The prevalence of 6 weeks postpartum abnormal glucose tolerance in Caucasian women with gestational diabetes.

AIMS

To evaluate the incidence of impaired glucose tolerance (IGT), impaired fasting glucose (IFG) and diabetes in 318 Caucasian women with gestational diabetes (GDM) at 6 weeks postpartum.

METHODS

All women had 75g OGTT and the following data were collected: age, height, weight, results of the challenge 50g and diagnostic 75g OGTT, and glycated hemoglobin (HbA1c).

RESULTS

13.5% of women had abnormal glucose tolerance, including 1.3% of diabetes, 2.5% of IFG and 7.5% of IGT. None of the prepregnancy independent variables, such as age, body mass index, prior GDM, prior macrosomia, family history of type 2 diabetes and multiparity was a predictor for the abnormal OGTT. In contrast, pregnancy-related risk factors, like gestational week at GDM diagnosis (P=0.001), glucose values in the challenge (P=0.007) and diagnostic (P=0.02) OGTTs and HbA1c (P=0.01) were significantly associated with the persistence of glucose intolerance after delivery.

CONCLUSION

The incidence of postpartum abnormal glucose tolerance in Caucasian women with GDM was 13.5% and was associated with an early diagnosis of GDM, severity of hyperglycemia and requirement for insulin therapy. The diagnosis of GDM should initiate a lifelong monitoring of glucose tolerance to minimize the risk of developing overt diabetes.