Implication of new diagnostic criteria for abnormal glucose tolerance in women with previous gestational diabetes mellitus

Abstract

INTRODUCTION. Our propose was to determinate the impact of the new World Health Organization criteria for the rate of postpartum glucose intolerance in women with previous gestational diabetes mellitus (GDM).
MATERIAL AND METHODS. Women identified as having gestational diabetes were instructed to undergo a 75-g 2-hour glucose tolerance test 6 months to 10 years after delivery. The results were retrospectively categorized with both the 1985 WHO criteria and whose recommended in 1999.
RESULTS. The rate of overt diabetes was higher when the 1999 WHO criteria were used (17.4% vs 23.3%), the rate of impaired glucose matabolism did not increase (25.8% vs 22%). 16.1% of women had impaired fasting glucose. If the fasting glucose concentrations alone had been obtained, only 64% of the women with diabetes have been classifield as diabetes mellitus.
CONCLUSIONS. The rate of postpartum abnormalities in glucose metabolism increases when the 1999 WHO criteria are applied. However, relying on fasting glucose levels alone, without glucose tolerance testing, may miss one third of women with such abnormalities.