,5-anhydroglucitol; noninvasive skin autofluorescence (SCOUT). We defined dysglycemia by American Diabetes Association and Endocrine Society criteria and as HbA1c of 5.7% or greater. In Tr2 in an available subset, we performed a repeat OGTT and SCOUT.

PARTICIPANTS:

Pregnant American Indian women (n = 244 at Tr1; n = 114 at Tr2) participated in the study.

OUTCOMES:

The prevalence of dysglycemia at Tr1 and incidence of GDM at Tr2 were measured.

RESULTS:

At Tr1, one woman had overt diabetes; 36 (15%) had impaired glucose tolerance (American Diabetes Association criteria and/or abnormal HbA1c) and 59 (24%) had GDM-Tr1 (Endocrine Society criteria). Overall, 74 (30%) had some form of dysglycemia. Associated factors were body mass index, hypertension, waist/hip circumferences, SCOUT score, fasting insulin, and homeostasis model assessment of insulin resistance. At Tr2, 114 of the Tr1 cohort underwent a repeat OGTT and SCOUT, and 26 (23%) had GDM. GDM-Tr2 was associated with increased SCOUT scores (P = .029) and Tr1 body mass index, waist/hip circumferences, diastolic blood pressure, fasting insulin, and triglyceride levels. Overall, dysglycemia at Tr1 and/or Tr2 affected 38% of the women.

CONCLUSIONS:

Dysglycemia at some point during pregnancy was common among American Indian women. It was associated with features of insulin resistance and may confer long-term health risks for mother and child.

PMID:
26091203
PMCID:
PMC4525008
DOI:
10.1210/jc.2015-1779
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Silverchair Information Systems Icon for PubMed Central
Loading ...
Support Center