PROSPECTIVE STUDY ON THE EFFECT OF PHARMACEUTICAL CARE ON MATERNAL AND FETAL OUTCOMES IN GESTATIONAL AND PREGESTATIONAL DIABETIC PATIENTS

Authors

  • AHMED ABDULLAH ELBERRY Clinical Pharmacology Department, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt, Pharmacy Practice Department, Pharmacy Program, Batterjee Medical College, Jeddah, Saudi Arabia https://orcid.org/0000-0002-0073-3066
  • HODA RABEA Clinical pharmacy department, faculty of Pharmacy, Beni Suef University, Beni Suef, Egypt
  • SHIREEN M. MOHSEN Clinical pharmacy department, College of Pharmaceutical Sciences and Drug Manufacturing, Misr University for Science and Technology, Giza, Egypt
  • ABDEL-REHIM MOURAD Clinical pharmacy department, College of Pharmaceutical Sciences and Drug Manufacturing, Misr University for Science and Technology, Giza, Egypt
  • GAAFAR KINAWY Obstetrics and gynecology department, faculty of Medicine, Misr University for Science and Technology, Giza, Egypt

DOI:

https://doi.org/10.22159/ijpps.2022v14i5.43598

Abstract

Objective: The prevalence of diabetes in pregnancy has increased in the U. S. The majority is gestational diabetes mellitus (GDM), with the remainder primarily preexisting type 1 diabetes and type 2 diabetes (pregestational diabetes, PGDM). The present study investigates the demographics and clinical differences between both types.

Methods: This prospective study was conducted on ninety pregnant females with normal menstrual cycles before pregnancy. Demographics, oral glucose tolerance test (OGTT), and HbA1c were assessed.

Results: There was a significant difference in the term of Oral glucose tolerance test Week 24 during fasting, Oral glucose tolerance test Week 24 after one hour, Oral glucose tolerance test Week 24 after two hours, Oral glucose tolerance test Week 24 after three hours, Oral glucose tolerance test Week 28 during fasting, Oral glucose tolerance test Week 28 after one hour, Oral glucose tolerance test Week 28 after two hours, Oral glucose tolerance test Week 28 after three hours, HbA1c week 24 and HbA1c week 28; p-value<0.05.

Conclusion: pregnant women in this study who needed insulin were educated to self-monitoring of blood glucose, diet control, medication adherence, and exercise, and we adjusted the needed insulin dose for them with restrictive follow-up.

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References

Holmes VA, Young IS, Patterson CC, Pearson DWM, Walker JD, Maresh MJA, McCance DR. Optimal glycemic control, pre-eclampsia, and gestational hypertension in women with type 1 diabetes in diabetes and pre-eclampsia intervention trial. Diabetes Care. 2011;34(8):1683-8. doi: 10.2337/dc11-0244.

Jensen DM, Korsholm L, Ovesen P, Beck-Nielsen H, Moelsted-Pedersen L, Westergaard JG, Moeller M, Damm P. Peri-conceptional A1C and risk of serious adverse pregnancy outcome in 933 women with type 1 diabetes. Diabetes Care. 2009;32(6):1046-8. doi: 10.2337/dc08-2061.

Charron Prochownik D, Sereika SM, Becker D. Long-term effects of the booster-enhanced ready-girls preconception counseling program on intentions and behaviors for family planning in teens with diabetes. Diabetes Care. 2013;36(12):3870-4. doi: 10.2337/dc13-0355.

Peterson C, Grosse SD, Li R, Sharma AJ, Razzaghi H, Herman WH, Gilboa SM. Preventable health and cost burden of adverse birth outcomes associated with pregestational diabetes in the United States. Am J Obstet Gynecol. 2015;212(1):74.e1-9. doi: 10.1016/j.ajog.2014.09.009, PMID 25439811.

Charron Prochownik D, Downs J. Diabetes and reproductive health for girls. Alexandria, VA: American Diabetes Association; 2016.

Manderson JG, Patterson CC, Hadden DR, Traub AI, Ennis C, McCance DR. Preprandial versus postprandial blood glucose monitoring in type 1 diabetic pregnancy: a randomized controlled clinical trial. Am J Obstet Gynecol. 2003;189(2):507-12. doi: 10.1067/s0002-9378(03)00497-6, PMID 14520226.

