Flat Oral Glucose Tolerance Test during Pregnancy and Risk for Type 2 Diabetes: A 5-Year Cohort Study.

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

American journal of perinatology Pub Date : 2024-12-24 DOI:10.1055/a-2490-3183

Danit Tarashandegan, Amir Naeh, Mordechai Hallak, Yoel Toledano, Rinat Gabbay-Benziv, Esther Maor-Sagie

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引用次数: 0

Abstract

Objective: This study aimed to evaluate the risk of type 2 diabetes mellitus (T2DM) in women with flat response in the 100-g oral glucose tolerance test (OGTT) performed during pregnancy in a large cohort of women with up to 5 years of follow-up.

Study design: A retrospective analysis of women with documented OGTT during pregnancy and T2DM data up to 5 years after pregnancy. Gestational diabetes mellitus (GDM) screening was done by a two-step strategy. Glucose levels during pregnancy were extracted from the computerized laboratory system of Meuhedet Health Maintenance Organization (HMO) and cross-tabulated with the Israeli National Diabetes Registry. Flat OGTT was defined as fasting glucose <95 mg/dl and three postprandial values lower than 100 mg/dl. The cohort was stratified by OGTT results to normal glucose values, flat OGTT, and GDM according to Carpenter and Coustan thresholds. Cumulative risk for T2DM was evaluated and compared between groups. Statistical analysis included univariate analysis followed by survival analysis.

Results: A total of 14,122 parturients entered the analysis. Of them, 965 (6.8%) had flat OGTT, 11,427 (80.9%) had normal OGTT, and 1,730 (12.3%) had GDM. Women with flat OGTT were younger, had lower body mass index (BMI; kg/m²), and had lower rates of hypertension. Their glucose values throughout pregnancy were lower compared with the other groups (p < 0.001 for all). During the study period and following adjustment to maternal age, obesity, and hypertension, women with flat OGTT had a low incidence of T2DM, even when compared with women with normal OGTT (adjusted hazard ratio 0.212, 95% confidence interval 0.052-0.856).

Conclusion: Parturients with flat OGTT during pregnancy are at a low risk of developing T2DM up to 5 years following pregnancy.

Key points: · Women with flat OGTT are younger, with lower BMI and lower hypertension rates.. · During pregnancy, glucose levels were lower in flat OGTT women than in normal OGTT or GDM.. · Postpartum women with flat OGTT had lower risk of developing type 2 diabetes over 5 years..

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妊娠期口服糖耐量试验与2型糖尿病风险的关系——一项为期五年的队列研究

目的：通过长达5年的随访，评估妊娠期100克口服葡萄糖耐量试验（OGTT）反应平缓的女性患2型糖尿病（T2DM）的风险。研究设计：回顾性分析妊娠期间有OGTT记录的妇女和妊娠5年后有T2DM数据的妇女。妊娠期糖尿病（GDM）筛查采用两步策略。妊娠期间的血糖水平从Meuhedet HMO的计算机实验室系统中提取，并与以色列国家糖尿病登记处交叉制表。低OGTT定义为空腹血糖< 95mg/dl，餐后3次低于100mg/dl。根据Carpenter & Coustan阈值，根据OGTT结果对该队列进行分层，分为正常血糖值、平坦OGTT和GDM。评估两组间T2DM累积风险并进行比较。统计分析包括单变量分析和生存分析。结果：14122例产妇进入分析。其中965例（6.8%）OGTT正常，11427例（80.9%）OGTT正常，1730例（12.3%）GDM。OGTT持平的女性更年轻，BMI更低，高血压发病率也更低。与其他组相比，她们在整个妊娠期间的血糖值较低(结论：妊娠期间OGTT水平较低的孕妇妊娠后5年内发生2型糖尿病的风险较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of perinatology 医学-妇产科学

CiteScore

5.90

自引率

0.00%

发文量

302

审稿时长

4-8 weeks

期刊介绍： The American Journal of Perinatology is an international, peer-reviewed, and indexed journal publishing 14 issues a year dealing with original research and topical reviews. It is the definitive forum for specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine, with emphasis on bridging the different fields. The focus is primarily on clinical and translational research, clinical and technical advances in diagnosis, monitoring, and treatment as well as evidence-based reviews. Topics of interest include epidemiology, diagnosis, prevention, and management of maternal, fetal, and neonatal diseases. Manuscripts on new technology, NICU set-ups, and nursing topics are published to provide a broad survey of important issues in this field. All articles undergo rigorous peer review, with web-based submission, expedited turn-around, and availability of electronic publication. The American Journal of Perinatology is accompanied by AJP Reports - an Open Access journal for case reports in neonatology and maternal/fetal medicine.