The Prevalence of Gestational Diabetes Mellitus Who were Admitted to a Single Center Private Hospital in Rize

Yıl 2019, Cilt: 16 Sayı: 1, 31 - 36, 01.01.2019

Beril Gürlek İbrahim Kale

Öz

Aim: The aim of the study was to analyze the prevalance of gestational diabetes mellitus according to the International Association of Diabetes and Pregnancy Study Groups’ criterias using the data collected from a single department in Rize.Material and Methods: Computer records of the women who applied for the routine follow up between July 2012 and April 2018 to Şar Hospital, between the age of 19-51 and 24 to 28 weeks of pregnancy were analyzed retrospectively. Participants who has a higher fasting plasma glucose than 126 mg/dl, patients diagnosed with diabetes or an endocrine disease Cushing’s disease, Addison’s disease, pituitary failure, acromegaly etc. known to affect blood glucose levels were not included in the study. Patients who were screened with 75 gr oral glucose tolerance test were included in the study. The prevalance of the gestational diabetes mellitus and distribution according to age groups is calculated.Results: 3204 patients records were examined and prevelance of GDM was found 27,9%. The mean age of the GDM patients was 33,78 ±5,50. The mean age of the patients without GDM was 31,84±4,96. The difference between the mean age of the two groups was statistically significant in terms of GDM prevalence p = 0.0001 .Conclusion: It has been shown that the prevalence of GDM in Rize province is higher than the other provinces of our country. In order to reduce maternal and perinatal mortality by decreasing the prevalence of GDM, urgent and effective interventions should be implemented to improve quality of life such as healthy nutrition and exercise during pregnancy.

Anahtar Kelimeler

Diabetes, pregnancy, prevalence

Rize İlinde Gestasyonel Diabetes Mellitus Prevalansı

Öz

Amaç: Çalışmamızda, ülkemizin doğusunda bulunan Rize’de, tek merkezin verileri kullanılarak ‘The International Association of Diabetes and Pregnancy Study Groups’ kriterlerine göre gestasyonel diyabetes mellitus prevalansını araştırmayı ve kriterlerin prevalansı nasıl etkilediğini ülkemizde yapılan diğer çalışmaları da derleyerek göstermeyi amaçladık.Gereç ve Yöntemler: Temmuz 2012 ve Nisan 2018 tarihleri arasında, Özel Şar Hastanesi ‘Kadın Hastalıkları ve Doğum bölümüne’ rutin gebelik takipleri için başvuran 24-28 gebelik haftasındaki 19-51 yaş arasındaki tüm gebeler hastanenin bilgisayar kayıt sistemleri aracılığıyla retrospektif olarak incelendi. Açlık plazma glukozu 126 mg/dl üzerinde olan, daha önce diyabet tanısı alan ve kan glukoz düzeyini etkileyebileceği bilinen bir endokrin hastalığı Cushing hastalığı, Addison hastalığı, hipofiz yetmezliği, akromegali vs. olan gebeler çalışmaya dahil edilmedi. ‘The International Association of Diabetes and Pregnancy Study Groups’ tarafından önerilen tek basamaklı 75 gr oral glukoz tolerans testi ile taraması yapılan hastalar çalışmaya dahil edildi. Gestasyonel diyabetes mellitus prevalansı hesaplandı ve yaş gruplarına göre dağılımı incelendi.Bulgular: 3204 hastanın incelendiği bu çalışmada gestasyonel diyabetes mellitus prevalansı %27,9 bulundu. Gestasyonel diyabetes mellitusu olan hastaların yaş ortalamaları 33,78±5,50, sağlıklı hastaların yaş ortalamaları 31,84±4,96 olarak hesaplandı. Her iki grubun yaş ortalamaları arasındaki fark istatistiksel olarak anlamlıydı p=0,0001 .Sonuç: Rize ilindeki gestasyonel diyabetes mellitus prevalansının ülkemizin diğer illerine oranla daha yüksek olduğu gösterilmiştir. Gestasyonel diyabetes mellitus, tüm dünyada ve ülkemizde gittikçe insidansı artan, hem maternal hem de perinatal komplikasyonları açısından önemli bir sağlık sorunudur. Prevalansının düşürülerek maternal ve perinatal mortalitenin azaltılabilmesi için sağlıklı beslenme ve gebelikte egzersiz gibi yaşam kalitesini artıran acil ve etkili müdahalelerin hayata geçirilmesi gerekmektedir.

