Special Issue "Hyperglycaemia in Pregnancy: Detection, Management and Postnatal Care in Rural Communities"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Women's Health".

Deadline for manuscript submissions: closed (31 May 2020).

Special Issue Editors

Assoc. Prof. Julia Marley
Website SciProfiles
Guest Editor
The University of Western Australia, Rural Clinical School of Western Australia,Other Affiliation: Kimberley Aboriginal Medical Services Inc.,Broome, WA, Australia
Interests: Improving the quality of preventive health programs for Aboriginal people by trialling new programs and evaluating their effectiveness; improving screening for chronic diseases and mental health by trialling new screening protocols; and improving the quality of primary health care for Aboriginal people by evaluating health services
Ms. Emma Jamieson
Website
Guest Editor
The University of Western Australia, Rural Clinical School of Western Australia,Bunbury, WA, Australia
Interests: The causes, prediction and prevention of diabetes mellitus; background in pathophysiology of type 1 diabetes and pancreatic islet transplantation models; current clinical diabetes research focus on alternate biomarkers to improve detection of gestational diabetes mellitus in rural and remote antenatal patients; translational research aimed at improving birth outcomes and prevention or delayed progression to type 2 diabetes in mother and child
Dr. Andrew Kirke
Website
Guest Editor
The University of Western Australia, Rural Clinical School of Western Australia,Bunbury, WA, Australia
Interests: rural obstetrics, GP obstetrics, gestational diabetes; rural health; community screening for familial hypercholesterolaemia

Special Issue Information

Dear Colleagues,

We are organising a Special Issue on "Hyperglycaemia in Pregnancy: Detection, Management and Postnatal Care in Rural Communities" in the International Journal of Environmental Research and Public Health, a peer-reviewed journal that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health. For detailed information on the journal, we refer you to https://www.mdpi.com/journal/ijerph.

Increasing maternal glycaemia in pregnancy is associated with adverse perinatal outcomes as well as long-term disordered maternal glucose metabolism and worsening childhood glucose metabolism. Due to the high prevalence of hyperglycaemia in pregnancy and potential for improved perinatal outcome, the International Association of Diabetes in Pregnancy Study Groups (IADPSG) recommends that all pregnant women without pre-existing diabetes be screened for hyperglycaemia by 75 g Oral Glucose Tolerance Test (OGTT).  In 2010, the IADPSG derived new OGTT diagnostic cut-points for gestational diabetes (GDM). The use of specific cut-points assumes that the result is dichotomous, despite the fact that these cut-points were predominantly based on evidence of a continuous linear association between mild maternal hyperglycaemia and adverse perinatal outcomes from the Hyperglycaemia and Adverse Pregnancy Outcomes (HAPO) study. Implementation of new screening guidelines can be challenging in resource-poor environments and can lead to unintended consquences. The 2015 International Federation of Gynaecology and Obstetrics (FIGO) guidelines for GDM recommend both optimal, evidence-based standards for testing, diagnosis, management and postnatal care, as well as pragmatic alternatives, acknowledging limitations in low-resourced countries and regions. This Special Issue will explore the on-the-ground realities of screening and managing hyperglycaemia in pregnancy and the impact on outcomes for women living in regional, rural and remote communities and their health services. The issue is open to any topic related to hyperglycaemia in pregnancy for women living in regional, rural and remote communities. The listed keywords suggest just a few of the many possibilities.

