Comparison of pregnancy outcomes between women with gestational diabetes and overt diabetes first diagnosed in pregnancy: A retrospective multi-institutional study in Japan

T. Sugiyama, M. Saito, H. Nishigori, S. Nagase, N. Yaegashi, N. Sagawa, R. Kawano, K. Ichihara, M. Sanaka, S. Akazawa, S. Anazawa, M. Waguri, H. Sameshima, Y. Hiramatsu, N. Toyoda

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Abstract

Aims: To determine differences in pregnancy outcomes including diabetic complications, maternal and perinatal complications between gestational diabetes mellitus and overt diabetes in pregnancy in Japan. Methods: A multi-institutional retrospective study compared pregnancy outcomes between gestational diabetes mellitus and overt diabetes in pregnancy. We examined pregnant women who met the former criteria for gestational diabetes mellitus and received dietary intervention with self-monitoring of blood glucose with or without insulin. Overt diabetes in pregnancy was defined as ≥2 abnormal values on 75-g oral glucose tolerance test, fasting glucose ≥126 mg/dl (7.0 mmol/l) and 2-h postprandial glucose ≥200. mg/dl (11.1 mmol/l), or glycated hemoglobin levels ≥6.5% (48. mmol/mol). Results: Data were collected on 1267 women with gestational diabetes and 348 with overt diabetes in pregnancy. Pregestational body mass index was higher (26.2 ± 6.1 vs. 24.9 ± 5.7 kg, P<0.05) and gestational age at delivery was earlier (37.8 ± 2.5 weeks vs. 38.1 ± 2.1 weeks, P<0.05) in overt diabetes than in gestational diabetes. Glycated hemoglobin (6.8 ± 1.1% [51. mmol/mol] vs. 5.8 ± 0.5% [40. mmol/mol], P<0.05) and glucose on 75-g oral glucose tolerance test and prevalence of retinopathy (1.2% vs. 0%, P<0.05) and pregnancy-induced hypertension (10.1% vs. 6.1%, P<0.05) were higher in overt diabetes than in gestational diabetes. Pregnancy-induced hypertension was associated with pregestational body mass index, gestational weight gain, chronic hypertension, and nulliparity but not with 75-g oral glucose tolerance test. Conclusions: Overt diabetes in pregnancy is significantly associated with maternal complications such as retinopathy and pregnancy-induced hypertension.

Original languageEnglish
Pages (from-to)20-25
Number of pages6
JournalDiabetes Research and Clinical Practice
Volume103
Issue number1
DOIs
Publication statusPublished - Jan 2014

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Gestational Diabetes
Pregnancy in Diabetics
Pregnancy Outcome
Japan
Pregnancy
Pregnancy Induced Hypertension
Glucose Tolerance Test
Glycosylated Hemoglobin A
Glucose
Body Mass Index
Mothers
Blood Glucose Self-Monitoring
Diabetes Complications
Parity
Gestational Age
Weight Gain
Pregnant Women
Fasting
Retrospective Studies
Insulin

Keywords

  • Gestational diabetes mellitus
  • LGA
  • Pregnancy outcome

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine
  • Endocrinology

Cite this

Comparison of pregnancy outcomes between women with gestational diabetes and overt diabetes first diagnosed in pregnancy : A retrospective multi-institutional study in Japan. / Sugiyama, T.; Saito, M.; Nishigori, H.; Nagase, S.; Yaegashi, N.; Sagawa, N.; Kawano, R.; Ichihara, K.; Sanaka, M.; Akazawa, S.; Anazawa, S.; Waguri, M.; Sameshima, H.; Hiramatsu, Y.; Toyoda, N.

In: Diabetes Research and Clinical Practice, Vol. 103, No. 1, 01.2014, p. 20-25.

Research output: Contribution to journalArticle

Sugiyama, T, Saito, M, Nishigori, H, Nagase, S, Yaegashi, N, Sagawa, N, Kawano, R, Ichihara, K, Sanaka, M, Akazawa, S, Anazawa, S, Waguri, M, Sameshima, H, Hiramatsu, Y & Toyoda, N 2014, 'Comparison of pregnancy outcomes between women with gestational diabetes and overt diabetes first diagnosed in pregnancy: A retrospective multi-institutional study in Japan', Diabetes Research and Clinical Practice, vol. 103, no. 1, pp. 20-25. https://doi.org/10.1016/j.diabres.2013.10.020
Sugiyama, T. ; Saito, M. ; Nishigori, H. ; Nagase, S. ; Yaegashi, N. ; Sagawa, N. ; Kawano, R. ; Ichihara, K. ; Sanaka, M. ; Akazawa, S. ; Anazawa, S. ; Waguri, M. ; Sameshima, H. ; Hiramatsu, Y. ; Toyoda, N. / Comparison of pregnancy outcomes between women with gestational diabetes and overt diabetes first diagnosed in pregnancy : A retrospective multi-institutional study in Japan. In: Diabetes Research and Clinical Practice. 2014 ; Vol. 103, No. 1. pp. 20-25.
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AU - Nagase, S.

AU - Yaegashi, N.

AU - Sagawa, N.

AU - Kawano, R.

AU - Ichihara, K.

AU - Sanaka, M.

AU - Akazawa, S.

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N2 - Aims: To determine differences in pregnancy outcomes including diabetic complications, maternal and perinatal complications between gestational diabetes mellitus and overt diabetes in pregnancy in Japan. Methods: A multi-institutional retrospective study compared pregnancy outcomes between gestational diabetes mellitus and overt diabetes in pregnancy. We examined pregnant women who met the former criteria for gestational diabetes mellitus and received dietary intervention with self-monitoring of blood glucose with or without insulin. Overt diabetes in pregnancy was defined as ≥2 abnormal values on 75-g oral glucose tolerance test, fasting glucose ≥126 mg/dl (7.0 mmol/l) and 2-h postprandial glucose ≥200. mg/dl (11.1 mmol/l), or glycated hemoglobin levels ≥6.5% (48. mmol/mol). Results: Data were collected on 1267 women with gestational diabetes and 348 with overt diabetes in pregnancy. Pregestational body mass index was higher (26.2 ± 6.1 vs. 24.9 ± 5.7 kg, P<0.05) and gestational age at delivery was earlier (37.8 ± 2.5 weeks vs. 38.1 ± 2.1 weeks, P<0.05) in overt diabetes than in gestational diabetes. Glycated hemoglobin (6.8 ± 1.1% [51. mmol/mol] vs. 5.8 ± 0.5% [40. mmol/mol], P<0.05) and glucose on 75-g oral glucose tolerance test and prevalence of retinopathy (1.2% vs. 0%, P<0.05) and pregnancy-induced hypertension (10.1% vs. 6.1%, P<0.05) were higher in overt diabetes than in gestational diabetes. Pregnancy-induced hypertension was associated with pregestational body mass index, gestational weight gain, chronic hypertension, and nulliparity but not with 75-g oral glucose tolerance test. Conclusions: Overt diabetes in pregnancy is significantly associated with maternal complications such as retinopathy and pregnancy-induced hypertension.

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