<strong>Background</strong> It is well known that both pre-excising and gestational diabetes mellitus in pregnancy is associated with multiple maternal and fetal complications. There are various guidelines...<strong>Background</strong> It is well known that both pre-excising and gestational diabetes mellitus in pregnancy is associated with multiple maternal and fetal complications. There are various guidelines developed to reduce these complications, yet there is no universal agreement regarding the ideal management. For those with pre-exciting or gestational diabetes mellitus, the control of blood sugar is assessed either with 1st-hour post-prandial blood sugar values or with the 2nd-hour post-prandial blood sugar values. <strong>Objective </strong>To compare the long-term blood glucose control (HbA1c values) of pregnant women by utilizing results of 1-hour postprandial blood sugar values against 2-hour post-prandial blood sugar values, in the antenatal ward at the professorial unit, Teaching Hospital Peradeniya. <strong>Materials and Methods</strong> A prospective cohort study was carried out among 138 pregnant women with diabetes mellitus, who were managed in two different clinics at the professorial unit, Teaching Hospital Peradeniya. The blood glucose control in group 1 (n = 69) was assessed and optimized with 1st-hour postprandial blood sugar values and group 2 (n = 69) was evaluated with 2nd-hour postprandial values throughout the pregnancies. Following delivery, all subjects were reassessed with blood HbA1c and analyzed with the independent t-test. Feto-maternal complications were analyzed and evaluated using descriptive statistics and Chi-Square tests. <strong>Results</strong> Of the subjects, 97.1% were diagnosed with gestational diabetes mellitus. The mean value of HbA1c for group 1, managed with 1st-hour blood glucose values was 5.73 and 6.04 (p = 0.02) respectively for group 2. Fetal macrosomia was also significantly (p < 0.01) low in the 1-hour blood sugar control group.<strong> Conclusion</strong> Long-term control of blood sugar was significantly superior among the subjects managed with 1st-hour postprandial blood sugars with a statistically significant reduction in foetal macrosomia.展开更多
<strong>Aim</strong>: Evaluation of the occurrence of glucose intolerance after 34 - 36 weeks in pregnant mothers attending the Teaching Hospital, Peradeniya. <strong>Materials & Method</stron...<strong>Aim</strong>: Evaluation of the occurrence of glucose intolerance after 34 - 36 weeks in pregnant mothers attending the Teaching Hospital, Peradeniya. <strong>Materials & Method</strong>: This is a descriptive cross-sectional study carried out from October 2017 to March 2018 among 183 pregnant mothers attending antenatal clinic at Teaching Hospital Peradeniya. After informed consent a repeat Oral Glucose Tolerance Test (OGTT) was done among the pregnant mothers, at period of amenorrhoea of 34 - 36 weeks, whose initial OGTT values were normal. Gestational diabetes was diagnosed according to the NICE guideline cut off values and the percentage of late occurrence of Gestational diabetes (GDM) was analyzed. <strong>Results</strong>: Mean age of the population was 29.1 years and the age range in this group was 18 to 45 years and the majority (73.9%) of women were primipara. There were 3.3% of teenage pregnancies and 14% of mothers were over 35 years. Majority (59.7%) of mothers underwent repeat OGTT test at 34 weeks of gestation and the rest (40.3%) underwent test between 34 to 36 weeks of gestation. Although the mean BMI was 23.74, 9.7% of mothers were obese (>30 kg/m2), 30.3% of mothers were pre-obese (25.0 - 29.9 kg/m2). 8.2% of mothers were diagnosed with Gestational diabetes at 34 - 36 weeks whose initial OGTT values were normal.<strong> Conclusion</strong>: In view of reducing feto-maternal morbidity and mortality, considering a repeat OGTT at a later gestation (34 - 36 weeks of gestation) should be considered in mothers, whose initial OGTT values are normal as Sri Lanka is a high risk country for GDM. <strong>Clinical Significance</strong>: The study may play an important role in guideline alteration process and screening for gestational diabetes in Sri Lankan set-up.展开更多
文摘<strong>Background</strong> It is well known that both pre-excising and gestational diabetes mellitus in pregnancy is associated with multiple maternal and fetal complications. There are various guidelines developed to reduce these complications, yet there is no universal agreement regarding the ideal management. For those with pre-exciting or gestational diabetes mellitus, the control of blood sugar is assessed either with 1st-hour post-prandial blood sugar values or with the 2nd-hour post-prandial blood sugar values. <strong>Objective </strong>To compare the long-term blood glucose control (HbA1c values) of pregnant women by utilizing results of 1-hour postprandial blood sugar values against 2-hour post-prandial blood sugar values, in the antenatal ward at the professorial unit, Teaching Hospital Peradeniya. <strong>Materials and Methods</strong> A prospective cohort study was carried out among 138 pregnant women with diabetes mellitus, who were managed in two different clinics at the professorial unit, Teaching Hospital Peradeniya. The blood glucose control in group 1 (n = 69) was assessed and optimized with 1st-hour postprandial blood sugar values and group 2 (n = 69) was evaluated with 2nd-hour postprandial values throughout the pregnancies. Following delivery, all subjects were reassessed with blood HbA1c and analyzed with the independent t-test. Feto-maternal complications were analyzed and evaluated using descriptive statistics and Chi-Square tests. <strong>Results</strong> Of the subjects, 97.1% were diagnosed with gestational diabetes mellitus. The mean value of HbA1c for group 1, managed with 1st-hour blood glucose values was 5.73 and 6.04 (p = 0.02) respectively for group 2. Fetal macrosomia was also significantly (p < 0.01) low in the 1-hour blood sugar control group.<strong> Conclusion</strong> Long-term control of blood sugar was significantly superior among the subjects managed with 1st-hour postprandial blood sugars with a statistically significant reduction in foetal macrosomia.
文摘<strong>Aim</strong>: Evaluation of the occurrence of glucose intolerance after 34 - 36 weeks in pregnant mothers attending the Teaching Hospital, Peradeniya. <strong>Materials & Method</strong>: This is a descriptive cross-sectional study carried out from October 2017 to March 2018 among 183 pregnant mothers attending antenatal clinic at Teaching Hospital Peradeniya. After informed consent a repeat Oral Glucose Tolerance Test (OGTT) was done among the pregnant mothers, at period of amenorrhoea of 34 - 36 weeks, whose initial OGTT values were normal. Gestational diabetes was diagnosed according to the NICE guideline cut off values and the percentage of late occurrence of Gestational diabetes (GDM) was analyzed. <strong>Results</strong>: Mean age of the population was 29.1 years and the age range in this group was 18 to 45 years and the majority (73.9%) of women were primipara. There were 3.3% of teenage pregnancies and 14% of mothers were over 35 years. Majority (59.7%) of mothers underwent repeat OGTT test at 34 weeks of gestation and the rest (40.3%) underwent test between 34 to 36 weeks of gestation. Although the mean BMI was 23.74, 9.7% of mothers were obese (>30 kg/m2), 30.3% of mothers were pre-obese (25.0 - 29.9 kg/m2). 8.2% of mothers were diagnosed with Gestational diabetes at 34 - 36 weeks whose initial OGTT values were normal.<strong> Conclusion</strong>: In view of reducing feto-maternal morbidity and mortality, considering a repeat OGTT at a later gestation (34 - 36 weeks of gestation) should be considered in mothers, whose initial OGTT values are normal as Sri Lanka is a high risk country for GDM. <strong>Clinical Significance</strong>: The study may play an important role in guideline alteration process and screening for gestational diabetes in Sri Lankan set-up.
