Open AccessOne‐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
Author(s) -
Nishikawa Takeshi,
Ono Keiko,
Hashimoto Shoko,
Kinoshita Hiroyuki,
Watanabe Takuro,
Araki Hirotaka,
Otsu Kae,
Sakamoto Wakana,
Harada Masahiro,
Toyonaga Tetsushi,
Kawakami Shoichi,
Fukuda Jyunichiro,
Haga Yoshio,
Kukidome Daisuke,
Takahashi Takeshi,
Araki Eiich
Publication year - 2018
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.12848
Subject(s) - medicine , gestational diabetes , impaired glucose tolerance , glycated hemoglobin , diabetes mellitus , glucose tolerance test , insulin , endocrinology , pregnancy , obstetrics , insulin resistance , gestation , type 2 diabetes , genetics , biology
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 .