One‐hour oral glucose tolerance test plasma glucose at gestational diabetes diagnosis is a common predictor of the need for insulin therapy in pregnancy and postpartum impaired glucose tolerance

Aims/Introduction Gestational diabetes mellitus (GDM) is a risk for adverse perinatal outcomes, and patients with a history of GDM have an increased risk of impaired glucose tolerance (IGT). Here, we carried out two non‐interventional and retrospective studies of GDM patients in Japan. Materials and...

Full description

Saved in:

Bibliographic Details
Published in:	Journal of diabetes investigation Vol. 9; no. 6; pp. 1370 - 1377
Main Authors:	Nishikawa, Takeshi, Ono, Keiko, Hashimoto, Shoko, Kinoshita, Hiroyuki, Watanabe, Takuro, Araki, Hirotaka, Otsu, Kae, Sakamoto, Wakana, Harada, Masahiro, Toyonaga, Tetsushi, Kawakami, Shoichi, Fukuda, Jyunichiro, Haga, Yoshio, Kukidome, Daisuke, Takahashi, Takeshi, Araki, Eiich
Format:	Journal Article
Language:	English
Published:	Japan John Wiley & Sons, Inc 01-11-2018 John Wiley and Sons Inc
Subjects:	Adult Blood Glucose - analysis Body mass index Diabetes Diabetes mellitus Diabetes, Gestational - diagnosis Diabetes, Gestational - drug therapy Diagnosis Female Gestational Age Gestational diabetes Glucose Glucose Intolerance - complications Glucose Intolerance - diagnosis Glucose Intolerance - drug therapy Glucose tolerance Glucose Tolerance Test - methods Hemoglobin Humans Hypoglycemic Agents - therapeutic use Insulin Insulin - therapeutic use Japan Ketones Original Postpartum Postpartum Period Pregnancy Retrospective Studies Risk Factors Urine Japan Glucose tolerance Insulin Gestational diabetes
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Aims/Introduction Gestational diabetes mellitus (GDM) is a risk for adverse perinatal outcomes, and patients with a history of GDM have an increased risk of impaired glucose tolerance (IGT). Here, we carried out two non‐interventional and retrospective studies of GDM patients in Japan. Materials and Methods In the first study, we enrolled 529 GDM patients and assessed predictors of the need for insulin therapy. In the second study, we enrolled 185 patients from the first study, and assessed predictors of postpartum IGT. Results In the first study, gestational weeks at GDM diagnosis and history of pregnancy were significantly lower, and pregestational body mass index, family history of diabetes mellitus, 1‐ and 2‐h glucose levels in a 75‐g oral glucose tolerance test (OGTT), the number of abnormal values in a 75‐g OGTT, and glycated hemoglobin were significantly higher in participants receiving insulin therapy. In the second study, 1‐ and 2‐h glucose levels in a 75‐g OGTT, the number of abnormal values in a 75‐g OGTT, glycated hemoglobin, and ketone bodies in a urine test were significantly higher in participants with OGT. Logistic regression analysis showed that gestational weeks at GDM diagnosis, 1‐h glucose levels in a 75‐g OGTT and glycated hemoglobin were significant predictors of the need for insulin therapy, and 1‐h glucose levels in a 75‐g OGTT at diagnosis and ketone bodies in a urine test were significant predictors for postpartum IGT. Conclusions Antepartum 1‐h glucose levels in a 75‐g OGTT was a predictor of the need for insulin therapy in pregnancy and postpartum IGT. We performed two non‐interventional and retrospective studies of GDM patients in Japan to assess predictors of the need for insulin therapy in pregnancy, and predictors of postpartum impaired glucose tolerance. Gestational weeks at GDM diagnosis, plasma glucose levels in a 75 g OGTT at 1 hour, and HbA1c were significant predictors of the need for insulin therapy, and 1‐hour glucose levels in a 75 g OGTT at diagnosis and ketone bodies in a urine test were significant predictors for impaired glucose tolerance during the 6‐to‐12‐weeks postpartum period. In particular, antepartum 1‐hour glucose levels in a 75 g OGTT was a predictor of both the need for insulin therapy in pregnancy and postpartum impaired glucose tolerance.
ISSN:	2040-1116 2040-1124
DOI:	10.1111/jdi.12848