Bhavadharini Balaji, Anjana Ranjit Mohan, Mahalakshmi Manni Mohanraj, Maheswari Kumar, Kayal Arivudainambi, Unnikrishnan Ranjit, Ranjani Harish, Ninov Lyudmil, Pastakia Sonak D, Usha Sriram, Malanda Belma, Belton Anne, Uma Ram, Mohan Viswanathan
Madras Diabetes Research Foundation, Chennai, India.
International Diabetes Federation, Brussels, Belgium.
Diabetes Res Clin Pract. 2016 Jul;117:22-7. doi: 10.1016/j.diabres.2016.04.050. Epub 2016 May 3.
To determine postpartum glucose tolerance status among women with gestational diabetes mellitus (GDM) recruited under the Women In India with GDM Strategy (WINGS) Model of Care (MOC).
Through the WINGS MOC programme, 212 women with GDM were followed till delivery between November 2013 and August 2015. All women were advised to return for a postpartum oral glucose tolerance test (OGTT) 6-12weeks after delivery. A multivariate logistic regression (MLR) model was developed to identify the risk factors for postpartum dysglycemia which was defined as presence of diabetes (DM) or prediabetes.
203/212(95.8%) women completed their postpartum OGTT. Of the 161 women (79.3%) who came back for the test between 6 and 12weeks, 2(1.2%) developed DM, 5(3.1%), isolated IFG, 13(8.1%), isolated IGT and 5(3.1%) combined IFG/IGT [dysglycemia 25(15.5%)]. 136 women (84.5%) reverted to normal glucose tolerance (NGT). Of the 42 women who came back between 12weeks and a year, 5(11.9%) developed DM, 10(23.8%), isolated IFG and 1(2.4%) combined IFG/IGT [dysglycemia 16(38.1%)]. 26/42 women (61.9%) reverted to NGT. Thus overall dysglycemia occurred in 41/203 women (20.2%). MLR showed that BMI ⩾25kg/m(2) was significantly associated with postpartum dysglycemia (odds ratio: 4.47; 95% confidence interval: 1.8-11.2, p=0.001).
Among Asian Indian women with GDM, over 20% develop dysglycemia within one year postpartum, and BMI ⩾25kg/m(2) increased this risk four-fold. Early postpartum screening can identify high risk women and help plan strategies for prevention of type 2 diabetes in the future.
确定在印度妊娠糖尿病（GDM）女性患者中采用印度GDM女性战略（WINGS）护理模式（MOC）招募的女性产后糖耐量状况。
通过WINGS MOC项目，对2013年11月至2015年8月期间的212例GDM女性患者进行随访直至分娩。建议所有女性在产后6 - 12周返回进行产后口服葡萄糖耐量试验（OGTT）。建立多因素逻辑回归（MLR）模型以确定产后血糖异常的危险因素，产后血糖异常定义为患有糖尿病（DM）或糖尿病前期。
203/212（95.8%）例女性完成了产后OGTT。在6至12周之间返回进行检测的161例女性（79.3%）中，2例（1.2%）患DM，5例（3.1%）为单纯空腹血糖受损（IFG），13例（8.1%）为单纯糖耐量受损（IGT），5例（3.1%）为IFG/IGT合并存在[血糖异常25例（15.5%）]。136例女性（84.5%）恢复至正常糖耐量（NGT）。在12周与1年之间返回的42例女性中，5例（11.9%）患DM，10例（23.8%）为单纯IFG，1例（2.4%）为IFG/IGT合并存在[血糖异常16例（38.1%）]。26/42例女性（61.9%）恢复至NGT。因此，总体上41/203例女性（20.2%）出现血糖异常。MLR显示，体重指数（BMI）⩾25kg/m²与产后血糖异常显著相关（比值比：4.47；95%置信区间：1.8 - 11.2，p = 0.001）。
在患有GDM的亚洲印度女性中，超过20%在产后1年内出现血糖异常，且BMI⩾25kg/m²使该风险增加四倍。产后早期筛查可识别高危女性，并有助于制定未来预防2型糖尿病的策略。
