| Diabetes in pregnancy among indigenous women in Australia, Canada, New Zealand and the United States: A systematic review of the evidence for screening in early pregnancy. | |
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MedLine Citation:
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PMID: 23315909 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Recently proposed international guidelines for screening for Gestational Diabetes Mellitus (GDM) recommend additional screening in early pregnancy for sub-populations at a high risk of Type 2 Diabetes Mellitus (T2DM), such as indigenous women. However, there are criteria that should be met to ensure the benefits outweigh the risks of population-based screening. This review examines the published evidence for early screening for indigenous women as related to these criteria. METHODS: Any publications were included that referred to diabetes in pregnancy (DIP) among indigenous women in Australia, Canada, New Zealand and the United States (n = 145). The risk of bias was appraised. RESULTS: There is sufficient evidence describing the epidemiology of DIP, demonstrating that it imposes a significant disease burden on indigenous women and their infants at birth and across the lifecourse (n = 120 studies). Women with pre-existing T2DM have a higher risk than women who develop GDM during pregnancy. However, there was insufficient evidence to address the remaining five criteria, including: understanding current screening practice and rates (n = 7); acceptability of GDM screening (n = 0); efficacy and cost of screening for GDM (n = 3); availability of effective treatment after diagnosis (n = 6); and effective systems for follow-up after pregnancy (n = 5). CONCLUSIONS: Given the impact of DIP, particularly undiagnosed T2DM, GDM screening in early pregnancy offers potential benefits for indigenous women. However, researchers, policy-makers and clinicians must work together with communities to develop effective strategies for implementation and minimising the potential risks. Evidence of effective strategies for primary prevention, GDM treatment and follow-up after pregnancy are urgently needed. Copyright © 2013 John Wiley & Sons, Ltd. |
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Authors:
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Catherine Chamberlain; Bridgette McNamara; Emily D Williams; Daniel Yore; Brian Oldenburg; Jeremy Oats; Sandra Eades |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-1-12 |
Journal Detail:
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Title: Diabetes/metabolism research and reviews Volume: - ISSN: 1520-7560 ISO Abbreviation: Diabetes Metab. Res. Rev. Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2013-1-14 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100883450 Medline TA: Diabetes Metab Res Rev Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2013 John Wiley & Sons, Ltd. |
Affiliation:
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International Public Health Unit, Department of Epidemiology and Preventive Medicine, School of Medicine, Nursing and Health Sciences, Monash University, L3/89 Commercial Rd, Prahan, Victoria, 3181, AUSTRALIA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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