Ichiro Yasuhi, Yukari Kugishima, Hiroshi Yamashita, Masashi Fukuda, Akiko Kuzume, So Sugimi, Yasushi Umezaki, Sachie Suga and Nobuko Kusuda
NHO Nagasaki Medical Center, Japan
Posters-Accepted Abstracts: J Diabetes Metab
Objective: Gestational Diabetes Mellitus (GDM) is associated with a significantly increased risk of developing Diabetes later in life. We identified the risk factors associated with abnormal glucose tolerance (AGT) on the first postpartum glucose tolerance test (OGTT) in Japanese women with GDM. Research Design & Methods: We included Gestational diabetic women who underwent their first postpartum OGTT at 6-8 weeks postpartum. We defined the combination of impaired glucose tolerance and Diabetes as postpartum AGT according to the WHO criteria. We investigated the association between postpartum AGT and risk factors including maternal age, prepregnancy BMI, insulin therapy during pregnancy, plasma glucose (PG) levels, HbA1c, fasting immunoreactive insulin (IRI), the insulinogenic index (II), homeostasis assessment model (HOMA)-insulin resistance, and HOMA-� at diagnosis of GDM during pregnancy. Results: We investigated 169 women with GDM, who underwent OGTT at 6.9±1.5 weeks postpartum. Fifty-eight women (34%) exhibited postpartum AGT. In a univariate analysis, 1-hour PG (p<0.005), HbA1c (p<0.001), II (p<0.05), and insulin therapy (p<0.001) were associated with postpartum AGT. After adjusting for confounding variables, II (p<0.005) and insulin therapy (p<0.005) were found to be independent risk factors associated with postpartum AGT. The adjusted odds ratios for postpartum AGT in women with II<0.4 and women treated with insulin therapy were 5.7 (95% confidence interval, 1.69-21.66) and 3.43 (1.03-12.55), respectively. Conclusion: In Japanese Gestational diabetic women, a lower II, a marker of early-phase insulin secretion, and the use of insulin therapy during pregnancy were independent risk factors predicting early postpartum AGT.
Email: yasuhi@nagasaki-mc.com
