عوامل پيشگويي كننده ديابت پس از بارداري در زنان با سابقه ديابت بارداري

THE PREDICTIVE FACTORS FOR POSTPARTUM DIABETES MELLITUS AFTER GESTATIONAL DIABETES

Background: Women with gestational diabetes mellitus (GDM) have a reported 3% to 65% risk of developing type 2 diabetes. This study aims to identify the factors in GDM patients which can predict the risk of postpartum impaired glucose tolerance (T2DM+IGT) and T2DM. Methods: A cohort study was conducted on 2416 pregnant women referred to five university hospital clinics. The universal screening was performed with a GCT- 50g and those with plasma glucose level 130mg/dI, were diagnosed as GDM if they had an impaired GTT-100g based on Carpenter and Coustan criteria. All pregnancies were followed until delivery. Available GDM patients underwent an OGTT-75gr within 6 to 12 weeks after delivery. Postpartum diabetes mellitus was diagnosed according to ADA criteria. Results: Such factors as FBS>105 during pregnancy, insulin requirement during pregnancy and BMI_>27kg/m2 before pregnancy were more prevalent in postpartum diabetic patients as compared with normal controls, significantly. Multivariate analysis suggested that gestational requirement for insulin and BMI>27kg/m^2 were the best predictors for developing postpartum diabetes. Also history of abortion, gestational requirement for insulin and BMI>27kg/m^2 were the best predictors for postpartum IGT. Conclusion: Women with GDM have a substantially increased risk of developing postpartum IGT or diabetes. High glucose levels, insulin requirement during pregnancy, history of abortion and BMI>27kg/m^2 are the best predictors for postpartum diabetes and IGT.