Glycemic Status: A A Description of Pregnant Cree i i f C Women - - PowerPoint PPT Presentation

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Jun 15, 2023 146 likes •357 views

Glycemic Status: A A Description of Pregnant Cree i i f C Women Living in Women Living in James Bay, Qubec Julie K. Laverdire Noreen D. Willows, Rhonda C. Bell Dept. Agricultural, Food, & Nutritional Science Dept. Agricultural,

SLIDE 1

Glycemic Status: A i i f C A Description of Pregnant Cree Women Living in Women Living in James Bay, Québec

Julie K. Laverdière Noreen D. Willows, Rhonda C. Bell

Dept. Agricultural, Food, & Nutritional Science
Dept. Agricultural, Food, & Nutritional Science

University of Alberta, Edmonton, AB

SLIDE 2

Gestational Diabetes Mellitus Gestational Diabetes Mellitus

“Carbohydrate intolerance resulting in Carbohydrate intolerance resulting in hyperglycemia of variable severity with onset

r first recognition during pregnancy”
st ecog

t o du g p eg a cy

Meltzer. Diabetes 1991; 40 (suppl):197

Mother Mother – PIH, preeclampsia Infant Infant – Macrosomia – Type 2 diabetes – Hypoglycemia at birth – Type 2 diabetes

SLIDE 3

Background Information

The sociocultural and biological determinants

f overweight in Cree children

Purpose: T i th th f C hild f – To examine the growth of Cree children from 0 to 5 yrs of age. – To identify factors that may affect child growth To identify factors that may affect child growth (eg.anemia, type of feeding, maternal glucose tolerance)

SLIDE 4

Obj ti Objective

To describe the physical characteristics of women with normoglycemia, IGT, and GDM g y during pregnancy.

SLIDE 5

M th d Methods

Medical chart review (1709 women)

– January 1994 to December 2000 – January 1994 to December 2000 – Obstetric forms, laboratory reports, medical notes notes

9 communities in James Bay Region
9 communities in James Bay Region

SLIDE 6

SLIDE 7

Data Collected

Early During Infant Pregnancy pregnancy Characteristics Pregnancy pregnancy Characteristics

Weight 50 g OCGT Birth weight g g g Height 75 or 100 gm OCGT Age Fasting glucose

SLIDE 8

Diagnostic Criteria g

All women are given f i l l fasting plasma sample All h 50 OGCT All women have 50g OGCT Normal glycemia: <7.8mmol/l Further testing: 7.8-10.2mmol/l GDM: ≥10.3mmol/l OGTT

SLIDE 9

GDM Diagnostic Criteria: GDM Diagnostic Criteria: OGTT

NDDGa – 100gm Time CPGb – 75gm

5 8 fasting (mmol/l) 5 3 5.8 fasting (mmol/l) 5.3 10.6 1h (mmol/l) 10.6 ( ) 9.2 2h (mmol/l) 8.9 8.1 3h (mmol/l)

a National Diabetes Data Group. Diabetes 1979; 28: 1039.

National Diabetes Data Group. Diabetes 1979; 28: 1039.

b Clinical Practice Guidelines. CMAJ 1998; 159: S1.

SLIDE 10

Prevalence Prevalence

Glycemic Number % of Sample Glycemic Status Number % of Sample

N l

1296 75 8

Normal

1296 75.8

Impaired Glucose

142 8 3

Tolerance (IGT)

142 8.3

Gestational Diabetes Mellitus (GDM)

271 15.8

Total

1709 100

SLIDE 11

Prevalence Prevalence

Glycemic Number % of Sample Status

Normal 1296 75 8

Normal

1296 75.8

Impaired Glucose

Tolerance (IGT) 142 8 3 Tolerance (IGT) 142 8.3

Gestational Diabetes

Mellitus (GDM) 271 15.8 ( ) Total 1709 100

SLIDE 12

Body Weight Early in Pregnancy

79.4 86.1 86.9 80 100

* *

60 80

WEIGHT (kg)

20 40

(kg)

20 NORMAL IGT GDM NORMAL IGT GDM

*Different from NORMAL glycemic group, p<0.001

SLIDE 13

Body Mass Index Entering Body Mass Index Entering Pregnancy

30 33.8 32.6

35 40

* *

20 25 30

BMI (k /

10 15 20

(kg/m2)

5 NORMAL IGT GDM NORMAL IGT GDM

*Different from NORMAL glycemic group, p<0.001

SLIDE 14

Maternal Age

25.5 26.8 23.3 25 30

* *

15 20

Age (yrs)

