Endocrine Abstracts

Introduction: Women with gestational diabetes mellitus (GDM) have an increased risk for developing glucose intolerance in postpartum. The aim of our study was to describe the general characteristics of pregnant women with GDM and to assess the prevalence of glucose intolerance in early postpartum by postpartum oral glucose tolerance test (ppOGTT).

Methods: Retrospective study from January 2017 to December 2020 including patients with GDM followed at endocrinology department of Garcia Orcoyen Hospital in Estella (Spain). Relevant data of pregnancy and postpartum were recorded. Diagnosis of GDM was performed using the two-step strategy at 24–28th week of gestation. Early pregnancy screening was perfomed in women at increased risk of undiagnosed diabetes, defined by the American Diabetes Association (ADA). After delivery, a ppOGTT was performed, and prediabetes and type 2 diabetes were diagnosed according to the ADA criteria.

Results: A total of 84 women with GDM were included. The mean age was 33.7 ± 5.1 years (21 to 47 years), 42.2% were caucasian and family history of diabetes was found in 48.8% of them. 36.9% of women were primiparous (n = 31) and 23/53 women with previous pregnancies had history of GDM. Mean pregestational BMI was 28.2 kg/m² ± 6.2 (19 to 49). GDM was diagnosed in the 1st trimester in 20 women, in the 2nd trimester in 63 women and in the 3rd trimester in 1 woman During pregnancy, insulin therapy was required in 44% women. The average maternal weight gain was 8.2 ± 5.0 kg. 14.3% of fetus were above the 90th percentile and 4.8% newborns were macrosomes. After delivery, 58.3% of women (n = 49) performed the ppOGTT at 17 weeks postpartum, with the following Results: 33 women had a normal response; 14 women had prediabetes (8 had impaired fasting glycemia, 3 had impaired glucose tolerance and 3 women had a combination of both) and 2 women had type 2 diabetes criteria.

Conclusion: The proportion of women with GDM who underwent postpartum glucose testing is low due to high prevalence of loss of follow up after delivery. One-third of women who underwent ppOTTG after delivery had glucose intolerance.