Prevalence of gestational diabetes and associated maternal and neonatal complications in a fast-developing community: global comparisons

Abdulbari Bener1,2, Najah M Saleh3, Abdulla Al-Hamaq41Department of Medical Statistics and Epidemiology, Hamad Medical Corporation, Hamad General Hospital, Department of Public Health and Medical Education, Weill Cornell Medical College, Qatar; 2Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, University of Manchester, Manchester, UK; 3Department of Obstetrics and Gynecology, Women's Hospital, Hamad Medical Corporation, Qatar; 4Qatar Diabetes Association and Qatar Foundation, QatarBackground: The prevalence of gestational diabetes (GDM) is increasing all over the world. Hence, the impact of GDM on maternal and infant health is an important topic of research. No study has been conducted in Qatar to evaluate the outcome of pregnancies complicated by diabetes mellitus.Objective: The aim of the study was to determine the prevalence of GDM, compare the maternal–neonatal complications among women with GDM and non-GDM pregnant women, and investigate the risk factors and potential outcomes associated with GDM.Design: This is a prospective cohort study.Setting: The survey was carried out at the antenatal clinics of the Women's Hospital, Qatar.Subjects and methods: A representative sample of 2056 pregnant women who attended the antenatal clinics of the Women's Hospital were surveyed during the period from the first week of January 2010 to April 2011. From this sample, 1608 women (78.2%) expressed their consent to participate in the study. Questionnaires were administered to pregnant women who were seeking antenatal care at this urban hospital. The questionnaire covered variables related to sociodemographic factors, family history, medical history, maternal complications, and neonatal outcome.Results: The prevalence of GDM in Qatar was 16.3%. Women with GDM were significantly higher in the age group of 35–45 years (45%; P = 0.001). Family history of diabetes (31.7%; P < 0.001), increased parity (55.3%; P = 0.004), and obesity (59.2%; P < 0.001) were determinants of GDM in pregnant women. Maternal complications like pregnancy-induced hypertension (19.1% vs 10.3%; P <0.001), pre-eclampsia (7.3% vs 3.8%; P = 0.012), antepartum hemorrhage (19.2% vs 14.6%; P = 0.05), and cesarean (27.9% vs 12.4%; P < 0.001) were significantly higher in GDM women. Neonates were at increased risk of preterm birth (12.6% vs 8.3%; P = 0.03), macrosomia (10.3% vs 5.9%; P = 0.01), and birth trauma (8% vs 3%; P < 0.001).Conclusion: The study findings revealed that GDM was higher in women in Qatar and that they were at increased risk of developing maternal and neonatal complications. Obesity emerged as an essential risk factor for subsequent GDM. The advanced maternal age, low monthly income, family history of diabetes, and obesity were the main significant risk factors for GDM.Keywords: gestational diabetes, obstetric risks, macrosomic, Qata

Prevalence of gestational diabetes and associated maternal and neonatal complications in a fast-developing community: global comparisons

