title: Comparison of pregnancy outcomes between women with gestational diabetes and overt diabetes first diagnosed in pregnancy: a retrospective multi-institutional study in Japan.
abstract: OBJECTIVE
  To determine differences in pregnancy outcomes including diabetic complications, maternal and perinatal complications between gestational diabetes mellitus and overt diabetes in pregnancy in Japan.
  
  
  METHODS
  A multi-institutional retrospective study compared pregnancy outcomes between gestational diabetes mellitus and overt diabetes in pregnancy. We examined pregnant women who met the former criteria for gestational diabetes mellitus and received dietary intervention with self-monitoring of blood glucose with or without insulin. Overt diabetes in pregnancy was defined as ≥2 abnormal values on 75-g oral glucose tolerance test, fasting glucose ≥126 mg/dl (7.0 mmol/l) and 2-h postprandial glucose ≥200 mg/dl (11.1 mmol/l), or glycated hemoglobin levels ≥6.5% (48 mmol/mol).
  
  
  RESULTS
  Data were collected on 1267 women with gestational diabetes and 348 with overt diabetes in pregnancy. Pregestational body mass index was higher (26.2 ± 6.1 vs. 24.9 ± 5.7 kg, P<0.05) and gestational age at delivery was earlier (37.8 ± 2.5 weeks vs. 38.1 ± 2.1 weeks, P<0.05) in overt diabetes than in gestational diabetes. Glycated hemoglobin (6.8 ± 1.1% [51 mmol/mol] vs. 5.8 ± 0.5% [40 mmol/mol], P<0.05) and glucose on 75-g oral glucose tolerance test and prevalence of retinopathy (1.2% vs. 0%, P<0.05) and pregnancy-induced hypertension (10.1% vs. 6.1%, P<0.05) were higher in overt diabetes than in gestational diabetes. Pregnancy-induced hypertension was associated with pregestational body mass index, gestational weight gain, chronic hypertension, and nulliparity but not with 75-g oral glucose tolerance test.
  
  
  CONCLUSIONS
  Overt diabetes in pregnancy is significantly associated with maternal complications such as retinopathy and pregnancy-induced hypertension.
authors.affiliation: Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan. Electronic address: sugiyama@med.tohoku.ac.jp.
authors.forename: T
authors.initials: T
authors.lastname: Sugiyama
authors.affiliation: Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Saito
authors.affiliation: Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Nishigori
authors.affiliation: Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Nagase
authors.affiliation: Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Yaegashi
authors.affiliation: Department of Obstetrics and Gynecology, Rakuwakai Otowa Hospital, Kyoto 607-8062, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Sagawa
authors.affiliation: Department of Laboratory Science, Faculty of Health Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Kawano
authors.affiliation: Department of Laboratory Science, Faculty of Health Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ichihara
authors.affiliation: Diabetes Center, Tokyo Women's University School of Medicine, Tokyo 162-8666, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Sanaka
authors.affiliation: Department of Diabetes and Endocrinology, Shin-Koga Hospital, Kurume, Fukuoka 830-8522, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Akazawa
authors.affiliation: Saiseikai Central Hospital, Tokyo 108-0073, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Anazawa
authors.affiliation: Department of Maternal Internal Medicine, Osaka Medical Center and Research Institute for Maternal and Children Health, Izumi 594-1101, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Waguri
authors.affiliation: Department of Obstetrics and Gynecology, Miyazaki University School of Medicine, Miyazaki 889-1692, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Sameshima
authors.affiliation: Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Hiramatsu
authors.affiliation: Department of Obstetrics and Gynecology, Suzuka University of Medical Science, Suzuka, Mie 513-3670, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Toyoda
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000453:epidemiology* / Q000628:therapy; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis / Q000453:epidemiology*; D007328:Insulin / Q000378:metabolism; D007564:Japan / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011254:Pregnancy in Diabetics / Q000453:epidemiology* / Q000628:therapy; D012189:Retrospective Studies; D015430:Weight Gain
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin
keywords: Gestational diabetes mellitus; LGA; Pregnancy outcome