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Long term prognosis of women with gestational diabetes in a multiethnic population
  1. Matthew D Oldfield1,
  2. Penelope Donley1,
  3. Linda Walwyn1,
  4. Ian Scudamore2,
  5. Robert Gregory1
  1. 1Department of Diabetes, Leicester General Hospital, Leicester, UK
  2. 2Department of Obstetrics and Gynaecology, Leicester General Hospital, Leicester, UK
  1. Correspondence to:
 Dr Matthew Oldfield
 Department of Diabetes, Kingston Hospital, Galsworthy Road, Kingston Upon Thames, Surrey, KT2 7QB, UK; matthew.oldfield{at}kingstonhospital.nhs.uk

Abstract

Aim: To assess the glucose tolerance of South Asian and Caucasian women with previous gestational diabetes mellitus (GDM).

Method: A retrospective follow-up study of 189 women diagnosed with GDM between 1995 and 2001. Glucose tolerance was reassessed by oral glucose tolerance test at a mean duration since pregnancy of 4.38 years.

Results: South Asian women comprised 65% of the GDM population. Diabetes developed in 36.9% of the population, affecting more South Asian (48.6%) than Caucasian women (25.0%). Women developing diabetes were older at follow-up (mean (SD) 38.8 (5.7) vs 35.9 (5.6) years; p<0.05) and had been heavier (body mass index 31.4 (6.3) vs 27.7 (6.7) kg/m2; p<0.05), more hyperglycaemic (Gl0 6.5 (1.7) vs 5.2 (1.1) mmol/l; p<0.01: G120 11.4 (3.3) vs 9.6 (1.8) mmol/l; p<0.01: HbA1c 6.4 (1.0) vs 5.6 (0.7); p<0.01) and more likely to require insulin during pregnancy (88.1% vs 34.0%; p<0.01). Future diabetes was associated with and predicted by HbA1c taken at GDM diagnosis in both South Asian (odds ratio 4.09, 95% confidence interval 1.35 to 12.40; p<0.05) and Caucasian women (OR 9.15, 95% CI 1.91 to 43.87; p<0.01) as well as by previously reported risk factors of increasing age at follow-up, pregnancy weight, increasing hyperglycaemia and insulin requirement during pregnancy.

Conclusion: GDM represents a significant risk factor for future DM development regardless of ethnicity. Glycated haemoglobin values at GDM diagnosis have value in predicting future diabetes mellitus.

  • BMI, body mass index
  • GDM, gestational diabetes mellitus
  • HbA1c, glycated haemoglobin
  • IFG, impaired fasting glucose
  • IGT, impaired glucose tolerance
  • OGTT, oral glucose tolerance test
  • ROC, receiver operator characteristic

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Footnotes

  • Conflict of interest: none stated

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