Arterial hypertension and diabetes developed in pregnancy

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Abstract

BACKGROUND: Gestational diabetes mellitus is a significant medical and social problem in most countries. Despite the relatively high level of development of modern medicine, following the growth of obesity and type 2 diabetes, the prevalence of gestational diabetes mellitus is also increasing worldwide.

AIM: To identify the frequency and structure of carbohydrate metabolism disorders and to compare the level of blood pressure in a random sample of pregnant women registered in the Perinatal center.

MATHERIALS AND METHODS: The analysis of the data of examination of carbohydrate metabolism of pregnant women who are registered in the Perinatal Center (Leningrad region, Gatchina), has been carried out. The analysis of medical documentation, survey, endocrinological and gynecological examination, calculation of the body mass index and the study of carbohydrate metabolism have been carried out.

RESULTS: There is an increase in the number of pregnant women with impaired carbohydrate metabolism over the years of observation. Gestational diabetes on diet therapy was 64.4% in 2019, 31.0% — in 2020, 65.1% — in 2021, on insulin therapy — 32.2, 62.3, 28.9% respectively. There was an increase in the number of women with type 1 and type 2 diabetes diagnosed before pregnancy and newly diagnosed diabetes during pregnancy. Body mass index and blood pressure levels are higher and glycated hemoglobin levels are lower in diet-treated pregnant women with gestational diabetes compared with insulin therapy. An increase in glycated hemoglobin was found annually in a group of women with gestational diabetes mellitus on insulin therapy.

CONCLUSIONS: The high prevalence of carbohydrate metabolism disorders and the associated increase in blood pressure in pregnant women in Saint Petersburg and the Leningrad Region justifies a targeted search for carbohydrate metabolism disorders in pregnant women.

About the authors

Elena Yu. Zagarskikh

North-Western State Medical University named after I.I. Mechnikov

Email: zagarsklena@mail.ru
ORCID iD: 0000-0002-9716-1905
SPIN-code: 1149-7540

MD, Dr. Sci. (Med.), Professor

Russian Federation, Saint Petersburg

Sergey A. Partsernyak

North-Western State Medical University named after I.I. Mechnikov

Email: professorpsa@mail.ru
SPIN-code: 4182-2470

MD, Dr. Sci. (Med.), Professor

Russian Federation, Saint Petersburg

Sergey V. Rishchuk

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: s.rishchuk@mail.ru
ORCID iD: 0000-0002-9993-7543
SPIN-code: 1558-3335

MD, Dr. Sci. (Med.), Professor

Russian Federation, Saint Petersburg

Galina A. Proshchai

Toksovskaya interdistrict hospital

Email: galina.proshchai@mail.ru
ORCID iD: 0000-0003-3539-0398
SPIN-code: 7247-7085

MD, Cand. Sci. (Med.)

