OBJECTIVE: The aim of this study was to research the rates of diabetes mellitus (DM) and the risk factors that may play a role in the prediction of this condition by evaluating patients with the diagnosis of gestational diabetes mellitus (GDM) at the 6(th)-12(th) postpartum months. MATERIAL AND METHOD: Among 109 cases who had been invited to the hospital for oral glucose tolerance test (OGTT) at the 6(th)-12(th) postpartum months, 84 cases (77%) were enrolled in the study. To the 78 patients that were found to be appropriate according to the study criteria, 75 gr OGTT was administered. Patients who had new pregnancies during the period of postpartum screening, and those with previously diagnosed DM were excluded from the study. RESULTS: While the results of 23 cases (29.5%) included in the study were normal, 27 cases (34.6%) were diagnosed with DM and 28 cases (35.9%) were diagnosed as having an impaired glucose tolerance and/or impaired fasting glucose (IGT/IFG). Among patients diagnosed with DM, the history of DM in the first degree relatives (n=21, 77.8%, p=0.018), body mass index before pregnancy (mean=30.1±4.4, p=0.009) and insulin requirement for the treatment of GDM (n=25, 92.6%, p<0.05) were determined at higher rates. In the logistic regression analysis, multiparity (OR=2) and insulin requirement during pregnancy (OR: 7.27) were found to be the predictive factors in the development of postpartum DM. DISCUSSION: In this study, the determination of high rates of DM development in the postpartum period after GDM demonstrates the necessity of augmentation in efforts to increase the screening rates after delivery and to increase the patients' acknowledgement of this topic.
OBJECTIVE: The aim of this study was to research the rates of diabetes mellitus (DM) and the risk factors that may play a role in the prediction of this condition by evaluating patients with the diagnosis of gestational diabetes mellitus (GDM) at the 6(th)-12(th) postpartum months. MATERIAL AND METHOD: Among 109 cases who had been invited to the hospital for oral glucose tolerance test (OGTT) at the 6(th)-12(th) postpartum months, 84 cases (77%) were enrolled in the study. To the 78 patients that were found to be appropriate according to the study criteria, 75 gr OGTT was administered. Patients who had new pregnancies during the period of postpartum screening, and those with previously diagnosed DM were excluded from the study. RESULTS: While the results of 23 cases (29.5%) included in the study were normal, 27 cases (34.6%) were diagnosed with DM and 28 cases (35.9%) were diagnosed as having an impaired glucose tolerance and/or impaired fasting glucose (IGT/IFG). Among patients diagnosed with DM, the history of DM in the first degree relatives (n=21, 77.8%, p=0.018), body mass index before pregnancy (mean=30.1±4.4, p=0.009) and insulin requirement for the treatment of GDM (n=25, 92.6%, p<0.05) were determined at higher rates. In the logistic regression analysis, multiparity (OR=2) and insulin requirement during pregnancy (OR: 7.27) were found to be the predictive factors in the development of postpartum DM. DISCUSSION: In this study, the determination of high rates of DM development in the postpartum period after GDM demonstrates the necessity of augmentation in efforts to increase the screening rates after delivery and to increase the patients' acknowledgement of this topic.
Authors: Erica P Gunderson; Cora E Lewis; Gina S Wei; Rachel A Whitmer; Charles P Quesenberry; Steve Sidney Journal: Obstet Gynecol Date: 2007-03 Impact factor: 7.661