Increasing trend in the prevalence of gestational diabetes mellitus in Taiwan.

AIMS/INTRODUCTION: Maternal hyperglycemia leads to adverse pregnancy outcomes, and also subsequently affects both mothers and their offspring in later life. The prevalence of type 2 diabetes mellitus is increasing worldwide, and gestational diabetes mellitus (GDM) is also believed to be increasing. More precise nationwide and up-to-date data on GDM are required. MATERIALS AND METHODS: A population-based retrospective cohort study was carried out with the Birth Certificate Application database and linked to the National Health Insurance Research Database to explore trends in the annual crude prevalence of GDM in all women who gave birth between 1 January 2004 and 31 December 2015 in Taiwan and their pregnancy outcomes. The registry is considered complete, reliable and accurate. RESULTS: A total of 2,468,793 births from 2,430,307 pregnancies were reported between 1 January 2004 and 31 December 2015. Finally, 2,053,305 pregnancies were included for further analysis. The annual prevalence of GDM increased by 1.8-fold during the 12 years from 2004 to 2015, with a significant continuous increasing trend (from 7.6% to 13.4%, P < 0.001). The annual prevalence of GDM significantly increased in each age group (all trends P < 0.001), particularly for women with maternal ages of 31 years and older. Urbanization level, geographic risk factors and seasonal variations were also noted. CONCLUSION: The annual prevalence of GDM increased by 1.8-fold in the 12-year period from 2004 to 2015 in Taiwan, with a significant continuous increasing trend (from 7.6% to 13.4%, P < 0.001).

Risk factors associated with diabetic retinopathy onset and progression in diabetes patients: a Taiwanese cohort study.

Diabetic retinopathy (DR) is a common complication of type 2 diabetes mellitus (T2DM) and the leading cause of adult blindness. This study aimed to clarify the risk factors associated with DR onset and progression in patients with T2DM in Taiwan. This retrospective analysis enrolled 743 T2DM patients, including 170 with DR and 573 without DR at baseline who were enrolled in the Diabetes Shared-Care Program. The average follow-up period was 2.9 years. Variables, including demographic characteristics, DM duration, anthropometric data and clinical laboratory results, were compared between patients with DR at baseline, those with new-onset DR, and patients without DR using a chi-squared test and one-way ANOVA. A multivariate Cox proportional hazards model was performed to identify risk factors associated with progression of preexisting DR or new-onset DR. During the follow-up period, 38 (22.4%) patients with preexisting DR experienced disease progression, and 91 (15.9%) patients had new-onset DR. Multivariate analysis revealed that the presence of neuropathy (HR: 3.96, 95% CI: 1.84, 8.53) and diastolic blood pressure (HR: 1.05, 95% CI: 1.02, 1.08) were associated with increased risk of DR progression (both P < 0.001). Factors associated with new-onset DR included neuropathy, systolic BP, cholesterol, and updated mean of HbA1c (all P ≤ 0.001). The risk factors associated with DR onset and progression in Taiwanese patients with T2DM are different. Neuropathy and blood pressure increased the risk of both DR onset and progression; however, the risk of DR onset was also increased with updated mean of HbA1c and cholesterol.