Skip to main content
  • Original article
  • Open access
  • Published:

Prevalence and risk factors for gestational diabetes mellitus according to the Diabetes in Pregnancy Study Group India in comparison to Internationa Association of the Diabetes and Pregnancy Study Groups in El-Minya, Egypt

Abstract

Background

The prevalence of gestational diabetes mellitus (GDM) has increased dramatically worldwide in the last decades, but unfortunately it was not studied in Egypt.

Objective

Assessment of the prevalence of GDM in El-Minya city, Egypt using the Diabetes in Pregnancy Study Group India (DIPSI) in comparison to the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria, and assessment of the risk factors for GDM in this locality.

Patients and methods

There were 700 pregnant women who underwent the 75 g oral glucose tolerance test irrespective of the meal and plasma glucose measurement after 2 h. In the next morning, fasting and 1 h, and 2 h post-75 g oral glucose tolerance test were assessed. Diagnosis of GDM was carried out according to the DIPSI and IADPSG criteria.

Results

GDM was diagnosed in 62/700 women (8.86%) by DIPSI versus 52/700 (7.43%) by IADPESG. Compared with IADPSG, the sensitivity and specificity of DIPSI were 100 and 98.5%, respectively, while the positive and negative predictive values were 83 and 100%, respectively. The multiple logistic regression analysis has shown that BMI, urban residency, gestational hypertension, previous history of GDM, gestational hypertension, family history of DM, and the educational level less than secondary school were determined as independent risk factors of GDM.

Conclusion

The GDM prevalence in El-Minya city was 8.86% by DIPSI versus 7.43% by IADPSG with high sensitivity, specificity, and predictive values. The DIPSI could be considered as a simple, single, convenient, and economical method of GDM screening. However, more evaluation in a bigger patient sample is recommended.

References

  1. Ben-Haroush A, Yogev Y, Hod M. Epidemiology of gestational diabetes mellitus and its association with type 2 diabetes. Diabet Med 2004; 21:103–113.

    CAS  PubMed  Google Scholar 

  2. Reece EA, Leguizamón G, Wiznitzer A. Gestational diabetes: the need for a common ground. Lancet 2009; 373:1789–1797.

    PubMed  Google Scholar 

  3. Petry CJ. Gestational diabetes: risk factors and recent advances in its genetics and treatment. Br J Nutr 2010; 104:775–787.

    CAS  PubMed  Google Scholar 

  4. Pridjian G, Benjamin TD. Update on gestational diabetes. Obstet Gynecol Clin North Am 2010; 37:255–267.

    PubMed  Google Scholar 

  5. Jang HC. Gestational diabetes in Korea: incidence and risk factors of diabetes in women with previous gestational diabetes. Diabetes Metab J 2011; 35:1–7.

    PubMed  PubMed Central  Google Scholar 

  6. Yang H, Wei Y, Gao X, Xu X, Fan L, He J, et al. Risk factors for gestational diabetes mellitus in Chinese women: a prospective study of 16,286 pregnant women in China. Diabet Med 2009; 26:1099–1104.

    CAS  PubMed  Google Scholar 

  7. Di Cianni G, Volpe L, Lencioni C, Miccoli R, Cuccuru I, Ghio A, et al. Prevalence and risk factors for gestational diabetes assessed by universal screening. Diabetes Res Clin Pract 2003; 62:131–137.

    PubMed  Google Scholar 

  8. Erem C, Kuzu UB, Deger O, Can G. Prevalence of gestational diabetes mellitus and associated risk factors in Turkish women: the Trabzon GDM Study. Arch Med Sci 2015; 11:724–735.

    PubMed  PubMed Central  Google Scholar 

  9. Dode MAS de O, dos Santos IS. Non-classical risk factors for gestational diabetes mellitus: a systematic review of the literature. Cad Saude Publica 2009; 25(Suppl 3):S341–S359.

