Publication: Gestational diabetes mellitus prevalence in Maela refugee camp on the Thai-Myanmar border: a clinical report.
Accepted Date
2014-04-10
Issued Date
2014-05-12
Copyright Date
2014
Resource Type
Language
eng
ISSN
1654-9880 (electronic)
1654-9716 (printed)
1654-9716 (printed)
Rights
Mahidol University
Rights Holder(s)
Global health action
Bibliographic Citation
Gilder 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.
Suggested Citation
Gilder, Mary Ellen, Zin, Thet Wai, Wai, Nan San, Ner, Ma, Say, Paw Si, Htoo, Myint, Say Say, Htay, Win Win, Simpson, Julie A., Sasithon Pukrittayakamee, ศศิธร ผู้กฤตยาคามี, Nosten, Francois, McGready, Rose Gestational diabetes mellitus prevalence in Maela refugee camp on the Thai-Myanmar border: a clinical report.. Gilder 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.. doi:10.3402/gha.v7.23887 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/858
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Title
Gestational diabetes mellitus prevalence in Maela refugee camp on the Thai-Myanmar border: a clinical report.
Corresponding Author(s)
Abstract
BACKGROUND: 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.