OBJECTIVE: To determine the prevalence of diabetes and impaired glucose tolerance after gestational diabetes mellitus in relation to different categories of glucose tolerance during pregnancy. DESIGN: Prospective study. SETTING: Four delivery departments and three hospitals in southern Sweden took part in recruitment and follow-up. POPULATION: Women undergoing a 75g oral glucose tolerance test during pregnancy delivering in 2003-2005. METHODS: At first follow-up, one to two years after delivery, 29% of eligible women with abnormal glucose tolerance during pregnancy had an oral glucose tolerance test - 160 with gestational diabetes and 309 with gestational impaired glucose tolerance - in addition to 167 control women. Cut-off levels defining gestational diabetes and impaired glucose tolerance were two-hour capillary blood glucose levels of 9.0 and 7.8mmol/l or plasma glucose 10.0 and 8.6mmol/l, respectively. MAIN OUTCOME MEASURES: Frequency of abnormal test results at follow-up. RESULTS: Diabetes was diagnosed in 11% and impaired glucose tolerance in 24% of women with gestational diabetes vs. 4 and 23% in those with gestational impaired glucose tolerance, respectively. Combining women with abnormal test results during pregnancy revealed diabetes or impaired glucose tolerance in 29% as compared to 10% among controls; the odds ratio (95% confidence interval) for having abnormal test results was 3.3 (1.8-5.9) in a multivariate logistic regression analysis. CONCLUSIONS: Lowering the cut-off level for gestational diabetes to include the category of impaired glucose tolerance would identify a high percentage of women with diabetes and impaired glucose tolerance postpartum, who constitute target groups for intervention and/or diabetes prevention.
OBJECTIVE: To determine the prevalence of diabetes and impaired glucose tolerance after gestational diabetes mellitus in relation to different categories of glucose tolerance during pregnancy. DESIGN: Prospective study. SETTING: Four delivery departments and three hospitals in southern Sweden took part in recruitment and follow-up. POPULATION: Women undergoing a 75g oral glucose tolerance test during pregnancy delivering in 2003-2005. METHODS: At first follow-up, one to two years after delivery, 29% of eligible women with abnormal glucose tolerance during pregnancy had an oral glucose tolerance test - 160 with gestational diabetes and 309 with gestational impaired glucose tolerance - in addition to 167 control women. Cut-off levels defining gestational diabetes and impaired glucose tolerance were two-hour capillary blood glucose levels of 9.0 and 7.8mmol/l or plasma glucose 10.0 and 8.6mmol/l, respectively. MAIN OUTCOME MEASURES: Frequency of abnormal test results at follow-up. RESULTS:Diabetes was diagnosed in 11% and impaired glucose tolerance in 24% of women with gestational diabetes vs. 4 and 23% in those with gestational impaired glucose tolerance, respectively. Combining women with abnormal test results during pregnancy revealed diabetes or impaired glucose tolerance in 29% as compared to 10% among controls; the odds ratio (95% confidence interval) for having abnormal test results was 3.3 (1.8-5.9) in a multivariate logistic regression analysis. CONCLUSIONS: Lowering the cut-off level for gestational diabetes to include the category of impaired glucose tolerance would identify a high percentage of women with diabetes and impaired glucose tolerance postpartum, who constitute target groups for intervention and/or diabetes prevention.
Authors: Helena Fadl; Maryam Saeedi; Scott Montgomery; Anders Magnuson; Erik Schwarcz; Kerstin Berntorp; Verena Sengpiel; Elisabeth Storck-Lindholm; Helena Strevens; Anna-Karin Wikström; Sophia Brismar-Wendel; Martina Persson; Stefan Jansson; Fredrik Ahlsson; Carina Ursing; Linda Ryen; Kerstin Petersson; Ulla-Britt Wennerholm; Karin Hildén; David Simmons Journal: BMC Pregnancy Childbirth Date: 2019-11-01 Impact factor: 3.007