Boriboonhirunsarn Dittakarn, Robkhonburi Amporn, Gusonkhum Dawrueng
Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700 Thailand.
Diabetol Int. 2024 Feb 24;15(3):406-413. doi: 10.1007/s13340-024-00694-w. eCollection 2024 Jul.
To determine the incidence of overt diabetes in pregnancy (ODIP) among women with 50-g GCT results ≥ 200 mg/dL and compare characteristics and pregnancy outcomes between women with and without gestational diabetes (GDM).
A retrospective cohort study was conducted in 212 pregnant women whose 50-g GCT results ≥ 200 mg/dL. ODIP was diagnosed from 75-g OGTT if fasting plasma glucose ≥ 126 and/or 2-h plasma glucose ≥ 200 mg/dL. Various characteristics and pregnancy outcomes were compared between ODIP and those with and without GDM.
Incidence of ODIP was 1.9% of all pregnant women and 23.6% of women with 50-g GCT ≥ 200 mg/dL. Women with ODIP and GDM were more likely to be overweight or obese than those without GDM (52%, 39.6%, and 18.2%, p < 0.001). Women with ODIP had significantly higher 50-g GCT results, lower gestational weight gain, and were less likely to deliver vaginally. Insulin therapy was significantly more common in women with ODIP compared to GDM (70.2% vs. 15.4%, p < 0.001). Rates of LGA, macrosomia, and other neonatal outcomes were comparable. BMI ≥ 25 kg/m and 50-g GCT ≥ 240 mg/dL independently increased the risk of any abnormal glucose tolerance [adjusted OR 3.22 (95% CI 1.55-6.70) and 2.28 (95% CI 1.14-4.58)] and ODIP [adjusted OR 9.43 (95% CI 2.15-41.38) and 6.36 (95% CI 2.85-14.18)], respectively.
Incidence of ODIP was 23.6% of women with 50-g GCT ≥ 200 mg/dL. BMI ≥ 25 kg/m and 50-g GCT ≥ 240 mg/dL independently increased the risk of GDM and ODIP. Neonatal complications were comparable between ODIP and those with and without GDM.
确定50克葡萄糖耐量试验（GCT）结果≥200mg/dL的孕妇中显性糖尿病妊娠（ODIP）的发生率，并比较患有和未患有妊娠期糖尿病（GDM）的女性的特征及妊娠结局。
对212例50克GCT结果≥200mg/dL的孕妇进行了一项回顾性队列研究。如果空腹血糖≥126mg/dL和/或餐后2小时血糖≥200mg/dL，则通过75克口服葡萄糖耐量试验（OGTT）诊断ODIP。比较了ODIP患者与患有和未患有GDM的患者的各种特征及妊娠结局。
ODIP的发生率在所有孕妇中为1.9%，在50克GCT≥200mg/dL的孕妇中为23.6%。与未患GDM的女性相比，患有ODIP和GDM的女性更有可能超重或肥胖（分别为52%、39.6%和18.2%，p<0.001）。患有ODIP的女性50克GCT结果显著更高，孕期体重增加更低，且阴道分娩的可能性更小。与GDM患者相比，ODIP患者中胰岛素治疗明显更为常见（70.2%对15.4%，p<0.001）。大于胎龄儿（LGA）、巨大儿及其他新生儿结局的发生率相当。BMI≥25kg/m²和50克GCT≥240mg/dL分别独立增加了任何糖耐量异常的风险[校正比值比（OR）为3.22（95%可信区间[CI]为1.55 - 6.70）和2.28（95%CI为1.14 - 4.58）]以及ODIP的风险[校正OR为9.43（95%CI为2.15 - 41.38）和6.36（95%CI为2.85 - 14.18）]。
在50克GCT≥200mg/dL的女性中，ODIP的发生率为23.6%。BMI≥25kg/m²和50克GCT≥240mg/dL分别独立增加了GDM和ODIP的风险。ODIP患者与患有和未患有GDM的患者之间的新生儿并发症相当。
