Hyperglycemia recognised in early pregnancy is phenotypically type 2 diabetes mellitus not gestational diabetes mellitus: a case control study
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
OBJECTIVE: Gestational diabetes mellitus is defined as "diabetes recognized in the second or third trimester that is not clearly overt diabetes". Evidence relating to women with hyperglycemia early in pregnancy is limited. We aimed to evaluate women diagnosed with hyperglycemia early in pregnancy (eGDM) and compared them to those with pregestational established type 2 diabetes mellitus (T2DM) and gestational diabetes diagnosed routinely at 24-28-week gestation (rtGDM) to determine if the length of exposure to hyperglycemia adversely affected outcomes. METHODS: Forty consecutive women with eGDM who attended a multidisciplinary antenatal clinic were reviewed. Two separate BMI-matched control groups were identified, recognized pregestational T2DM (n = 80) and rtGDM (n = 80). Baseline demographics and outcomes were compared. RESULTS: A higher proportion of women in the eGDM and T2DM group required insulin and the incidence of hypertensive disorders was similarly increased compared with the rtGDM group (88.6, 77.0 versus 8.1%, p < .001 and 42.5%, 37.5 versus 12.5% p < .001, respectively). The proportion of infants born small for gestational age varied (eGDM 11.1%, T2DM 13.0%, and rtGDM 2.5%, p=.049). Postpartum, 7.5% of eGDM women were diagnosed with T2DM versus 1.3% in the rtGDM group (p<.001). CONCLUSIONS: These novel data demonstrate that the length of exposure to glucose adversely affects materno-foetal outcomes independent of maternal adiposity.
Date Issued
2020-12-01
Date Acceptance
2019-03-08
Citation
Journal of Maternal-Fetal and Neonatal Medicine, 2020, 33 (23), pp.3977-3983
ISSN
1476-4954
Publisher
Taylor & Francis
Start Page
3977
End Page
3983
Journal / Book Title
Journal of Maternal-Fetal and Neonatal Medicine
Volume
33
Issue
23
Copyright Statement
© 2019 Informa UK Limited, trading as Taylor & Francis Group. This is an Accepted Manuscript of an article published by Taylor & Francis in Journal of Maternal-Fetal and Neonatal Medicine on 26 Mar 2019, available online: https://www.tandfonline.com/doi/full/10.1080/14767058.2019.1593959
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/30913941
Subjects
Foetal outcomes
gestational diabetes mellitus
maternal outcomes
pregnancy
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2019-03-26