Background: The prevalence of gestational diabetes (GDM) is increasing all over the world. Hence, the impact of GDM on maternal and infant health is an important topic of research. No study has been conducted in Qatar to evaluate the outcome of pregnancies complicated by diabetes mellitus. Objective: The aim of the study was to determine the prevalence of GDM, compare the maternal-neonatal complications among women with GDM and non-GDM pregnant women, and investigate the risk factors and potential outcomes associated with GDM. Design: This is a prospective cohort study. Setting: The survey was carried out at the antenatal clinics of the Women's Hospital, Qatar. Subjects and methods: A representative sample of 2056 pregnant women who attended the antenatal clinics of the Women's Hospital were surveyed during the period from the first week of January 2010 to April 2011. From this sample, 1608 women (78.2%) expressed their consent to participate in the study. Questionnaires were administered to pregnant women who were seeking antenatal care at this urban hospital. The questionnaire covered variables related to sociodemographic factors, family history, medical history, maternal complications, and neonatal outcome. Results: The prevalence of GDM in Qatar was 16.3%. Women with GDM were significantly higher in the age group of 35-45 years (45%; P = 0.001). Family history of diabetes (31.7%; P , 0.001), increased parity (55.3%; P = 0.004), and obesity (59.2%; P , 0.001) were determinants of GDM in pregnant women. Maternal complications like pregnancy-induced hypertension (19.1% vs 10.3%; P , 0.001), pre-eclampsia (7.3% vs 3.8%; P = 0.012), antepartum hemorrhage (19.2% vs 14.6%; P = 0.05), and cesarean (27.9% vs 12.4%; P , 0.001) were significantly higher in GDM women. Neonates were at increased risk of preterm birth (12.6% vs 8.3%; P = 0.03), macrosomia (10.3% vs 5.9%; P = 0.01), and birth trauma (8% vs 3%; P , 0.001). Conclusion: The study findings revealed that GDM was higher in women in Qatar and that they were at increased risk of developing maternal and neonatal complications. Obesity emerged as an essential risk factor for subsequent GDM. The advanced maternal age, low monthly income, family history of diabetes, and obesity were the main significant risk factors for GDM

A diabetes risk score for Qatar utilizing a novel mathematical modeling approach to identify individuals at high risk for diabetes

We developed a diabetes risk score using a novel analytical approach and tested its diagnostic performance to detect individuals at high risk of diabetes, by applying it to the Qatari population. A representative random sample of 5,000 Qataris selected at different time points was simulated using a diabetes mathematical model. Logistic regression was used to derive the score using age, sex, obesity, smoking, and physical inactivity as predictive variables. Performance diagnostics, validity, and potential yields of a diabetes testing program were evaluated. In 2020, the area under the curve (AUC) was 0.79 and sensitivity and specificity were 79.0% and 66.8%, respectively. Positive and negative predictive values (PPV and NPV) were 36.1% and 93.0%, with 42.0% of Qataris being at high diabetes risk. In 2030, projected AUC was 0.78 and sensitivity and specificity were 77.5% and 65.8%. PPV and NPV were 36.8% and 92.0%, with 43.0% of Qataris being at high diabetes risk. In 2050, AUC was 0.76 and sensitivity and specificity were 74.4% and 64.5%. PPV and NPV were 40.4% and 88.7%, with 45.0% of Qataris being at high diabetes risk. This model-based score demonstrated comparable performance to a data-derived score. The derived self-complete risk score provides an effective tool for initial diabetes screening, and for targeted lifestyle counselling and prevention programs.Peer reviewe

Preventing type 2 diabetes mellitus in Qatar by reducing obesity, smoking, and physical inactivity: mathematical modeling analyses.

BACKGROUND: The aim of this study was to estimate the impact of reducing the prevalence of obesity, smoking, and physical inactivity, and introducing physical activity as an explicit intervention, on the burden of type 2 diabetes mellitus (T2DM), using Qatar as an example. METHODS: A population-level mathematical model was adapted and expanded. The model was stratified by sex, age group, risk factor status, T2DM status, and intervention status, and parameterized by nationally representative data. Modeled interventions were introduced in 2016, reached targeted level by 2031, and then maintained up to 2050. Diverse intervention scenarios were assessed and compared with a counter-factual no intervention baseline scenario. RESULTS: T2DM prevalence increased from 16.7% in 2016 to 24.0% in 2050 in the baseline scenario. By 2050, through halting the rise or reducing obesity prevalence by 10-50%, T2DM prevalence was reduced by 7.8-33.7%, incidence by 8.4-38.9%, and related deaths by 2.1-13.2%. For smoking, through halting the rise or reducing smoking prevalence by 10-50%, T2DM prevalence was reduced by 0.5-2.8%, incidence by 0.5-3.2%, and related deaths by 0.1-0.7%. For physical inactivity, through halting the rise or reducing physical inactivity prevalence by 10-50%, T2DM prevalence was reduced by 0.5-6.9%, incidence by 0.5-7.9%, and related deaths by 0.2-2.8%. Introduction of physical activity with varying intensity at 25% coverage reduced T2DM prevalence by 3.3-9.2%, incidence by 4.2-11.5%, and related deaths by 1.9-5.2%. CONCLUSIONS: Major reductions in T2DM incidence could be accomplished by reducing obesity, while modest reductions could be accomplished by reducing smoking and physical inactivity, or by introducing physical activity as an intervention

