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Article ; Online: Hemoglobin at the first visit of pregnancy and developing gestational diabetes mellitus: Results of a prospective registry cohort study.

Sedigheh, Nouhjah / Hajieh, Shahbazian / Javad, Zarei / Mehrdad, Sharifi

Clinical nutrition ESPEN

2023 Volume 57, Page(s) 469–474

Abstract: Background and aim: Gestational diabetes mellitus (GDM) is associated with a considerable risk of diabetes in the future. Few studies focused on the association between hemoglobin levels and developing gestational diabetes. This study aimed to determine ...

Abstract	Background and aim: Gestational diabetes mellitus (GDM) is associated with a considerable risk of diabetes in the future. Few studies focused on the association between hemoglobin levels and developing gestational diabetes. This study aimed to determine the association of hemoglobin in early pregnancy and developing gestational diabetes mellitus. Methods: A prospective registry cohort study was designed for the recall of women with gestational diabetes mellitus. The registry was implemented in the health centers of Ahvaz City in 2019. Biological and clinical assessments were done, and interviewer-administered questionnaires were used to collect data on socio-demographic Features, medical and obstetric history, and risk factors of GDM. SPSS used for data analysis. The optimal hemoglobin cut-off point, its sensitivity, and specificity for the prediction of GDM were estimated using ROC analysis. Results: The prevalence of anemia was 17.1% in pregnant women (8.1% in women with gestational diabetes versus %24.2% in the healthy group, p < 0.001). The hemoglobin mean in women with GDM was significantly higher than in healthy women (P < 0.001). Hemoglobin at the first visit was significantly associated with a greater risk of gestational diabetes (OR = 3.80, 95% CI: 3.05-4.74). The area under the curve (AUC) was 0.76 (95% CI 0.73-79), and the optimal cut-off point for hemoglobin was 11.90 g/dL, with a sensitivity of 75% and a specificity of 68%. Women with a higher hemoglobin level had a 3.8- more risk of developing GDM. Conclusion: Measurement of hemoglobin can be a relatively good tool for predicting gestational diabetes in the first months of pregnancy. The combination of hemoglobin with fasting blood sugar and BMI improves the predictive value for gestational diabetes incidence.
MeSH term(s)	Pregnancy ; Female ; Humans ; Diabetes, Gestational/diagnosis ; Diabetes, Gestational/epidemiology ; Cohort Studies ; Hemoglobins ; Area Under Curve ; Registries
Chemical Substances	Hemoglobins
Language	English
Publishing date	2023-07-26
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2405-4577
ISSN (online)	2405-4577
DOI	10.1016/j.clnesp.2023.07.084
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Hemoglobin at the first visit of pregnancy and developing gestational diabetes mellitus: results of a prospective registry cohort study

Sedigheh, Nouhjah / Hajieh, Shahbazian / Javad, Zarei / Mehrdad, Sharifi

European Society for Clinical Nutrition and Metabolism Clinical Nutrition ESPEN. 2023 July 26,

2023

Abstract: Gestational diabetes mellitus (GDM) is associated with a considerable risk of diabetes in the future. Few studies focused on the association between hemoglobin levels and developing gestational diabetes. This study aimed to determine the association of ... ...

Abstract	Gestational diabetes mellitus (GDM) is associated with a considerable risk of diabetes in the future. Few studies focused on the association between hemoglobin levels and developing gestational diabetes. This study aimed to determine the association of hemoglobin in early pregnancy and developing gestational diabetes mellitus. A prospective registry cohort study was designed for the recall of women with gestational diabetes mellitus. The registry was implemented in the health centers of Ahvaz City in 2019. Biological and clinical assessments were done, and interviewer-administered questionnaires were used to collect data on socio-demographic Features, medical and obstetric history, and risk factors of GDM. SPSS used for data analysis. The optimal hemoglobin cut-off point, its sensitivity, and specificity for the prediction of GDM were estimated using ROC analysis. The prevalence of anemia was 17.1% in pregnant women (8.1% in women with gestational diabetes versus %24.2% in the healthy group, p<0.001). The hemoglobin mean in women with GDM was significantly higher than in healthy women (P < 0.001). Hemoglobin at the first visit was significantly associated with a greater risk of gestational diabetes (OR=3.80, 95% CI: 3.05-4.74). The area under the curve (AUC) was 0.76 (95% CI 0.73-79), and the optimal cut-off point for hemoglobin was 11.90 g/dL, with a sensitivity of 75% and a specificity of 68%. Women with a higher hemoglobin level had a 3.8- more risk of developing GDM. Measurement of hemoglobin can be a relatively good tool for predicting gestational diabetes in the first months of pregnancy. The combination of hemoglobin with fasting blood sugar and BMI improves the predictive value for gestational diabetes incidence.
Keywords	anemia ; blood glucose ; clinical nutrition ; cohort studies ; gestational diabetes ; hemoglobin ; prediction ; pregnancy ; risk ; ROC curve ; cohort study ; registry
Language	English
Dates of publication	2023-0726
Publishing place	Elsevier Ltd
Document type	Article ; Online
Note	Pre-press version
ISSN	2405-4577
DOI	10.1016/j.clnesp.2023.07.084
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Changes in self-care behaviors of Iranian patients with type 2 diabetes using insulin pens during COVID-19 pandemic.

Nouhjah, Sedigheh / Shahbazian, Hajieh / Ghodrati, Niloofar

Obesity medicine

2022 Volume 33, Page(s) 100418

Abstract: Aims: The COVID-19 pandemic as a serious public health concern has been accompanied with changes and restrictions in everyday life. This can affect directly or indirectly health behaviors and disease management, particularly in developing countries with ...

Abstract	Aims: The COVID-19 pandemic as a serious public health concern has been accompanied with changes and restrictions in everyday life. This can affect directly or indirectly health behaviors and disease management, particularly in developing countries with low resources. This study aimed to compare self-care behaviors of patients with type 2 diabetes using insulin pens before and after the COVID-19 pandemic. Methods: This was a prospective cohort study involving 300 patients with type 2 diabetes who had been referred to a referral tertiary care diabetes clinic during 2018-2019. The Summary of Diabetes Self-Care Activities Assessment (SDSCA) questionnaire was used for the evaluation of 5 self-care activities. Results: The mean total self-care score before and one year after the onset of the COVID-19 crisis was 37.63 (SD, 10.89) and 26.14 (SD, 10.99), respectively. Before the COVID-19 crisis, 27%, 54.3%, and 18.7% of patients had poor, moderate, and good self-care, respectively. One year after the onset of the epidemic, however, these rates were 66.3%, 29%, and 4.7%, respectively. There was a significant difference between the mean score of 5 indices of self-care behaviors before and after the COVID-19 crisis (p < 0.01). Conclusion: Our findings suggest the deterioration of self-care behaviors amidst the COVID-19 pandemic in an Iranian population. Continuous follow-up of patients with diabetes and the design of effective educational programs for these patient can prevent or delay the long-term consequences of diabetes, especially in the context of the COVID-19 crisis.
Language	English
Publishing date	2022-05-28
Publishing country	England
Document type	Journal Article
ISSN	2451-8476
ISSN (online)	2451-8476
DOI	10.1016/j.obmed.2022.100418
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Challenges of diabetes care management in developing countries with a high incidence of COVID-19: A brief report.

Nouhjah, Sedigheh / Jahanfar, Shayesteh

Diabetes & metabolic syndrome

2020 Volume 14, Issue 5, Page(s) 731–732

Abstract: Background and aims: Diabetes mellitus (DM) is one of the most critical risk factors for complications and death in COVID-19 patients. The present study aims to highlight challenges in the management of diabetic patients during the COVID-19 outbreak in ... ...

