7 In a systematic review and meta-analysis of 39 studies from 27 African countries, the pooled prevalence of T2DM was even higher, at 7.2%, in women of childbearing age 8 this figure may have been incorrectly high because the upper age limit for inclusion of women was 54 years. Diabetes in Women of Reproductive AgeĪ population estimate of the prevalence of diabetes in US women aged 24–32 years was surprisingly high at 6.5% as far back as in 2007–2008 the data were drawn from the nationally representative National Longitudinal Study of Adolescent to Adult Health, Wave IV. 5 Some antipsychotics, such as olanzapine (OR, 5.8 95% CI, 2.0–16.7), 6 have specifically been identified to carry greater risk. 3 Antipsychotic drugs have more particularly been associated with an increased risk of T2DM (pooled odds ratio, 2.58 95% CI, 1.56–4.24) 4 and gestational diabetes (pooled RR, 1.24 95% CI, 1.09–1.42). 2Īmong psychotropic drugs, as examples, antidepressants (pooled hazard ratio, 1.24 95% confidence interval, 1.18–1.31), and specifically tricyclic antidepressants (pooled relative risk, 1.39 95% CI, 1.17–1.65), have been associated with new-onset T2DM. An umbrella review and meta-analysis found pooled T2DM prevalences of 40% in sleep disorder, 21% in binge eating disorder, 16% in substance use disorder, 14% in anxiety disorder, 11% in bipolar disorder, 10% in schizophrenia, 9% in depression, and 8% in intellectual disability. This is partly because some disorders, such as mood disorders and schizophrenia, are associated with eating disturbances and sedentariness, and partly because some psychotropic drugs, such as some antipsychotics, antidepressants, anxiolytics, and mood stabilizers, are associated with increased appetite, weight gain, and even the metabolic syndrome. T2DM is common in patients with psychiatric disorders. The highest prevalences, in middle age and later, were observed in North Africa and in the Middle East, followed by South Asia. The prevalence was lowest, at < 1%, at age < 20 years and peaked at nearly 25% at age 75–79 years. In 2021, estimates of the prevalence of diabetes were 6.5% for males and 5.8% for females, with T2DM comprising 96% of cases. It was estimated that the age-standardized global prevalence of total diabetes grew from 3.2% in 1990 to 6.1% in 2021. The prevalence of type 2 diabetes mellitus (T2DM) is increasing across the world. A reasonable conclusion from a reading of the reviewed literature is that pregestational and gestational diabetes are best treated during pregnancy, that insulin is a first-line treatment, that metformin is an increasingly accepted alternative, and that safety data on second-line antidiabetic treatments are, so far, reassuring.Īuthor affiliations appear at the end of this article These findings are reassuring but have limitations that are discussed. A recent large retrospective cohort study with data from 6 countries in Europe, Asia, and North America found that, in about 51,000 women with pregestational T2DM, neither MCMs nor cardiac malformations were more prevalent in offspring of children periconceptionally exposed to second-line antidiabetic treatments relative to exposure to insulin. Risks to the child include spontaneous abortion, fetal death, macrosomia, major congenital malformations (MCMs), preterm delivery, neonatal hypoglycemia, neonatal hyperbilirubinemia, and neonatal respiratory distress syndrome. Risks to the mother include obesity, hypertension, and preeclampsia. Exposure of pregnancy to pregestational and gestational diabetes is associated with risks to the mother as well as risks to the child. As a result, many women of reproductive age who have diabetes, including women who do not know that they have diabetes, may unintentionally become pregnant, thus unknowingly exposing their pregnancy to diabetes and its treatment. About 20%–50% of pregnancies, across the world, are unplanned this figure is higher, at about 65%, in women with psychiatric disorders. The prevalence of pregestational diabetes is 0.5%–2.4%, and that of gestational diabetes is 7%–28%, depending on geographical region. T2DM occurs in 2%–7% of women of reproductive age. T2DM is more common in patients with psychiatric disorders and those who take certain psychotropic drugs. The global prevalence of type 2 diabetes mellitus (T2DM) is increasing.
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