Endocrine Abstracts

Background and aims: The history of GDM predisposes to cardiovascular disease (CVD) in the future. The aim of this study was to evaluate risk factors predicting the development of glucose intolerance and insulin resistance syndrome (IRS) in women with history of GDM in the future.

Materials and methods: 55 women who had GDM 11±2 years before were enrolled into the study. After clinical examination 75 g OGTT and inflammatory markers(hsCRP, uric acid, interleukin 6 (IL6), tumor necrosis factor alpha (TNFα), visfatin, plasminogen activated inhibitor 1 (PAI1), asymmetric dimetilarginine (ADMA), and adiponectin) was performed to evaluate of current metabolic status after a decade of delivery. Based on IDF criteria participants were classified into two groups as normal (group 1) and IRS (group 2). We evaluated the relationship between metabolic status and possible risk factors such as; age, BMI, family history of DM, poor obstetric history, HbA1c and OGTT glucose levels at diagnosis of GDM; weight gain and insulin requirement during index pregnancy. SPSS 21 was used to analyse data.

Results: 51% of participants developed IRS after 10th year of delivery. No predictive factor was found except screening time, first hour glucose level at the diagnosis of GDM and insulin requirement during index pregnancy Although difference was not significantly, patients in group 2 were found to have higher BMI, much more family history of DM before pregnancy and also they put less excess weight during pregnancy. As compared inflammatory parameters between two groups; HOMA-IR, hsCRP, visfatin, IL6, and PAI1 levels were detected istatistically higher; on contrary adiponectin level was less in group 2 than group 1. And currently, 43% of all participants were found that they had at any level glucose intolerance and higher insulin levels at basal and first hour of OGTT.

Conclusion: Early screening of GDM and following the patient during gestational period is important but it’s much more important to follow those individuals who had high BMI, family history of DM and high glucose at first hour of OGTT at the beginning; they should be monitored closely postpartum and at least yearly follow-up should be done based on increased risk for developing IRS and therefore CVD.