Endocrine Abstracts

Introduction: Gestational diabetes mellitus (GDM) is an important public health issue because of its frequency and its risk of progression to T2DM. Risk of subsequent type 2 diabetes is associated with quality screening and to certain risk factors.

Objective: The aim of our study was to assess the evolving risk of GDM to type 2 diabetes, and to find its significant predictive factors.

Methods: We report a retrospective study from January 2016, aboutpatients followed at the Ibn Rochd University Hospital of Casablanca’s Endocrinology – Diabetology department for gestational diabetes. The parameters studied were age, GDM’s recurrence, family history of diabetes, pre-gestational BMI, pregnancy term at GDM’s discovery, initial fasting glucose, treatment adopted, taking weight during pregnancy, delay of postpartum screening, and means of screening. Statistical analysis was univariate for all the variables using SPSS version 22.0.0.

Results: Mean age of our patients was 32.4±6.5 years. Two thirds of the patients were between the ages of 30 and 40. The average gestational diabetes’ term diagnostic was 20.2±0.45 weeks of gestation. Family history of Diabetes was found in 68% of cases.During pregnancy, insulin therapy was required in 59% of the patients. Screening for dysglycemia was 1.5 to 16 months post-partum (average 6 months). An OGTT 75g was made in 47 patients (62.7%). In contrast, 9.3% of the study population benefited only from fasting blood glucose and HbA1c. We noted that 21% were lost to follow-up. Type 2 diabetes was diagnosed in 22 patients (25.5%), moderate fasting hyperglycemia in 8 patients (9.5%), carbohydrate intolerance in 12 patients (14%). The only factor significantly associated with development of diabetes has been the use of insulin during pregnancy (P=0.02). The FPG and HbA1c initially high were frequently associated, without having a significant impact.

Discussion: Consistent with the literature, our results reflected a high incidence of postpartum dysglycemia in our population, hence the importance of an initial awareness and extended follow-up, with a particular attention for use of insulin during pregnancy.