    Google Scholar 

  10. Wendland EM, Pinto ME, Duncan BB, Belizán JM, Schmidt MI. Cigarette smoking and risk of gestational diabetes: a systematic review of observational studies. BMC Pregnancy Childbirth 2008; 8:53.

    PubMed  PubMed Central  Google Scholar 

  11. Hossein-Nezhad A, Maghbooli Z, Vassigh AR, Larijani B. Prevalence of gestational diabetes mellitus and pregnancy outcomes in Iranian women. Taiwan J Obstet Gynecol 2007; 46:236–241.

    PubMed  Google Scholar 

  12. Lemeshow S, Hosmer DW, Klar J, Lwanga SK, Organization WH. Adequacy of sample size in health studies. 1990. Available at: http://www.who.int/iris/handle/10665/4160. [Accessed 23 February 2018].

  13. National guidelines for diagnosis and management of gestational diabetes mellitus. New Delhi. Maternal Health Division, Ministry of Health & Family Welfare. New Delhi: Government of India; 2015.

  14. International Association of Diabetes and Pregnancy Study Groups Consensus Panel. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care 2010; 33:676–682.

    PubMed Central  Google Scholar 

  15. Hegazi R, El-Gamal M, Abdel-Hady N, Hamdy O. Epidemiology of and risk factors for type 2 diabetes in Egypt. Ann Glob Health 2015; 81:814–820.

    PubMed  Google Scholar 

  16. Mashahit M, Ezzat E, Hanafy E. Prevalence of non-communicable diseases in patients with type 2 diabetes mellitus in egypt; a retrospective survey. Asian J Med Health 2017; 7:1–9.

    Google Scholar 

  17. Khalil NA, Fathy WM, Mahmoud NS. Screening for gestational diabetes among pregnant women attending a rural family health center, Menoufia Governorate, Egypt. J Fam Med Health Care 2017; 3:6.

    Google Scholar 

  18. Catalano PM, Tyzbir ED, Wolfe RR, Calles J, Roman NM, Amini SB, Sims EA. Carbohydrate metabolism during pregnancy in control subjects and women with gestational diabetes. Am J Physiol 1993; 264:E60–E67.

    CAS  PubMed  Google Scholar 

  19. Swami SR, Mehetre R, Shivane V, Bandgar TR, Menon PS, Shah NS. Prevalence of carbohydrate intolerance of varying degrees in pregnant females in western India (Maharashtra) – a hospital-based study. J Indian Med Assoc 2008; 106:712–714.

    PubMed  Google Scholar 

  20. Anzaku AS, Musa J. Prevalence and associated risk factors for gestational diabetes in Jos, North-central, Nigeria. Arch Gynecol Obstet 2013; 287:859–863.

    CAS  PubMed  Google Scholar 

  21. Seyoum B, Kiros K, Haileselase T, Leole A. Prevalence of gestational diabetes mellitus in rural pregnant mothers in northern Ethiopia. Diabetes Res Clin Pract 1999; 46:247–251.

    CAS  PubMed  Google Scholar 

  22. Macaulay S, Dunger DB, Norris SA. Gestational diabetes mellitus in Africa: a systematic review. PLoS One 2014; 9:e97871.

    PubMed  PubMed Central  Google Scholar 

  23. Jafari-shobeiri M, Ghojazadeh M, Azami-aghdash S, Naghavi-bdhzad M, Piri R, Pourali-akbar Y, et al. Prevalence and risk factors of gestational diabetes in Iran: a systematic review and meta-analysis. Iran J Public Health 2015; 44:1036–1044.

    PubMed  PubMed Central  Google Scholar 

  24. Agarwal MM. Gestational diabetes mellitus: an update on the current international diagnostic criteria. World J Diabetes 2015; 6:782–791.

    PubMed  PubMed Central  Google Scholar 

  25. Vijayalakshmi UB, Adusumalli P, Venkata RG, Pernenkil S. Effectiveness of Diabetes in Pregnancy Study Group India (DIPSI) Diagnostic Criterion in Detecting Gestational Diabetes Mellitus – a Pilot Study in a Rural Population. Indian J Basic Appl Med Res 2013; 2:614–618.