Committee on Practice Bulletins–obstetrics. Practice Bulletin No. 137. Gestational diabetes mellitus. Obstet Gynecol; 2013.

Chew EY, Mills JL, Metzger BE. Metabolic control and progression of retinopathy: the S142 Management of Diabetes in Pregnancy Diabetes Care. Jan 2018;41 Suppl 1.

Institute of Medicine, National Research Council. Weight gain during pregnancy: reexamining the guidelines. Washington, DC: National Academies Press; 2009.

Cundy T, Gamble G, Neale L, Elder R, McPherson P, Henley P, Rowan J. Differing causes of pregnancy loss in type 1 and type 2 diabetes. Diabetes Care. 2007;30(10):2603-7. doi: 10.2337/dc07-0555, PMID 17586739.

Kim C, Newton KM, Knopp RH. Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care. 2002;25(10):1862-8. doi: 10.2337/diacare.25.10.1862, PMID 12351492.

Sutherland HW, Stowers JM, Pearson DWM (Eds.). Carbohydrate metabolism in pregnancy and the newborn IV. Edinburgh: Churchill Livingstone; 1984.

Tobias DK, Hu FB, Chavarro J, Rosner B, Mozaffarian D, Zhang C. Healthful dietary patterns and type 2 diabetes mellitus risk among women with a history of gestational diabetes mellitus. Arch Intern Med. 2012;172(20):1566-72. doi: 10.1001/archinternmed.2012.3747, PMID 22987062.

Villamor E, Cnattingius S. Interpregnancy weight change and risk of adverse pregnancy outcomes: a population-based study. Lancet. 2006;368(9542):1164-70. doi: 10.1016/S0140-6736(06)69473-7, PMID 17011943.

Ratner RE, Christophi CA, Metzger BE. Diabetes prevention program research group. Prevention of Diabetes in women with a history of gestational diabetes: effects of metformin and lifestyle interventions. J Clin Endocrinol Metab. 2008.

Aroda VR, Christophi CA, Edelstein SL. Diabetes prevention program Research Group. The effect of lifestyle intervention and metformin on preventing or delaying diabetes among women with and without gestational diabetes: the diabetes prevention program outcomes study 10 y followup. J Clin Endocrinol Metab. 2015.

Duckitt K, Harrington D. Risk factors for pre-eclampsia at antenatal booking: a systematic review of controlled studies. BMJ. 2005;330(7491):565. doi: 10.1136/ bmj.38380. 674340.E0, PMID 15743856.

Henderson JT, Whitlock EP, O’Conner E, Senger CA, Thompson JH, Rowland MG. Low dose aspirin for the prevention of morbidity and mortality from preeclampsia: a systematic evidence review for the U.S. Preventive Services Task Force, 2017.

Werner EF, Hauspurg AK, Rouse DJ. A cost-benefit analysis of low-dose aspirin prophylaxis for the prevention of preeclampsia in the United States. Obstet Gynecol. 2015;126(6):1242-50. doi: 10.1097/AOG.0000000000001115, PMID 26551178.

American Diabetes Association. 13. Management of Diabetes in Pregnancy. Diabetes Care. 2017;40(Suppl 1):S114-9. doi: 10.2337/dc17-S016, PMID 27979900.

Yasuhi I, Soda T, Yamashita H, Urakawa A, Izumi M, Kugishima Y, Umezaki Y. The effect of high-intensity breastfeeding on postpartum glucose tolerance in women with recent gestational diabetes. Int Breastfeed J. 2017;12:32. doi: 10.1186/s13006-017-0123-z, PMID 28725256.

American Diabetes Association. 12. Management of Diabetes in Pregnancy. Diabetes Care. 2016;39 Suppl 1:S94-8. doi: 10.2337/dc16-S015, PMID 26696688.

Battarbee AN, Venkatesh KK, Aliaga S, Boggess KA. The association of pregestational and gestational diabetes with severe neonatal morbidity and mortality. J Perinatol. 2020;40(2):232-9. doi: 10.1038/s41372-019-0516-5, PMID 31591489.

