Long term (>1year) postpartum glucose tolerance status among Indian women with history of Gestational Diabetes Mellitus (GDM) diagnosed by IADPSG criteria
Long term (>1year) postpartum glucose tolerance status among Indian women with history of Gestational Diabetes Mellitus (GDM) diagnosed by IADPSG criteria
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DOI：
10.1016/j.diabres.2018.05.027
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发表时间：
2018-08-01
影响因子：
5.1
通讯作者：
Tandon, Nikhil
中科院分区：
文献类型：
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作者：
Goyal, Alpesh;Gupta, Yashdeep;Tandon, Nikhil
目的：为了确定在北India.Methods的三级保健医院使用IADPSG标准诊断的GDM病史的女性中长期精神障碍的患病率及其危险因素：邀请了2012年至2016年诊断的GDM女性。社会人口统计学，人体测量学，医疗数据收集和75克OGTT与血清胰岛素估计，HbA 1c和空腹血脂在医院visit.Results：妇女（N = 267）进行了测试，在32.5（+/- 4.6）岁，并在中位数（q25-q75）的20（12-44）个月后的指数交付。根据ADA标准，在57.7%的患者中发现了功能障碍[糖尿病10.5%，前驱糖尿病47.2%]。心血管疾病的危险因素在这些妇女中明显更普遍。多变量分析显示HOMA-IR呈正相关，而胰岛素生成指数与产后dysplasia呈负相关。结论：这可能是首次对南亚妇女进行的长期（>1年）糖耐量结局研究，该研究以IADPSG标准诊断有GDM病史，表明产后dysplasia的风险显著升高。虽然IADPSG标准确定了与以前的标准相比未来转化为糖尿病的女性较低，但糖尿病前期转化仍然很高，从而提供了早期干预并预防未来糖尿病进展的机会。(C)2018爱思唯尔B. V.保留所有权利。
Aim: To determine prevalence of long term dysglycemia and its risk factors among women with history of GDM diagnosed using IADPSG criteria at a tertiary care hospital in North India.Methods: Women with GDM diagnosed between 2012 and 2016 were invited. Socio-demographic, anthropometric, medical data were collected and 75 gm OGTT with serum insulin estimation, HbA1c and fasting lipid profile were done at the hospital visit.Results: Women (N = 267) were tested at 32.5 (+/- 4.6) years of age and at a median (q25-q75) of 20 (12-44) months following the index delivery. Dysglycemia was found in 57.7% by ADA criteria [Diabetes in 10.5% and prediabetes in 47.2%]. Risk factors for cardiovascular disease were significantly more prevalent among these women. On multivariable analysis, HOMA-IR correlated positively, while insulinogenic index correlated negatively with postpartum dysglycemia.Conclusion: This is possibly the first long term (>1 year) glucose tolerance outcome study in South Asian women with history of GDM diagnosed by IADPSG criteria, which demonstrates significantly elevated risk of postpartum dysglycemia. While the IADPSG criteria identify women with a lower future conversion to diabetes compared with previous criteria, prediabetes conversion remains high, thereby offering an opportunity to intervene early and prevent progression to future diabetes. (C) 2018 Elsevier B.V. All rights reserved.