title: Gestational diabetes in Turkmenistan: implementation of a screening program and first results.
abstract: OBJECTIVE
  Data on the prevalence of gestational diabetes (GDM) is not available for Turkmenistan or any other central Asian country with large energy resources and rapidly increasing wealth and rates of obesity. We initiated a screening program to determine the prevalence of and the risk factors for GDM in Turkmenistan.
  
  
  METHODS
  Between March 2008 and March 2011, all pregnant women presenting to the Ene-Maehri-Merkezi perinatal center in Ashgabat before week 34 of pregnancy received a glucose screening test (after 26 weeks of pregnancy; 50 g glucose). If 60-min glucose was ≥7.8 mmol/l, an oral glucose tolerance test (oGTT) (75gr) was performed. GDM was diagnosed if ≥1 glucose values were abnormal (≥5.0, ≥10.0, ≥8.0 mmol/l at 0-, 60-, 120-min, respectively). Birth weight, 30 min glucose, and APGAR (1, 5, and 10 min) were recorded for all newborns.
  
  
  RESULTS
  Of 1,738 women, 22.7 % had a pathological screening test. 70 % of these, underwent an oGTT and of these, 39.5 % had GDM (overall prevalence 6.3 %). Age, BMI, parity, and blood pressure were associated with screening glucose (all p < 0.001). In a multivariate analysis, age, BMI, and family history for diabetes were associated with GDM. Newborns from affected mothers were heavier (3,622 ± 435 vs. 3,480 ± 464 g, p = 0.007) and developed postnatal hypoglycaemia more often (21.6 vs. 9.3 %, p = 0.001), while there was no difference in APGAR.
  
  
  CONCLUSIONS
  GDM is a relevant problem in Turkmenistan and probably also in other central Asian countries. The prevalence is similar to other developing countries such as India or China. Risk factors are comparable to those determined in other parts of the world.
authors.affiliation: Medical Department II, Grosshadern, University Munich, Marchioninistraße 15, 81377, Munich, Germany, klaus.parhofer@med.uni-muenchen.de.
authors.forename: K G
authors.initials: KG
authors.lastname: Parhofer
authors.forename: U
authors.initials: U
authors.lastname: Hasbargen
authors.forename: A
authors.initials: A
authors.lastname: Ulugberdiyewa
authors.forename: M
authors.initials: M
authors.lastname: Abdullayewa
authors.forename: B
authors.initials: B
authors.lastname: Melebayewa
authors.forename: A
authors.initials: A
authors.lastname: Annamuhammedov
authors.forename: M
authors.initials: M
authors.lastname: Gaipow
authors.forename: O
authors.initials: O
authors.lastname: Atabayeva
authors.forename: A W
authors.initials: AW
authors.lastname: Flemmer
mesh_terms: D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003906:Developing Countries; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007231:Infant, Newborn; D008403:Mass Screening; D008423:Maternal Age; D010298:Parity; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D014423:Turkmenistan / Q000453:epidemiology
chemical_list: D001786:Blood Glucose