Endocrine Abstracts

Introduction: Women with gestational diabetes mellitus (GDM) have a reported 17% to 63% risk of developing type 2 diabetes. This study aims to identify the factors in GDM patients which can predict the risk of postpartum impaired glucose tolerance(IGT) and overt diabetes
Methods: A cohort study was conducted on 2416 pregnant women referred to five university hospital clinics. The universal screening was performed with a GCT- 50g and those with plasma glucose level >= 130mg/dl, were diagnosed as having GDM if they had an impaired GTT-100g based on Carpenter and Coustan criteria. All pregnancies were followed up until delivery.Available GDM patients underwent an OGTT-75gr within 6 to 12 weeks after delivery. Postpartum diabetes mellitus was diagnosed according to ADA criteria.Multivariate logistic regression was used to estimate the odds ratios with 95% confindence intervals,and to control for confounding variables.
Results: The prevalence of GDM and pospartum diabetes mellitus and IGT were 4.7% and 6.3% and 16.7% respectively. In comparison with the healthy group, the affected patients had a significantly higher parity, blood pressure and BMI as well as the presence of a family history of diabetes and the history of poor obstetric outcome and older. Univariate analysis suggested that highest fasting glucose level, maternal obesity, early gestational age at GDM diagnosis, gestational requirement for insulin was the best predictors for postpartum diabetes or IGT.
Conclusion: Approximately one fourth of GDM patients were experienced IGT or overt diabetes in the early postpartum period. Because of the high incidence of development of type 2diabetes and IGT in women with previous GDM, postpartum blood glucose testing recommend. The postpartum visit and diabetes education especially for high risk women may prevent or delay the development of type 2 diabetes and its sequelae.