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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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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container_title Revista Brasileira de ginecologia e obstetrícia
container_volume 38
creator Alves, Jacy Maria
Stollmeier, Aline
Leite, Isabelle Gasparetto
Pilger, Camilla Gallo
Detsch, Josiane Cristine Melchioretto
Radominski, Rosana Bento
Réa, Rosângela Roginski
description 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 
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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 &lt; 0.001) were significant independent risk factors for the development of T2DM. Conclusion A high rate of abnormal glucose tolerance was found in women with previous GDM. Family history of T2DM, higher pre-pregnancy BMI, early onset of GDM, higher glucose levels, and insulin requirement during pregnancy were important risk factors for the early identification of women at high risk of developing T2DM. These findings may be useful for developing preventive strategies.</description><identifier>ISSN: 0100-7203</identifier><identifier>ISSN: 1806-9339</identifier><identifier>EISSN: 1806-9339</identifier><identifier>DOI: 10.1055/s-0036-1588008</identifier><identifier>PMID: 27541185</identifier><language>eng</language><publisher>Brazil: Thieme Publicações Ltda</publisher><subject>Adult ; Cohort Studies ; Diabetes Mellitus, Type 2 - blood ; Diabetes, Gestational - blood ; Disease Progression ; Female ; gestational diabetes ; Glucose Intolerance - blood ; Glucose Tolerance Test ; Humans ; OBSTETRICS &amp; GYNECOLOGY ; oral glucose tolerance test ; Original ; Postpartum Period - blood ; postpartum test ; Pregnancy ; Retrospective Studies ; Risk Factors ; type 2 diabetes</subject><ispartof>Revista Brasileira de ginecologia e obstetrícia, 2016-08, Vol.38 (8), p.381-390</ispartof><rights>Thieme Publicações Ltda Rio de Janeiro, Brazil.</rights><rights>Thieme Medical Publishers</rights><rights>This work is licensed under a Creative Commons Attribution 4.0 International License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c496t-1d8505685507aa4f88050eccb0157a7d6096f45d817bbae2b203de4387b882073</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10309312/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10309312/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,24150,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27541185$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alves, Jacy Maria</creatorcontrib><creatorcontrib>Stollmeier, Aline</creatorcontrib><creatorcontrib>Leite, Isabelle Gasparetto</creatorcontrib><creatorcontrib>Pilger, Camilla Gallo</creatorcontrib><creatorcontrib>Detsch, Josiane Cristine Melchioretto</creatorcontrib><creatorcontrib>Radominski, Rosana Bento</creatorcontrib><creatorcontrib>Réa, Rosângela Roginski</creatorcontrib><title>Postpartum Reclassification of Glycemic Status in Women with Gestational Diabetes Mellitus and Associated Risk Factors</title><title>Revista Brasileira de ginecologia e obstetrícia</title><addtitle>Rev Bras Ginecol Obstet</addtitle><description>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 &lt; 0.001) were significant independent risk factors for the development of T2DM. Conclusion A high rate of abnormal glucose tolerance was found in women with previous GDM. Family history of T2DM, higher pre-pregnancy BMI, early onset of GDM, higher glucose levels, and insulin requirement during pregnancy were important risk factors for the early identification of women at high risk of developing T2DM. These findings may be useful for developing preventive strategies.</description><subject>Adult</subject><subject>Cohort Studies</subject><subject>Diabetes Mellitus, Type 2 - blood</subject><subject>Diabetes, Gestational - blood</subject><subject>Disease Progression</subject><subject>Female</subject><subject>gestational diabetes</subject><subject>Glucose Intolerance - blood</subject><subject>Glucose Tolerance Test</subject><subject>Humans</subject><subject>OBSTETRICS &amp; GYNECOLOGY</subject><subject>oral glucose tolerance test</subject><subject>Original</subject><subject>Postpartum Period - blood</subject><subject>postpartum test</subject><subject>Pregnancy</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>type 2 