5 10 15 5 NORMAL IGT GDM

*Different from NORMAL glycemic group, P<0.001

SLIDE 15

Fasting Plasma Glucose Fasting Plasma Glucose Early in Pregnancy

4.5 4.6 4.8 5 6

Normal: < 5.3mmol/l

*

4.5 3 4 Fasting Plasma 1 2 3 Glucose (mmol/l) 1 NORMAL IGT GDM

* GDM different from IGT & Normal glycemic group, p<0.001

SLIDE 16

Infant Birth Weight Infant Birth Weight

Maternal Infant Birth % of Group with Glygemic Status Weight (g) Birth Weight >4000g Normal 3766 32.1 Impaired Glucose Tolerance 3900 39.4 Gestational Diabetes Mellitus 3970 48.5

SLIDE 17

Summary

A quarter of women has abnormal glucose

tolerance

Women with IGT and GDM are heavier &
lder than those with normal glucose tolerance
Women with IGT and GDM are similar

– Body weight, BMI, age Body weight, BMI, age

SLIDE 18

Conclusion

High prevalence of abnormal glucose

tolerance

High body weight & increasing age are

High body weight & increasing age are predisposing characteristics

Importance of universal screening

SLIDE 19

Acknowledgement Acknowledgement

Community Members Clinic Staff

I. Kovitch, MD

Clinic Staff Cree Board of Health & Social Services of

D. Dannebaum, MD

Glycemic Status: A i i f C A Description of Pregnant Cree Women Living in Women Living in James Bay, Québec

Julie K. Laverdière Noreen D. Willows, Rhonda C. Bell

Gestational Diabetes Mellitus Gestational Diabetes Mellitus

“Carbohydrate intolerance resulting in Carbohydrate intolerance resulting in hyperglycemia of variable severity with onset

t o du g p eg a cy

Mother Mother – PIH, preeclampsia Infant Infant – Macrosomia – Type 2 diabetes – Hypoglycemia at birth – Type 2 diabetes

Background Information

The sociocultural and biological determinants

Purpose: T i th th f C hild f – To examine the growth of Cree children from 0 to 5 yrs of age. – To identify factors that may affect child growth To identify factors that may affect child growth (eg.anemia, type of feeding, maternal glucose tolerance)

Obj ti Objective

To describe the physical characteristics of women with normoglycemia, IGT, and GDM g y during pregnancy.

M th d Methods

– January 1994 to December 2000 – January 1994 to December 2000 – Obstetric forms, laboratory reports, medical notes notes

Data Collected

Early During Infant Pregnancy pregnancy Characteristics Pregnancy pregnancy Characteristics

Weight 50 g OCGT Birth weight g g g Height 75 or 100 gm OCGT Age Fasting glucose

Diagnostic Criteria g

All women are given f i l l fasting plasma sample All h 50 OGCT All women have 50g OGCT Normal glycemia: <7.8mmol/l Further testing: 7.8-10.2mmol/l GDM: ≥10.3mmol/l OGTT

GDM Diagnostic Criteria: GDM Diagnostic Criteria: OGTT

NDDGa – 100gm Time CPGb – 75gm

5 8 fasting (mmol/l) 5 3 5.8 fasting (mmol/l) 5.3 10.6 1h (mmol/l) 10.6 ( ) 9.2 2h (mmol/l) 8.9 8.1 3h (mmol/l)

Prevalence Prevalence

Glycemic Number % of Sample Glycemic Status Number % of Sample

N l

1296 75 8

Normal

1296 75.8

Impaired Glucose

142 8 3

Tolerance (IGT)

142 8.3

Gestational Diabetes Mellitus (GDM)

271 15.8

Total

1709 100

Prevalence Prevalence

Glycemic Number % of Sample Status

Normal 1296 75 8

1296 75.8

Tolerance (IGT) 142 8 3 Tolerance (IGT) 142 8.3

Mellitus (GDM) 271 15.8 ( ) Total 1709 100

Body Weight Early in Pregnancy

* *

Body Mass Index Entering Body Mass Index Entering Pregnancy

* *

Maternal Age

Fasting Plasma Glucose Fasting Plasma Glucose Early in Pregnancy

*

Infant Birth Weight Infant Birth Weight

Maternal Infant Birth % of Group with Glygemic Status Weight (g) Birth Weight >4000g Normal 3766 32.1 Impaired Glucose Tolerance 3900 39.4 Gestational Diabetes Mellitus 3970 48.5

Summary

tolerance

– Body weight, BMI, age Body weight, BMI, age

Conclusion

tolerance

High body weight & increasing age are predisposing characteristics

Acknowledgement Acknowledgement

Community Members Clinic Staff

Clinic Staff Cree Board of Health & Social Services of

AHFMR, NSTP, C/BAR James Bay , NS , C/