Anahtar Kelimeler

Diyabet, gebelik, prevalans

Kaynakça

• American Diabetes Association. 2. Classification and Diagnosis of Di- abetes: Standards of Medical Care in Diabetes-2018. Diabetes Care 2018; 41:S13.
• Hod M, Kapur A, Sacks DA, et al. The International Federation of Gyne- cology and Obstetrics (FIGO) initiative on gestational diabetes mellitus: A pragmatic guide for diagnosis, management, and care. Int J Gynecol Obst 2015;131:S173–211.
• International Diabetes Federation, IDF Diabetes Atlas, vol. 6th, Internati- onal Diabetes Federation, Brussels, Belgium, 2013.
• American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2009;32(Suppl 1):S62-7.
• Erem C, Cihanyurdu N, Deger O, Karahan C, Can G, Telatar M. Screening for gestational diabetes mellitus in northeasternTurkey (Trabzon City). Eur J Epidemiol 2003;18(1):39-43.
• Tanir HM, Sener T, Gürer H, Kaya M. A ten year gestational diabetes mel- litus cohort at a university clinic of themid-Anatolian region of Turkey. Clin Exp Obstet Gynecol 2005;32(4):241-4.
• Akış N, Pala K, Seçkin RÇ. Gestational diabetes mellitus prevalence and related risk factors. Uludag Medical Journal 2008;34(3):93-6.
• Gürel C, Özgün MT, Batukan C, Başbuğ M. Prevalence of gestational diabetes among pregnant women attending Erciyes University Medical Faculty. Erciyes Medical Journal 2009;31(4):323-30.
• Karcaaltincaba D, Kandemir O, Yalvac S, Guvendag-Guven S, Haberal A: Prevalenceof gestational diabetes mellitus and gestational impaired glucose tolerance in pregnantwomen evaluated by National Diabetes Data Group and Carpenter and Coustan criteria. IntJ Gynecol Obstet 2009;106(3):246-249.
• Akbay E, Torun Sİ, Yalçınkaya H, Uzunçakmak C. Toklucu G. Prevalence of gestational diabetes among pregnant women attending in MD Sadi Konuk Training and Research Hospital. Turkiye Klinikleri J Gynecol Obst 2010;20(3):170-5.
• Özyurt R, Aşıcıoğlu O, Gültekin T, Güngördük K, Boran B. The prevalence of gestational diabetes mellitus in pregnant women who were admitted to İstanbul Teaching and Research Hospital Obstetric and Gynecology Department. JOPP Derg 2013;5(1):7-12.
• 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? Gynecol Obstet Reprod Med. 2016;19(3):157-61.
• Sevket O, Ates S, Uysal O, Molla T, Dansuk R, Kelekci S. To evaluate the prevalence and clinical out comes using a one-step method versus a two-step method to screen gestational diabetes mellitus. J Matern Fetal Neonatal Med 2014;27(1):36-41.
• Özdemir Ö, Sarı ME, Ertuğrul F, Şakar V, Özcanlı G,Atalay C. Prevalence of gestational diabetes among pregnant women attending Ankara Nu- mune Training and Research hospital. Türkiye Klinikleri J Gynecol Obst 2014;24(1):24-9.
• Yavuz A, Demirtaş Ö, Terzi H, Işıkkent N, Kale A. The prevalance and peri- natal results of gestational diabetes mellitus in pregnant women who were admitted to Derince Teaching and research hospital obstetric and gyne- cology department. Kocatepe Medical Journal, Ekim 2015; 16:244-248.
• Balık G, Şahin BS, Tekin BY, Şentürk Ş, Kağıtçı M, Şahin FK. The preve- lence of gestational diyabetesmellitus in pregnants who applied to the maternity out patient clinic of a university hospital. Ege Journal of Medi- cine 2016; 55(2): 55-58.
