DOES IMMEDIATE POSTPARTUM GLUCOSE SCREENING PREDICT DIABETES MELLITUS IN WOMEN

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 妊娠期糖尿病(GDM)约占妊娠总数的14%。它可能导致妊娠期间的严重发病率和死亡率，并增加在以后的生活中发展为糖尿病的风险。美国糖尿病协会(ADA)建议医生在产后6至8周进行两小时75克的口服葡萄糖耐量试验(OGTT)来诊断糖尿病。这在后勤上是困难的，因为患者产后随访的依从性很差，而且需要在75克葡萄糖负荷之前的空腹血糖水平。因此，许多女性没有得到诊断，可能会患上更严重的疾病。 这项研究将评估一种诊断产后糖尿病的替代策略。我们假设，立即进行OGTT将产生与产后6-8周进行的OGTT类似的结果。如果我们证明它们的血糖值相似，那么早期OGTT可能是一个可行的替代方案。由于患有妊娠期糖尿病的妇女将在出院前接受OGTT，我们假设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大的临床意义。我们假设OGTT将识别出比单独的空腹血糖水平更多的有糖尿病风险的女性，这将支持在临床实践中进行OGTT而不仅仅是空腹血糖水平。我们将描述妊娠期糖尿病妇女从产后即刻到产后6-8周期间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.