Kayseri şehir hastanesinde gestasyonel diabetes mellitus prevalansının değerlendirilmesi: Kesitsel bir çalışma

Abstract

Amaç: Gestasyonel diyabet (GDM) dünya genelinde önemli bir sağlık problem olup obezitenin ve maternal yaşın artmasıyla sıklığı giderek artmaktadır. Bu çalışmada, Kayseri'deki tek bir merkezden veri kullanarak International Association of Diabetes and Pregnancy Study Group (IADPSG) kriterlerine göre GDM prevalansını araştırmayı amaçladık.

Yöntemler: Ocak 2018 ile Ocak 2019 arasında, 18-45 yaş arası, 24-28. gebelik haftaları arasında, Kayseri Şehir Hastanesi Kadın Hastalıkları ve Doğum Kliniğinde rutin gebelik takibi için başvuran tüm gebeler retrospektif olarak bilgisayar hastane sistemi kayıtları ile incelendi. Hastalar tek aşamalı 75 g oral glikoz tolerans testi (OGTT) ile tarandı ve tanı için IADPSG kriterleri kullanıldı. 

Bulgular: Çalışmaya toplam 2652 gebe dahil edildi ve tek adımlı 75 g OGTT ile GDM taraması yapıldı. Tüm gebelerin yaş ortalaması 26,42 (22-31) idi. Ortalama gravid değeri 3 (1-5 arasında), ortalama parite 3 (1-4 arasında) ve test sırasındaki ortalama gebelik haftası 26 idi (24-28 aralığı). GDM 2652 hastanın 424'ünde tespit edildi. GDM prevalansı %16 olarak bulundu (424/2652).

Sonuç: Kliniğimize başvuran gebelerde, tek adımlı 75 g OGTT ile IADPSG kriterlerine göre GDM prevalansı %16 olarak bulundu.

Keywords

• Gestasyonel diabetes mellitus,Prevalans,Kayseri

Evaluation of the prevalence of gestational diabetes mellitus in Kayseri city hospital: A cross-sectional study

Abstract

Aim: Gestational diabetes mellitus (GDM) is an important disease worldwide and its incidence is rising with increasing maternal age and obesity. The aim of this study is to investigate the prevalence of GDM in accordance with International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria by obtaining data from a single center in Kayseri.

Methods: All pregnant women between the ages of 18 and 45 who were referred to the clinic for routine pregnancy follow-up visits between January 2018-2019 at Kayseri City Hospital’s Gynecology and Obstetrics Department were included in this study. Their records were obtained from the hospital registry and retrospectively examined. A single stage 75g oral glucose tolerance test (OGTT) was performed to all patients and IADPSG criteria were used for diagnosis. 

Results: 2652 pregnant women were included in this study and screened for GDM with a single-step 75-g OGTT. The mean age of all pregnant women was 26.42 (22-31) years. The mean gravid, parity and gestational weeks at the time of testing were 3 (range 1-5), 3 (range 1-4), 26 (range 24-28), respectively. The prevalence of GDM, detected in 424 of 2652 patients, was 16% (424/2652).

Conclusion: The prevalence of GDM among pregnant women who were referred to our clinic for routine pregnancy follow-up was 16% according to the IADPSG criteria, as determined with a single-step 75-g OGTT.

Keywords

• Gestational diabetes mellitus,Prevalence,Kayseri

References

1. 1. Sahin E, Col Madendag I, Sahin ME, Madendag Y, Acmaz G, Muderris, II. Effect of vitamin D deficiency on the 75 g oral glucose tolerance test screening and insulin resistance. Gynecol Endocrinol. 2019;35(6):535-8. Epub 2019/01/10. doi: 10.1080/09513590.2018.1554038.
2. 2. Aydın A, Atadağ Y, Öksüz A, Kaya D, Aydın NE. Comparison of the effects of impaired fasting glucose and impaired glucose tolerance on diabetic development risks on HbA1c levels: A retrospective study. J Surg Med. 2008;1(1):1-4.
3. 3. American Diabetes A. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2019. Diabetes Care. 2019;42(Suppl 1):S13-S28. Epub 2018/12/19. doi: 10.2337/dc19-S002.
4. 4. Metzger BE, Coustan DR, Trimble ER. Hyperglycemia and Adverse Pregnancy Outcomes. Clin Chem. 2019;65(7):937-8. Epub 2019/04/19. doi: 10.1373/clinchem.2019.303990.
5. 5. Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009;373(9677):1773-9. Epub 2009/05/26. doi: 10.1016/S0140-6736(09)60731-5.
6. 6. Reece EA, Leguizamon G, Wiznitzer A. Gestational diabetes: the need for a common ground. Lancet. 2009;373(9677):1789-97. Epub 2009/05/26. doi: 10.1016/S0140-6736(09)60515-8.
7. 7. Erem C, Cihanyurdu N, Deger O, Karahan C, Çan G, Telatar M. Screening for gestational diabetes mellitus in northeastern Turkey (Trabzon City). European journal of epidemiology. 2003;18(1):39-43.
8. 8. Tanir H, Sener T, Gürer H, Kaya M. A ten-year gestational diabetes mellitus cohort at a university clinic of the mid-Anatolian region of Turkey. Clinical and experimental obstetrics & gynecology. 2005;32(4):241-4.

