Glucose tolerance status of Asian Indian women with gestational diabetes at 6 weeks to 1 year postpartum (WINGS-7)
Glucose tolerance status of Asian Indian women with gestational diabetes at 6 weeks to 1 year postpartum (WINGS-7)
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DOI：
10.1016/j.diabres.2016.04.050
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发表时间：
2016-07-01
影响因子：
5.1
通讯作者：
Mohan, Viswanathan
中科院分区：
文献类型：
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作者：
Bhavadharini, Balaji;Anjana, Ranjit Mohan;Mohan, Viswanathan
目的：为了确定产后葡萄糖耐量状态的妇女与妊娠期糖尿病（GDM）招募下的妇女在印度与GDM战略（WINGS）模式的护理（MOC）：方法：通过WINGS MOC程序，212名妇女与GDM随访，直到2013年11月和2015年8月之间分娩。建议所有妇女在分娩后6-12周返回进行产后口服葡萄糖耐量试验（OGTT）。结果：203/212例（95.8%）妇女完成了产后OGTT，其中203/212例（95.8%）妇女完成了产后OGTT。在161名（79.3%）在6至12周之间返回进行测试的女性中，2名（1.2%）发展为DM，5名（3.1%）发展为单纯IFG，13名（8.1%）发展为单纯IGT，5名（3.1%）发展为IFG/IGT联合[糖尿病25名（15.5%）]。136例（84.5%）恢复正常糖耐量（NGT）。在12周至1年之间返回的42名妇女中，5名（11.9%）发展为DM，10名（23.8%）为孤立性IFG，1名（2.4%）为IFG/IGT联合[16名（38.1%）患有糖尿病]。26/42例女性（61.9%）恢复NGT。因此，41/203名女性（20.2%）发生了总体功能障碍。MLR显示BMI >= 25 kg/m2与产后发育不良显著相关（优势比：4.47; 95%可信区间：1.8-11.2，p = 0.001）。结论：在亚洲印度GDM妇女中，超过20%在产后一年内发生发育不良，BMI >= 25 kg/m2使这种风险增加4倍。早期产后筛查可以识别高风险女性，并帮助计划未来预防2型糖尿病的策略。(C)2016作者（S）出版社：Elsevier爱尔兰Ltd.
Aim: To determine postpartum glucose tolerance status among women with gestational diabetes mellitus (GDM) recruited under the Women In India with GDM Strategy (WINGS) Model of Care (MOC).Methods: Through the WINGS MOC programme, 212 women with GDM were followed till delivery between November 2013 and August 2015. All women were advised to return for a postpartum oral glucose tolerance test (OGTT) 6-12 weeks after delivery. A multivariate logistic regression (MLR) model was developed to identify the risk factors for postpartum dysglycemia which was defined as presence of diabetes (DM) or prediabetes.Results: 203/212(95.8%) women completed their postpartum OGTT. Of the 161 women (79.3%) who came back for the test between 6 and 12 weeks, 2(1.2%) developed DM, 5 (3.1%), isolated IFG, 13(8.1%), isolated IGT and 5(3.1%) combined IFG/IGT [dysglycemia 25 (15.5%)]. 136 women (84.5%) reverted to normal glucose tolerance (NGT). Of the 42 women who came back between 12 weeks and a year, 5(11.9%) developed DM, 10(23.8%), isolated IFG and 1(2.4%) combined IFG/IGT [dysglycemia 16(38.1%)]. 26/42 women (61.9%) reverted to NGT. Thus overall dysglycemia occurred in 41/203 women (20.2%). MLR showed that BMI >= 25 kg/m(2) was significantly associated with postpartum dysglycemia (odds ratio: 4.47; 95% confidence interval: 1.8-11.2, p = 0.001).Conclusion: Among Asian Indian women with GDM, over 20% develop dysglycemia within one year postpartum, and BMI >= 25 kg/m(2) increased this risk four-fold. Early postpartum screening can identify high risk women and help plan strategies for prevention of type 2 diabetes in the future. (C) 2016 The Author(s). Published by Elsevier Ireland Ltd.