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Diabetes Mellitus: Type 2 and Gestational01:22

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Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
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Gestational diabetes mellitus: Challenges for different ethnic groups.

Lili Yuen1, Vincent W Wong1

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World Journal of Diabetes
|August 5, 2015
PubMed
Summary

Gestational diabetes mellitus (GDM) risk and outcomes vary significantly by ethnicity. Culturally sensitive management and individualized care are crucial for optimal antenatal outcomes in diverse populations.

Keywords:
EthnicityGestational diabetes mellitusMedical nutrition therapyPeri-natal outcomesPrevalence

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Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Public Health

Background:

  • Gestational diabetes mellitus (GDM) prevalence and risk factors differ across ethnic groups.
  • Studies on ethnic variations in GDM are predominantly from Western countries, representing diverse populations.
  • Specific ethnic groups, such as those from South and Southeast Asia, exhibit higher GDM prevalence compared to Caucasian, African-American, and Hispanic communities.

Purpose of the Study:

  • To review the impact of ethnicity on gestational diabetes mellitus (GDM) clinical characteristics and pregnancy outcomes.
  • To highlight ethnic variations in GDM risk, management, and maternal/perinatal outcomes.
  • To emphasize the need for individualized and culturally sensitive antenatal care for women with GDM from diverse ethnic backgrounds.

Main Methods:

  • Literature review of studies examining ethnic differences in gestational diabetes mellitus (GDM).
  • Analysis of data on GDM prevalence, risk factors (including BMI and country of birth), and management strategies across various ethnic groups.
  • Synthesis of information on perinatal outcomes (e.g., macrosomia) and maternal outcomes (e.g., postpartum glucose tolerance, hypertension) stratified by ethnicity.

Main Results:

  • Higher GDM prevalence is observed in South Asian and Southeast Asian women compared to other groups.
  • Body mass index is a risk factor for some, but not all, ethnic groups.
  • Women born in their native countries may have different GDM risk profiles than those born in Western countries.
  • Culturally sensitive medical nutrition therapy (MNT) and individualized insulin therapy are important.
  • Perinatal outcomes vary, with Pacific Islander women having higher rates of macrosomia and Chinese women having lower adverse outcomes.
  • Asian women with GDM have increased risk of postpartum abnormal glucose tolerance and future type 2 diabetes.
  • Hispanic and African-American women with GDM have higher rates of postpartum hypertension.

Conclusions:

  • Ethnicity significantly influences GDM clinical characteristics, management, and outcomes.
  • Individualized and culturally sensitive care is essential for pregnant women with GDM from diverse ethnic backgrounds.
  • Understanding ethnic-specific differences is critical for delivering optimal antenatal care and improving maternal and infant health outcomes.