Prediction of postpartum diabetes in women with gestational diabetes mellitus

Ekelund, Magnus; Shaat, Nael; Almgren, Peter; Groop, Leif; Berntorp, Kerstin

doi:10.1007/s00125-009-1621-3

Cited by 111 publications

(102 citation statements)

References 13 publications

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“…The results of this study showed that high levels of FBS and BMI play an effective role in the development of diabetes, which was consistent with our results (17). What is clear from the analysis of other studies and our study is that high levels of blood sugar during pregnancy is certainly effective and useful in predicting and forecasting the development of diabetes after gestational diabetes.…”

Section: Page 233supporting

confidence: 92%

“…Ekelund et al reported that women who have had abnormal blood glucose levels during pregnancy have assigned higher levels of fasting blood sugar after pregnancy. In this study, a significant relationship between increasing levels of BMI and diabetes after pregnancy was observed (17). Treatment of diabetes and its acute and chronic complications requires significant spending by patients and the healthcare system; further, disability due to this disease is a source of considerable damage at the community level.…”

Section: Introductionmentioning

confidence: 67%

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Evaluation of Predictive Factors of Development of Type 2 Diabetes Mellitus (T2dm) in Patients With Gestational Diabetes Mellitus (Gdm)

Razmpoor¹,

Kheirandish²,

Zare³

2017

Acta Healthmedica

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Introduction: Several groups have been considered as the population at risk for diabetes, one of which is women with a history of gestational diabetes. Women with gestational diabetes are likely to develop type 2 diabetes mellitus (T2DM) and cardiovascular disease. Given the great importance of controlling risk factors for T2DM following gestational diabetes, it was decided to conduct a study to investigate predictive factors of the development of T2DM in patients with gestational diabetes mellitus (GDM). Methods: This cross-sectional study had been conducted on pregnant women with gestational diabetes in 2015. All pregnant women underwent screening for gestational diabetes at the first visit. At six to 12 weeks after parturition, they were put under oral glucose tolerance test (OGTT) again. Follow-up was done in all cases where there was an abnormality in diagnostic test or symptoms of hyperglycemia, glycosuria, and abnormal weight gain. All blood samples were centrifuged, and plasma samples obtained were transferred to measure glucose. Chi-square test was used for data analysis with IBM SPSS 21.0 statistical software. P-value less than 0.05 was considered as the significance level. Results: A total of approximately 185 patients were included in this study with a mean age of 27.7 ± 4.8 years. Among 185 patients who were followed-up for six to 12 weeks after parturition, 10% of patients were with type 2 diabetes after pregnancy. In addition, 10% of postpartum patients have had impaired glucose tolerance test (IGT), but diabetes was not found. Also, 30.27% (n = 56) of the patients have had impaired fasting glucose (IFG). Finally, about 44.32% (n = 82) of the patients had abnormal blood glucose test (AGT). After analyzing the data, it was found that, of 185 patients, two patients had a BMI less than 20, three people with a BMI between 20-24.9, seven patients with a BMI between 25-29.9, and three patients with BMI between 30-40 had diabetes, according to GTT test. Risk factors such as cholesterol, history of hyperthyroidism, history of hypothyroidism, polycystic ovarian syndrome, obesity, acanthosis nigricans, and family history of diabetes had no significant relationship with development of diabetes after pregnancy (p>0.05). Conclusion: About 10% of patients after parturition clearly had diabetes, according to the tests carried out. Our study showed that BMI and FBS play a significant role in predicting the development of diabetes, but factors such as history of miscarriage, stillbirth, macrosomia, death without cause and medical records such as hypertension, obesity, hyperthyroidism, and hypothyroidism have not played a significant role in this prediction.

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Section: Page 233supporting

confidence: 92%

Section: Introductionmentioning

confidence: 67%

Evaluation of Predictive Factors of Development of Type 2 Diabetes Mellitus (T2dm) in Patients With Gestational Diabetes Mellitus (Gdm)

Razmpoor¹,

Kheirandish²,

Zare³

2017

Acta Healthmedica

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“…Although glucose tolerance usually reverts to normal after delivery, the risk of developing type 2 diabetes following GDM is increased [2], with a cumulative incidence of 30−50% within five to ten years after delivery [3,4].…”

