Epidemiology/Genetics

2014 Diabetes  
glucose metabolism (AGM) for women postpartum with previous gestational diabetes mellitus (GDM). A 75 g OGTT underwent at 6-8 weeks after delivery in 179 GDM patients. The clinical and obstetric characteristics, serum lipid level (TCH, TG, LDL-C, HDL-C), insulin level, GA, IGF-1, IGF-BP3, HOMA-B, and HOMA-IR were compared between the two groups. We found that: (1) 45.8% (82/179) of GDM patients remained abnormal glucose level. The rates of DM, IGT, IFG and IGR were 20.1% (36/179), 17.3%
more » ... , 3.3% (6/179) and 5% (9/179) respectively. (2) Compared to the women who reverted to normal, women with AGM showed shorter pregnant period (38.04±1.18 weeks vs. 38.42±1.11 weeks, P=0.003), signifi cantly higher fasting insulin (FINS) level (58.59±38.22 pmol/L vs. 46.46±28.32 pmol/L, P=0.021), higher 2h postprandial insulin (2hINS) concentration (375.63±325.83 pmol/L vs. 223.93±169.17 pmol/L, P=0), higher GA level (13.53±2.45% vs. 11.85±0.99%, P=0), lower HOMA-B (71.29±50.73 vs. 89.27±55.86, P=0.03), higher HOMA-IR (2.41±1.81 vs. 1.51±0.96, P=0) as well as more DM family history (43.9% vs. 27.8%, P=0.025). ( 3 ) Compared to the prediabetic patients after GDM (IFG, IGT and IGR), diabetic patients had higher BMI (P=0.042), higher maximum pre-pregnancy weight (P=0.012), higher maximum pre-pregnancy BMI (P=0.011), higher GA level (P=0.001) and higher HOMA-IR (P=0.002). ( 4 ) Multiple stepwise regression analysis revealed that fasting blood glucose, FINS and 1hPG were the independent risk factors for the development of insulin resistance after delivery. This study has identifi ed a high prevalence of AGM after GDM. Insulin resistance is the major contributor. The medication of relieving insulin resistance may be useful for the GDM patients with sustained higher FBG, FINS and 1hPG after delivery.
doi:10.2337/db14-1317-1629 fatcat:osja3wyrmzgsdmn5tfu5t6c42q