Diabetic medicine : a journal of the British Diabetic Association
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It has been well documented that overweight or obesity before pregnancy is a strong predictor of gestational diabetes mellitus (GDM). The aim of this study was to assess the risk of GDM in women who were classified on the basis of pregravid body mass index (BMI) as normal weight and underweight. ⋯ Not only in overweight but also in normal-weight women, the risk for GDM increases with increases in pregravid BMI and adjustment for confounding variables (age, prior GDM and parity) did not influence this relationship. Pregravid BMI is a strong predictor for GDM requiring insulin treatment.
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Quality of life (QoL) is recognized widely as an important health outcome in diabetes, where the burden of self-management places great demands on the individual. However, the concept of QoL remains ambiguous and poorly defined. The aim of our review is to clarify the measurement of QoL in terms of conceptualization, terminology and psychometric properties, to review the instruments that have been used most frequently to assess QoL in diabetes research and make recommendations for how to select measures appropriately. ⋯ No single measure can suit every purpose or application but, when measures are selected inappropriately and data misinterpreted, any conclusions drawn are fundamentally flawed. If we value QoL as a therapeutic goal, we must ensure that the instruments we use are both valid and reliable. QoL assessment has the proven potential to identify ways in which treatments can be tailored to reduce the burden of diabetes. With careful consideration, appropriate measures can be selected and truly robust assessments undertaken successfully.