Premium
Nomograms for incident risk of post‐partum type 2 diabetes in Chinese women with prior gestational diabetes mellitus
Author(s) -
Li Weiqin,
Leng Junhong,
Liu Huikun,
Zhang Shuang,
Wang Leishen,
Hu Gang,
Mi Jie
Publication year - 2019
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.13863
Subject(s) - medicine , gestational diabetes , nomogram , obstetrics , hazard ratio , pregnancy , type 2 diabetes , proportional hazards model , multivariate analysis , diabetes mellitus , gynecology , gestation , confidence interval , endocrinology , genetics , biology
Summary Objective Counselling patients with gestational diabetes mellitus (GDM) on their individual risk of post‐partum type 2 diabetes (T2D) is challenging. This study aimed to develop nomograms for predicting incident risk of post‐partum T2D in women with GDM diagnosed by WHO 1998 criteria. Methods We performed a retrospective cohort study in 1263 Chinese women with GDM, of whom 83 were diagnosed as T2D at 2.3 years post‐partum. Multivariate Cox proportional hazards models were used to investigate the independent predictors for post‐partum T2D. The results of multivariate analyses were used to formulate nomograms for predicting incident risk of post‐partum T2D. The predictive accuracy was evaluated using the area under the receiver operating characteristic curve (AUROC). Results On multivariate analysis, independent predictors of post‐partum T2DM in women with GDM included family history of diabetes [hazard ratio (HR) and its 95% confidential interval (95% CI): 2.06 (95% CI: 1.32‐3.22)], history of pregnancy‐induced hypertension [3.11 (95% CI: 1.86‐5.21)], pre‐pregnancy BMI [1.00, 1.90 (95% CI: 1.14‐3.16), and 3.67 (95% CI: 2.03‐6.63) for BMI <24, 24‐28, and ≥28 kg/m 2 ], and 2‐hour glucose at 26‐30 gestational weeks [1.00, 2.84 (95% CI: 1.42‐5.69), and 9.42 (95% CI: 4.46‐19.90) for 2‐hour glucose at 7.8 ~ <8.5, 8.5 ~ <11.1, and ≥11.1 mmol/L). The overall AUROC of nomogram was 82.8% (95% CI: 78.1%‐87.5%), with AUROCs of 85.9% (95% CI: 79.7%‐92.1%) and 83.2% (95% CI: 77.9%‐88.6%) for post‐partum 2‐year and 3‐year risk of T2D, respectively. Conclusions This easy‐to‐use nomogram, with non‐invasive clinical characteristics, can accurately predict the risk of post‐partum T2D in women with GDM. It may facilitate risk communication between patients and clinicians.