Abstract	Background and aims: Diabetes mellitus (DM) is one of the most critical risk factors for complications and death in COVID-19 patients. The present study aims to highlight challenges in the management of diabetic patients during the COVID-19 outbreak in developing countries. Methods: We reviewed the literature to obtain information about diabetic care during the Covid-19 crisis. We also seek opinions of clinicians working in undeveloped countries. Results: Current challenges faced by clinicians in the management of diabetic patients in developing countries are as follows: lack of preventive measures, inadequate number of visits, loss of the traditional method of communication with the patient, shortage of medications, impaired routine diabetic care, and absence of telehealth services. Conclusions: Developing countries are faced with many challenges in diabetes management due to a lack of resources.
MeSH term(s)	Ambulatory Care/economics ; Ambulatory Care/standards ; Ambulatory Care/statistics & numerical data ; Betacoronavirus/physiology ; COVID-19 ; Coronavirus Infections/complications ; Coronavirus Infections/epidemiology ; Developing Countries/economics ; Developing Countries/statistics & numerical data ; Diabetes Mellitus/economics ; Diabetes Mellitus/epidemiology ; Diabetes Mellitus/therapy ; Health Services Accessibility/economics ; Health Services Accessibility/standards ; Health Services Accessibility/statistics & numerical data ; Humans ; Incidence ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/epidemiology ; Risk Factors ; SARS-CoV-2 ; Telemedicine/economics ; Telemedicine/methods
Keywords	covid19
Language	English
Publishing date	2020-05-19
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2273766-2
ISSN	1878-0334 ; 1871-4021
ISSN (online)	1878-0334
ISSN	1871-4021
DOI	10.1016/j.dsx.2020.05.012
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Article ; Online: The relationship between fasting plasma glucose in the first trimester of pregnancy and the incidence of gestational diabetes in Iran.

Rashidi, Homeira / Kalantari, Kamelia / Shahbazian, Hajieh / Nouhjah, Sedigheh

Diabetes & metabolic syndrome

2021 Volume 15, Issue 4, Page(s) 102193

Abstract: Aims: This study aimed to investigate the relationship between fasting plasma glucose in the first trimester of pregnancy and the incidence of gestational diabetes.: Methods: This descriptive-analytical study was conducted using the merging data from ...

Abstract	Aims: This study aimed to investigate the relationship between fasting plasma glucose in the first trimester of pregnancy and the incidence of gestational diabetes. Methods: This descriptive-analytical study was conducted using the merging data from two prospective cohort studies that were carried out from 2015 to 2018 in Ahvaz, southwest of Iran. Logistic regression and ROC curves were used to evaluate the predictive power of risk factors. Results: Of all 1270 pregnant women studied, 454 (35.75%) had gestational diabetes who were compared with the other 816 (64.25%) healthy women. The area under the curve (AUC) of fasting glucose for the first pregnancy visit was 0.80 (95% CI: 0.76-83), and the optimum fasting glucose cut-off point was 85.5 mg/dL with a sensitivity of 71% and a specificity of 69%. AUC of the combination of fasting glucose at the first visit with body mass index ≥25 kg/m Conclusion: Fasting plasma glucose in the first trimester of pregnancy is a relatively good predictor of gestational diabetes. If this factor is combined with other risks, its diagnostic value will increase.
MeSH term(s)	Adult ; Blood Glucose ; Body Mass Index ; Diabetes, Gestational/epidemiology ; Female ; Humans ; Incidence ; Iran/epidemiology ; Logistic Models ; Pregnancy ; Pregnancy Trimester, First/blood ; Prospective Studies ; ROC Curve ; Risk Factors ; Young Adult
Chemical Substances	Blood Glucose
Language	English
Publishing date	2021-06-30
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2273766-2
ISSN	1878-0334 ; 1871-4021
ISSN (online)	1878-0334
ISSN	1871-4021
DOI	10.1016/j.dsx.2021.102193
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The effect of distance on the adherence to postpartum follow-up in women with gestational diabetes.

Nouhjah, Sedigheh / Shahbazian, Hajieh / Jahanfar, Shayesteh / Shahbazian, Nahid

Environmental science and pollution research international

2021 Volume 28, Issue 46, Page(s) 65428–65434

Abstract: Despite the increasing prevalence of gestational diabetes mellitus and well-known long-term metabolic consequences, a low rate of postpartum screening in this population is reported. Few studies focused on environmental factors of attending and ... ...