    Google Scholar 

  26. Lee A, Ader M, Bray GA, Bergman RN. Diurnal variation in glucose tolerance. Cyclic suppression of insulin action and insulin secretion in normal-weight, but not obese, subjects. Diabetes 1992; 41:750–759.

    CAS  Google Scholar 

  27. Goldberg RJ, Ye C, Sermer M, Connelly PW, Hanley AJG, Zinman B, Retnakaran R. Circadian variation in the response to the glucose challenge test in pregnancy: implications for screening for gestational diabetes mellitus. Diabetes Care 2012; 35:1578–1584.

    CAS  PubMed  PubMed Central  Google Scholar 

  28. McElduff A, Hitchman R. Screening for gestational diabetes: the time of day is important. Med J Aust 2002; 176:136.

    PubMed  Google Scholar 

  29. Wong VW, Garden F, Jalaludin B. Hyperglycaemia following glucose challenge test during pregnancy: when can a screening test become diagnostic?. Diabetes Res Clin Pract 2009; 83:394–396.

    PubMed  Google Scholar 

  30. Vij P, Jha S, Gupta SK, Aneja A, Mathur R, Waghdhare S, Panda M. Comparison of DIPSI and IADPSG criteria for diagnosis of GDM: a study in a north Indian tertiary care center. Int J Diabetes Dev Ctries 2015; 35:285–288.

    Google Scholar 

  31. Mohan V, Mahalakshmi MM, Bhavadharini B, Maheswari K, Kalaiyarasi G, Anjana RM, et al. Comparison of screening for gestational diabetes mellitus by oral glucose tolerance tests done in the non-fasting (random) and fasting states. Acta Diabetol 2014; 51:1007–1013.

    CAS  PubMed  PubMed Central  Google Scholar 

  32. Seshiah V, Balaji V, Balaji MS, Sekar A, Sanjeevi CB, Green A. One step procedure for screening and diagnosis of gestational diabetes mellitus. J Obstet Gynecol India 2005; 55:525–529.

    Google Scholar 

  33. Seshiah V, Balaji V, Balaji MS, Paneerselvam A, Arthi T, Thamizharasi M, Datta M. Prevalence of gestational diabetes mellitus in South India (Tamil Nadu) – a community based study. J Assoc Physicians India 2008; 56:329–333.

    CAS  PubMed  Google Scholar 

  34. Zokaie M, Majlesi F, Rahimi-Foroushani A, Esmail-Nasab N. Risk factors for gestational diabetes mellitus in Sanandaj, Iran. Chronic Dis J 2014; 2:1–9.

    Google Scholar 

  35. Kanadys WM. Occurrence of gestational diabetes mellitus: prognostic value of diabetes risk factors. Arch Perinat Med 2009; 15:106–111.

    Google Scholar 

  36. Yang X, Hsu-Hage B, Zhang H, Yu L, Dong L, Li J, et al. Gestational diabetes mellitus in women of single gravidity in Tianjin City, China. Diabetes Care 2002; 25:847–851.

    PubMed  Google Scholar 

  37. Duman NK. Frequency of gestational diabetes mellitus and the associated risk factors. Pak J Med Sci 2015; 31:194–197.

    PubMed  PubMed Central  Google Scholar 

  38. Seghieri G, De Bellis A, Anichini R, Alviggi L, Franconi F, Breschi MC. Does parity increase insulin resistance during pregnancy?. Diabet Med 2005; 22:1574–1580.

    CAS  PubMed  Google Scholar 

  39. Soheilykhah S, Mogibian M,Rahimi-Saghand S, Rashidi M, Soheilykhah S, Piroz M. Incidence of gestational diabetes mellitus in pregnant women. Iran J Reprod Med 2010; 8:24–28.

    Google Scholar 

  40. Rajput R, Yadav Y, Nanda S, Rajput M. Prevalence of gestational diabetes mellitus & associated risk factors at a tertiary care hospital in Haryana. Indian J Med Res 2013; 137:728–733.

