Abnormal screening glucose challenge test in pregnancy and future risk of diabetes in young women

• Published in: Diabetic medicine 2009-05, Vol.26 (5), p.474-477
• Main Authors: Retnakaran, R., Shah, B. R.
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Blood Glucose - metabolism; Cohort Studies; diabetes; Diabetes Mellitus, Type 2 - epidemiology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; glucose challenge test; glucose intolerance; Glucose Intolerance - blood; Glucose Intolerance - epidemiology; Glucose Tolerance Test; Humans; Medical sciences; Middle Aged; Ontario - epidemiology; Prediabetic State - epidemiology; Predictive Value of Tests; Pregnancy; Pregnancy Complications - blood; Pregnancy Complications - epidemiology; Risk Factors; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vertebrates: endocrinology
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/j.1464-5491.2009.02712.x

Aims  Pregnant women commonly undergo screening for gestational diabetes mellitus (GDM) using a 50‐g glucose challenge test (GCT), followed by a diagnostic oral glucose tolerance test (OGTT) in those women in whom the GCT is abnormal. Although it has long been recognized that GDM is associated with subsequent Type 2 diabetes, it has recently emerged that any degree of abnormal antepartum glucose homeostasis predicts an increased risk of postpartum glucose intolerance. Thus, in this context, we sought to determine whether women who have a pregnancy complicated by an abnormal GCT, but who do not have GDM, are at increased risk of subsequent diabetes, compared with their peers with an abnormal GCT. Methods  A population‐based, retrospective cohort study was conducted. Women referred for an antepartum OGTT indicative of an abnormal GCT (n = 15 381), but without GDM, were matched (for age, region, socioeconomic status, and year of delivery) with up to four other women without such referral (n = 61 237). The two cohorts were followed over a median 6.4 years for the development of diabetes. Results  The rate of incident diabetes was 5.04 cases per 1000 person‐years in the cohort of women who underwent an antepartum OGTT, compared with 1.74 cases per 1000 person‐years in women without an OGTT. The hazard ratio for subsequent diabetes in women with an antepartum OGTT was 2.56 (95% confidence interval 2.28, 2.87) (P