Predisposition to impaired glucose metabolism after GDM in women with normal oral glucose tolerance

Abstract

INTRODUCTION. Women with previous GDM also have a high risk of obesity, dyslipidemia, hypertension and atherosclerotic vascular disease. The aim of the study was to assess predisposition to disturbances of glucose metabolism in former GDM subjects with normal glucose tolerance at follow-up.
MATERIAL AND METHODS. Former GDM (n = 155) and control (n = 36) subjects were studied to a 75-g oral glucose tolerance test with measurements of insilin, C-peptide and lipid profile. GDM subjects with normal glucose tolerance at follow-up were compared with non-GDM.
RESULTS. A comparison between GDM subjects and control subjects with normal OGTT at follow-up demonstrated differences in gestational age (30 vs 26 years old) and pregestational weight (68 vs 60 kg) and BMI (25 vs 22 kg/m²). At follow-up GDM subjects have significantly higher whist circumstance (82 vs 76 cm), whist to hip ratio (0.8 vs 0.77), increased fasting insulin (9.5 vs 7 µg/dl), C-peptide (1.8 vs 1.5 ng/dl), and 1-h glucose in OGTT (153 vs 132 mg/dl). There were no significant differences in frequency of GADA between groups (16.7% vs 13.8%). Control subjects have significantly lower wieght gain from pregnancy to follow-up (2.8 vs 4.2 kg).
CONCLUSIONS. Women with previous GDM, despite normal glucose tolerance at follow-up, have a high risk of diabetes, because of high frequency of abdominal obesity and increased fasting insulin, C-peptide and 1-h glucose in OGTT. GDM sucjects compared with non-GDM are significantly more obese before pregnancy and older at delivery.