Endocrine Abstracts

Gestational diabetes mellitus (GDM) poses multiple risks to both the mother and foetus. This includes foetal macrosomia and the development of type 2 diabetes mellitus (T2DM). Women with polycystic ovary syndrome (PCOS) due to their metabolic profile are at greater risk of developing GDM and its long-term sequelae. This study aimed to investigate the prevalence and associations of GDM at St George’s Hospital, with emphasis on women diagnosed with PCOS. The K2 maternal medical system was used to compile a database of 61 231 pregnancies recorded from 1 January 2002 to 26 November 12. Maternal data regarding age, ethnicity, BMI, diabetic status, PCOS status and metformin exposure was collected. Data was grouped and analysed using Microsoft Excel and conclusions were drawn from mean averages and standard error. The study found that 4.0% of the pregnant population had diagnosis of PCOS. PCOS group had an average age of 30.9 years and BMI of 26.2 kg/m2 compared with an average age of 30.2 years and BMI of 22.8 kg/m2 in non PCOS pregnancies. GDM developed in 1.9% of the pregnancies. This was more common in women with PCOS than in non PCOS women (3.7 vs 1.8%). Women from the Indian subcontinent constituted the majority of patients with GDM in both the PCOS and non PCOS groups (38.4 and 32.9%). Women with PCOS treated with metformin prior to pregnancy had a higher BMI than those PCOS women who were not treated (27.1 vs 25.6). Individuals who developed GDM despite being on metformin were exclusively from the Indian subcontinent. In conclusion, ethnicity and PCOs with higher BMI that requires treatment with metformin before pregnancy are the risk factors for GDM. Recognition of this combination of risk factors should enable clinicians to anticipate and treat GDM aggressively in this group.