A Korean multicenter study of prenatal risk factors for overt diabetes during the postpartum period after gestational diabetes mellitus

Na Ri Shin, So Yeon Yoon, Geum-Joon Cho, Suk Joo Choi, Han Sung Kwon, Soon Cheol Hong, Ja Young Kwon, Soo Young Oh

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3 Citations (Scopus)

Abstract

Objective To identify prenatal risk factors for postpartum diabetes among pregnant women with gestational diabetes mellitus (GDM). Methods In a retrospective study, baseline characteristics and data from a postpartum 75-g glucose tolerance test (GTT) were reviewed for patients with GDM who had delivered in four Korean tertiary institutions from 2006 to 2012. Clinical characteristics were compared between women with and those without postpartum diabetes. Cutoffs to predict postpartum diabetes and diagnostic values were calculated from receiver operating characteristic (ROC) curves. Results Of 1637 patients with GDM, 498 (30.4%) underwent a postpartum 75-g GTT. Postpartum diabetes was diagnosed in 40 (8.0%) patients and impaired glucose intolerance in 157 (31.5%). Women with postpartum diabetes had higher glycated hemoglobin (HbA1c) levels at GDM diagnosis (P = 0.008) and higher 100-g GTT values (P <0.05 for all). In ROC curve analysis, optimal cutoffs for predicting postpartum diabetes were 0.058 for HbA1c level and 5.3 mmol/L (fasting), 10.9 mmol/L (1 h), 10.2 mmol/L (2 h), and 8.6 mmol/L (3 h) for 100-g GTT. The highest sensitivity was observed for 3-h 100-g GTT (76.9%) and the highest positive predictive value was for HbA1c at diagnosis (15.2%). Conclusion HbA1c level at GDM diagnosis and 100-g GTT values could be used to identify patients at high risk of postpartum diabetes who should undergo postpartum screening.

Original languageEnglish
Pages (from-to)342-346
Number of pages5
JournalInternational Journal of Gynecology and Obstetrics
Volume132
Issue number3
DOIs
Publication statusPublished - 2016 Mar 1

Fingerprint

Gestational Diabetes
Postpartum Period
Multicenter Studies
Glucose Tolerance Test
ROC Curve
Glucose Intolerance
Glycosylated Hemoglobin A
Pregnant Women
Fasting
Retrospective Studies

Keywords

  • 100-g glucose tolerance test
  • 75-g glucose tolerance test
  • Gestational diabetes mellitus
  • Glycated hemoglobin
  • Overt diabetes mellitus
  • Postpartum period

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

A Korean multicenter study of prenatal risk factors for overt diabetes during the postpartum period after gestational diabetes mellitus. / Shin, Na Ri; Yoon, So Yeon; Cho, Geum-Joon; Choi, Suk Joo; Kwon, Han Sung; Hong, Soon Cheol; Kwon, Ja Young; Oh, Soo Young.

In: International Journal of Gynecology and Obstetrics, Vol. 132, No. 3, 01.03.2016, p. 342-346.

Research output: Contribution to journalArticle

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abstract = "Objective To identify prenatal risk factors for postpartum diabetes among pregnant women with gestational diabetes mellitus (GDM). Methods In a retrospective study, baseline characteristics and data from a postpartum 75-g glucose tolerance test (GTT) were reviewed for patients with GDM who had delivered in four Korean tertiary institutions from 2006 to 2012. Clinical characteristics were compared between women with and those without postpartum diabetes. Cutoffs to predict postpartum diabetes and diagnostic values were calculated from receiver operating characteristic (ROC) curves. Results Of 1637 patients with GDM, 498 (30.4{\%}) underwent a postpartum 75-g GTT. Postpartum diabetes was diagnosed in 40 (8.0{\%}) patients and impaired glucose intolerance in 157 (31.5{\%}). Women with postpartum diabetes had higher glycated hemoglobin (HbA1c) levels at GDM diagnosis (P = 0.008) and higher 100-g GTT values (P <0.05 for all). In ROC curve analysis, optimal cutoffs for predicting postpartum diabetes were 0.058 for HbA1c level and 5.3 mmol/L (fasting), 10.9 mmol/L (1 h), 10.2 mmol/L (2 h), and 8.6 mmol/L (3 h) for 100-g GTT. The highest sensitivity was observed for 3-h 100-g GTT (76.9{\%}) and the highest positive predictive value was for HbA1c at diagnosis (15.2{\%}). Conclusion HbA1c level at GDM diagnosis and 100-g GTT values could be used to identify patients at high risk of postpartum diabetes who should undergo postpartum screening.",
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