Assoc. Prof. Julia Marley
Ms. Emma Jamieson
Dr. Andrew Kirke
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • hyperglycaemia in pregnancy
  • gestational diabetes
  • screening
  • diagnosis
  • oral glucose tolerance test
  • glycated haemoglobin
  • glycated albumin
  • management
  • antenatal care
  • postnatal care
  • glycolysis
  • clinical laboratory techniques
  • reproducibility of results
  • point-of-care testing
  • birth outcomes
  • epidemiology
  • user acceptability
  • rural and remote health
  • primary health care
  • Indigenous, Aboriginal, First Nations
  • health policy
  • implementation

Published Papers (4 papers)

Order results
Result details
Select all
Export citation of selected articles as:

Research

Open AccessArticle
High Prevalence of Gestational Diabetes Mellitus in Rural Tanzania—Diagnosis Mainly Based on Fasting Blood Glucose from Oral Glucose Tolerance Test
Int. J. Environ. Res. Public Health 2020, 17(9), 3109; https://doi.org/10.3390/ijerph17093109 - 29 Apr 2020
Abstract
Gestational diabetes mellitus (GDM) is associated with poor pregnancy outcomes and increased long-term risk of metabolic diseases for both mother and child. In Tanzania, GDM prevalence increased from 0% in 1991 to 19.5% in 2016. Anaemia has been proposed to precipitate the pathogenesis [...] Read more.
Gestational diabetes mellitus (GDM) is associated with poor pregnancy outcomes and increased long-term risk of metabolic diseases for both mother and child. In Tanzania, GDM prevalence increased from 0% in 1991 to 19.5% in 2016. Anaemia has been proposed to precipitate the pathogenesis of GDM. We aimed to examine the prevalence of GDM in a rural area of Tanzania with a high prevalence of anaemia and to examine a potential association between haemoglobin concentration and blood glucose during pregnancy. The participants were included in a population-based preconception, pregnancy and birth cohort study. In total, 538 women were followed during pregnancy and scheduled for an oral glucose tolerance test (OGTT) at week 32–34 of gestation. Gestational diabetes mellitus was diagnosed according to the WHO 2013 guidelines. Out of 392 women screened, 39% (95% CI: 34.2–44.1) had GDM, the majority of whom (94.1%) were diagnosed based solely on the fasting blood sample from the OGTT. No associations were observed between haemoglobin or ferritin and glucose measurements during pregnancy. A very high prevalence of GDM was found in rural Tanzania. In view of the laborious, costly and inconvenient OGTT, alternative methods such as fasting blood glucose should be considered when screening for GDM in low- and middle-income countries. Full article
Show Figures

