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Cited by 10Gestational Diabetes Research and ManagementPregnancy and Medication ImpactDiabetes, Cardiovascular Risks, and Lipoproteins

Associations between maternal characteristics and pharmaceutical treatment of gestational diabetes: An analysis of the UK Born in Bradford (BiB) cohort study

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Martine-Edith, Gilberte, Johnson, William, Hunsicker, Eugenie, Hamer, Mark, Petherick, Emily S·2021·BMJ Open
DOI 10.1136/bmjopen-2021-053753PMC PMC8572403
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Abstract

Objectives: To identify the maternal characteristics associated with pharmaceutical treatment of gestational diabetes mellitus (GDM). Design: Prospective birth cohort study. Setting: Bradford, UK. Participants: 762 women from the Born in Bradford (BiB) cohort who were treated for GDM in a singleton pregnancy. BiB cohort participants were recruited from 2007 to 2010. All women booked for delivery were screened for GDM between 26 and 28 weeks of gestation using a 75 g 2-hour oral glucose tolerance test (OGTT). Outcome measure: GDM treatment type: lifestyle changes advice (lifestyle changes), lifestyle changes advice with supplementary insulin (insulin) and lifestyle changes advice with supplementary metformin (metformin). Results: 244 (32%) women were prescribed lifestyle changes advice alone while 518 (68%) were offered supplemental pharmaceutical treatment. The odds of receiving pharmaceutical treatment relative to lifestyle changes advice alone were increased for mothers who were obese (OR 4.6, 95% CI 2.8 to 7.5), those who smoked (OR 2.6, 95% CI 1.2 to 5.5) and had higher fasting glucose levels at OGTT (OR 2.1, 95% CI 1.6 to 2.7). The odds of being prescribed pharmaceutical treatment rather than lifestyle changes advice were lower for Pakistani women (OR 0.7, 95% CI 0.4 to 1.0)) than White British women. Relative to insulin treatment, metformin was more likely to be offered to obese women than normal weight women (relative risk ratio, RRR 3.2, 95% CI 1.3 to 7.8) and less likely to be prescribed to women with higher fasting glucose concentrations at OGTT (RRR 0.3, 95% CI 0.2 to 0.6). Conclusions: In the BiB cohort, GDM pharmaceutical treatment tended to be prescribed to women who were obese, White British, who smoked and had more severe hyperglycaemia. The characteristics of metformin-treated mothers differed from those of insulin-treated mothers as they were more likely to be obese but had lower glucose concentrations at diagnosis.

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  • In Born in Bradford cohort study (2007-2010), GDM prevalence was 6.77% using modified WHO 1999 criteria.

    “A similar result—at 6.77% was estimated by Martine-Edith et al. in Born in Bradford (BiB) cohort study using modified WHO 1999 criteria, according to local recommendations at the time of the study (2007–2010): fasting glucose level ≥ 6.1 mmol/L (≥110 mg/dL) and 2 h post-load glucose level ≥ 7.8 mmol/L (≥140 mg/dL) [156].”

    From Evolution of Gestational Diabetes Mellitus across Continents in 21st Century (2022) · cites this paper as [156]

    Methods (Screening and diagnosis of GDM; page unavailable) confirms that the BiB study used modified 1999 WHO criteria with the stated glucose thresholds, and the Participants section gives recruitment as 2007–2010. Results reports 844 women diagnosed with GDM, but our copy does not report a 6.77% prevalence or provide a denominator that verifies it. The paper specifies that either glucose threshold could meet the diagnostic criterion. (LLM, conf=0.86)

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Cited by

Sorted by citations

Authors
Martine-Edith, G., Johnson, W., Hunsicker, E., Hamer, M., & Petherick, E. S.
Affiliations
  • School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
  • Loughborough University (GB)
  • School of Science, Loughborough University, Loughborough, UK
  • University College London (GB)
Corresponding author
Johnson, William
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2021-11
Volume
11
Issue
11
Pages
e053753
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2021-053753
PMC
PMC8572403
OpenAlex
W3211101375
Cited by
10
References
3
Citations by year
2025: 2 · 2024: 3 · 2023: 3 · 2022: 2
FWCI
1.81
Type
journal article
Language
en
Open access
Licence
Locations
  • BMJ Open (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
Funders
  • Loughborough University (N/A)
  • NIHR Collaboration for Applied Health Research and Care (IS-CLA-0113-10020)
  • Wellcome (WT101597MA)
  • NIHR Leicester Biomedical Research Centre (N/A)
  • UK Medical Research Council (MR/P023347/1)
  • NIHR Clinical Research Network (N/A)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
gestational diabetes mellitus, pharmacotherapy, metformin, insulin, lifestyle advice, maternal obesity, maternal smoking, fasting blood glucose, ethnic differences, Pakistani women, Born in Bradford cohort
MeSH terms
Birth Cohort, Blood Glucose, Pharmaceutical Preparations, Female, United Kingdom, Humans, Pregnancy, Prospective Studies, Cohort Studies, Diabetes, Gestational

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