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Published on: February 28, 2013
Predictors of postpartum diabetes mellitus in patients with gestational diabetes
Soralla Civantos1, María Durán2, Beatriz Flández2
1Sección de Endocrinología y Nutrición, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España; Servicio de Endocrinología y Nutrición, Hospital Universitario Quirón, Madrid, España.
Introduction:
Gestational diabetes (GD) is related to development of diabetes mellitus (DM) after delivery. The predictive factors in this association are not yet well defined. Objetive: to study the predictive factors of dysglucosis in the postpartum period in a sample of patients with GD.
Material And Methods:
A total of 1765 women with DG were studied. Variables analyzed: anthropometric data and maternal history. Glycemia in OGTT with 100g (basal: 1, 2 and 3h) and HbA1c. Use of insulin in pregnancy. The OGTT with 75g and HbA1c at 3 months after delivery.
Results:
Postpartum DM prevalence 2.1%. Among these patients, there was a higher percentage of patients with a history of GD (25.9 vs. 12.9%; P<.05), pre-pregnancy obesity (20.8 vs. 14.9%; P<.05) and insulin use during pregnancy (79.2 vs. 20%; P<.01). In the OGTT with 100g, the number of pathological points was higher (3.18±0.69 in DM vs. 2.3±0.28 normal, 2.6±0.47 IFG, 2.5±0.32 IGT; P<.001). In the OGTT 100g, the blood glucose level above which the diagnosis of postpartum DM is most likely is 189mg/dl in the 2h determination (S: 86.2%, E: 72%). A level of HbA1c>5.9% during pregnancy has a specificity of 95.9% for the diagnosis of postpartum DM in our sample.
Conclusion:
We show factors associated with the diagnosis of postpartum DM, among which are quantitative determinations such as glycemia at 2h of the OGTT with 100g and HbA1c during pregnancy in patients with DG.
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