ORIGINAL ARTICLE

Postpartum Metabolic Outcomes and Related Factors in Women with Gestational Diabetes Mellitus History
Gestasyonel Diabetes Mellitus Öyküsü Olan Kadınlarda Postpartum Metabolik Sonuçlar ve İlişkili Faktörler
Received Date : 06 Apr 2021
Accepted Date : 24 Jun 2021
Doi: 10.25179/tjem.2021-83687 - Makale Dili: EN
Turk J Endocrinol Metab. 2021;25:295-305
Bu makale, CC BY-NC-SA altında lisanslanmış açık erişim bir makaledir.
ABSTRACT
Objective: This study aimed to investigate early and late postpartum glycemic abnormalities and related factors in women with a history of gestational diabetes mellitus (GDM). Material and Methods: This study included 152 women aged 18-40 years who were diagnosed with GDM either by one- or two-step oral glucose tolerance test (OGTT). Sociodemographic characteristics, body mass index (BMI), biochemical parameters, and OGTT results of the participants were recorded from files. In addition, BMI, fasting plasma glucose, lipid parameters, and glycosylated hemoglobin (HbA1c) levels were measured, and OGTT was performed between 4 and 12 weeks after postpartum and at the first year. Results: The mean age of the participants was 31.86±6.096 years, and their mean BMI was 26.23±3.67 kg/m2. In the early postpartum period (4-6 weeks) after 75 g OGTT, 70.4% of patients had normal glucose tolerance (NGT), 25% had prediabetes (preDM), and 4.6% had diabetes mellitus (DM). In the late postpartum period, 48.0% of patients had NGT, 45.4% had preDM, and 6.6% had DM. BMI and HbA1c levels were significantly higher in patients with both preDM and DM than women with NGT in both early and late periods (p<0.05). In addition, BMI before and 1 year after pregnancy and HbA1c level between 4 and 6 weeks after delivery were independent risk factors for the development of dysglycemia (OR: 1.004, p<0.001; OR: 2.848, p<0.001; and OR: 4.437, p=0.016, respectively). Conclusion: Women with GDM have a high risk of developing preDM and type 2 DM in the first year after delivery.
ÖZET
Amaç: Bu çalışmanın amacı, gestasyonel diabetes mellitus (GDM) öyküsü olan kadınlarda, erken ve geç postpartum dönemde glisemik anormallik oranı ve ilişkili faktörleri değerlendirmekti. Gereç ve Yöntemler: Çalışmaya 18-40 yaş arasında, 24-28. haftada tek basamaklı ya da iki basamaklı yaklaşımla GDM tanısı konmuş ve doğum yapmış olan 152 kadın alındı. Katılımcıların sosyodemografik özellikleri, beden kitle indeksi (BKİ), biyokimyasal verileri ve oral glukoz tolerans testi (OGTT) sonuçları dosyalarından kaydedildi. Ayrıca postpartum 4-12. hafta ile 1. yılda BKİ, açlık plazma glukozu, lipid parametreleri, glikozile hemoglobin (HbA1c) seviyeleri ölçüldü ve 75 g OGTT yapıldı. Bulgular: Katılımcıların ortalama yaşı 31,86±6,096 ve BKİ 26,23±3,67kg/m2 idi. Postpartum erken dönemde (4-6. hafta) 75 g OGTT sonrası %70,4 normal glukoz toleransı (NGT),%25,0 prediyabet (preDM) ve %4,6 diabetes mellitus (DM), geç dönemde (1. yıl) ise %48,0 oranında NGT, %45,4 preDM ve %6,6 DM saptandı. BKİ ve HbA1c seviyeleri, hem erken hemde geç dönemde NGT’li kadınlara kıyasla hem preDM hem de DM’lilerde anlamlı düzeyde daha yüksek saptandı (p<0,05). Ayrıca disglisemi gelişimi için gebelik öncesi ve 1 yıl sonraki BKİ ile gebelik sonrası 4-6. haftadaki HbA1c seviyesi bağımsız risk faktörleri idi (sırasıyla, OR: 1,004, p<0,001, OR: 2,848, p<0,001 ve OR: 4,437, p=0,016). Sonuç: GDM’li kadınların doğumdan sonraki ilk yılda preDM ve tip 2 DM geliştirme riskleri yüksektir.
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