Valérie Mievis, Caro Minschart, Nele Myngheer, Toon Maes, Christophe de Block, Niels Bochanen, Inge van Pottelbergh, Pascale Abrams, Wouter Vinck, Liesbeth Leuridan, Sabien Driessens, Jaak Billen, Christophe Matthys, Annouschka Laenen, Annick Bogaerts, Chantal Mathieu, Katrien Benhalima
{"title":"妊娠糖尿病前期妇女产后一年的体重潴留和葡萄糖不耐受症。","authors":"Valérie Mievis, Caro Minschart, Nele Myngheer, Toon Maes, Christophe de Block, Niels Bochanen, Inge van Pottelbergh, Pascale Abrams, Wouter Vinck, Liesbeth Leuridan, Sabien Driessens, Jaak Billen, Christophe Matthys, Annouschka Laenen, Annick Bogaerts, Chantal Mathieu, Katrien Benhalima","doi":"10.1111/dme.15400","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aims</h3>\n \n <p>To determine risk factors for 1-year postpartum weight retention (PPWR) and glucose intolerance (prediabetes + diabetes) in women with a previous history of gestational diabetes (GDM) and prediabetes in early postpartum.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>In this exploratory analysis of the MELINDA randomized controlled trial, we report data of 167 women with prediabetes at the 6–16 weeks (early) postpartum oral glucose tolerance test after a recent history of GDM.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Of all participants, 45% (75) had PPWR >0 kg at 1-year postpartum. Compared to women without PPWR, women with PPWR had higher gestational weight gain [10.5 ± 6.4 vs. 6.5 ± 4.5 kg, <i>p</i> < 0.001], higher BMI (<i>p</i> < 0.01) and a worse metabolic profile (higher waist circumference, worse lipid profile and more insulin resistance) (all <i>p</i> < 0.05) both in early and late postpartum. Of all women with PPWR, 40.0% developed metabolic syndrome, compared to 18.9% of women without late PPWR (<i>p</i> = 0.003). The only independent predictor for late PPWR was weight retention in early postpartum (<i>p</i> < 0.001). Of all participants, 55.1% (92) had glucose intolerance (84 prediabetes, 8 diabetes) 1-year postpartum. Independent predictors for late postpartum glucose intolerance were lower gestational age at start insulin therapy in pregnancy and delivery by caesarean section (resp. <i>p</i> = 0.044 and 0.014).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>In women with a previous history of GDM and prediabetes in early postpartum, PPWR in early postpartum was a strong independent predictor for late PPWR, while earlier start of insulin therapy during pregnancy and delivery by caesarean section were independent predictors of glucose intolerance in late postpartum.</p>\n </section>\n </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"41 9","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"One-year postpartum weight retention and glucose intolerance in women with prediabetes after gestational diabetes\",\"authors\":\"Valérie Mievis, Caro Minschart, Nele Myngheer, Toon Maes, Christophe de Block, Niels Bochanen, Inge van Pottelbergh, Pascale Abrams, Wouter Vinck, Liesbeth Leuridan, Sabien Driessens, Jaak Billen, Christophe Matthys, Annouschka Laenen, Annick Bogaerts, Chantal Mathieu, Katrien Benhalima\",\"doi\":\"10.1111/dme.15400\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aims</h3>\\n \\n <p>To determine risk factors for 1-year postpartum weight retention (PPWR) and glucose intolerance (prediabetes + diabetes) in women with a previous history of gestational diabetes (GDM) and prediabetes in early postpartum.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>In this exploratory analysis of the MELINDA randomized controlled trial, we report data of 167 women with prediabetes at the 6–16 weeks (early) postpartum oral glucose tolerance test after a recent history of GDM.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Of all participants, 45% (75) had PPWR >0 kg at 1-year postpartum. Compared to women without PPWR, women with PPWR had higher gestational weight gain [10.5 ± 6.4 vs. 6.5 ± 4.5 kg, <i>p</i> < 0.001], higher BMI (<i>p</i> < 0.01) and a worse metabolic profile (higher waist circumference, worse lipid profile and more insulin resistance) (all <i>p</i> < 0.05) both in early and late postpartum. Of all women with PPWR, 40.0% developed metabolic syndrome, compared to 18.9% of women without late PPWR (<i>p</i> = 0.003). The only independent predictor for late PPWR was weight retention in early postpartum (<i>p</i> < 0.001). Of all participants, 55.1% (92) had glucose intolerance (84 prediabetes, 8 diabetes) 1-year postpartum. Independent predictors for late postpartum glucose intolerance were lower gestational age at start insulin therapy in pregnancy and delivery by caesarean section (resp. <i>p</i> = 0.044 and 0.014).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>In women with a previous history of GDM and prediabetes in early postpartum, PPWR in early postpartum was a strong independent predictor for late PPWR, while earlier start of insulin therapy during pregnancy and delivery by caesarean section were independent predictors of glucose intolerance in late postpartum.</p>\\n </section>\\n </div>\",\"PeriodicalId\":11251,\"journal\":{\"name\":\"Diabetic Medicine\",\"volume\":\"41 9\",\"pages\":\"\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2024-07-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetic Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/dme.15400\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetic Medicine","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/dme.15400","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
One-year postpartum weight retention and glucose intolerance in women with prediabetes after gestational diabetes
Aims
To determine risk factors for 1-year postpartum weight retention (PPWR) and glucose intolerance (prediabetes + diabetes) in women with a previous history of gestational diabetes (GDM) and prediabetes in early postpartum.
Methods
In this exploratory analysis of the MELINDA randomized controlled trial, we report data of 167 women with prediabetes at the 6–16 weeks (early) postpartum oral glucose tolerance test after a recent history of GDM.
Results
Of all participants, 45% (75) had PPWR >0 kg at 1-year postpartum. Compared to women without PPWR, women with PPWR had higher gestational weight gain [10.5 ± 6.4 vs. 6.5 ± 4.5 kg, p < 0.001], higher BMI (p < 0.01) and a worse metabolic profile (higher waist circumference, worse lipid profile and more insulin resistance) (all p < 0.05) both in early and late postpartum. Of all women with PPWR, 40.0% developed metabolic syndrome, compared to 18.9% of women without late PPWR (p = 0.003). The only independent predictor for late PPWR was weight retention in early postpartum (p < 0.001). Of all participants, 55.1% (92) had glucose intolerance (84 prediabetes, 8 diabetes) 1-year postpartum. Independent predictors for late postpartum glucose intolerance were lower gestational age at start insulin therapy in pregnancy and delivery by caesarean section (resp. p = 0.044 and 0.014).
Conclusions
In women with a previous history of GDM and prediabetes in early postpartum, PPWR in early postpartum was a strong independent predictor for late PPWR, while earlier start of insulin therapy during pregnancy and delivery by caesarean section were independent predictors of glucose intolerance in late postpartum.
期刊介绍:
Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions.
The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed.
We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services.
Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”