9. 9. Akış N, Pala K, Seçkin R. Gestational diabetes mellitus prevalence and related risk factors. Uludag Medical Journal. 2008;34(3):93-6.
10. 10. Gürel C, Özgün M, Batukan C, Bașbuğ M. Prevalence of gestational diabetes among pregnant women attending Erciyes University Medical Faculty. Erciyes Medical Journal. 2009;31(4):323-30.
11. 11. Karcaaltincaba D, Kandemir O, Yalvac S, Güvendag‐Guven S, Haberal A. Prevalence of gestational diabetes mellitus and gestational impaired glucose tolerance in pregnant women evaluated by National Diabetes Data Group and Carpenter and Coustan criteria. International Journal of Gynecology & Obstetrics. 2009;106(3):246-9.
12. 12. Akbay E, Torun Sİ, Yalçınkaya H, Uzunçakmak C, Toklucu G. Prevalence of gestational diabetes among pregnant women attending in MD SadiKonuk Training and Research Hospital. TürkiyeKlinikleriJinekolojiObstetrik. 2010;20(3):170-5.
13. 13. Özyurt R, Aşıcıoğlu O, Gültekin T, Güngördük K, Boran B. The Prevelance of Gestational Diabetes Mellitus In Pregnant Women Who Administered to İstanbul Teaching and Research Hospital Obstetrics and Gynecology Department. İstanbul Kanuni Sultan Süleyman Tip Dergisi (IKSST). 2013;5(1):7-12.
14. 14. Altay MM, Özdoğan S, Tohma A, Esin S, Erol O, Gelişen O, et al. Can the 3rd Hour Value of 100 g Oral Glucose Tolerance Test Be Ignored in the Diagnosis of Gestational Diabetes Mellitus? Gynecology Obstetrics & Reproductive Medicine. 2016;19(3):157-61.
15. 15. Sevket O, Ates S, Uysal O, Molla T, Dansuk R, Kelekci S. To evaluate the prevalence and clinical outcomes using a one-step method versus a two-step method to screen gestational diabetes mellitus. The Journal of Maternal-Fetal & Neonatal Medicine. 2014;27(1):36-41.
16. 16. Özdemir Ö, Sari ME, Ertuğrul FA, Şakar VS, Özcanli G, Atalay C. Ankara numuneeğitimvearaştırmahastanesikadınhastalıklarıvedoğumkliniğinebaşvurangebelerdegestasyoneldiyabetsıklığı. Journal of Clinical Obstetrics & Gynecology. 2014;24(1):24-9.
17. 17. Balık G, Şahin SB, TekinYB, Şentürk Ş, Kağıtcı M, Şahin FK. The prevalence of gestational diabetes mellitus in pregnants who applied to the maternity outpatient clinic of a university hospital. Ege Journal of Medicine. 2016;55(2):55-8.
18. 18. Karcaaltincaba D, Calis P, Ocal N, Ozek A, AltugInan M, Bayram M. Prevalence of gestational diabetes mellitus evaluated by universal screening with a 75‐g, 2‐hour oral glucose tolerance test and IADPSG criteria. International Journal of Gynecology & Obstetrics. 2017;138(2):148-51.
19. 19. Ozgu-Erdinc AS, SertUY, BuyukGN, Engin-Ustun Y. Prevalence of gestational diabetes mellitus and results of the screening tests at a tertiary referral center: A cross-sectional study. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2019;13(1):74-7.
20. 20. Gürlek B, Kale İ. RizeİlindeGestasyonel Diabetes Mellitus Prevalansı. Jinekoloji-ObstetrikveNeonatolojiTıpDergisi. 2019;16(1).
21. 21. Madendag Y, Sahin E, Madendag Col I, Eraslan SM, Tayyar A, Ozdemir F, et al. The effect of hyperemesis gravidarum on the 75 g oral glucose tolerance test screening and gestational diabetes mellitus. The Journal of Maternal-Fetal & Neonatal Medicine. 2018;31(15):1989-92.
22. 22. International Association of D, Pregnancy Study Groups Consensus P, Metzger BE, Gabbe SG, Persson B, Buchanan TA, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33(3):676-82. Epub 2010/03/02. doi: 10.2337/dc09-1848.
23. 23. Practice CoO. Practice bulletin no. 137: gestational diabetes mellitus. Obstet Gynecol. 2013;122:406-16.