Glucose Intolerance after a Recent History of Gestational Diabetes

Abstract EN

Aim.

Our aim was to evaluate the uptake of our current screening strategy postpartum and the risk factors for glucose intolerance in women with a recent history of gestational diabetes (GDM).

Methods.

Retrospective analysis of files of women with a recent history of GDM diagnosed with the Carpenter and Coustan criteria from 01-01-2010 till 31-12-2013.

Multivariable logistic regression was used to adjust for confounders.

Results.

Of all 231 women with a recent history of GDM, 21.4% (46) did not attend the scheduled postpartum OGTT.

Of the women tested, 39.1% (66) had glucose intolerance and 5.3% (9) had diabetes.

These women were more often overweight (39.7% versus 25.3%, P = 0.009), were more often treated with basal-bolus insulin injections (52.0% versus 17.4%, P = 0.032), and had a lower beta-cell function and lower insulin sensitivity, remaining significant after adjustment for age, BMI, and ethnicity (insulin secretion sensitivity index-2 (ISSI-2) in pregnancy 1.5 ± 0.5 versus 1.7 ± 0.4, P = 0.029; ISSI-2 postpartum 1.5 (1.2–1.9) versus 2.2 (1.8–2.6), P = 0.020; Matsuda index postpartum 3.8 (2.6–6.2) versus 6.0 (4.3–8.8), P = 0.021).

Conclusion.

Glucose intolerance is frequent in early postpartum and these women have a lower beta-cell function and lower insulin sensitivity.

One fifth of women did not attend the scheduled OGTT postpartum.