DOES IMMEDIATE POSTPARTUM GLUCOSE SCREENING PREDICT DIABETES MELLITUS IN WOMEN

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 妊娠糖尿病（GDM）使大约14%的妊娠并发症。 妊娠期糖尿病可导致严重的发病率和死亡率，并增加日后患糖尿病的风险。 美国糖尿病协会（ADA）建议医生在产后6至8周进行2小时75克口服葡萄糖耐量试验（OGTT）来诊断糖尿病。 这在逻辑上是困难的，因为患者产后随访的依从性差，并且需要在75克葡萄糖负荷之前的空腹葡萄糖水平。 因此，许多妇女未被诊断，并可能发展为更严重的疾病。 本研究将评估一种诊断产后糖尿病的替代策略。 我们假设，立即OGTT将提供与产后6-8周进行的OGTT相当的结果。 如果我们证明他们有相似的血糖值，那么早期OGTT可能是一个可行的选择。 由于GDM妇女在出院前接受OGTT检查，我们推测这将增加产后检查的依从性，并可能通过改善这些妇女的糖尿病检测而具有重要的临床意义。 我们假设OGTT将比单独的空腹血糖水平识别更多的糖尿病风险女性，这将支持在临床实践中进行OGTT而不是仅空腹血糖水平。 我们将描述一个妊娠期糖尿病妇女亚组在产后即刻和产后6-8周之间葡萄糖代谢和体脂的变化。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Gestational diabetes mellitus (GDM) complicates approximately 14% of pregnancies. It can lead to significant morbidity and mortality during pregnancy and increases the risk for developing diabetes mellitus later in life. The American Diabetes Association (ADA) recommends that physicians diagnose diabetes using a two hour, 75 gram, oral glucose tolerance test (OGTT) done 6 to 8 weeks postpartum. This is logistically difficult due to the poor compliance with patient follow-up postpartum, and the need for a fasting glucose level prior to the 75 gram glucose load. As a result, many women are undiagnosed and may develop more advanced disease. This study will evaluate an alternative strategy for diagnosing diabetes mellitus postpartum. We hypothesize that an immediate OGTT will give comparable results to an OGTT performed 6-8 weeks postpartum. If we show that they have similar glucose values, then the early OGTT may be a feasible alternative. Since women with GDM would receive the OGTT prior to discharge from the hospital, we hypothesize that this would increase compliance with postpartum testing and could have significant clinical implications by improving the detection of diabetes mellitus in these women. We hypothesize that the OGTT will identify more women at risk of diabetes than the fasting plasma glucose level alone, which would support doing OGTT in clinical practice instead of a fasting glucose level only. We will characterize the changes in glucose metabolism, and body fat between the immediate postpartum period and 6-8 weeks postpartum in a subgroup of women with gestational diabetes.