Postpartum follow up of gestational diabetes in a Tertiary Care Center

Abstract Background Gestational diabetes is a risk factor for future development of type 2 diabetes. The primary aim of this study was to estimate the prevalence of postpartum glucose tolerance status evaluation in pregnancies complicated by gestational diabetes 6–12 weeks after delivery. The second...

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Main Authors: C. A. Cabizuca, P. S. Rocha, J. V. Marques, T. F. L. R. Costa, A. S. N. Santos, A. L. Schröder, C. A. G. Mello, H. D. Sousa, E. S. G. Silva, F. O. Braga, R. C. Abi-Abib, M. B. Gomes
Format: Article
Language:English
Published: BMC 2018-01-01
Series:Diabetology & Metabolic Syndrome
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13098-017-0303-4
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author C. A. Cabizuca
P. S. Rocha
J. V. Marques
T. F. L. R. Costa
A. S. N. Santos
A. L. Schröder
C. A. G. Mello
H. D. Sousa
E. S. G. Silva
F. O. Braga
R. C. Abi-Abib
M. B. Gomes
author_facet C. A. Cabizuca
P. S. Rocha
J. V. Marques
T. F. L. R. Costa
A. S. N. Santos
A. L. Schröder
C. A. G. Mello
H. D. Sousa
E. S. G. Silva
F. O. Braga
R. C. Abi-Abib
M. B. Gomes
author_sort C. A. Cabizuca
collection DOAJ
description Abstract Background Gestational diabetes is a risk factor for future development of type 2 diabetes. The primary aim of this study was to estimate the prevalence of postpartum glucose tolerance status evaluation in pregnancies complicated by gestational diabetes 6–12 weeks after delivery. The secondary one was to identify the factors that are implicated with postpartum glucose retesting. Methods This was a retrospective study performed with a cohort of women with gestational diabetes, with prenatal care and delivery at a tertiary care center, from January 2013 to April 2017. The diagnosis of gestational diabetes was based on IADPSG criteria (Fasting ≥ 92 mg/dl, 1 h ≥ 180 mg/dl and/or 2 h ≥ 153 mg/dl, respectively) and the diagnosis of type 2 diabetes and prediabetes were made using the 2016 ADA’s criteria (fasting and 2 h after glucose load ≥ 126 mg/dl and/or ≥ 200 and 100–125 mg/dl and/or 140 and 199 mg/dl, respectively). All women had an appointment scheduled 6–12 weeks postpartum with the results of a 75-g oral glucose tolerance test (OGTT). Results Of the 152 evaluated women, 21 (13.8%) returned with the postpartum OGTT results. Of these, 9 (45.0%) had a diagnosis of prediabetes. The use of insulin during gestation was the only factor implicated in a higher adherence rate to postpartum testing OR 6.33 (p 0.002). No significance was found for other demographic and clinical variables (age, family income, years of study, parity, gestational age at first visit, smoking, family history of type 2 diabetes, diagnosis of gestational diabetes before the third trimester, pregestational body mass index, previous history of gestational diabetes and ethnicity). Conclusion The majority of patients with gestational diabetes did not return postpartum to perform OGTT and in our study the only factor implicated in a higher postpartum return was the use of insulin during pregnancy. Considering that 45.0% were diagnosed with prediabetes, diabetes care teams should initially identify non-adherent patients.
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spelling doaj.art-616e42fbb6b34e55bff09ad86abda8312022-12-22T03:10:38ZengBMCDiabetology & Metabolic Syndrome1758-59962018-01-011011610.1186/s13098-017-0303-4Postpartum follow up of gestational diabetes in a Tertiary Care CenterC. A. Cabizuca0P. S. Rocha1J. V. Marques2T. F. L. R. Costa3A. S. N. Santos4A. L. Schröder5C. A. G. Mello6H. D. Sousa7E. S. G. Silva8F. O. Braga9R. C. Abi-Abib10M. B. Gomes11Diabetes Unit, State University of Rio de JaneiroDiabetes Unit, State University of Rio de JaneiroDiabetes Unit, State University of Rio de JaneiroDiabetes Unit, State University of Rio de JaneiroDiabetes Unit, State University of Rio de JaneiroDiabetes Unit, State University of Rio de JaneiroDiabetes Unit, State University of Rio de JaneiroDiabetes Unit, State University of Rio de JaneiroDiabetes Unit, State University of Rio de JaneiroDiabetes Unit, State University of Rio de JaneiroDiabetes Unit, State University of Rio de JaneiroDiabetes Unit, State University of Rio de JaneiroAbstract Background Gestational diabetes is a risk factor for future development of type 2 diabetes. The primary aim of this study was to estimate the prevalence of postpartum glucose tolerance status evaluation in pregnancies complicated by gestational diabetes 6–12 weeks after delivery. The secondary one was to identify the factors that are implicated with postpartum glucose retesting. Methods This was a retrospective study performed with a cohort of women with gestational diabetes, with prenatal care and delivery at a tertiary care center, from January 2013 to April 2017. The diagnosis of gestational diabetes was based on IADPSG criteria (Fasting ≥ 92 mg/dl, 1 h ≥ 180 mg/dl and/or 2 h ≥ 153 mg/dl, respectively) and the diagnosis of type 2 diabetes and prediabetes were made using the 2016 ADA’s criteria (fasting and 2 h after glucose load ≥ 126 mg/dl and/or ≥ 200 and 100–125 mg/dl and/or 140 and 199 mg/dl, respectively). All women had an appointment scheduled 6–12 weeks postpartum with the results of a 75-g oral glucose tolerance test (OGTT). Results Of the 152 evaluated women, 21 (13.8%) returned with the postpartum OGTT results. Of these, 9 (45.0%) had a diagnosis of prediabetes. The use of insulin during gestation was the only factor implicated in a higher adherence rate to postpartum testing OR 6.33 (p 0.002). No significance was found for other demographic and clinical variables (age, family income, years of study, parity, gestational age at first visit, smoking, family history of type 2 diabetes, diagnosis of gestational diabetes before the third trimester, pregestational body mass index, previous history of gestational diabetes and ethnicity). Conclusion The majority of patients with gestational diabetes did not return postpartum to perform OGTT and in our study the only factor implicated in a higher postpartum return was the use of insulin during pregnancy. Considering that 45.0% were diagnosed with prediabetes, diabetes care teams should initially identify non-adherent patients.http://link.springer.com/article/10.1186/s13098-017-0303-4Gestational diabetesPostpartum glucose testingOral glucose tolerance test
spellingShingle C. A. Cabizuca
P. S. Rocha
J. V. Marques
T. F. L. R. Costa
A. S. N. Santos
A. L. Schröder
C. A. G. Mello
H. D. Sousa
E. S. G. Silva
F. O. Braga
R. C. Abi-Abib
M. B. Gomes
Postpartum follow up of gestational diabetes in a Tertiary Care Center
Diabetology & Metabolic Syndrome
Gestational diabetes
Postpartum glucose testing
Oral glucose tolerance test
title Postpartum follow up of gestational diabetes in a Tertiary Care Center
title_full Postpartum follow up of gestational diabetes in a Tertiary Care Center
title_fullStr Postpartum follow up of gestational diabetes in a Tertiary Care Center
title_full_unstemmed Postpartum follow up of gestational diabetes in a Tertiary Care Center
title_short Postpartum follow up of gestational diabetes in a Tertiary Care Center
title_sort postpartum follow up of gestational diabetes in a tertiary care center
topic Gestational diabetes
Postpartum glucose testing
Oral glucose tolerance test
url http://link.springer.com/article/10.1186/s13098-017-0303-4
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