Figure 1

Open AccessArticle
“If I Don’t Eat Enough, I Won’t Be Healthy”. Women’s Experiences with Gestational Diabetes Mellitus Treatment in Rural and Urban South India
Int. J. Environ. Res. Public Health 2020, 17(9), 3062; https://doi.org/10.3390/ijerph17093062 - 28 Apr 2020
Abstract
Gestational diabetes mellitus (GDM) is associated with a range of adverse pregnancy outcomes as well as increased risk of future type 2 diabetes and cardiovascular disease. In India, 10%–35% of pregnant women develop GDM. In this study, we investigated women’s experiences with the [...] Read more.
Gestational diabetes mellitus (GDM) is associated with a range of adverse pregnancy outcomes as well as increased risk of future type 2 diabetes and cardiovascular disease. In India, 10%–35% of pregnant women develop GDM. In this study, we investigated women’s experiences with the dietary and pharmaceutical treatment for GDM in rural and urban Tamil Nadu, India. Semi-structured interviews were conducted with 19 women diagnosed with GDM. Data were analyzed using qualitative content analysis. Three overall aspects were discovered with several sub-aspects characterizing women’s experiences: emotional challenges (fear and apprehension for the baby’ health and struggling to accept a treatment seen as counterintuitive to being safe and healthy), interpersonal challenges (managing treatment in the near social relations and social support, and coordinating treatment with work and social life), and health system-related challenges (availability and cost of treatment, interaction with health care providers). Some aspects acted as barriers. However, social support and positive, high-quality interactions with health care providers could mitigate some of these barriers and facilitate the treatment process. Greater efforts at awareness creation in the social environment and systemic adjustments in care delivery targeting the individual, family, community and health system levels are needed in order to ensure that women with GDM have the opportunity to access treatment and are enabled and motivated to follow it as well. Full article
Open AccessArticle
Initial Validation of the Diabetes and Breastfeeding Management Questionnaire (DBM-Q)
Int. J. Environ. Res. Public Health 2020, 17(9), 3044; https://doi.org/10.3390/ijerph17093044 - 27 Apr 2020
Abstract
Women with pre-gestational diabetes face additional challenges after birth as they struggle with breastfeeding and managing unpredictable blood glucose levels. The aim of this study is to validate the Diabetes and Breastfeeding Management Questionnaire (DBM-Q). In total, 142 mothers with type 1 diabetes [...] Read more.
Women with pre-gestational diabetes face additional challenges after birth as they struggle with breastfeeding and managing unpredictable blood glucose levels. The aim of this study is to validate the Diabetes and Breastfeeding Management Questionnaire (DBM-Q). In total, 142 mothers with type 1 diabetes mellitus answered the questionnaire, which initially consisted of 11 items. The response rate was 82.5% (n = 128) at two months, and 88.4% (n = 137) at six months postpartum. The measurement properties of the Diabetes and Breastfeeding Management Questionnaire were tested according to the Rasch measurement theory (RMT). One item showed both disordered thresholds and several model misfits and was removed. Two items showed disordered thresholds which were resolved by collapsing response categories. This resulted in a 10-item questionnaire with all the fit residuals within the range of +2.5, minor significant differential item functioning, well-targeted items and a person separation index of 0.73. Evaluating the DBM-Q according to the RMT is a strength, as it evaluates data against strict measurement criteria. This study provides an initial validation of the questionnaire. The DBM-Q shows good measurement properties for measuring diabetes and breastfeeding management postpartum in women with pre-gestational diabetes. Further studies are needed to identify cutoffs for when professional support is needed. Full article
Show Figures

Figure 1

Open AccessArticle
Primary Health Care for Aboriginal Australian Women in Remote Communities after a Pregnancy with Hyperglycaemia
Int. J. Environ. Res. Public Health 2020, 17(3), 720; https://doi.org/10.3390/ijerph17030720 - 22 Jan 2020
Cited by 1
Abstract
Background: Hyperglycaemia in pregnancy contributes to adverse outcomes for women and their children. The postpartum period is an opportune time to support women to reduce cardiometabolic and diabetes risk in subsequent pregnancies. Aims: To identify strengths and gaps in current care for Aboriginal [...] Read more.
Background: Hyperglycaemia in pregnancy contributes to adverse outcomes for women and their children. The postpartum period is an opportune time to support women to reduce cardiometabolic and diabetes risk in subsequent pregnancies. Aims: To identify strengths and gaps in current care for Aboriginal women after a pregnancy complicated by hyperglycaemia. Methods: A retrospective review of the 12 month postpartum care provided by primary health centres in remote Australia in 2013–2014 identified 195 women who experienced hyperglycaemia in pregnancy (gestational diabetes (GDM) (n = 147), type 2 diabetes (T2D) (n = 39), and unclear diabetes status (n = 9)). Results: Only 80 women (54%) with GDM had postpartum glycaemic checks. Of these, 32 women were diagnosed with prediabetes (n = 24) or diabetes (n = 8). Compared to women with GDM, women with T2D were more likely to have their weight measured (75% vs. 52%, p <0.01), and smoking status documented as “discussed” (65% vs. 34%, p < 0.01). Most women (97%) accessed the health centre at least once in the 12 month postpartum period but, during these visits, only 52% of women had service provision, either structured or opportunistic, related to diabetes. Conclusion: High rates of dysglycaemia among women screened for T2D after GDM in the 12 month postpartum period highlight the need for increased screening and early intervention to prevent the development of T2D and its complications. Whilst a clear strength was high postpartum attendance, many women did not attend health services for diabetes screening or management. Full article
Show Figures

Figure 1

Back to TopTop