Section: Introductionmentioning

confidence: 99%

The impact of ethnicity on glucose homeostasis after gestational diabetes mellitus

et al. 2013

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The impact of ethnicity on glucose homeostasis after gestational diabetes mellitus.Ignell, Claes; Shaat, Nael; Ekelund, Magnus; Berntorp, Kerstin Link to publication Citation for published version (APA): Ignell, C., Shaat, N., Ekelund, M., & Berntorp, K. (2013). The impact of ethnicity on glucose homeostasis after gestational diabetes mellitus. Acta Diabetologica, 50(6), 927-934. DOI: 10.1007/s00592-013-0484-8 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Take down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. (17)Claes Ignell ⋅ Nael Shaat ⋅ Magnus Ekelund ⋅ Kerstin Berntorp -5 ). In addition to BMI, non-European and Asian origin was associated with the development of diabetes after GDM in a multivariate logistic regression analysis, whereas Arab origin was not.Our results highlight the importance of preventive measures to ensure a healthy lifestyle in women with GDM, particularly in high-risk ethnic groups.

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“…It is well established that women who are diagnosed with gestational diabetes mellitus (GDM) have an increased risk of developing type 2 diabetes mellitus (T2DM) in the years after the index pregnancy (1)(2)(3)(4)(5)(6)(7). Furthermore, it is now recognized that even women with milder degrees of glucose intolerance in pregnancy (i.e., less severe than GDM) have an increased risk of ultimately developing prediabetes and T2DM in the future (6,(8)(9)(10)(11)(12)(13)(14)(15).…”

mentioning

confidence: 99%

Each Degree of Glucose Intolerance in Pregnancy Predicts Distinct Trajectories of β-Cell Function, Insulin Sensitivity, and Glycemia in the First 3 Years Postpartum

et al. 2014

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OBJECTIVEGlucose intolerance in pregnancy predicts an increased risk of future type 2 diabetes mellitus (T2DM) that is proportional to the severity of antepartum dysglycemia (i.e., highest in women with gestational diabetes mellitus [GDM], followed by those with milder dysglycemia). However, the pathophysiologic changes driving this risk are not known. Thus, we evaluated the longitudinal changes in b-cell function, insulin sensitivity, and glycemia in the first 3 years postpartum after gestational dysglycemia. RESEARCH DESIGN AND METHODSA total of 337 women underwent glucose challenge test (GCT) and oral glucose tolerance test (OGTT) in pregnancy, followed by repeat OGTT at 3 months, 1 year, and 3 years postpartum. The antepartum GCT/OGTT identified four gestational glucose tolerance groups: GDM (n = 105); gestational impaired glucose tolerance (GIGT; n = 60); abnormal GCT, followed by normal glucose tolerance (NGT) on the OGTT (abnormal GCT NGT; n = 96); and normal GCT with NGT (n = 76). RESULTSAt each of 3 months, 1 year, and 3 years postpartum, the prevalence of glucose intolerance increased from normal GCT NGT to abnormal GCT NGT to GIGT to GDM (all P < 0.001), whereas b-cell function, assessed by the Insulin SecretionSensitivity Index-2 (ISSI-2), and insulin sensitivity (Matsuda index), progressively decreased across the groups (all P < 0.002). Each group predicted distinct trajectories of ISSI-2, Matsuda index, and fasting and 2-h glucose (all P < 0.001). Notably, GDM, GIGT, and abnormal GCT NGT predicted varying rates of declining b-cell function and insulin sensitivity, as well as rising glycemia, compared with normal GCT NGT. CONCLUSIONSEach degree of gestational glucose intolerance predicts distinct trajectories of b-cell function, insulin sensitivity, and glycemia in the first 3 years postpartum that drive their differential risk of future T2DM.

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Prediction of postpartum diabetes in women with gestational diabetes mellitus

Cited by 111 publications

References 13 publications

Evaluation of Predictive Factors of Development of Type 2 Diabetes Mellitus (T2dm) in Patients With Gestational Diabetes Mellitus (Gdm)

Evaluation of Predictive Factors of Development of Type 2 Diabetes Mellitus (T2dm) in Patients With Gestational Diabetes Mellitus (Gdm)

The impact of ethnicity on glucose homeostasis after gestational diabetes mellitus

Each Degree of Glucose Intolerance in Pregnancy Predicts Distinct Trajectories of β-Cell Function, Insulin Sensitivity, and Glycemia in the First 3 Years Postpartum

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