Fasting and 2-hour plasma glucose, and HbA1c in pregnancy and the postpartum risk of diabetes among Chinese women with gestational diabetes. (February 2016)

• Record Type: Journal Article
• Authors: Liu, Huikun; Zhang, Shuang; Wang, Leishen; Leng, Junhong; Li, Weiqin; Li, Nan; Li, Min; Qiao, Yijuan; Tian, Huiguang; Tuomilehto, Jaakko; Yang, Xilin; Yu, Zhijie; Hu, Gang
• Is Part Of: Diabetes research and clinical practice. Volume 112(2016)
• Page Start: 30
• Page End: 36
• Publication Date: 2016-02
• Subjects: Fasting plasma glucose -- HbA1c -- Gestational diabetes -- Pregnancy -- Postpartum diabetes; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2015.11.007
• Languages: English
• ISSNs: 0168-8227

Abstract

Highlights: We assessed postpartum diabetes risk among women with prior gestational diabetes mellitus (GDM). 2 h glucose and HbA1c were positive predictors for postpartum diabetes. 2 h glucose and HbA1c predict diabetes risk, independent of fasting glucose. Abstract: Aims: Very few studies have assessed the association of fasting and 2 h glucose, and HbA1c during pregnancy with postpartum diabetes risk among women with prior gestational diabetes mellitus (GDM). We assessed the association of fasting glucose, 2 h glucose and HbA1c at 26–30 gestational weeks with postpartum diabetes risk among women with prior GDM. Methods: A cohort study in 1263 GDM women at 1–5 years after delivery was performed. Cox proportional hazards regression models were used to evaluate the association of fasting and 2 h plasma glucose, and HbA1c at 26–30 gestational weeks with the risk of diabetes at postpartum. Results: The multivariable-adjusted (age, pre-pregnancy body mass index, weight gain during pregnancy, current body mass index, family history of diabetes, marital status, education, family income, smoking status, passive smoking, leisure-time physical activity, alcohol drinking, and intake of energy, saturated fat, and dietary fiber) hazard ratios of postpartum diabetes were 1.61 (95% confidence interval [CI]: 1.36–1.91) for each 1 mmol/l increase in fasting glucose during pregnancy, 1.63 (95% CI: 1.45–1.84) for each 1 mmol/l increase in 2 h glucose during pregnancy, 2.11 (95% CI: 1.50–2.97) for each 1 unit (%) increase in HbA1c during pregnancy. When fasting glucose, 2 h glucose and HbA1c during pregnancy were entered multivariable-adjusted model simultaneously, 2 h glucose and HbA1c but not fasting glucose remained to be significant and positive predictors for postpartum diabetes. Conclusions: For women with prior GDM, 2 h plasma glucose and HbA1c during pregnancy are independent predictors of postpartum diabetes, but fasting plasma glucose during pregnancy is not.