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

Authors
 Na-Ri Shin  ;  So-Yeon Yoon  ;  Geum Joon Cho  ;  Suk-Joo Choi  ;  Han-Sung Kwon  ;  Soon Cheol Hong  ;  Ja-Young Kwon  ;  Soo-young Oh 
Citation
 International Journal of Gynecology & Obstetrics, Vol.132(3) : 342-346, 2016 
Journal Title
 International Journal of Gynecology & Obstetrics 
ISSN
 0020-7292 
Issue Date
2016
MeSH
Adult ; Blood Glucose/analysis* ; Diabetes Mellitus, Type 2/epidemiology* ; Diabetes, Gestational/diagnosis* ; Female ; Glucose Tolerance Test ; Glycated Hemoglobin A/analysis* ; Humans ; Postpartum Period/blood* ; Pregnancy ; ROC Curve ; Republic of Korea ; Retrospective Studies ; Risk Factors
Keywords
100-g glucose tolerance test ; 75-g glucose tolerance test ; Gestational diabetes mellitus ; Glycated hemoglobin ; Overt diabetes mellitus ; Postpartum period
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 (1h), 10.2 mmol/L (2h), and 8.6 mmol/L (3h) 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.
Full Text
http://onlinelibrary.wiley.com/doi/10.1016/j.ijgo.2015.07.031/abstract
DOI
10.1016/j.ijgo.2015.07.031
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
권자영(Kwon, Ja Young) ORCID logo https://orcid.org/0000-0003-3009-6325
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/153151
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