High frequency of diabetes in early post- partum assessment of women with gestational diabetes mellitus

Gestational diabetes mellitus (GDM) constitutes a risk factor for diabetes. To determine the frequency of abnormal glucose tolerance (AGT), Metabolic Syndrome (MS) and insulin resistance (IR), 117 women with GDM were studied, 24 months post-partum. Body mass index (BMI), waist circumference (WC), waist/hip index (W/HI) and blood pressure (BP) were measured. Plasma insulin was measured during a 75-g oral glucose tolerance test (OGTT) and levels of triglycerides, cholesterol and HDL-C were assessed. The HOMA-R model was used for the IR index calculation. Clinical and obstetric history was compared as well as variables at GDM diagnosis, metabolic control and results of the pregnancy in women with AGT, and in those with normal glucose tolerance (NGT). Student's t was used for continuous variables, and Fisher exact test for discrete variables. 46.15% of the women presented AGT: 18.80% had diabetes, 15.38% impaired glucose tolerance (IGT) and 11.97% impaired fasting glucose (IFG). 40.74% of the AGT and 15.87% of the NGT group had MS (p < 0.01). HOMA-R was >2.50 in 40.7% of the first group and in 34.9% of the second group, which is a non-significant difference. Basal and 2 h post-load glucose of the OGTT during pregnancy were higher in the AGT group (p < 0.001) (p < 0.05). In conclusion, a high proportion of women with GDM presented diabetes and MS in early post-partum. (C) 2007 Diabetes India. Published by Elsevier Ltd. All rights reserved.