Type 2 diabetes epidemic and key risk factors in Qatar: A mathematical modeling analysis

Introduction We aimed to characterize and forecast type 2 diabetes mellitus (T2DM) disease burden between 2021 and 2050 in Qatar where 89% of the population comprises expatriates from over 150 countries. Research design and methods An age-structured mathematical model was used to forecast T2DM burden and the impact of key risk factors (obesity, smoking, and physical inactivity). The model was parametrized using data from T2DM natural history studies, Qatar's 2012 STEPwise survey, the Global Health Observatory, and the International Diabetes Federation Diabetes Atlas, among other data sources. Results Between 2021 and 2050, T2DM prevalence increased from 7.0% to 14.0%, the number of people living with T2DM increased from 170 057 to 596 862, and the annual number of new T2DM cases increased from 25 007 to 45 155 among those 20-79 years of age living in Qatar. Obesity prevalence increased from 8.2% to 12.5%, smoking declined from 28.3% to 26.9%, and physical inactivity increased from 23.1% to 26.8%. The proportion of incident T2DM cases attributed to obesity increased from 21.9% to 29.9%, while the contribution of smoking and physical inactivity decreased from 7.1% to 6.0% and from 7.3% to 7.2%, respectively. The results showed substantial variability across various nationality groups residing in Qatar - for example, in Qataris and Egyptians, the T2DM burden was mainly due to obesity, while in other nationality groups, it appeared to be multifactorial. Conclusions T2DM prevalence and incidence in Qatar were forecasted to increase sharply by 2050, highlighting the rapidly growing need of healthcare resources to address the disease burden. T2DM epidemiology varied between nationality groups, stressing the need for prevention and treatment intervention strategies tailored to each nationality

Epidemiological impact of public health interventions against diabetes in Qatar: mathematical modeling analyses

AimsTo predict the epidemiological impact of specific, and primarily structural public health interventions that address lifestyle, dietary, and commuting behaviors of Qataris as well as subsidies and legislation to reduce type 2 diabetes mellitus (T2DM) burden among Qataris.MethodsA deterministic population-based mathematical model was used to investigate the impact of public health interventions on the epidemiology of T2DM among Qataris aged 20–79 years, which is the age range typically used by the International Diabetes Federation for adults. The study evaluated the impact of interventions up to 2050, a three-decade time horizon, to allow for the long-term effects of different types of interventions to materialize. The impact of each intervention was evaluated by comparing the predicted T2DM incidence and prevalence with the intervention to a counterfactual scenario without intervention. The model was parameterized using representative data and stratified by sex, age, T2DM risk factors, T2DM status, and intervention status.ResultsAll intervention scenarios had an appreciable impact on reducing T2DM incidence and prevalence. A lifestyle management intervention approach, specifically applied to those who are categorized as obese and ≥35 years old, averted 9.5% of new T2DM cases by 2050. An active commuting intervention approach, specifically increasing cycling and walking, averted 8.5% of new T2DM cases by 2050. Enhancing consumption of healthy diets including fruits and vegetables, specifically a workplace intervention involving dietary modifications and an educational intervention, averted 23.2% of new T2DM cases by 2050. A subsidy and legislative intervention approach, implementing subsidies on fruits and vegetables and taxation on sugar-sweetened beverages, averted 7.4% of new T2DM cases by 2050. A least to most optimistic combination of interventions averted 22.8–46.9% of new T2DM cases by 2050, respectively.ConclusionsImplementing a combination of individual-level and structural public health interventions is critical to prevent T2DM onset and to slow the growing T2DM epidemic in Qatar