Russian Federation, Leningrad region

References

  1. Bettikher OA, Zazerskaya IE, Popova PV, Kustarov VN. A comparison of the clinical outcomes of induced and spontaneous labour in patients with gestational diabetes. Diabetes mellitus. 2016;19(2):158–163. (In Russ.). doi: 10.14341/DM2004130-33
  2. Dedov II, Kolesnikova LI, Bardymova TP, et al. Ethnic specific features of diabetes mellitus in nations of Pribaikalje. The Bulletin of Siberian Branch of Russian Academy of Medical Sciences. 2008;28(1):16–20. (In Russ.)
  3. Hajifaraji M, Jahanjou F, Abbasalizadeh F, et al. Effect of probiotic supplements in women with gestational diabetes mellitus on inflammation and oxidative stress biomarkers: a randomized clinical trial. Asia Pac J Clin Nutr. 2018;27(3):581–591. doi: 10.6133/apjcn.082017.03
  4. Moyer VA. Screening for gestational diabetes mellitus: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;160:414–420. doi: 10.7326/M13-2905
  5. Peng TY, Ehrlich SF, Crites Y, et al. Trends and racial and ethnic disparities in the prevalence of pregestational type 1 and type 2 diabetes in Northern California: 1996-2014. Am J Obstet Gynecol. 2017;216(2):177.e1–177.e8. doi: 10.1016/j.ajog.2016.10.007
  6. Hagiwara Y, Kasai J, Nakanishi S, et al. Should the IADPSG criteria be applied when diagnosing early-onset gestational diabetes? Diabetes Res Clin Pract. 2018;140:154–161. doi: 10.1016/j.diabres.2018.03.048
  7. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33 Suppl 1(Suppl 1):S62–69. doi: 10.2337/dc10-S062
  8. Endocrinology: national guidelines. Ed. by I.I. Dedov, G.A. Melnichenko. Мoscow: GEHOTAR-Media; 2008. (In Russ.)
  9. Flack JR, Ross GP. Survey on testing for gestational diabetes mellitus in Australia. Aust N Z J Obstet Gynaecol. 2016;56(4):346–348. doi: 10.1111/ajo.12457
  10. Wu ET, Nien FJ, Kuo CH, et al. Diagnosis of more gestational diabetes lead to better pregnancy outcomes: Comparing the International Association of the Diabetes and Pregnancy Study Group criteria, and the Carpenterand Coustan criteria. J Diabetes Investig. 2016;7(1):121–126. doi: 10.1111/jdi.12378
  11. Dedov II, Kolesnikova LI, Ivanova ON, et al. Polimorfizm genov HLA klassa II i CTLA4 zdorovykh buryat i bol’nykh sakharnym diabetom 1 tipa v Buryatskoj Respublike. Diabetes mellitus. 2006;(1):2–8. (In Russ.). doi: 10.14341/2072-0351-5373
  12. Lavery JA, Friedman AM, Keyes KM, et al. Gestational diabetes in the United States: temporal changes in prevalence rates between 1979 and 2010. BJOG. 2017;124(5):804–813. doi: 10.1111/1471-0528.14236
  13. Zaman F, Nouhjah S, Shahbazian H, et al. Risk factors of gestational diabetes mellitus using results of a prospective population-based study in Iranian pregnant women. Diabetes Metab Syndr. 2018;12(5):721–725. doi: 10.1016/j.dsx.2018.04.014
  14. Xiao Y, Chen R, Chen M, et al. Age at menarche and risks of gestational diabetes mellitus: a meta-analysis of prospective studies. Oncotarget. 2017;9(24):17133–17140. doi: 10.18632/oncotarget.23658
  15. Lizneva D, Suturina L, Walker W, et al. Criteria, prevalence and phenotypes of polycystic ovary syndrome. Fertil Steril. 2016;106(1):6–15. doi: 10.1016/j.fertnstert.2016.05.003
  16. Buckley BS, Harreiter J, Damm P, et al. Gestational diabetes mellitus in Europe: prevalence, current screening practice and barriers to screening. A review. Diabet Med. 2012;29(7):844–854. doi: 10.1111/j.1464-5491.2011.03541.x
  17. McGuane JT, Grlj L, Peek MJ. Obesity, gestational diabetes and macrosomia are associated with increasing rates of early-term induction of labour at The Canberra Hospital. Aust N Z J Obstet Gynaecol. 2019;59(2):215–220. doi: 10.1111/ajo.12820
  18. Lima RJCP, Batista RFL, Ribeiro MRC, et al. Prepregnancy body mass index, gestational weight gain, and birth weight in the BRISA cohort. Rev Saude Publica. 2018;52:46. doi: 10.11606/s1518-8787.2018052000125
  19. International Weight Management in Pregnancy (i-WIP) Collaborative Group. Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials. BMJ. 2017;358:j3119. doi: 10.1136/bmj.j3119
  20. Meinilä J, Valkama A, Koivusalo SB, et al. Association between diet quality measured by the Healthy Food Intake Index and later risk of gestational diabetes-a secondary analysis of the RADIEL trial. Eur J Clin Nutr. 2017;71(7):913. doi: 10.1038/ejcn.2017.66
  21. Valkama AJ, Meinilä J, Koivusalo S, et al. The effect of pre-pregnancy lifestyle counselling on food intakes and association between food intakes and gestational diabetes in high-risk women: results from a randomised controlled trial. J Hum Nutr Diet. 2018;31(3):301–305. doi: 10.1111/jhn.12547
  22. Michalakis K, Mintziori G, Kaprara A, et al. The complex interaction between obesity, metabolic syndrome and reproductive axis: A narrative review. Metabolism. 2013;62(4):457–478. doi: 10.1016/j.metabol.2012.08.012
  23. Petunina NA, Kuzina IA. The role of hormones of adipose tissue in the development pregnancy complications in obese women. Obesity and metabolism. 2013;10(1):3–8. (In Russ.). doi: 10.14341/2071-8713-5063
