ESTIMATION OF THE RISK OF POSTPARTUM MATERNAL GLUCOSE INTOLERANCE IN WOMEN WITH GESTATIONAL DIABETES MELLITUS
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| Year of publication | 2013 |
| Type | Conference abstract |
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| Description | Objective. Given that women with previous gestational diabetes mellitus (GDM) have a higher risk of diabetes development later in life compared to women with a physiological pregnancy, the aims of our study were (1) to find an eventual significant predictive factors for early postpartum conversion of GDM into permanent diabetes or persistent impaired glucose tolerance from a panel of routinely measured parameters (anthropometric, biochemical and clinical data) during the second trimester of gravidity and (2) to test whether the degree of glucose intolerance diagnosed by standard criteria at the time of GDM diagnosis correlates with the incidence and the degree of early postpartum glucose intolerance. Design. A retrospective epidemiological study Setting. The Diabetology Centre of Faculty Hospital Brno Bohunice Patients. A total of 305 female patients with GDM diagnosis followed during the period 2005 – 2011 that underwent repeated oGTT test up to 1 year after the delivery. Following data were monitored: age in time of GDM diagnosis, parity, week of gestation in time of GDM diagnosis, positive family history of DM, pregnancy after IVF, pre-gestational BMI and biochemical parameters in time of GDM diagnosis (glucose during oGTT,HbA1c, total cholesterol), oGTT Area Under the Curve (AUCoGTT, mmol/l/hour) was calculated. Main outcome measurements. Three point oGTT evaluation was used with physiological values: under 5.5 mmol/l fasting plasma glucose, under 8.8 mmol/l in 60th min. and under 7.7 mmol/l in 120th min. during pregnancy and for the postpartum test: diabetes - when fasting plasma glucose was above 7.0 mmol/l or glycaemia in 120th min. oGTT more than 11.0 mmol/l, prediabetes - glycaemia 7.8 - 11.0 mmol/l in 120th min. or fasting glycaemia 5.6 – 6.9 mmol/l. Results. Postpartum oGTT test was normal in 251 GDM women, 54 women exhibited some degree of glucose intolerance. We have found a highly statistically significant difference among both groups in a glucose levels in all three values of oGTT test, AUCoGTT and HbA1c. Moreover, we counted how many threshold values of oGTT were exceeded and identified a highly statistically significant trend (P<1.10-12): 8% of patients with one oGTT value above a cut point converted to prediabetes/DM, more than 25% with two values and almost 2/3 of patients who have had all three values of oGTT test above cut points was later detected with prediabetes or DM. Conclusions. Parameters of glucose metabolism measured during 24-28th week of pregnancy fulfilling criteria of GDM diagnosis statistically significantly differed between women with and without persistent postpartum glucose metabolism abnormality and conferred significant predictive potential. Acknowledgement: Supported by grants NT/11405 from Ministry of Health of Czech Republic and MUNI/A/0839/2011 |
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