population-based screening for gestational diabetes mellitus in non-diabetic women in Bahrain

Maternal hyperglycemia is considered a risk factor for fetal morbidity. Since there is a high prevalence of diabetes mellitus among the population of Bahrain, we conducted a prospective population-based study of gestational diabetes mellitus [GDM] in non-diabetic pregnant women. All non-diabetic pregnant women attending antenatal clinics during January 2001 to December 2002 [n=10 495] were screened for GDM during the 24th to 28th weeks of gestation. All positive subjects based on a 50-g glucose challenge test [GCT] were further evaluated by a diagnostic 75-g oral glucose tolerance test [OGTT]. The birth weight of the child and post-delivery insulin resistance were monitored. The homeostasis model of insulin resistance [HOMA-IR] was used to assess insulin resistance. Of 10 495 non-diabetic pregnant women screened, 32.8% [n=3443] had plasma glucose >/= 7.8 mmol/L [140 mg/dL] in the GCT. The 75-g OGTT found a prevalence of GDM of 13.5%. There were twice as many Bahrainis as expatriates. Of children born to women with GDM, 6.5% had a birth weight >4000 g. Post-delivery evaluation of insulin resistance indicated that 33% of women with GDM had a HOMA-IR value >2. The population of Bahrain is a high-risk ethnic group for GDM. The association of insulin resistance in the post-gravid state with GDM among 33% of the study population suggests that insulin resistance, the possible cause of the pathophysiological mechanism underlying the development of gestational diabetes, continues in the post gravid state

Peutz-Jeghers syndrome

This report describes a case of Peutz-Jeghers syndrome in a 17-year-old Bahraini male patient who presented with recurrent attacks of abdominal pain with distinctive melanin pigmentation of the lips, buccal mucosa, palms of the hands and soles of the feet. This was associated with iron deficiency anaemia and multiple hamartomatous polyps in the gastro-intestinal tract. The main purpose of this communication is to draw the attention of the clinician to the existence of this condition in Bahrain and to stress the clinical features, the radiological findings and the pathological diagnosis