Early Postpartum Diabetes Screening for Women With Gestational Diabetes Mellitus

2014 ◽  
Vol 123 ◽  
pp. 82S ◽  
Author(s):  
Erika F. Werner ◽  
Gofran Tarabulsi ◽  
Christina Han ◽  
Andrew Satin
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diabetes Screening ◽  
Early Postpartum ◽  
Postpartum Diabetes

scholarly journals Postpartum glucose tolerance status 6 to 12 weeks after gestational diabetes mellitus: a Brazilian cohort

2014 ◽  
Vol 58 (2) ◽  
pp. 197-204 ◽  
Author(s):  
Letícia Schwerz Weinert ◽  
Livia Silveira Mastella ◽  
Maria Lúcia Rocha Oppermann ◽  
Sandra Pinho Silveiro ◽  
Luciano Santos Pinto Guimarães ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Family History ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Oral Glucose ◽  
Diabetes Screening ◽  
Family History Of Diabetes ◽  
History Of ◽  
Postpartum Diabetes

Objectives: The aims of this study were to estimate the local rate of postpartum diabetes screening after gestational diabetes mellitus (GDM) pregnancies, and to identify clinical variables associated with retesting rates and with the persistence of decreased glucose tolerance. Subjects and methods: Prospective cohort of GDM women with prenatal delivery at a specialized center, from November 2009 to May 2012. All women were advised to schedule a 6 weeks postpartum 75-g oral glucose tolerance test (OGTT). Results: Of the 209 women included, 108 (51.7%) returned to be tested with fasting plasma glucose (n = 14), OGTT (n = 93) or random glucose (n = 1). Return was associated with lower parity rate (2 vs. 3, p < 0.001) and higher pregnancy 2-h OGTT (165 vs. 155 mg/dL, p = 0.034), but not with socio-demographic characteristics. Four women (3.7%) had diabetes, 22 (20.4%) had impaired fasting glucose or impaired glucose tolerance. Persistent hyperglycemia was associated with a positive family history of diabetes (relative risk - RR 2.41, p = 0.050), diagnostic 2-h OGTT in pregnancy (RR 1.01, p = 0.045), insulin use during pregnancy (RR 2.37, p = 0.014), and cesarean section (RR 2.61, p = 0.015). Conclusions: Even though postpartum abnormalities were frequent in GDM, rates of postpartum diabetes screening were undesirably low. As no specific clinical profile defines who will adhere to postpartum testing, it is essential to encourage all women to reevaluate their glucose status, particularly those with a family history of diabetes and more severe hyperglycemia. Arq Bras Endocrinol Metab. 2014;58(2):197-204

A physician reminder to improve postpartum diabetes screening in women with gestational diabetes mellitus

2012 ◽  
Vol 95 (3) ◽  
pp. 352-357 ◽  
Author(s):  
Iliana C. Lega ◽  
Heather McLaughlin ◽  
Marie Coroneos ◽  
Frances Handley-Derry ◽  
Nicola Donovan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diabetes Screening ◽  
Postpartum Diabetes

scholarly journals Relationship between Gestational Diabetes Mellitus and Type 2 Diabetes: Evidence of Mitochondrial Dysfunction

2007 ◽  
Vol 53 (3) ◽  
pp. 377-383 ◽  
Author(s):  
Rob NM Weijers ◽  
Dick J Bekedam
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Glucose Concentration ◽  
C Peptide ◽  
Early Postpartum ◽  
Postpartum Diabetes

Abstract Background: We examined the pathogenesis of gestational diabetes mellitus (GDM) in a large Dutch multiethnic cohort. Methods: We used a 2-step testing procedure to stratify 2031 consecutive pregnant women into 4 groups according to American Diabetes Association criteria: (a) normal glucose tolerance (NGT), (b) mild gestational hyperglycemia (MGH), (c) GDM without early postpartum diabetes within 6 months of delivery (GDM1), and (d) GDM with early postpartum diabetes (GDM2). Antepartum and postpartum clinical characteristics and measures of glucose tolerance were documented. Results: Overall, 1627 women had NGT, 237 had MGH, 156 had GDM1, and 11 had GDM2. Prepregnancy body mass index values progressively increased from NGT to MGH to GDM1. The fasting plasma glucose concentration, the 100-g oral glucose tolerance test (OGTT) area under the curve, and the mean glucose concentration during the OGTT all increased progressively among the 4 groups. The fasting C-peptide concentration displayed an inverted-U pattern, with a maximum at a mean plasma glucose concentration during the OGTT of 9.6 mmol/L in the transition from GDM1 to GDM2. The fasting C-peptide/glucose concentration ratio decreased by 42% in GDM patients compared with NGT patients, whereas the ratios in MGH and NGT women were similar. Conclusions: Progressive metabolic derangement of glucose tolerance 1st detected during pregnancy mimics the pathogenesis of type 2 diabetes. In addition, our results imply an impaired basal glucose effectiveness in the early prediabetic state. To explain the parallel in both metabolic derangements, we postulate that GDM, like type 2 diabetes, is attributable to the same inherited mitochondrial dysfunction.

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