Diabetology and Dietetics Unit, Department of Medicine DIMED, University of Padova, Via Giustiniani 2, 35128, Padua, Italy.
Acta Diabetol. 2020 Dec;57(12):1473-1480. doi: 10.1007/s00592-020-01564-y. Epub 2020 Aug 1.
The aim of this study was to examine attendance for early postpartum follow-up among women with gestational diabetes mellitus (GDM), and to identify factors that influenced their likelihood of attending.
One thousand eight hundred and nineteen women with GDM were retrospectively analyzed. During pregnancy, the following data were collected: age, family history of diabetes, ethnicity, prepregnancy BMI, fasting plasma glucose, glycated hemoglobin, gestational week of GDM diagnosis, timing and mode of delivery, newborn's birth weight and length. Glycemia and insulinemia during OGTT, lipid profile and postpartum BMI were assessed at follow-up. Based on the OGTT, women were classified as having normal glucose tolerance (NGT) or abnormal glucose tolerance (AGT), which included impaired fasting glucose (IFG), impaired glucose tolerance (IGT), IFG + IGT, and DM2. Factors predicting postpartum attendance for follow-up and onset of AGT were considered.
Of the 889 (48.9%) who attended the scheduled postpartum OGTT, 741 (83.4%) had NGT, while 148 (16.6%) had AGT (IFG 6.7%, IGT 7.7%, IFG + IGT 0.8%, DM2 1.5%). The predictors of adherence to follow-up were: not belonging to an immigrant group; family history of DM2; and insulin therapy in pregnancy. The same factors were also predictive of AGT. Our data suggest a role of ethnicity in both attendance for postpartum follow-up and its outcome.
Despite efforts to provide care for women with GDM, postpartum screening rates are still low among Italian women, and especially among immigrants. Hence, the need to improve these patients' awareness of the severe risk of developing diabetes after pregnancy, concentrating efforts especially on women belonging to the most at risk ethnic groups.
本研究旨在探讨妊娠期糖尿病（GDM）女性产后早期随访的就诊情况，并确定影响其就诊可能性的因素。
回顾性分析了 1819 例 GDM 女性。在妊娠期间，收集了以下数据：年龄、糖尿病家族史、种族、孕前 BMI、空腹血糖、糖化血红蛋白、GDM 诊断的孕周、分娩方式和时机、新生儿的出生体重和身长。在随访时评估 OGTT 时的血糖和胰岛素水平、血脂谱和产后 BMI。根据 OGTT，将女性分为正常糖耐量（NGT）或异常糖耐量（AGT），包括空腹血糖受损（IFG）、糖耐量受损（IGT）、IFG+IGT 和 2 型糖尿病（DM2）。考虑了预测产后随访和 AGT 发病的因素。
在 889 例（48.9%）接受计划产后 OGTT 的女性中，741 例（83.4%）糖耐量正常，而 148 例（16.6%）糖耐量异常（IFG 6.7%、IGT 7.7%、IFG+IGT 0.8%、DM2 1.5%）。依从性随访的预测因素包括：不属于移民群体；2 型糖尿病家族史；和妊娠期间胰岛素治疗。同样的因素也预测了 AGT。我们的数据表明，种族在产后随访的依从性及其结果中都起着作用。
尽管努力为 GDM 女性提供护理，但意大利女性，尤其是移民女性，产后筛查率仍然很低。因此，需要提高这些患者对妊娠后发生糖尿病的严重风险的认识，特别要关注风险最高的种族群体的女性。