  24. Lobo TF, Torloni MR, Mattar R, et al. Adipokine levels in overweight women with early-onset gestational diabetes mellitus. J Endocrinol Invest. 2019;42(2):149–156. doi: 10.1007/s40618-018-0894-0
  25. Nanda S, Yu CKH, Giurcaneanu L, et al. Maternal Serum Adiponectin at 11–13 weeks of gestation in preeclampsia. Fetal Diagn Ther. 2011;29(3):208–215. doi: 10.1159/000322402
  26. Parlea L, Bromberg IL, Feig DS, et al. Association between serum 25-hydroxyvitamin D in early pregnancy and risk of gestational diabetes mellitus. Diabet Med. 2012;29(7):e25–32. doi: 10.1111/j.1464-5491.2011.03550.x
  27. Ruyatkina LA, Sorokin MY. Detemir potential applications in the treatment of diabetes during pregnancy: proven benefits and perspectives. Diabetes mellitus. 2016;19(2):171–178. doi: 10.14341/DM2004150-55
  28. Kapustin RV, Arzhanova ON, Tisel’ko AV. Oxidative stress in pregnant women with diabetes mellitus. Diabetes mellitus. 2017;20(6):461–471. (In Russ.). doi: 10.14341/DM8669
  29. Kolesnikova LI, Grebenkina LA, Darenskaya MA, Vlasov BYa. Oxidative stress as nonspecific pathogenetic link of reproductive disorders (systematic review). The Bulletin of Siberian Branch of Russian Academy of Medical Sciences. 2012;32(1):58–66. (In Russ.)
  30. Kolesnikova LI, Osipova EV, Grebenkina LA. Okislitel’nyj stress pri reproduktivnykh narusheniyakh ehndokrinnogo geneza u zhenshhin. Novosibirsk; 2011. (In Russ.)
  31. Cundy T, Gamble G, Townend K, et al. Perinatal mortality in Type 2 diabetes mellitus. Diabet Med. 2000;17(1):33–39. doi: 10.1046/j.1464-5491.2000.00215.x
  32. Li X, Zhang W, Lin J, et al. Risk factors for adverse maternal and perinatal outcomes in women with preeclampsia: analysis of 1396 cases. J Clin Hypertens (Greenwich). 2018;20(6):1049–1057. doi: 10.1111/jch.13302
  33. Baliutavičienė D, Buinauskienė JB, Petrenko V, et al. Gestational diabetes, obesity, and metabolic syndrome diagnosed during pregnancy. Metab Syndr Relat Disord. 2012;10(3):214–217. doi: 10.1089/met.2011.0067
  34. Sacks DA. The use of pharmacotherapy in pregnancies with suspected diabetic fetopathy. J Matern Fetal Neonatal Med. 2012;25(1):45–49. doi: 10.3109/14767058.2012.626929
  35. Desoye G, Nolan CJ. The fetal glucose steal: an underappreciated phenomenon in diabetic pregnancy. Diabetologia. 2016;59(6):1089–1094. doi: 10.1007/s00125-016-3931-6
  36. Esakoff TF, Cheng YW, Sparks TN, Caughey AB. The association between birthweight 4000 g or greater and perinatal outcomes in patients with and without gestational diabetes mellitus. Am J Obstet Gynecol. 2009;200(6):672.e1–4. doi: 10.1016/j.ajog.2009.02.035
  37. Li J, Qian G, Zhong X, Yu T. Insulin treatment cannot promote lipogenesis in rat fetal lung in gestational diabetes mellitus because of failure to redress the imbalance among SREBP-1, SCAP, and INSIG-1. DNA Cell Biol. 2018;37(3):264–270. doi: 10.1089/dna.2017.3906
  38. Mikhalev EV, Shanina OM, Saprina TV. Hormonal, electrolyte disturbances and features of hemostasis in term newborn infants of mothers with gestational diabetes mellitus. Diabetes mellitus. 2015;18(1):78–86. (In Russ.). doi: 10.14341/DM2015178-86
  39. Chabanova NB, Mataev SI, Vasil’kova T, Troshina IA. Metabolic disorders in adipocytokine imbalance and gestational complications. Obesity and metabolism. 2017;14(1):9–16. (In Russ.). doi: 10.14341/OMET201719-16
  40. McLachlan KA, O’Neal D, Jenkins A, Alford FP. Do adiponectin, TNFα, leptin and CRP relate to insulin resistance in pregnancy? Studies in women with and without gestational diabetes, during and after pregnancy. Diabetes Metab Res Rev. 2006;22(2):131–138. doi: 10.1002/dmrr.591
  41. Agarwal MM, Punnose J, Sukhija K, et al. Gestational diabetes mellitus: Using the fasting plasma glucose level to simplify the International Association of Diabetes and Pregnancy Study Groups Diagnostic Algorithm in an adult South Asian population. Can J Diabetes. 2018;42(5):500–504. doi: 10.1016/j.jcjd.2017.12.009
  42. Abdrakhmanova AI, Oslopova YuV, Khasanova RN, Tsibul’kin NA. Arterial’naya gipertenziya u beremennykh: uchebnoe posobie. Kazan’; 2017. (In Russ.)
  43. Wang L, Leng J, Liu H, et al. Association between hypertensive disorders of pregnancy and the risk of postpartum hypertension: a cohort study in women with gestational diabetes. J Hum Hypertens. 2017;31(11):725–730. doi: 10.1038/jhh.2017.46
  44. Sathish T, Kapoor N, Cao Y, et al. Proportion of newly diagnosed diabetes in COVID-19 patients: A systematic review and meta-analysis. Diabetes Obes Metab. 2021;23(3):870–874. doi: 10.1111/dom.14269
  45. Standards of specialized diabetes care. Ed. by I.I. Dedov, M.V. Shestakova, A.Yu. Mayorov. 10th edition. Moscow; 2021. (In Russ.). doi: 10.14341/DM12802

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Copyright (c) 2022 Zagarskikh E.Y., Partsernyak S.A., Rishchuk S.V., Proshchai G.A.

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