High prevalence of diabetes and abnormal glucose tolerance in Thai women with previous gestational diabetes mellitus

Sirisawat Wanthong; Raweewan Lertwattanarak; Prasert Sunsaneevithayakul; Sutin Sriussadaporn; Sathit Vannasaeng; Apiradee Sriwijitkamol

doi:10.1016/j.jcte.2017.06.004

High prevalence of diabetes and abnormal glucose tolerance in Thai women with previous gestational diabetes mellitus

J Clin Transl Endocrinol. 2017 Jun 29:9:21-24. doi: 10.1016/j.jcte.2017.06.004. eCollection 2017 Sep.

Authors

Sirisawat Wanthong¹, Raweewan Lertwattanarak¹, Prasert Sunsaneevithayakul², Sutin Sriussadaporn¹, Sathit Vannasaeng¹, Apiradee Sriwijitkamol¹

Affiliations

¹ Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
² Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Abstract

Aim: To determine the prevalence of and risk factors for abnormal glucose tolerance (AGT) in previous gestational diabetes mellitus (pGDM) women.

Methods: 100 pGDM women randomly selected from the database of the Department of Obstetrics/Gynecology. 75 g-OGTT were performed in subjects without known diabetes. AGT was diagnosed using the American Diabetes Association criteria.

Results: The mean age, pre-gestational BMI, and time since delivery were 38 ± 5 years, 24.5 ± 5.7 kg/m², and 46 ± 26 months. Overall, 81% of the subjects had AGT, including IGT (38%), IGT + IFG (5%), T2DM (38%). Plasma glucose (PG) at 1 h after a 50 g-glucose challenge test (GCT), PG at 1 h after 100 g-OGTT, HbA_1c, and HOMA-IR were significantly greater in women with AGT than normal glucose tolerance (NGT) women. The proportion of women with ≥3 abnormal PG values during 100 g-OGTT was greater in AGT than NGT group (50.7% vs. 15.8%). Multivariate analysis showed that PG ≥ 150 mg/dl at 1 h after a 50 g-GCT and ≥3 abnormal PG values in 100 g-OGTTs were risk factors for developing AGT.

Conclusions: Eighty-one percent of pGDM women developed AGT within 4 years after delivery. Risk factors for AGT were PG ≥ 150 mg/dl at 1 h after a 50 g-GCT and ≥3 abnormal PG values in a 100 g-OGTT.

Keywords: Abnormal glucose tolerance; Gestational diabetes; Postpartum diabetes.