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Prediction of glucose intolerance in early postpartum in women with gestational diabetes mellitus based on the 2013 WHO criteria

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Predictors for glucose intolerance postpartum were evaluated in women with gestational diabetes mellitus (GDM) based on the 2013 World Health Organization (WHO) criteria. 1841 women were tested for GDM in a prospective cohort study. A postpartum 75g oral glucose tolerance test (OGTT) was performed in women with GDM at 14 +/- 4.1 weeks. Of all 231 mothers with GDM, 83.1% (192) had a postpartum OGTT of which 18.2% (35) had glucose intolerance. Women with glucose intolerance were more often of Asian origin [15.1% vs. 3.7%, OR 4.64 (1.26-17.12)], had more often a recurrent history of GDM [41.7% vs. 26.7%, OR 3.68 (1.37-9.87)], higher fasting glycaemia (FPG) [5.1 (4.5-5.3) vs. 4.6 (4.3-5.1) mmol/L, OR 1.05 (1.01-1.09)], higher HbA1c [33 (31-36) vs. 32 (30-33) mmol/mol, OR 4.89 (1.61-14.82)], and higher triglycerides [2.2 (1.9-2.8) vs. 2.0 (1.6-2.5) mmol/L, OR 1.00 (1.00-1.01)]. Sensitivity of glucose challenge test (GCT) >= 7.2 mmol/l for glucose intolerance postpartum was 80% (63.1%-91.6%). The area under the curve to predict glucose intolerance was 0.76 (0.65-0.87) for FPG, 0.54 (0.43-0.65) for HbA1c and 0.75 (0.64-0.86) for both combined. In conclusion, nearly one-fifth of women with GDM have glucose intolerance postpartum. A GCT >= 7.2 mmol/L identifies a high risk population for glucose intolerance postpartum.
Tijdschrift: Journal of Clinical Medicine
ISSN: 2077-0383
Volume: 8
Jaar van publicatie:2019
Trefwoorden:A1 Journal article
BOF-keylabel:ja
BOF-publication weight:3
CSS-citation score:1
Authors from:Higher Education
Toegankelijkheid:Open