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Conversion of gestational diabetes mellitus to future Type 2 diabetes mellitus and the predictive value of HbA1cin an Indian cohort
- Source :
- Diabetic Medicine. 34:37-43
- Publication Year :
- 2016
- Publisher :
- Wiley, 2016.
-
Abstract
- © 2016 Diabetes UK Aim: To investigate the distribution of and risk factors for dysglycaemia (Type 2 diabetes and prediabetes) in women with previous gestational diabetes mellitus in India. Methods: All women (n = 989) from two obstetric units in New Delhi and Hyderabad with a history of gestational diabetes were invited to participate, of whom 366 (37%) agreed. Sociodemographic, medical and anthropometric data were collected and 75-g oral glucose tolerance test were carried out. Results: Within 5 years (median 14 months) of the pregnancy in which they were diagnosed with gestational diabetes, 263 (72%) women were dysglycaemic, including 119 (32%) and 144 (40%) with Type 2 diabetes and prediabetes, respectively. A higher BMI [odds ratio 1.16 per 1-kg/m2 greater BMI (95% CI 1.10, 1.28)], presence of acanthosis nigricans [odds ratio 3.10, 95% CI (1.64, 5.87)], postpartum screening interval [odds ratio 1.02 per 1 month greater screening interval 95% CI (1.01, 1.04)] and age [odds ratio 1.10 per 1-year older age 95% CI (1.04, 1.16)] had a higher likelihood of having dysglycaemia. The American Diabetes Association-recommended threshold HbA1c value of ≥ 48 mmol/mol (6.5%) had a sensitivity and specificity of 81.4 and 90.7%, respectively, for determining the presence of Type 2 diabetes postpartum. Conclusion: The high post-pregnancy conversion rates of gestational diabetes to diabetes reported in the present study reinforce the need for mandatory postpartum screening and identification of strategies for preventing progression to Type 2 diabetes. Use of the American Diabetes Association-recommended HbA1c threshold for diabetes may lead to significant under-diagnosis.
- Subjects :
- Adult
medicine.medical_specialty
Glycated Hemoglobin A
Endocrinology, Diabetes and Metabolism
India
030209 endocrinology & metabolism
Type 2 diabetes
Sensitivity and Specificity
Prediabetic State
Cohort Studies
Endocrinology & Metabolism
03 medical and health sciences
0302 clinical medicine
Endocrinology
Risk Factors
Predictive Value of Tests
Pregnancy
Diabetes mellitus
Glucose Intolerance
Prevalence
Internal Medicine
medicine
Humans
Prospective Studies
030212 general & internal medicine
Prediabetes
Glucose tolerance test
medicine.diagnostic_test
Obstetrics
business.industry
Postpartum Period
Type 2 Diabetes Mellitus
Odds ratio
Glucose Tolerance Test
medicine.disease
Surgery
Gestational diabetes
Diabetes, Gestational
Diabetes Mellitus, Type 2
Disease Progression
Female
business
Postpartum period
Follow-Up Studies
Subjects
Details
- ISSN :
- 07423071
- Volume :
- 34
- Database :
- OpenAIRE
- Journal :
- Diabetic Medicine
- Accession number :
- edsair.doi.dedup.....87e6c563f40fa5ff3108e4dae40f39fe