Glucose tolerance status of Asian Indian women with gestational diabetes at 6 weeks to 1 year postpartum (WINGS-7). (July 2016)

• Record Type: Journal Article
• Authors: Bhavadharini, Balaji; Anjana, Ranjit Mohan; Mahalakshmi, Manni Mohanraj; Maheswari, Kumar; Kayal, Arivudainambi; Unnikrishnan, Ranjit; Ranjani, Harish; Ninov, Lyudmil; Pastakia, Sonak D.; Usha, Sriram; Malanda, Belma; Belton, Anne; Uma, Ram; Mohan, Viswanathan
• Is Part Of: Diabetes research and clinical practice. Volume 117(2016)
• Page Start: 22
• Page End: 27
• Publication Date: 2016-07
• Subjects: Gestational diabetes mellitus -- Post partum follow-up -- Dysglycemia -- IADPSG -- Asian Indians -- South Asians; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2016.04.050
• Languages: English
• ISSNs: 0168-8227

Abstract

Highlights: 203/212 (95.8%) women with GDM recruited under WINGS Model of Care completed their postpartum OGTT. 15.5% of women were detected to have dysglycemia by 12 weeks. 38.1% were detected to have dysglycemia between 12 weeks and 1 year of delivery. Overall 41/203 women (20%) developed dysglycemia within one year postpartum. This calls for improving postpartum follow-up testing of GDM women. Abstract: Aim: To determine postpartum glucose tolerance status among women with gestational diabetes mellitus (GDM) recruited under the Women In India with GDM Strategy (WINGS) Model of Care (MOC). Methods: Through the WINGS MOC programme, 212 women with GDM were followed till delivery between November 2013 and August 2015. All women were advised to return for a postpartum oral glucose tolerance test (OGTT) 6–12 weeks after delivery. A multivariate logistic regression (MLR) model was developed to identify the risk factors for postpartum dysglycemia which was defined as presence of diabetes (DM) or prediabetes. Results: 203/212(95.8%) women completed their postpartum OGTT. Of the 161 women (79.3%) who came back for the test between 6 and 12 weeks, 2(1.2%) developed DM, 5(3.1%), isolated IFG, 13(8.1%), isolated IGT and 5(3.1%) combined IFG/IGT [dysglycemia 25(15.5%)]. 136 women (84.5%) reverted to normal glucose tolerance (NGT). Of the 42 women who came back between 12 weeks and a year, 5(11.9%) developed DM, 10(23.8%), isolated IFG and 1(2.4%) combined IFG/IGT [dysglycemia 16(38.1%)]. 26/42 women (61.9%) reverted to NGT. Thus overall dysglycemia occurred in 41/203 women (20.2%). MLR showed that BMI ⩾25 kg/m 2 was significantly associated with postpartum dysglycemia (odds ratio: 4.47; 95% confidence interval: 1.8–11.2, p = 0.001). Conclusion: Among Asian Indian women with GDM, over 20% develop dysglycemia within one year postpartum, and BMI ⩾25 kg/m 2 increased this risk four-fold. Early postpartum screening can identify high risk women and help plan strategies for prevention of type 2 diabetes in the future.