Glucose intolerance in early postpartum in women with gestational diabetes: Who is at increased risk?

Leuridan, Liesbeth; Wens, Johan; Devlieger, Roland; Verhaeghe, Johan; Mathieu, Chantal; Benhalima, Katrien

doi:10.1016/j.pcd.2015.03.007

Cited by 30 publications

(24 citation statements)

References 49 publications

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“…Maternal age, prepregnancy weight, early GDM diagnosis, pharmaceutical treatment during pregnancy, and the FPG on the diagnostic OGTT during pregnancy often emerge as important risk factors for glucose intolerance postpartum [17, 40, 41]. This is in line with our data showing that women with a higher age, BMI, and waist circumference had the highest risk for glucose intolerance postpartum.…”

Section: Discussionsupporting

confidence: 90%

“…The most important risk factors to develop glucose intolerance in early postpartum differ according to the populations studied [40]. Maternal age, prepregnancy weight, early GDM diagnosis, pharmaceutical treatment during pregnancy, and the FPG on the diagnostic OGTT during pregnancy often emerge as important risk factors for glucose intolerance postpartum [17, 40, 41].…”

Section: Discussionmentioning

confidence: 99%

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Implementing a Reminder System in the Northern Part of Belgium to Stimulate Postpartum Screening for Glucose Intolerance in Women with Gestational Diabetes: The “Sweet Pregnancy” Project

Benhalima

Verstraete²,

Muylle³

et al. 2017

International Journal of Endocrinology

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Aims To evaluate the feasibility and efficacy of a gestational diabetes (GDM) recall register on the long-term screening uptake postpartum and to evaluate the prevalence of prediabetes postpartum. Methods Evaluation of a GDM recall register implemented in 66 obstetrical centers in the northern part of Belgium from 2009 to 2016. Registrants receive yearly reminders to have a fasting plasma glucose test in primary care to timely detect prediabetes. Results After 6 years, 7269 women were registered. The yearly response rates varied from 74.4% after the first year to 61.8% after the fifth year. The number of women who reported a screening test varied from 67.4% after the first year to 71.9% after the fifth year. Compared to women who responded at least once to a reminder, women who never responded were more often <30 years (41.4% versus 33.9%, p < 0.001) and were more often obese (29.3% versus 20.8%, p ≤ 0.001). Over a period of 6 years, 7.3% (CI 6.0%–8.8%) developed diabetes and 27.4% (CI 23.9%–31.0%) developed impaired fasting glycaemia. Conclusion We show now the long-term feasibility and efficacy of a GDM recall register to stimulate screening postpartum. One-third of women developed prediabetes within 6 years.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Implementing a Reminder System in the Northern Part of Belgium to Stimulate Postpartum Screening for Glucose Intolerance in Women with Gestational Diabetes: The “Sweet Pregnancy” Project

Benhalima

Verstraete²,

Muylle³

et al. 2017

International Journal of Endocrinology

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“…It is concerning that abnormal glucose homeostasis persisted in one‐third of the study participants diagnosed with true GDM; among these 49 patients, pre‐diabetes was recorded in 11 (23%) patients and diabetes was recorded in 6 (12%). Previous studies have evaluated the glucose status of women with GDM at different time intervals postpartum, but few have reported early (6–12 weeks) postpartum assessment …”

Section: Discussionmentioning

confidence: 99%

“…Elevated FPG is a robust, independent predictor of long‐term maternal diabetes risk . HbA1c has various limitations in pregnancy but, in both mid‐trimester and late pregnancy, it has been shown to predict diabetes after GDM …”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have evaluated the glucose status of women with GDM at different time intervals postpartum, but few have reported early (6-12 weeks) postpartum assessment. 12,13 In a retrospective audit of women with GDM in Soweto, South Africa, 14 a diabetes persistence of 20.3% was documented at 6 weeks postpartum. Elsewhere in Sub-Saharan Africa, data on diabetes after GDM are limited to a single study from Nigeria, 15 where abnormal glucose values were noted in a small number of women (3/200) 6 weeks after delivery.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence and predictive factors of early postpartum diabetes among women with gestational diabetes in a single‐center cohort

Coetzee

Mason

Hall

et al. 2018

Intl J Gynecology & Obste

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Models Predicting Postpartum Glucose Intolerance Among Women with a History of Gestational Diabetes Mellitus: a Systematic Review

Belsti¹,

Moran²,

Handiso³

et al. 2023

Curr Diab Rep

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Purpose of Review Despite the crucial role that prediction models play in guiding early risk stratification and timely intervention to prevent type 2 diabetes after gestational diabetes mellitus (GDM), their use is not widespread in clinical practice. The purpose of this review is to examine the methodological characteristics and quality of existing prognostic models predicting postpartum glucose intolerance following GDM. Recent Findings. A systematic review was conducted on relevant risk prediction models, resulting in 15 eligible publications from research groups in various countries. Our review found that traditional statistical models were more common than machine learning models, and only two were assessed to have a low risk of bias. Seven were internally validated, but none were externally validated. Model discrimination and calibration were done in 13 and four studies, respectively. Various predictors were identified, including body mass index, fasting glucose concentration during pregnancy, maternal age, family history of diabetes, biochemical variables, oral glucose tolerance test, use of insulin in pregnancy, postnatal fasting glucose level, genetic risk factors, hemoglobin A1c, and weight. Summary The existing prognostic models for glucose intolerance following GDM have various methodological shortcomings, with only a few models being assessed to have low risk of bias and validated internally. Future research should prioritize the development of robust, high-quality risk prediction models that follow appropriate guidelines, in order to advance this area and improve early risk stratification and intervention for glucose intolerance and type 2 diabetes among women who have had GDM.

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Glucose intolerance in early postpartum in women with gestational diabetes: Who is at increased risk?

Cited by 30 publications

References 49 publications

Implementing a Reminder System in the Northern Part of Belgium to Stimulate Postpartum Screening for Glucose Intolerance in Women with Gestational Diabetes: The “Sweet Pregnancy” Project

Implementing a Reminder System in the Northern Part of Belgium to Stimulate Postpartum Screening for Glucose Intolerance in Women with Gestational Diabetes: The “Sweet Pregnancy” Project

Prevalence and predictive factors of early postpartum diabetes among women with gestational diabetes in a single‐center cohort

Models Predicting Postpartum Glucose Intolerance Among Women with a History of Gestational Diabetes Mellitus: a Systematic Review

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