Risk factors for postpartum diabetes mellitus in Japanese patients with gestational diabetes mellitu

Abstract

Purpose: The objective of this study was to assess the risk factors for postpartum development of impaired glucose tolerance (IGT), impaired fasting glucose (IFG) and diabetes mellitus (DM) in Japanese women with a history of gestational diabetes mellitus (GDM).
Methods: We conducted this retrospective cohort study at St. Luke’s International Hospital between January 2011 and February 2019. The results of the 75-g oral glucose tolerance test (OGTT) performed at 3 months after delivery were taken as the primary outcome measure, while the secondary outcome measure was insulin sensitivity (HOMA-IR) measured at 3 months after delivery.
Results: In a total of 293 patients, postpartum OGTT results revealed normal glucose tolerance in 229 patients (78.2%), and IGT, IFG, or both, in 61 patients (20.8%); DM was detected in 3 patients (1.0%). Significant risk factors for the detection of IGT, IFG or DM on the postpartum OGTT were the severity of GDM (p = 0.037) and use of insulin therapy during pregnancy (p = 0.039). The HOMA-IR value was positively correlated with pregestational BMI (p < 0.001).
Conclusion: In the Japanese population, the significant risk factors for postpartum development of IGT, IFG or DM were the severity of GDM and use of insulin therapy during pregnancy.