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Assessment of risk factors for early post-partum conversion of gestational diabetes mellitus to permanent diabetes mellitus or persistent impaired glucose tolerance in Czech Republic
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Year of publication | 2013 |
Type | Conference abstract |
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Description | Introduction Incidence of type 1 and 2 as well as gestational diabetes mellitus (GDM) are increasing worldwide. Given that women with previous GDM have a higher risk of diabetes development later in life compared to women with a physiological pregnancy, the aims of our study were (1) to ascertain a frequency of early postpartum conversion of GDM into permanent diabetes or persistent impaired glucose tolerance and (2) to find an eventual significant predictive factors from those routinely measured during the GDM follow up. Methods We carried out a retrospective epidemiological analysis of anamnestic, anthropometric, biochemical and clinical data of female patients (n=1090) from Faculty Hospital Brno with GDM diagnosis during the 2005 – 2011 period that underwent repeated oGTT up to 1 year after the delivery. Results Any degree of impairment of glucose tolerance postpartum was detected in 11.7% subjects, of those 4.1% had manifest DM (2.8% T2DM and 1.3% T1DM). Glycaemia in all three time-points of baseline oGTT, area under the curve (AUCoGTT) and baseline HbA1c were significantly associated (P<0.05, Mann-Whitney) with the postpartum disorder. Using regression analysis predictive risk model was developed using these baseline parameters. Conclusions Parameters of glucose metabolism measured during 24-28th week of pregnancy fulfilling criteria of GDM diagnosis exhibited highly statistically significant differences between women with and without persistent postpartum glucose metabolism abnormality and conferred significant predictive potential. Considering generally low-compliance of GDM women any more specific assessment of future risk stratifying GDM population could enable more effective screening of postpartum glucose metabolism disorder. |
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