Postpartum Reclassification of Glycemic Status in Women with Gestational Diabetes Mellitus and Associated Risk Factors

Objective The aims of the study were to evaluate, after pregnancy, the glycemic status of women with history of gestational diabetes mellitus (GDM) and to identify clinical variables associated with the development of type 2 diabetes mellitus (T2DM), impaired fasting glucose (IFG), and impaired gluc...

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Bibliographic Details
Published in:Revista Brasileira de ginecologia e obstetrícia 2016-08, Vol.38 (8), p.381-390
Main Authors: Alves, Jacy Maria, Stollmeier, Aline, Leite, Isabelle Gasparetto, Pilger, Camilla Gallo, Detsch, Josiane Cristine Melchioretto, Radominski, Rosana Bento, Réa, Rosângela Roginski
Format: Article
Language:English
Subjects:
Adult
Cohort Studies
Diabetes Mellitus, Type 2 - blood
Diabetes, Gestational - blood
Disease Progression
Female
gestational diabetes
Glucose Intolerance - blood
Glucose Tolerance Test
Humans
OBSTETRICS & GYNECOLOGY
oral glucose tolerance test
Original
Postpartum Period - blood
postpartum test
Pregnancy
Retrospective Studies
Risk Factors
type 2 diabetes
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Summary:Objective The aims of the study were to evaluate, after pregnancy, the glycemic status of women with history of gestational diabetes mellitus (GDM) and to identify clinical variables associated with the development of type 2 diabetes mellitus (T2DM), impaired fasting glucose (IFG), and impaired glucose tolerance (IGT). Methods Retrospective cohort of 279 women with GDM who were reevaluated with an oral glucose tolerance test (OGTT) after pregnancy. Characteristics of the index pregnancy were analyzed as risk factors for the future development of prediabetes (IFG or IGT), and T2DM. T2DM was diagnosed in 34 (12.2%) patients, IFG in 58 (20.8%), and IGT in 35 (12.5%). Women with postpartum T2DM showed more frequently a family history of T2DM, higher pre-pregnancy body mass index (BMI), lower gestational age, higher fasting and 2-hour plasma glucose levels on the OGTT at the diagnosis of GDM, higher levels of hemoglobin A1c, and a more frequent insulin requirement during pregnancy. Paternal history of T2DM (odds ratio [OR] = 5.67; 95% confidence interval [95%CI] = 1.64-19.59; p = 0.006), first trimester fasting glucose value (OR = 1.07; 95%CI = 1.03-1.11; p = 0.001), and insulin treatment during pregnancy (OR = 15.92; 95%CI = 5.54-45.71; p 
ISSN:0100-7203
1806-9339
1806-9339
DOI:10.1055/s-0036-1588008