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Prediction of postpartum diabetes in women with gestational diabetes mellitus

Ekelund, M.; Shaat, Nael LU ; Almgren, Peter LU ; Groop, Leif LU and Berntorp, Kerstin LU (2010) In Diabetologia 53(3). p.452-457
Abstract
We studied the incidence of postpartum diabetes after gestational diabetes mellitus and investigated biochemical and clinical predictors of postpartum diabetes. We monitored 174 women with gestational diabetes by performing oral glucose tolerance tests during pregnancy as well as 1, 2 and 5 years postpartum. Women who developed impaired fasting glucose, impaired glucose tolerance or diabetes were compared with women who remained normoglycaemic at 5 years. Insulinogenic index, disposition index and HOMA-beta cell index were used to assess beta cell function; insulin resistance was estimated by HOMA index of insulin resistance. At 5 years postpartum, 30% of the women had developed diabetes and 51% some form of abnormal glucose tolerance.... (More)
We studied the incidence of postpartum diabetes after gestational diabetes mellitus and investigated biochemical and clinical predictors of postpartum diabetes. We monitored 174 women with gestational diabetes by performing oral glucose tolerance tests during pregnancy as well as 1, 2 and 5 years postpartum. Women who developed impaired fasting glucose, impaired glucose tolerance or diabetes were compared with women who remained normoglycaemic at 5 years. Insulinogenic index, disposition index and HOMA-beta cell index were used to assess beta cell function; insulin resistance was estimated by HOMA index of insulin resistance. At 5 years postpartum, 30% of the women had developed diabetes and 51% some form of abnormal glucose tolerance. Women who developed diabetes had higher fasting glucose and HbA(1c) during pregnancy than those who remained normoglycaemic. They also had lower HOMA-beta cell index, insulinogenic index and disposition index than the normoglycaemic women. HbA(1c) and fasting glucose during pregnancy as well as the number of previous pregnancies and family history of diabetes were independent predictors of postpartum diabetes. HbA(1c) a parts per thousand yen4.7% (Swedish Mono S) or a parts per thousand yen5.7% (National Glycohemoglobin Standardization Program) and fasting blood glucose a parts per thousand yen5.2 mmol/l were associated with a four- to sixfold increased risk. Among women with gestational diabetes mellitus, those at risk of future diabetes can be identified by HbA(1c) and fasting glucose values in the upper normal range during pregnancy. A family history of diabetes and previous pregnancies further increase this risk. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
resistance, Insulin, Insulinogenic index, HOMA, HbA(1c), diabetes mellitus, Gestational, GAD-antibodies, Beta cell dysfunction, Disposition index, OGTT, Postpartum diabetes
in
Diabetologia
volume
53
issue
3
pages
452 - 457
publisher
Springer Verlag
external identifiers
  • wos:000274238500008
  • scopus:77949275838
ISSN
1432-0428
DOI
10.1007/s00125-009-1621-3
language
English
LU publication?
yes
id
5650f1b7-d1a7-4a95-babe-7bb6d030571b (old id 1571085)
date added to LUP
2010-03-16 15:04:41
date last changed
2018-06-24 03:18:57
@article{5650f1b7-d1a7-4a95-babe-7bb6d030571b,
  abstract     = {We studied the incidence of postpartum diabetes after gestational diabetes mellitus and investigated biochemical and clinical predictors of postpartum diabetes. We monitored 174 women with gestational diabetes by performing oral glucose tolerance tests during pregnancy as well as 1, 2 and 5 years postpartum. Women who developed impaired fasting glucose, impaired glucose tolerance or diabetes were compared with women who remained normoglycaemic at 5 years. Insulinogenic index, disposition index and HOMA-beta cell index were used to assess beta cell function; insulin resistance was estimated by HOMA index of insulin resistance. At 5 years postpartum, 30% of the women had developed diabetes and 51% some form of abnormal glucose tolerance. Women who developed diabetes had higher fasting glucose and HbA(1c) during pregnancy than those who remained normoglycaemic. They also had lower HOMA-beta cell index, insulinogenic index and disposition index than the normoglycaemic women. HbA(1c) and fasting glucose during pregnancy as well as the number of previous pregnancies and family history of diabetes were independent predictors of postpartum diabetes. HbA(1c) a parts per thousand yen4.7% (Swedish Mono S) or a parts per thousand yen5.7% (National Glycohemoglobin Standardization Program) and fasting blood glucose a parts per thousand yen5.2 mmol/l were associated with a four- to sixfold increased risk. Among women with gestational diabetes mellitus, those at risk of future diabetes can be identified by HbA(1c) and fasting glucose values in the upper normal range during pregnancy. A family history of diabetes and previous pregnancies further increase this risk.},
  author       = {Ekelund, M. and Shaat, Nael and Almgren, Peter and Groop, Leif and Berntorp, Kerstin},
  issn         = {1432-0428},
  keyword      = {resistance,Insulin,Insulinogenic index,HOMA,HbA(1c),diabetes mellitus,Gestational,GAD-antibodies,Beta cell dysfunction,Disposition index,OGTT,Postpartum diabetes},
  language     = {eng},
  number       = {3},
  pages        = {452--457},
  publisher    = {Springer Verlag},
  series       = {Diabetologia},
  title        = {Prediction of postpartum diabetes in women with gestational diabetes mellitus},
  url          = {http://dx.doi.org/10.1007/s00125-009-1621-3},
  volume       = {53},
  year         = {2010},
}