IS SHORT STATURE A RISK FACTOR FOR GESTATIONAL DIABETES MELLITUS ?

Sharron Meakins, Credentialed Diabetes Educator

Sally Meacock, Senior Dietitian

Rockingham Endocrinology & Diabetes Service Rockingham General Hospital

BACKGROUND

• Traditional indicators for predicting a client at risk of Gestational Diabetes Mellitus (GDM) have focussed on weight and Body Mass Index (BMI). There is evidence that shorter individuals are more likely to have abnormalities of glucose homeostasis. The significance of stature as a predictor of GDM may have been overlooked as an independent variable in glucose intolerance.

• At the Rockingham Diabetes Centre we collect data on our GDM clients who attend two self management education groups run over two weeks. This enabled us to retrospectively assess our population group.

AIM

We sought to determine from the data we collected if patients in our population group with a shorter stature were at increased risk of GDM.

METHOD

Our data was collected from 216 clients who attended the group education program from January 2012 to April 2013.

The data collected included height, age, family history of diabetes, history of prior GDM, weight, ethnicity, parity, OGTT results and HbA1c.

We reviewed the data to see if clients with a stature of less than 165cm represented a larger proportion of attendees at the group.

RESULTS

The results table shows that in our population group patients with a stature equal to or less than 165cm represented 70.4% of the patients referred with GDM over the 16 month period.

Height Number & % of Clients

≤165 cm N = 152 (70.4%)

>165 cm N = 64 (29.6%)

RESULTS

The graph shows the number of clients seen in the GDM group according to their height. As the data shows 54% of the clients fell within the 155-165cm height group.

0

10

20

30

40

50

60

70

< 154.9cm 155-160 160-165 165-170 >170

Number of patients

CONCLUSION

Stature could be used in our population group as an

independent variable for early risk factor identification and

education to reduce risk of GDM .

Clients with a height less then 165cm may require a longer

follow up period post diet and lifestyle education to

monitor management and

prevent risk of

T2DM.

IMPACT ON DIABETES EDUCATION PRACTICE & FUTURE CONSIDERATIONS

In the GP world using stature as a part of the screening assessment

for GDM could pick up patients at risk of GDM independent of weight

and/or BMI. This could then instigate the start of earlier education for

prevention of GDM.

We would like to look at the link between stature and the need for

insulin therapy pre & post birth. We would also like to assess if the

role of ethnicity impacts on these results.

REFERENCES

1. Anastasiou. E, et al., Decreased stature in gestational diabetes mellitus: Diabetologia, 1998. 41: p 997-1001.

2. Kousta. E, et al., Women with a history of gestational diabetes of European and South Asian origin are shorter than women with normal glucose tolerance in pregnancy: Diabetes UK. Diabetic Medicine, 2000. 17: 792-797. 3. Jang. HC, et al., Short stature in Korean women: a contribution to the multifactorial predisposition to gestational diabetes mellitus: Diabetologia,1998. 41: 778-783.

4. Graziano Di Cianni. L, et al., Prevalence and risk factors for gestational diabetes assessed by universal screening: Diabetes Research and Clinical Practice, 2003. 62, 131-137.