The Perinatal Risk Factors for the Development of Abnormal Glucose Metabolism in Women with a Prior History of Gestational Diabetes Mellitus
Background: Gestational Diabetes Mellitus (GDM) is defined as any degree of glucose intolerance diagnosed for the first time during pregnancy. Up to 60% of women who had a prior GDM will develop type II diabetes mellitus in the next 5 to 15 years after delivery. Our study aimed to examine perinatal factors associated with later development of impaired glucose metabolism in women with a recent history of GDM. Methods: We conducted a retrospective cohort study based on a 2-year follow-up of women with or without prior GDM. We recruited 39 women from the previous case-control study, including 19 women with prior GDM and 20 women without prior GDM. All the subjects were taken a 75-g oral glucose tolerance test (OGTT) and were interviewed with a questionnaire by research nurses. Chi-square tests were used to examine differences in proportions. Multiple log-linear regression models were used to determine whether there was an association between the prenatal potential risk factors and glucose metabolic abnormalities, after adjustment of various potential confounding variables. Results: Compared to women without a history of GDM, prior GDM women had significantly higher glucose and insulin concentration, increased insulin resistance and decreased β-cell function. Pre-pregnancy body mass index (BMI) and family history of diabetes were significantly reduced in early phase insulin responsiveness (IGI/HOMA-IR) and insulin secretion-sensitivity index (IS-SI) among women without prior GDM. Women’s parity was statistically significant decreased in Matsuda insulin sensitivity index (ISOGTT). Conclusion: Women with history of GDM have a significant higher risk of developing glucose metabolic abnormalities about two years after delivery. Pre-pregnancy BMI may have an association with later developing abnormal glucose metabolism in women without history of GDM.