    PubMed  PubMed Central  Google Scholar 

  41. Torloni MR, Betrán AP, Horta BL, Nakamura MU, Atallah AN, Moron AF, Valente O. Prepregnancy BMI and the risk of gestational diabetes: a systematic review of the literature with meta-analysis. Obes Rev 2009; 10:194–203.

    CAS  PubMed  Google Scholar 

  42. Bianco AT, Smilen SW, Davis Y, Lopez S, Lapinski R, Lockwood CJ. Pregnancy outcome and weight gain recommendations for the morbidly obese woman. Obstet Gynecol 1998; 91:97–102.

    CAS  PubMed  Google Scholar 

  43. Cypryk K, Szymczak W, Czupryniak L, Sobczak M, Lewiński A. Gestational diabetes mellitus – an analysis of risk factors. Endokrynol Pol 2008; 59:393–397.

    PubMed  Google Scholar 

  44. Ali AD, Mehrass AA, Al-Adhroey AH, Al-Shammakh AA, Amran AA. Prevalence and risk factors of gestational diabetes mellitus in Yemen. Int J Womens Health 2016; 25:35–41.

    Google Scholar 

  45. Sivan E, Boden G. Free fatty acids, insulin resistance, and pregnancy. Curr Diab Rep 2003; 3:319–322.

    PubMed  Google Scholar 

  46. Bouthoorn SH, Silva LM, Murray SE, Steegers EA, Jaddoe VW, Moll H. Low-educated women have an increased risk of gestational diabetes mellitus: the Generation R Study. Acta Diabetol 2015; 52:445–452.

    PubMed  Google Scholar 

  47. Evans JM, Newton RW, Ruta DA, MacDonald TM, Morris AD. Socioeconomic status, obesity and prevalence of type 1 and type 2 diabetes mellitus. Diabet Med 2000; 17:478–480.

    CAS  PubMed  Google Scholar 

  48. Agardh EE, Ahlbom A, Andersson T, et al. Explanations of socioeconomic differences in excess risk of type 2 diabetes in Swedish men and women. Diabetes Care 2004; 27:716–721.

    PubMed  Google Scholar 

  49. Anna V, van der Ploeg HP, Cheung NW, Huxley RR, Bauman AE. Sociodemographic correlates of the increasing trend in prevalence of gestational diabetes mellitus in a large population of women between1995 and 2005. Diabetes Care 2008; 31:2288–2293.

    PubMed  PubMed Central  Google Scholar 

  50. Bo S, Menato G, Bardelli C, et al. Low socioeconomic status as a risk factor for gestational diabetes. Diabetes Metab 2002; 28:139–140.

    CAS  PubMed  Google Scholar 

  51. Shen JJ, Tymkow C, MacMullen N. Disparities in maternal outcomes among four ethnic populations. Ethn Dis 2005; 15:492–497.

    PubMed  Google Scholar 

  52. Janghorbani M, Stenhouse EA, Jones RB, Millward BA. Is neighbourhood deprivation a risk factor for gestational diabetes mellitus?. Diabet Med 2006; 23:313–317.

    CAS  PubMed  Google Scholar 

  53. Leng J, Shao P, Zhang C, Tian H, Zhang F, Zhang S, et al. Prevalence of gestational diabetes mellitus and its risk factors in chinese pregnant women: a prospective population-based study in Tianjin, China. PLoS One 2015; 10:e0121029.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ghada M. El Sagheer MD Internal Medicine, Diabetology and Endocrinology Unit.

Additional information

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

El Sagheer, G.M., Hamdi, L. Prevalence and risk factors for gestational diabetes mellitus according to the Diabetes in Pregnancy Study Group India in comparison to Internationa Association of the Diabetes and Pregnancy Study Groups in El-Minya, Egypt. Egypt J Intern Med 30, 131–139 (2018). https://doi.org/10.4103/ejim.ejim_11_18

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/ejim.ejim_11_18

Keywords