Evidence to support the classification of hyperglycemia first detected in pregnancy to predict diabetes 6–12 weeks postpartum : a single center cohort study
Date
2020-09
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier
Abstract
Aims: Diagnostic criteria for type 2 diabetes mellitus (T2DM) applied to women with gestational diabetes mellitus (GDM) may predict postpartum T2DM but requires validation.
Methods: Women with GDM aged ≥ 18-years were prospectively evaluated 6–12 weeks after delivery at Tygerberg Hospital, Cape Town, South-Africa (November 2015- December 2018). Glucose status at GDM diagnosis was categorized into i) International Association for Diabetes in Pregnancy Study Group (IADPSG) T2DM (fasting glucose ≥ 7 mmol/L and/or 2hr-glucose ≥ 11.1 mmol/L) or ii) modified National Institute for Care Excellence (NICE) GDM (fasting glucose ≥ 5.6 mmol/L-6.9 mmol/L and/or 2hr-glucose ≥ 7.8 mmol/L-11 mmol/L) and compared with postpartum OGTT.
Results: IADPSG T2DM and NICE GDM was present in 35% (n = 64) and 65% (n = 117) of the 181 women who completed the 8 ± 2 weeks postpartum evaluation respectively. Postpartum, the prevalence of T2DM and prediabetes was 26% (n = 47/181) and 15% (n = 28). Antenatal IADPSG T2DM categorization identified 31/47 women with postpartum T2DM (sensitivity 75%; specificity 48%). All of the modified NICE GDM category women who developed T2DM (n = 16/117) had elevations of both fasting and 2hr-glucose values antenatally.
Conclusion: The utility of the IADPSG T2DM criteria to predict T2DM postpartum is confirmed. Women with both fasting and 2hr-glucose values above GDM cut-offs emerged as another high-risk category.
Description
CITATION: Coetzee, A. et al. 2020. Evidence to support the classification of hyperglycemia first detected in pregnancy to predict diabetes 6–12 weeks postpartum : a single center cohort study. Diabetes Research and Clinical Practice, 169. doi:10.1016/j.diabres.2020.108421
The original publication is available at https://www.sciencedirect.com/journal/diabetes-research-and-clinical-practice
The original publication is available at https://www.sciencedirect.com/journal/diabetes-research-and-clinical-practice
Keywords
Hyperglycemia, Diabetes in pregnancy, Puerperal disorders, Diabetes, Public health
Citation
Coetzee, A. et al. 2020. Evidence to support the classification of hyperglycemia first detected in pregnancy to predict diabetes 6–12 weeks postpartum : a single center cohort study. Diabetes Research and Clinical Practice, 169. doi:10.1016/j.diabres.2020.108421