- Title
- Conversion of gestational diabetes mellitus to future Type 2 diabetes mellitus and the predictive value of HbA1c in an Indian cohort
- Creator
- Gupta, Y.; Kapoor, D.; Tandon, N.; Desai, A.; Praveen, D.; Joshi, R.; Rozati, R.; Bhatla, N.; Prabhakaran, D.; Reddy, P.; Patel, A.
- Relation
- Diabetic Medicine Vol. 34, Issue 1, p. 37-43
- Publisher Link
- http://dx.doi.org/10.1111/dme.13102
- Publisher
- Wiley-Blackwell
- Resource Type
- journal article
- Date
- 2017
- Description
- 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/m 2 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 HbA 1c 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 HbA 1c threshold for diabetes may lead to significant under-diagnosis.
- Subject
- dysglycaemia; gestational diabetes; pregnancy; postpartum screening
- Identifier
- http://hdl.handle.net/1959.13/1351256
- Identifier
- uon:30673
- Identifier
- ISSN:0742-3071
- Language
- eng
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