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Aims/Introduction  Gestational diabetes mellitus ( GDM ) is a risk for adverse perinatal outcomes, and patients with a history of  GDM  have an increased risk of impaired glucose tolerance ( IGT ). Here, we carried out two non‐interventional and retrospective studies of  GDM  patients in Japan.    Materials and Methods  In the first study, we enrolled 529  GDM  patients and assessed predictors of the need for insulin therapy. In the second study, we enrolled 185 patients from the first study, and assessed predictors of postpartum  IGT .    Results  In the first study, gestational weeks at  GDM  diagnosis and history of pregnancy were significantly lower, and pregestational body mass index, family history of diabetes mellitus, 1‐ and 2‐h glucose levels in a 75‐g oral glucose tolerance test ( OGTT ), the number of abnormal values in a 75‐g  OGTT , and glycated hemoglobin were significantly higher in participants receiving insulin therapy. In the second study, 1‐ and 2‐h glucose levels in a 75‐g  OGTT , the number of abnormal values in a 75‐g  OGTT , glycated hemoglobin, and ketone bodies in a urine test were significantly higher in participants with  OGT . Logistic regression analysis showed that gestational weeks at  GDM  diagnosis, 1‐h glucose levels in a 75‐g  OGTT  and glycated hemoglobin were significant predictors of the need for insulin therapy, and 1‐h glucose levels in a 75‐g  OGTT  at diagnosis and ketone bodies in a urine test were significant predictors for postpartum  IGT .    Conclusions  Antepartum 1‐h glucose levels in a 75‐g  OGTT  was a predictor of the need for insulin therapy in pregnancy and postpartum  IGT .

journal of diabetes investigation

One‐hour oral glucose tolerance test plasma glucose at gestational diabetes diagnosis is a common predictor of the need for insulin therapy in pregnancy and postpartum impaired glucose tolerance