diabetes</subject><issn>0100-7203</issn><issn>1806-9339</issn><issn>1806-9339</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNpVUsFu1DAQjRCILoUrR-Qjl5RxHCfOCVWFLpWKQC2IozWxndZLEm8zTlH_Hqe7rOjFluyZN--9eVn2lsMJByk_UA4gqpxLpQDUs2zFFVR5I0TzPFsBB8jrAsRR9opoA1DUQpUvs6OiliXnSq6y---B4hanOA_sypkeiXznDUYfRhY6tu4fjBu8YdcR40zMj-xXGNzI_vh4y9aO4mMp9uyTx9ZFR-yr63u_1OJo2SlRMB6js-zK0292jiaGiV5nLzrsyb3Z38fZz_PPP86-5Jff1hdnp5e5KZsq5twqCbJSUkKNWHZJpARnTAtc1ljbCpqqK6VVvG5bdEWbtFpXClW3ShVQi-PsYodrA270dvIDTg86oNePD2G60Um7N73TTWtRCFlUztoyGdhyoYqmQmlkml_xhHWywyLjXR_0JsxTEk76evFZLz4XwCtIe0g7UUvDx13Ddm4HZ40b44T9ExZPf0Z_q2_CveYgoBG8SAjv9whTuJuT2XrwZJK_OLowk-aKq8RZpOPAzkyBaHLdYQ4HvURFk16iovdRSQ3v_md3KP-XDfEXlAq3lA</recordid><startdate>20160801</startdate><enddate>20160801</enddate><creator>Alves, Jacy Maria</creator><creator>Stollmeier, Aline</creator><creator>Leite, Isabelle Gasparetto</creator><creator>Pilger, Camilla Gallo</creator><creator>Detsch, Josiane Cristine Melchioretto</creator><creator>Radominski, Rosana Bento</creator><creator>Réa, Rosângela Roginski</creator><general>Thieme Publicações Ltda</general><general>Federação Brasileira das Sociedades de Ginecologia e Obstetrícia</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>GPN</scope><scope>DOA</scope></search><sort><creationdate>20160801</creationdate><title>Postpartum Reclassification of Glycemic Status in Women with Gestational Diabetes Mellitus and Associated Risk Factors</title><author>Alves, Jacy Maria ; Stollmeier, Aline ; Leite, Isabelle Gasparetto ; Pilger, Camilla Gallo ; Detsch, Josiane Cristine Melchioretto ; Radominski, Rosana Bento ; Réa, Rosângela Roginski</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c496t-1d8505685507aa4f88050eccb0157a7d6096f45d817bbae2b203de4387b882073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Cohort Studies</topic><topic>Diabetes Mellitus, Type 2 - blood</topic><topic>Diabetes, Gestational - blood</topic><topic>Disease Progression</topic><topic>Female</topic><topic>gestational diabetes</topic><topic>Glucose Intolerance - blood</topic><topic>Glucose Tolerance Test</topic><topic>Humans</topic><topic>OBSTETRICS &amp; GYNECOLOGY</topic><topic>oral glucose tolerance test</topic><topic>Original</topic><topic>Postpartum Period - blood</topic><topic>postpartum test</topic><topic>Pregnancy</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>type 2 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Alves, Jacy Maria</creatorcontrib><creatorcontrib>Stollmeier, Aline</creatorcontrib><creatorcontrib>Leite, Isabelle Gasparetto</creatorcontrib><creatorcontrib>Pilger, Camilla Gallo</creatorcontrib><creatorcontrib>Detsch, Josiane Cristine Melchioretto</creatorcontrib><creatorcontrib>Radominski, Rosana Bento</creatorcontrib><creatorcontrib>Réa, Rosângela Roginski</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SciELO</collection><collection>Directory of Open Access Journals (Open Access)</collection><jtitle>Revista Brasileira de ginecologia e obstetrícia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Alves, Jacy Maria</au><au>Stollmeier, Aline</au><au>Leite, Isabelle Gasparetto</au><au>Pilger, Camilla Gallo</au><au>Detsch, Josiane Cristine Melchioretto</au><au>Radominski, Rosana Bento</au><au>Réa, Rosângela Roginski</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Postpartum Reclassification of Glycemic Status in Women with Gestational Diabetes Mellitus and Associated Risk Factors</atitle><jtitle>Revista Brasileira de ginecologia e obstetrícia</jtitle><addtitle>Rev Bras Ginecol Obstet</addtitle><date>2016-08-01</date><risdate>2016</risdate><volume>38</volume><issue>8</issue><spage>381</spage><epage>390</epage><pages>381-390</pages><issn>0100-7203</issn><issn>1806-9339</issn><eissn>1806-9339</eissn><abstract>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 &lt; 0.001) were significant independent risk factors for the development of T2DM. Conclusion A high rate of abnormal glucose tolerance was found in women with previous GDM. Family history of T2DM, higher pre-pregnancy BMI, early onset of GDM, higher glucose levels, and insulin requirement during pregnancy were important risk factors for the early identification of women at high risk of developing T2DM. These findings may be useful for developing preventive strategies.</abstract><cop>Brazil</cop><pub>Thieme Publicações Ltda</pub><pmid>27541185</pmid><doi>10.1055/s-0036-1588008</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record>
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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
title Postpartum Reclassification of Glycemic Status in Women with Gestational Diabetes Mellitus and Associated Risk Factors
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