• Karcaaltincaba D, Calis P, Ocal N, Ozek A, Inan Altuğ M, Bayram M. Pre- valence of gestational diabetes mellitus evaluated by universal screening with a 75-g, 2-hour oral glucose tolerance test and IADPSG criteria. Int J Gynecol Obstet 2017; 138(2): 148-151.
• Ozgu-Erdinc AS, Sert YU, Buyuk NG, Engin-Ustun Y. Prevalence of ges- tational diabetes mellitus and results of the screening tests at a tertiary referral center: A cross-sectional study. Diabetes & Metabolic Syndro- me: Clinical Research & Reviews 2019;13:74-77.
• Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, Damm P, 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.
• Getahun D, Nath C, Ananth CV, Chavez MR, Smulian JC: Gestational diabetes in theUnited States: temporal trends 1989 through 2004. Am J Obstet Gynecol 2008;198(5):521-525.
• Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, Coustan DR, et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 2008;358(19): 1991-2002.
• Carpenter MW, Coustan DR. Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol 1982;144(7):768-73.
• National Diabetes Data Group. Classification and diagnosis of diabe- tes mellitus and other categories of glucose intolerance. Diabetes. 1979;28:1039–1057.
• Committee on Practice Bulletins-Obstetrics. Practice Bulletin No. 180: gestational diabetes mellitus. Obstet Gynecol 2017;130:e17–e37.
• Wielgos M, Bomba-Opon D, Czajkowski K, Wender-Ozegowska E, Hod M. Towards a European Consensus on Gestational Diabetes Mellitus: A Pragmatic Guide for Diagnosis, Management, and Care. The Polish Dia- betes in Pregnancy Study Group and FIGO. Ginekol Pol. 2017;88(1):46-9.
• Vandorsten JP, Dodson WC, Espeland MA, et al. NIH Consensus Deve- lopment Conference: Diagnosing gestational diabetes mellitus. IH Con- sens State Sci Statements 2013;29(1):1-31.
• HAPO Study Cooperative Research Group, Metzger BE, Lowe LP, et al. Hyperglycemia and adverse pregnancy outcomes. N Eng J Med 2008;358(19):1991-2002.
• Bodmer-Roy S, Morin L, Cousineau J, Rey E. Pregnancy outcomes in women with and without gestational diabetes mellitus according to the International Association of the Diabetes and Pregnancy Study Groups criteria. Obstet Gynecol 2012;120(4):746-52.
• National Institute for Health and Clinical Excellence (NICE). Diabetes in pregnancy: Management of diabetes and its complications from precon- ception to the postnatal period . 2008
• Türk Endokrinoloji ve Metabolizma Derneği. Diabetes Mellitus ve Kompli- kasyonlarının Tanı, Tedavi ve İzlem Kılavuzu. Mayıs 2013.
• Practice Bulletin No. 137: Gestational diabetes mellitus. Obstet Gynecol 2013;122(2 Pt 1): 406 416.
• Ayhan S, Altınkaya SÖ, Güngör T, Özcan U. Prognosis of Pregnancies with Different Degrees of Glucose Intolerance. Gynecol Obstet Reprod Med. 2016;19(2):76-81.
• K. F. McFarland and C. A. Case, “The relationship of maternal age on gestational diabetes,” Diabetes Care, vol. 8, no. 6,pp. 598–600,1985.
• O’Sullivan EP, Avalos G, O’Reilly M, Dennedy MC, Gaffney G, Dun- ne F; on behalf of the Atlantic DIP collaborators. Diabetologia. 2011 Jul;54(7):1670-1675.
• Lapolla A, Dalfra MG, Bonomo M, Parretti E, Mannino D, Mello G, Di Cianni G, Scientific Committee of GISOGD Group. Gestational diabetes mellitus in İtaly: a multicenter study. Eur J Obstet Gynecol Reprod Biol. 2009 Aug; 145(2):149-53.