Bental Y, Reichman B, Shiff Y, Weisbrod M, Boyko V, Lerner Geva L, Mimouni FB, Collaboration With the Israel Neonatal Network. Impact of maternal diabetes mellitus on mortality and morbidity of preterm infants (24-33 weeks’ gestation). Pediatrics. 2011;128(4):e848-55. doi: 10.1542/peds.2010-3443. PMID 21930550.

Billionnet C, Mitanchez D, Weill A, Nizard J, Alla F, Hartemann A, Jacqueminet S. Gestational diabetes and adverse perinatal outcomes from 716,152 births in france in 2012. Diabetologia. 2017;60(4):636-44. doi: 10.1007/s00125-017-4206-6, PMID 28197657.

Chu SY, Callaghan WM, Kim SY, Schmid CH, Lau J, England LJ, Dietz PM. Maternal obesity and risk of gestational diabetes mellitus. Diabetes Care. 2007;30(8):2070-6. doi: 10.2337/ dc06-2559a, PMID 17416786.

Cacho Diaz B, Garcia Botello DR, Wegman Ostrosky T, Reyes Soto G, Ortiz Sanchez E, Herrera Montalvo LA. Tumor microenvironment differences between primary tumor and brain metastases. J Transl Med. 2020;18(1):1. doi: 10.1186/s12967-019-02189-8. PMID 31900168.

Eltoony LF, Ibrahem SA, Hafez MZE-D, Ali OM, Elsewify WAE. Prevalence and risk factors for gestational diabetes in Aswan, Egypt according to international Association of the Diabetes and Pregnancy study groups (IADPSG). Egypt J Hosp Med. 2021;82(4):701-7. doi: 10.21608/ejhm.2021.150445.

Farrar D, Simmonds M, Bryant M, Sheldon TA, Tuffnell D, Golder S, Dunne F, Lawlor DA. Hyperglycaemia and risk of adverse perinatal outcomes: systematic review and meta-analysis. BMJ. 2016;354:i4694. doi: 10.1136/bmj.i4694. PMID 27624087.

Fong A, Serra A, Herrero T, Pan D, Ogunyemi D. Pre-gestational versus gestational diabetes: a population-based study on clinical and demographic differences. J Diabetes Complications. 2014;28(1):29-34. doi: 10.1016/j.jdiacomp.2013.08.009, PMID 24094665.

Kawakita T, Bowers K, Hazrati S, Zhang C, Grewal J, Chen Z, Sun L, Grantz KL. Increased neonatal respiratory morbidity associated with gestational and pregestational diabetes: a retrospective study. Am J Perinatol. 2017;34(11):1160-8. doi: 10.1055/s-0037-1604414, PMID 28738436.

Knowler WC, Drews K, Redman L, Joshipura KJ, Arteaga SS, Pi-Sunyer X, Van Horn L, Wing RR, Klein S, Group L-MR 2018. Changing glucose tolerance during pregnancy-implications for diagnosis of gestational diabetes mellitus (GDM). Am Diabetes Assoc. 2018;67 Suppl 1:119-OR. doi: 10.2337/db18-119-OR

Kong L, Nilsson IAK, Gissler M, Lavebratt C. Associations of maternal diabetes and body mass index with offspring birth weight and prematurity. JAMA Pediatr. 2019;173(4):371-8. doi: 10.1001/jamapediatrics.2018.5541, PMID 30801637.

Li Y, Ren X, He L, Li J, Zhang S, Chen W. Maternal age and the risk of gestational diabetes mellitus: A systematic review and meta-analysis of over 120 million participants. Diabetes Res Clin Pract. 2020;162:108044. doi: 10.1016/j.diabres.2020.108044.

HAPO Study Cooperative Research Group, Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, Coustan DR, Hadden DR, McCance DR, Hod M, McIntyre HD, Oats JJ, Persson B, Rogers MS, Sacks DA. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008;358(19):1991-2002. doi: 10.1056/NEJMoa0707943, PMID 18463375.

