Antenatal oral glucose tolerance test abnormalities in the prediction of future risk of postpartum diabetes in women with gestational diabetes: Results from the LIVING study.

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  • Additional Information
    • Source:
      Publisher: Blackwell Publishing Asia Country of Publication: Australia NLM ID: 101504326 Publication Model: Print Cited Medium: Internet ISSN: 1753-0407 (Electronic) Linking ISSN: 17530407 NLM ISO Abbreviation: J Diabetes Subsets: MEDLINE
    • Publication Information:
      Original Publication: Richmond, Vic. : Blackwell Publishing Asia, 2009-
    • Subject Terms:
      Diabetes, Gestational*/epidemiology ; Diabetes, Gestational*/diagnosis ; Diabetes, Gestational*/blood ; Glucose Tolerance Test* ; Blood Glucose*/analysis ; Blood Glucose*/metabolism ; Postpartum Period*; Humans ; Female ; Pregnancy ; Adult ; Risk Factors ; Incidence ; Sri Lanka/epidemiology ; India/epidemiology ; Bangladesh/epidemiology ; Prognosis ; Follow-Up Studies
    • Abstract:
      Objectives: To explore associations between type and number of abnormal glucose values on antenatal oral glucose tolerance test (OGTT) with postpartum diabetes in South Asian women diagnosed with gestational diabetes (GDM) using International Association of the Diabetes and Pregnancy Study Groups criteria.
      Methods: This post-hoc evaluation of the Lifestyle Intervention IN Gestational Diabetes (LIVING) study, a randomized controlled trial, was conducted among women with GDM in the index pregnancy, across 19 centers in Bangladesh, India, and Sri Lanka. Postpartum diabetes (outcome) was defined on OGTT, using American Diabetes Association (ADA) criteria.
      Results: We report data on 1468 women with GDM, aged 30.9 (5.0) years, and with median (interquartile range) follow-up period of 1.8 (1.4-2.4) years after childbirth following the index pregnancy. We found diabetes in 213 (14.5%) women with an incidence of 8.7 (7.6-10.0)/100 women-years. The lowest incidence rate was 3.8/100 women years, in those with an isolated fasting plasma glucose (FPG) abnormality, and highest was 19.0/100 women years in participants with three abnormal values. The adjusted hazard ratios for two and three abnormal values compared to one abnormal value were 1.73 (95% confidence interval [CI], 1.18-2.54; p = .005) and 3.56 (95% CI, 2.46-5.16; p < .001) respectively. The adjusted hazard ratio for the combined (combination of fasting and postglucose load) abnormalities was 2.61 (95% CI, 1.70-4.00; p < .001), compared to isolated abnormal FPG.
      Conclusions: Risk of diabetes varied significantly depending upon the type and number of abnormal values on antenatal OGTT. These data may inform future precision medicine approaches such as risk prediction models in identifying women at higher risk and may guide future targeted interventions.
      (© 2024 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.)
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    • Grant Information:
      Global Alliance for Chronic Disease; 1093171 National Health and Medical Research Council of Australia; USV Pharmaceuticals Ltd; Lupin Pharmaceuticals Ltd; Global Alliance for Chronic Disease grants from the Indian Council of Medical Research
    • Contributed Indexing:
      Keywords: South Asia; antenatal OGTT; gestational diabetes mellitus; postpartum; risk prediction; type 2 diabetes mellitus
    • Accession Number:
      0 (Blood Glucose)
    • Publication Date:
      Date Created: 20240506 Date Completed: 20240506 Latest Revision: 20240605
    • Publication Date:
      20240606
    • Accession Number:
      PMC11070840
    • Accession Number:
      10.1111/1753-0407.13559
    • Accession Number:
      38708437