Prediction of abnormal postpartum glucose tolerance testing in mild gestational diabetes mellitus

J Reprod Med. 2014 Jul-Aug;59(7-8):393-400.

Abstract

Objective: To describe the liikelihood of women with gestational diabetes mellitus (GDM)--who are at increased risk for developing overt diabetes--undergoing postpartum testing, and the patient characteristics associated with abnormal postpartum glucose tolerance testing (GTT) in mild GDM.

Study design: This was a retrospective chart review that included mild GDM patients, defined as those with fasting plasma glucose levels < 95 mg/dL on a 3-hour 100-g oral glucose tolerance test (OGTT). Patients who underwent postpartum testing were assessed and predictive factors for abnormal results evaluated.

Results: Mild GDM was diagnosed in 414 (39.6%) women, 201 (48.6%) of whom completed a postpartum 2-hour 75-g OGTT. Abnormal testing was seen in 69 (34.3%), with diabetes in 6 (3%); those with abnormal testing had been diagnosed with GDM at an earlier gestational age, had higher 1-hour 50-g OGTT values, and were also more likely to require pharmacologic therapy. Combining several variables produced a predictive model with positive and negative predictive values of 50% and 84%, respectively.

Conclusion: Antenatal factors (alone or in combination) do not allow for prediction of abnormal postpartum OGTT results in mild GDM patients. Patients with mild GDM are at a slightly decreased postpartum risk of developing diabetes and prediabetes as compared to other patients with GDM.

MeSH terms

  • Adult
  • Blood Glucose / analysis*
  • Diabetes, Gestational / blood*
  • Diabetes, Gestational / drug therapy
  • Female
  • Gestational Age
  • Glucose Tolerance Test*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Multivariate Analysis
  • Postpartum Period*
  • Prediabetic State / blood
  • Predictive Value of Tests
  • Pregnancy
  • Retrospective Studies
  • Sensitivity and Specificity
  • Severity of Illness Index

Substances

  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin