Disparities in glycated hemoglobin during and beyond pregnancy in a population-based cohort of women with gestational diabetes

基于人群的妊娠期糖尿病妇女在怀孕期间和怀孕后糖化血红蛋白的差异

• 批准号: 9979548
• 负责人: Teresa Janevic
• 金额: $ 21.19万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-03-11 至 2022-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9979548
• 关键词: Asians; Attention; Biological Assay; Birth; Birth Certificates; Cessation of life; Characteristics; Child; Clinical; Cohort Studies; Data; Data Analyses; Data Linkages; Diabetes Mellitus; Diagnosis; Diagnostic; Ethnic Origin; Ethnic group; First Pregnancy Trimester; Frequencies; Future; Gestational Diabetes; Glucose; Glucose Intolerance; Glycosylated Hemoglobin; Glycosylated hemoglobin A; Guidelines; Health; Hispanics; Hospitals; Hyperglycemia; Immigrant; Intervention; Knowledge; Laboratories; Link; Longterm Follow-up; Measures; Minority; Mothers; New York City; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Outcome Measure; Patients; Physiological; Population; Postpartum Period; Pregnancy; Pregnancy Complications; Pregnancy Trimesters; Premature Mortality; Prevalence; Puerto Rican; Race; Registries; Reporting; Research; Retrospective cohort; Risk; Socioeconomic Status; Subgroup; System; Testing; Translating; Woman; adverse pregnancy outcome; blood glucose regulation; cohort; critical period; data registry; ethnic minority population; follow-up; health plan; low socioeconomic status; novel; population based; premature; prenatal; prepregnancy obesity; prevent; racial and ethnic; racial difference; screening; socioeconomic disparity; socioeconomics; tool

PROJECT SUMMARY Gestational diabetes (GDM) is a common complication of pregnancy with substantial disparities between racial/ethnic and immigrant groups. diabetes on contribute Women with GDM are at an increased risk of later developing Type 2 (T2DM), and data on disparities in T2DM following GDM suggest the greatest effect of GDM the transition to T2DM in black and Hispanic women. Thus GDM disparities are critical because they could to lifecourse T2DM disparities. limited GDM has the potential to be an early warning system for T2DM and therefore is an opportunity to intervene to reduce T2DM disparities in women. Unfortunately, this opportunity is often missed due to inadequate long-term follow-up. Glycosylated hemoglobin (HbA1C) is a well-established diagnostic tool for T2DM, with recommended guidelines for diagnosis and control of T2DM. However, data is scarce about prevalence and predictors of long-term HbA1c screening following GDM, and population-based measures of HbA1c levels during and beyond pregnancy. Further, influence of race/ethnicity and nativity on these measures has not been adequately investigated. A major barrier to filling this gap is the lack of a large, diverse GDM cohort with valid outcome measures. We propose a secondary data analysis using linked birth certificate, hospital discharge, and HbA1c registry data from the years 2009-2017 to construct a population- based retrospective cohort. In this novel pregnancy cohort, we aim to: 1) Characterize HbA1c profiles prenatally and through eight years postpartum in women with and without gestational diabetes, overall and by race/ethnicity/nativity; 2) Among women with a GDM pregnancy, determine racial/ethnic/nativity and socioeconomic disparities in long-term HbA1c testing up to eight years postpartum; 3) Among women with a GDM pregnancy, measure racial/ethnic/nativity disparities in longitudinal T2DM outcomes (T2DM and glucose control) and examine prenatal HbA1c levels and clinical characteristics of pregnancy as predictors of poor outcomes. Discoveries of disparities in long-term screening and T2DM outcomes over 8 years of follow-up will guide future interventions to use GDM as a lever to prevent lifecourse T2DM disparities.

项目摘要 妊娠期糖尿病（GDM）是一种常见的妊娠并发症， 种族/族裔和移民群体。 糖尿病 对 贡献 患有GDM的女性以后患2型糖尿病的风险增加 （T2 DM），T2 DM与GDM之间的差异数据表明GDM的影响最大 黑人和西班牙裔女性向T2 DM的转变。因此，GDM差异至关重要，因为它们可能 2型糖尿病的生命周期差异。 有限 GDM有可能成为T2 DM的早期预警系统， 因此，这是一个干预减少女性T2 DM差异的机会。不幸的是，这个机会 由于长期随访不充分，常常漏诊。糖化血红蛋白（HbA 1C）是公认的 T2 DM的诊断工具，以及T2 DM诊断和控制的推荐指南。然而，数据是 缺乏GDM后长期HbA 1c筛查的患病率和预测因素， 测量怀孕期间和怀孕后的HbA 1c水平。此外，种族/族裔和出生对 这些措施尚未得到充分调查。填补这一空白的一个主要障碍是缺乏一个大的， 具有有效结局指标的多样化GDM队列。我们提出了一个二次数据分析使用链接出生 2009-2017年的证书、出院和HbA 1c登记数据，以构建人群- 基于回顾性队列。在这个新的妊娠队列中，我们的目标是：1）表征HbA 1c谱 妊娠期糖尿病和非妊娠期糖尿病妇女产前和产后8年的总体和 种族/民族/出生地; 2）在GDM妊娠女性中，确定种族/民族/出生地， 产后8年内长期HbA 1c检测的社会经济差异; 3） GDM妊娠，测量T2 DM纵向结局（T2 DM和血糖）中的种族/民族/出生差异 对照组），并检查产前HbA 1c水平和妊娠的临床特征作为不良预后的预测因素。 结果。在8年随访中发现长期筛查和T2 DM结局的差异， 指导未来的干预措施，将GDM作为预防生命周期T2 DM差异的杠杆。