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Predictors of postpartum glucose intolerance in women with gestational diabetes mellitus: a prospective cohort study in Ethiopia based on the updated diagnostic criteria
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  • Published on:
    Response to “High prevalence of postpartum glucose intolerance in women with gestational diabetes mellitus: Another reason to encourage exclusive breastfeeding?” Shivashri Chockalingam et.al

    Thank you for your interest, comments, and questions in our study!
    In our study, there was a relatively good adherence for postpartum glucose test or attend the postpartum OGTT as compared to evidence from other literatures (1, 2). It was happening due to frequent contact and closely following of study participants from pregnancy to postnatal period and sending a reminder for post-partum oral glucose test. However, for few women who did not attend the postpartum OGTT, we found the major reasons are changed their usual residence or left the city, perceived they will not have postpartum glucose intolerance, or it will be very mild, some of women delivered outside the study area, women either declined to participate, women could not be contacted (unreachable by phone contact) because they changed their contact information and some unknown reasons. We have also checked the presence or absence baseline differences among the two groups, we found that there is no any statistically baseline difference between the two groups (attended vs did not attend the postpartum OGTT). Though there is evidence that women with higher cardiovascular risk factors tend not to attend for the OGTT, but as we clearly stated in our baseline survey (3), pregnant women who had chronic diseases including known cardiovascular disorder were excluded at initial commencement. Hence, our participants had not any revealed higher cardiovascular risk factors tend not to attend the OGTT.
    Regarding...

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    Conflict of Interest:
    None declared.
  • Published on:
    High prevalence of postpartum glucose intolerance in women with gestational diabetes mellitus: Another reason to encourage exclusive breastfeeding?
    • Shivashri Chockalingam, PhD Scholar - Health Sciences Warwick Medical School, University of Warwick, Coventry, UK
    • Other Contributors:
      • Deepa Mohan, Senior Scientist - Dept. of Epidemiology
      • Anjana Ranjit Mohan, Vice President
      • Mohan Viswanathan, President
      • Yonas Weldeselassie, Senior Research Fellow - Population, evidence & technology, Health Sciences
      • Saravanan Ponnusamy, Professor - Diabetes, Endocrinology & Metabolism

    We read the article by Muche AA et al1on the predictors of postpartum glucose intolerance in women with history of GDM. The study is interesting despite the limited sample size, as the risk score developed would be useful for Ethiopia and other low-resource settings. The inclusion of the antenatal depression, dietary diversity, and level of physical activity adds value to the study. However, the study findings could have been strengthened further if the following details were provided. Firstly, what were the characteristics of the women who did not attend the post-partum OGTT? There is evidence that women with higher cardiovascular risk factors tend not to attend for the OGTT2. Secondly, what was the impact of breastfeeding? Breastfeeding has a positive impact on post-partum weight loss, which could potentially improve glucose intolerance and elevated lipid levels3.In addition, it may also have other positive benefits through other mechanisms4. Exclusive breastfeeding in Ethiopia at 59.3% is lower than international recommendations with wide variations across the regions.5Specifically, in Gondor town (place of study - Muche AA et al) the rate was reported to be 34.8% 6. This might also play a vital role in such a high glucose intolerance observed and will enable healthcare professionals to encourage women to breastfeed for their own metabolic benefit (in addition to their children, which is the primary reason for breastfeeding).Finally, did the authors have any data on ges...

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    Conflict of Interest:
    None declared.