Middleton P, Crowther CA, Simmonds L. Different intensities of glycaemic control for pregnant women with pre‐existing diabetes. Cochrane Database Syst Rev. 2016(5). doi: 10.1002/14651858.CD008540.pub4.

Persson M, Shah PS, Rusconi F, Reichman B, Modi N, Kusuda S, Lehtonen L, Hakansson S, Yang J, Isayama T, Beltempo M, Lee S, Norman M, International Network for Evaluating Outcomes of Neonates. Association of maternal diabetes with neonatal outcomes of very preterm and very-low-birth-weight infants: an international cohort study. JAMA Pediatr. 2018;172(9):867-75. doi: 10.1001/jamapediatrics.2018.1811, PMID 29971428.

Shefali AK, Kavitha M, Deepa R, Mohan, V. Pregnancy outcomes in pre-gestational and gestational diabetic women in comparison to a non-diabetic women-A prospective study in Asian Indian mothers (CURES-35). The Journal of the Association of Physicians of India. 2006;54:613-8. PMID 16941791.

Stacey T, Tennant PW, Mccowan LM, Mitchell EA, Budd J, Li M, Thompson JM, Martin B, Roberts D, Heazell AE. Gestational diabetes and the risk of late stillbirth: a case-control study from England, UK. BJOG: An International Journal of Obstetrics and Gynaecology. 2019;126(8):973-82. doi: 10.1111/1471-0528.15659, PMID 30891907.

Wahabi H, Fayed A, Esmaeil S, Mamdouh H, Kotb R. Prevalence and complications of pregestational and gestational Diabetes in Saudi women: analysis from Riyadh Mother and Baby cohort study (RAHMA). BioMed Research International. 2017;2017:6878263. doi: 10.1155/2017/6878263, PMID 28386562.

Wahabi HA, Alzeidan RA, Bawazeer GA, Alansari LA, Esmaeil SA. Preconception care for diabetic women for improving maternal and fetal outcomes: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2010;10:63. doi: 10.1186/1471-2393-10-63, PMID 20946676.

Wahabi HA, Esmaeil SA, Fayed A, Al-Shaikh G, Alzeidan RA. Pre-existing diabetes mellitus and adverse pregnancy outcomes. BMC Res Notes. 2012;5:496. doi: 10.1186/1756-0500-5-496, PMID 22963905.

Wahabi HA, Fayed A, Esmaeil SA. Maternal and perinatal outcomes of pregnancies complicated with pre-gestational and gestational diabetes mellitus in Saudi Arabia. J Diabetes Metab. 2014;5:2.

Wojtyla C, Stanirowski P, Gutaj P, Ciebiera M, Wojtyla A. Perinatal outcomes in a population of diabetic and obese pregnant women-the results of the national polish survey. International Journal of Environmental Research and Public Health. 2021;18(2):560. doi: 10.3390/ijerph18020560, PMID 33440848.

AM, KK. Pharmacoeconomic evaluation of antidiabetic therapy at a tertiary health care institution. Asian J Pharm Clin Res. July 2021;14(6):115-20.

Mussttaf GS, Habib A, Mahtook M. Drug prescribing pattern and cost-effectiveness analysis of oral antidiabetic drugs in patients with type-2 diabetes mellitus: real-world data from indian publication. Asian J Pharm Clin Res. May 2021;14(7):45-9. doi: 10.22159/ajpcr.2021.v14i7.41677.

Mahmood A, Ball P, Morrissey H. Exploring pharmacy students Knowledge and understanding of eating disorders and their impact on mental health and quality of life. Int J Curr Pharm Sci. Sep 2021;13(5):63-9.

Published

01-05-2022

How to Cite

ELBERRY, A. A., H. RABEA, S. M. MOHSEN, A.-R. MOURAD, and G. KINAWY. “PROSPECTIVE STUDY ON THE EFFECT OF PHARMACEUTICAL CARE ON MATERNAL AND FETAL OUTCOMES IN GESTATIONAL AND PREGESTATIONAL DIABETIC PATIENTS”. International Journal of Pharmacy and Pharmaceutical Sciences, vol. 14, no. 5, May 2022, pp. 42-48, doi:10.22159/ijpps.2022v14i5.43598.

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