Screening for gestational diabetes mellitus and associated risk factors before 20 weeks of g est ation in health clinics, Tanah merah,Kelantan

• Main Author: Yusof, Yusmawati Mohd
• Format: Thesis
• Language: English
• Published: 2007
• Subjects: R Medicine (General)
• Online Access: http://eprints.usm.my/48439/1/DR%20YUSMAWATI%20BT%20MOHD%20YUSOF.pdf; http://eprints.usm.my/48439/

Screening for Gestational Diabetes Mellitus and Associated Risk Factors Before 20 Weeks of Gestation in Health Clinics, Tanah Merah, Kelantan. Early diagnosis and treatment is the most important issue for the successful management of gestational diabetes mellitus. Thus lays the importance of screening for gestational diabetes mellitus, which allows for early initiation of appropriate therapy which remains the cornerstone of management of gestational diabetes mellitus. The objectives of this study were to determine the incidence of gestational diabetes mellitus before 20 weeks, at 24-28 weeks and at 32-34 weeks of gestation and to evaluate factors associated with gestational diabetes mellitus before 20 weeks of gestation. This is a cross sectional study. A total of 376 pregnant women started their antenatal care at health clinics Tanah Merah, Kelantan before 20 weeks of gestation and were at risk of developing gestational diabetes mellitus were enrolled. All pregnant women had initial two hours 75-g oral glucose tolerance test before 20 weeks of gestation. If the results were negative, second OGTT were performed at 24-28 weeks and subsequently at 32-34 weeks if still negative. A diagnosis of gestational diabetes mellitus was made if fasting glucose ~ 6.1 mmol/l or 2 hours ~ 7.8 mmoi/l. The main outcome measures were incidences of gestational diabetes mellitus before 20 weeks, at 24-28 and at 32-34 weeks of gestation and the association between clinical risk factors and gestational diabetes mellitus below 20 weeks of gestation. Data was analyzed using SPSS version 12.0. The results sho\ved that the overall incidence of gestational diabetes mellitus was 47.9 %. The incidence of GDM before 20 weeks of gestation was 33.0 %, another 13.5 % were diagnosed between 24-28 weeks and 10.1 % between 32-34 weeks. The three independent risks for developing gestational diabetes mellitus before 20 weeks of gestation were age ~ 35 years, history of gestational diabetes mellitus in previous pregnancy and family history of diabetes mellitus. In conclusion, screening for gestational diabetes mellitus in Tanah Merah, Kelantan is crucial in detecting early onset of gestational diabetes mellitus since nl0re than half of women with gestational diabetes mellitus ( 124 of 180 , 68.9%) \vere diagnosed early in their pregnancies. The three specific groups of women ( women age ~ 35 years, women who had gestational diabetes mellitus in previous pregnancy and women with family history of diabetes mellitus) should be promptly identified, counseled regarding the important of early booking and early screening for gestational diabetes mellitus.