Abstract	Despite the increasing prevalence of gestational diabetes mellitus and well-known long-term metabolic consequences, a low rate of postpartum screening in this population is reported. Few studies focused on environmental factors of attending and performing blood glucose screening tests in women with gestational diabetes. This work aimed to assess the proportion of uptake of postpartum follow-up after the first recall and to study the adherence-related factors in women with gestational diabetes. All women with gestational diabetes were recalled for postpartum screening in a tertiary care center as the center of the cohort study in 2016. The postal addresses were geocoded, and precise spatial (x, y) was provided for each mother's home location. SPSS and GIS were used for data analysis. The incidence rate of gestational diabetes was 8.5% (826/9630). Of women with gestational diabetes, 21.3% accepted to return and completed postpartum screening tests in the first recall. The distance from the cohort center, history of diabetes in the family, and a number of pregnancies were significant predictors for return to follow-up using binary logistic regression (P < 0.01). The first 25% of patients had a distance of 2346 m from the cohort center, and all of the mothers referred to the hospital were 0 to 5 km away, i.e., those who did not return were more than 5 km away (95% confidence interval). Overall screening uptake rate was low. Distance from the center of the screening was an essential factor in deciding to return and adhere to postpartum care in women with gestational diabetes. Geographic inequalities must be considered as a risk factor of visiting the healthcare center in addition to individual contributors. A more accessible center may improve the postpartum follow-up rate in women with a history of gestational diabetes.
MeSH term(s)	Blood Glucose ; Cohort Studies ; Diabetes Mellitus, Type 2 ; Diabetes, Gestational/epidemiology ; Female ; Follow-Up Studies ; Glucose Tolerance Test ; Humans ; Postpartum Period ; Pregnancy
Chemical Substances	Blood Glucose
Language	English
Publishing date	2021-07-28
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1178791-0
ISSN	1614-7499 ; 0944-1344
ISSN (online)	1614-7499
ISSN	0944-1344
DOI	10.1007/s11356-021-15472-3
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: The effect of distance on the adherence to postpartum follow-up in women with gestational diabetes

Nouhjah, Sedigheh / Shahbazian, Hajieh / Jahanfar, Shayesteh / Shahbazian, Nahid

Environmental science and pollution research. 2021 Dec., v. 28, no. 46

2021

Abstract	Despite the increasing prevalence of gestational diabetes mellitus and well-known long-term metabolic consequences, a low rate of postpartum screening in this population is reported. Few studies focused on environmental factors of attending and performing blood glucose screening tests in women with gestational diabetes. This work aimed to assess the proportion of uptake of postpartum follow-up after the first recall and to study the adherence-related factors in women with gestational diabetes. All women with gestational diabetes were recalled for postpartum screening in a tertiary care center as the center of the cohort study in 2016. The postal addresses were geocoded, and precise spatial (x, y) was provided for each mother’s home location. SPSS and GIS were used for data analysis. The incidence rate of gestational diabetes was 8.5% (826/9630). Of women with gestational diabetes, 21.3% accepted to return and completed postpartum screening tests in the first recall. The distance from the cohort center, history of diabetes in the family, and a number of pregnancies were significant predictors for return to follow-up using binary logistic regression (P < 0.01). The first 25% of patients had a distance of 2346 m from the cohort center, and all of the mothers referred to the hospital were 0 to 5 km away, i.e., those who did not return were more than 5 km away (95% confidence interval). Overall screening uptake rate was low. Distance from the center of the screening was an essential factor in deciding to return and adhere to postpartum care in women with gestational diabetes. Geographic inequalities must be considered as a risk factor of visiting the healthcare center in addition to individual contributors. A more accessible center may improve the postpartum follow-up rate in women with a history of gestational diabetes.
Keywords	blood glucose ; cohort studies ; confidence interval ; gestational diabetes ; health services ; hospitals ; pollution ; regression analysis ; research ; risk factors
Language	English
Dates of publication	2021-12
Size	p. 65428-65434.
Publishing place	Springer Berlin Heidelberg
Document type	Article
ZDB-ID	1178791-0
ISSN	1614-7499 ; 0944-1344
ISSN (online)	1614-7499
ISSN	0944-1344
DOI	10.1007/s11356-021-15472-3
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Challenges of diabetes care management in developing countries with a high incidence of COVID-19

Nouhjah, Sedigheh / Jahanfar, Shayesteh

Diabetes & Metabolic Syndrome: Clinical Research & Reviews

A brief report

2020 Volume 14, Issue 5, Page(s) 731–732

Keywords	Internal Medicine ; Endocrinology, Diabetes and Metabolism ; General Medicine ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ZDB-ID	2273766-2
ISSN	1878-0334 ; 1871-4021
ISSN (online)	1878-0334
ISSN	1871-4021
DOI	10.1016/j.dsx.2020.05.012
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Article ; Online: Temporary changes in clinical guidelines of gestational diabetes screening and management during COVID-19 outbreak: A narrative review.

