Endocrine Abstracts

Purpose: GDM is defined as any degree of carbonhydrate intolerance that is first diagnosed during pregnancy. Patients diagnosed with GDM are expected to have complications such as Type II DM, obesity, hypertension in the long term. Prevalence of GDM diagnosis during pregrancy changes between 2 and 10%. Our purpose is to revaluate the OGTT of the patients diagnosed with GDM, with regard to their postpartum Type II DM progress.

Materials and methods: 450 pregnant women who were not diagnosed with diabetes in the beginning of their pregrancy were included to the study, who had consulted to our clinic between 2012 and 2014. Seventy-two of those quitted the study willingly, 20 of those quitted during follow-up, 12 of those quitted due to spontaneous abortion in the first trimester. 346 remaining patients were included to the study. After 75 g OGTT, GDM screening was made to those patients between 24th and 28th weeks of their pregrancy. With 75 g OGTT, 61 patients were diagnosed with GDM. They were reevaluated with regard to their postpartum Type II DM progress. But 36 of these 61 patients were made 75 g OGTT. Two of those became pregnant again, two of those moved out of the city, 21 of those could not be reached; thus, they could not be reevaluated. Among the patients diagnosed with GDM, 29 of them were followed with diet, four of them with basal and short-acting insulin, two of them only with basal insulin, one of them only with short-acting insulin. Three of those who were followed with diet and one of those who were followed with basal and short-acting insulin were followed with metformin during postpartum period. None of the patients used insulin during postpartum period.

Results: Patients called postpartum in the mean month period 20.82±5.66. Mean age average of the patients was 32±5. Postpartum BMI was 29.10±5.47 kg/m². HbA1c average of the patients was 5.77±0.39%. Four patients who were using metformin during postpartum period were accepted as type 2 DM and were not given OGTT. According to 75 g OGTT; with their basal average being (101.83±10.77 mg/dl) and 2nd hour glucose average being (124.66±39.53 mg/dl), 11 (34.3%) patients were not diagnosed with diabetes. Thirteen (36.11%) patients were diagnosed with impaired fasting glucose, three (8.33%) with impaired glucose tolerance, three (8.33%) with impaired fasting glucose and impaired glucose tolerance, six (16.67%) with type 2 DM.

Discussion: Our study included pregnant women who had not been diagnosed with DM in the beginning of their pregnancy who later on were diagnosed with GDM during pregnancy. We followed them during their postpartum period. With these results, it is found necessary to follow and evaluate the postpartum period of the patients diagnosed with GDM during pregrancy with regard to Type II DM progress.