GESTATIONAL DIABETES - PREDICTORS OF SUBSEQUENT DISORDERED GLUCOSE-METABOLISM

OBJECTIVE: We tested the hypothesis that the development of abnormal g lucose metabolism after gestational diabetes can be predicted readily by means of available clinical variables. STUDY DESIGN: Three hundred fifty nonpregnant former gestational diabetic women delivered during t he previous 10 years underwent glucose tolerance tests. Variables incl uding body mass index before the index pregnancy, pregnancy glucose to lerance test values, gestational diabetes treatment, complications, ge stational age at diagnosis of gestational diabetes, and time elapsed s ince pregnancy were analyzed with logistic regression. RESULTS: Variab les that distinguished subjects who later developed diabetes or impair ed glucose tolerance included prepregnancy body mass index (28.5 +/- 7 versus 25 +/- 5 kg/m2, p < 0.001) and fasting glucose on the pregnant oral glucose tolerance test (109 +/- 20 vs 92 +/- 15 mg/dl, p < 0.001 ). Logistic results with these two variables plus time since the index pregnancy predict subsequent glucose tolerance test abnormality by th e following equation: estimated risk = 1/[1 + e-(-10.37 + 0.04 {fastin g plasma glucose} + 0.08 {body mass index} + 0.03 {month since deliver y})]. CONCLUSION: The risk for subsequent glucose abnormality among in dividuals with prevous gestational diabetes is quantifiable based on p repregant body mass index and fasting plasma glucose during pregnancy.