Author Interviews, Diabetes, OBGYNE / 18.02.2017

MedicalResearch.com Interview with: Dr Sophie Jacqueminet Praticien Hospitalier Service de Diabétologie Pole Cardio Métabolisme Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix MedicalResearch.com: What is the background for this study? What are the main findings? Response: The proportion of women who are overweight or obese is increasing in almost all countries worldwide, and this is being accompanied by an increased risk of developing both type 2 diabetes (T2D) (whether pregnant or not) and gestational diabetes (GDM). While other studies have analysed the links between GDM and adverse outcomes in babies, very large studies that draw on an entire national database, study, are rare. In our research, all 796,346 deliveries taking place after 22 weeks in France in 2012 were included by extracting data from the hospital discharge database and the national health insurance system. Outcomes were analysed according to the type of diabetes and, in the GDM group, whether or not diabetes was insulin-treated. The cohort of 796,346 deliveries involved 57,629 (7.24%) mothers with gestational diabetes mellitus. Data linking the mother to the child were available for 705,198 deliveries (88% of the total). The risks of adverse outcomes were two to four times higher for babies of mothers with type 2 diabetes before pregnancy (pregestational diabetes) than for those with GDM. We then adjusted our data, limiting the analysis to deliveries after 28 weeks to ensure all women diagnosed with GDM were included (since diagnosis of GDM in most cases takes place at or after 28 weeks). Following adjustment, the increased risk of various complications for mothers with gestational diabetes versus mothers without GDM were: preterm birth 30%; Caesarean section 40%; pre-eclampsia/eclampsia 70%; babies born significantly larger than average size (macrosomia) 80%; respiratory distress 10%; birth trauma 30%; and cardiac malformations 30%. While these increased risks combine women with both insulin- and diet-treated GDM, most of the increased risk is found in women with insulin-treated GDM. This is because as stated above, the diabetes is more serious and blood sugar more difficult to control in women who need insulin treatment, resulting in a higher risk of complications than in those women treated with diet only. (more…)