Volume 6 Supplement 4
ATLANTIC DIP: The prevalence of pre-diabetes/type 2 diabetes in an Irish population with gestational diabetes mellitus 1-5 years post index pregnancy
© Crowe et al; licensee BioMed Central Ltd. 2012
Published: 9 July 2012
The ATLANTIC-DIP (diabetes in pregnancy) programme showed 18% of women with gestational diabetes mellitus (GDM) screened with a 75g oral glucose tolerance test (OGTT) 12 weeks post-partum demonstrated glucose intolerance. However, long-term data on progression to type 2 diabetes (T2DM) post gestational diabetes (GDM) in an Irish population is lacking.
We compared Caucasian women with previous GDM (n=116), and with normal glucose tolerance (NGT) during pregnancy (n=52), using a 75g OGTT, to determine prevalence of diabetes/pre-diabetes 1-5 years post index pregnancy. Women with abnormal OGTT 12 weeks post-partum (n=22: IFG/IGT, n=20, DM, n=2) did not undergo OGTT, but were included in the analysis. American Diabetes Association diagnostic criteria for IFG/IGT/DM were used.
Twelve percent (11/94) of GDM patients rescreened had pre-diabetes/DM (IFG/IGT, n=10, DM, n=1), giving a prevalence of 28.4% (33/116) for pre-diabetes/diabetes, versus 2% (1/52) of women with NGT during pregnancy. Logistic regression analysis was used to determine index pregnancy factors associated with post–partum pre-diabetes/diabetes. These were: first-degree relative with DM (OR 2.8 95% CI 1.0,7.4, p=0.04), insulin use during pregnancy (OR 3.4, 95% CI 1.2,9.6, p=0.01), fasting glucose during pregnancy (OR for glucose ≥ 5.6mmol/L: 4.5 95% CI 1.4, 14.2, p= 0.01). and not breastfeeding (OR 3.2 95% CI 1.2, 9.1, p=0.02). BMI in pregnancy was not associated with pre-diabetes/diabetes at 1-5 years.
The high prevalence of diabetes/pre-diabetes in this population offers an opportunity to develop a screening program to benefit at risk individuals, particularly targeting those with insulin-requiring GDM, higher fasting glucose levels and positive family history.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.