Nouhjah, Sedigheh / Jahanfar, Shayesteh / Shahbazian, Hajieh

Diabetes & metabolic syndrome

2020 Volume 14, Issue 5, Page(s) 939–942

Abstract: Background and aims: New clinical approaches are needed to minimize complications of gestational diabetes during the COVID-19 outbreak with timely screening and proper management. The present study aims to highlight changes in the clinical guideline for ...

Abstract	Background and aims: New clinical approaches are needed to minimize complications of gestational diabetes during the COVID-19 outbreak with timely screening and proper management. The present study aims to highlight changes in the clinical guideline for gestational diabetes during the pandemic. Methods: In a narrative review, multiple databases were searched. Furthermore, online searches were conducted to identify guidelines or support documents provided by NGOs, local health authorities, and societies and organizations in the field of diabetes and obstetrics. Results: We included five national guidelines that were published in English from Canada, the United Kingdom, Australia, New Zealand, and Australia health agencies. FBG, A1C, RPG were recommended as alternative tests instead of a 2-h oral glucose tolerance test (OGGT) for GDM screening at 24-28 weeks of gestation. Recommendations also included a deferral of postpartum screening till the end of the pandemic, or postponement of testing to 6-12 months after delivery, use telemedicine and telecare. Conclusions: Updated temporary changes in clinical guidelines are sensible and accommodates social distancing and minimizes risk of exposure to COVID-19. Despite many unsolved controversies in screening, treatment, and follow-up of gestational diabetes, it seems involvement with novel coronavirus have made a reach to a global agreement simpler.
MeSH term(s)	Betacoronavirus/isolation & purification ; COVID-19 ; Coronavirus Infections/complications ; Coronavirus Infections/epidemiology ; Coronavirus Infections/virology ; Diabetes, Gestational/diagnosis ; Diabetes, Gestational/therapy ; Diabetes, Gestational/virology ; Disease Management ; Female ; Humans ; Iran/epidemiology ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/virology ; Practice Guidelines as Topic/standards ; Practice Patterns, Physicians'/standards ; Pregnancy ; Pregnancy Complications, Infectious/prevention & control ; Prognosis ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-06-18
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2273766-2
ISSN	1878-0334 ; 1871-4021
ISSN (online)	1878-0334
ISSN	1871-4021
DOI	10.1016/j.dsx.2020.06.030
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Challenges of diabetes care management in developing countries with a high incidence of COVID-19: A brief report

Nouhjah, Sedigheh / Jahanfar, Shayesteh

Diabetes Metab Syndr

Abstract: BACKGROUND AND AIMS: Diabetes mellitus (DM) is one of the most critical risk factors for complications and death in COVID-19 patients. The present study aims to highlight challenges in the management of diabetic patients during the COVID-19 outbreak in ... ...

Abstract	BACKGROUND AND AIMS: Diabetes mellitus (DM) is one of the most critical risk factors for complications and death in COVID-19 patients. The present study aims to highlight challenges in the management of diabetic patients during the COVID-19 outbreak in developing countries. METHODS: We reviewed the literature to obtain information about diabetic care during the Covid-19 crisis. We also seek opinions of clinicians working in undeveloped countries. RESULTS: Current challenges faced by clinicians in the management of diabetic patients in developing countries are as follows: lack of preventive measures, inadequate number of visits, loss of the traditional method of communication with the patient, shortage of medications, impaired routine diabetic care, and absence of telehealth services. CONCLUSIONS: Developing countries are faced with many challenges in diabetes management due to a lack of resources.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #305996
Database	COVID19

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