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Abstract
SUMMARY
he incidence of gestational diabetes mellitus (GDM) has been increasing the last 20 years. At postpartum follow-up, women with GDM have been found to be at risk of developing diabetes mellitus (DM), impaired glucose tolerance (IGT), impaired fasting glucose (IFG), and even metabolic syndrome. 110 pregnant women diagnosed as GDM, their gestational ages ranging from 24 to 37 weeks, were selected for this study. History was obtained, general examination was done, and body mass index (BMI) was determined for all 110 participants, as well as laboratory analysis of their serum for ferritin, c-reactive protein (CRP), glycated hemoglobin (HbA1c), and insulin. 8 weeks after delivery, all of them were evaluated for DM, based on the standard oral glucose tolerance test with 75 g glucose. Statistical analysis was used to compare variables between those who developed DM, IGT, or IFG; and those whose blood glucose levels returned to normal after delivery.
The following results were obtained:
21 cases developed postpartum DM, and 11 cases developed IGT/IFG.
The mean interquartile BMI was significantly higher in the diabetic group when compared to the normal group (P< 0.001).
The mean interquartile onset of gestational diabetes was significantly higher in the diabetic group when compared to
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the IGT/IFG group (P= 0.004) and normal group (P< 0.001).
The onset of GDM was a fair predictor for development of postpartum DM (area under the ROC curve (AUC) = 0.769, (P< 0.0001).
The onset of GDM was a fair predictor for development of postpartum IGT or DM (area under the ROC curve (AUC) = 0.769, (P= 0.0091).
The mean interquartile CRP was significantly higher in the diabetic group when compared to the normal group (P= 0.001).
The CRP level was a fair predictor for development of postpartum DM (area under the ROC curve (AUC) = 0.734, (P= 0.0007).
The CRP level was a fair predictor for development of postpartum IGT or DM (area under the ROC curve (AUC) = 0.7, (P= 0.0002).
The mean interquartile HbA1c was significantly higher in the diabetic group when compared to the IGT/IFG group (P= 0.011) or the normal group (P< 0.001).
The HbA1c level was an excellent predictor for development of postpartum DM (area under the ROC curve (AUC) = 0.947, (P = <0.0001).
The HbA1c level was a good predictor for development of postpartum IGT or DM (area under the ROC curve (AUC) = 0.885, (P= <0.0001).
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HbAa1c was the only independent predictor of postpartum diabetes or IGT/IFG (P< 0.001, Odds ratio = 7.123).
The mean interquartile serum insulin was insignificantly higher in the diabetic group when compared to the normal group (P= 0.061).
The serum insulin level was not a predictor for development of postpartum DM (area under the ROC curve (AUC) = 0.571, (P= 0.2904).
The serum insulin level was a poor predictor for development of postpartum IGT or DM (area under the ROC curve (AUC) = 0.603, (P= 0.0666).
The mean interquartile serum ferritin was insignificantly higher in the diabetic group when compared to the normal group (P= 0.215).
The serum ferritin level was a poor predictor for development of postpartum DM (area under the ROC curve (AUC) = 0.635, (P = 0.0661).
The serum ferritin level was a poor predictor for development of postpartum IGT or DM (area under the ROC curve (AUC) = 0.635, (P= 0.0175).
The correlation between CRP and serum ferritin was insignificant (P= 0.094).