A study of food-related consumer behaviour and the application of HACCP to the operation of food retail outlets in the State of Qatar

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Sleep quality and excessive daytime sleepiness in a Arab diabetic population

The aim of this cross-sectional study was to examine the sleep quality, excessive daytime sleepiness (EDS) and its patterns in a Diabetic population sample. The survey was carried out at the outpatient diabetic clinics of the Hamad General Hospital and Primary Health Care (PHC) centres. A total number of 1050 T2DM patients aged above 20 years of age were selected by a systematic sampling procedure from diabetic clinics of the hospitals and PHC centres and 847 cases agreed to participate in the study with a response rate of 80.7%. The study included information about socio-demographic characteristics including age, sex, marital status, education level, occupation, height, weight and parental consanguinity, medical history, smoking habit, physical activity and sleeping habits during the past month. We have used both instruments Epworth sleepiness scale (ESS) score and the Pittsburgh sleep quality index (PSQI). Of the studied diabetic patients, 46.9% were males and 53.1% females. Majority of the diabetic patients were in the age group (40 - 59) years old (59.3%). More than half of the diabetic women were housewives (56.9%) and most of the men were in sedentary and professional jobs (38.1%). ESS score revealed that diabetic women (64.4%) were significantly more sleepier than men (55.2%) during the daytime (p= 0.034). Overall, 60.1% of the diabetic patients were very sleepy during the daytime with 43% men and 57% women and a significant difference was observed between both the genders (p< 0.001). There was a significant association observed between both the genders in all the situations of the Epworth Sleepiness Scale, especially while watching TV (18.4% vs 23.8%, p= 0.024), sitting in the public place (4% vs 10.4%; p= 0.003) and sitting talking to someone (1.5% vs 6.4%, p< 0.001) and sitting in a car in the traffic (3.8% vs 7.1%; p< 0.001). Obesity was significantly higher in diabetic women who had high chances of EDS (51.7%) than men (39.3%) (p= 0.007). Physical activity was significantly lower in diabetic women with poor sleep (38.6%) compared to men (50.2%) (p= 0.012). The present study findings observed that sleep quality was very poor in diabetic population. Also, Excessive day time sleepiness was observed more in diabetic population

Is male fertility associated with type 2 diabetes mellitus?

The aim of this study was to determine the prevalence of infertility in Qatari men with Diabetes Mellitus (T2DM) and to examine the association between T2DM and infertility

Familial aggregation of T2DM among Arab diabetic population

The aim of the study was to estimate the prevalence of familial history of type 2 diabetes among Arab diabetic patients, compare the maternal and paternal transmission of type 2 DM in patients and evaluate its influence on the clinical characteristics of this disease. This was a cross sectional study. The survey was carried out in urban and semi-urban primary health care [PHC] centers. Of the 2,400 registered with diagnosed diabetes, 1,980 agreed and gave their consent to take part in this study, thus giving a response rate of 82.5 %. DM was defined according to the WHO expert group. Of the study population, 72.9 % reported family history of DM. Family history of DM was significantly higher in females (54.2 %; p = 0.04) and in the age group below 30 years (24 %; p < 0.001). The prevalence of diabetes was higher among patients with diabetic mother (25.4 % vs 22.1 %) and maternal aunts/uncles (31.2 % vs 22.2 %) compared to patients with diabetic father and paternal aunts/uncles. Family history of DM was higher in patients of consanguineous parents (77.4 %) than those of nonconsanguineous parents (70.4 %). The present study has found a significant maternal effect in transmission of T2 DM. Family history is associated with the increased incidence of diabetes