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dc.contributor.authorGilder, Mary Ellenen_US
dc.contributor.authorZin, Thet Waien_US
dc.contributor.authorWai, Nan Sanen_US
dc.contributor.authorNer, Maen_US
dc.contributor.authorSay, Paw Sien_US
dc.contributor.authorHtoo, Myinten_US
dc.contributor.authorSay Sayen_US
dc.contributor.authorHtay, Win Winen_US
dc.contributor.authorSimpson, Julie A.en_US
dc.contributor.authorSasithon Pukrittayakameeen_US
dc.contributor.authorศศิธร ผู้กฤตยาคามีen_US
dc.contributor.authorNosten, Francoisen_US
dc.contributor.authorMcGready, Roseen_US
dc.contributor.otherMahidol University. Faculty of Tropical Medicine. Mahidol-Oxford Tropical Medicine Research Unit. Shoklo Malaria Research Unit.en_US
dc.contributor.otherMahidol University. Faculty of Tropical Medicine.en_US
dc.identifier.citationGilder ME, Zin TW, Wai NS, Ner M, Say PS, Htoo M. et al. Gestational diabetes mellitus prevalence in Maela refugee camp on the Thai-Myanmar border: a clinical report. Glob Health Action. 2014 May 12;7:23887.en_US
dc.identifier.issn1654-9880 (electronic)-
dc.identifier.issn1654-9716 (printed)-
dc.description.abstractBACKGROUND: Individuals in conflict-affected areas rarely get appropriate care for chronic or non-infectious diseases. The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide, and new evidence shows conclusively that the negative effects of hyperglycemia occur even at mild glucose elevations and that these negative effects can be attenuated by treatment. Scientific literature on gestational diabetes in refugee camp settings is critically limited. METHODS: A 75 g 2-hour glucose tolerance test was administered to 228 women attending the antenatal care (ANC) clinic in Maela refugee camp on the Thai-Myanmar border. Prevalence of GDM was determined using the HAPO trial cut-offs [≥92 mg/dL (fasting),≥180 (1 hour), and≥153 (2 hour)] and the WHO criteria [≥126 mg/dL (fasting), and 140 mg/dL (2 hour)]. RESULTS: From July 2011 to March 2012, the prevalence of GDM was 10.1% [95% confidence interval (CI): 6.2-14.0] when the cut-off determined by the HAPO trial was applied. Applying the older WHO criteria yielded a prevalence of 6.6% (95% CI 3.3-9.8). Age, parity, and BMI emerged as characteristics that may be significantly associated with GDM in this population. Other risk factors that are commonly used in screening guidelines were not applicable in this diabetes-naïve population. DISCUSSION: The prevalence of GDM is lower in this population compared with other populations, but still complicates 10% of pregnancies. New evidence regarding gestational diabetes raises new dilemmas for healthcare providers in resource-poor settings. Efforts to identify and treat patients at risk for adverse outcomes need to be balanced with awareness of the risks and burdens associated with over diagnosis and unnecessary interventions. Screening approaches based on risk factors or using higher cut-off values may help minimize this burden and identify those most likely to benefit from intervention.en_US
dc.rightsMahidol Universityen_US
dc.subjectGestational diabetes mellitusen_US
dc.subjectOpen Access articleen_US
dc.titleGestational diabetes mellitus prevalence in Maela refugee camp on the Thai-Myanmar border: a clinical report.en_US
dc.rights.holderGlobal health actionen_US
dc.contributor.correspondenceGilder, Mary Ellenen_US
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