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Clinical Diabetes & Therapeutics
Progression to Gestational Diabetes Mellitus in Pregnant Women with One Abnormal Value in Repeated Oral Glucose Tolerance Tests
Sunyoung Kang, Min Hyoung Kim, Moon Young Kim, Joon-Seok Hong, Soo Heon Kwak, Sung Hee Choi, Soo Lim, Kyong Soo Park, Hak C. Jang
Diabetes Metab J. 2019;43(5):607-614.   Published online February 28, 2019
DOI: https://doi.org/10.4093/dmj.2018.0159
  • 5,900 View
  • 103 Download
  • 9 Web of Science
  • 9 Crossref
AbstractAbstract PDFPubReader   
Background

Women with one abnormal value (OAV) in a 100 g oral glucose tolerance test (OGTT) during pregnancy are reported to have an increased risk of adverse pregnancy outcomes. However, there is limited data about whether women with OAV will progress to gestational diabetes mellitus (GDM) when the OGTT is repeated.

Methods

To identify clinical and metabolic predictors for GDM in women with OAV, we conducted a retrospective study and identified women with OAV in the OGTT done at 24 to 30 weeks gestational age (GA) and repeated the second OGTT between 32 and 34 weeks of GA.

Results

Among 137 women with OAV in the initial OGTT, 58 (42.3%) had normal, 40 (29.2%) had OAV and 39 (28.5%) had GDM in the second OGTT. Maternal age, prepregnancy body mass index, weight gain from prepregnancy to the second OGTT, GA at the time of the OGTT, and parity were similar among normal, OAV, and GDM groups. Plasma glucose levels in screening tests were different (151.8±15.7, 155.8±14.6, 162.5±20.3 mg/dL, P<0.05), but fasting, 1-, 2-, and 3-hour glucose levels in the initial OGTT were not. Compared to women with screen negative, women with untreated OAV had a higher frequency of macrosomia.

Conclusion

We demonstrated that women with OAV in the initial OGTT significantly progressed to GDM in the second OGTT. Clinical parameters predicting progression to GDM were not found. Repeating the OGTT in women with OAV in the initial test may be helpful to detect GDM progression.

Citations

Citations to this article as recorded by  
  • Maternal and fetal outcomes of pregnancies associated with single versus double abnormal values in 100 gr glucose tolerance test
    Mohammadali Shahriari, Ali Shahriari, Maryam Khooshideh, Anahita Dehghaninezhad, Arezoo Maleki-Hajiagha, Rana Karimi
    Journal of Diabetes & Metabolic Disorders.2023; 22(2): 1347.     CrossRef
  • One abnormal value or vomiting after oral glucose tolerance test in pregnancy: incidence and impact on maternal-fetal outcomes
    Humberto Navarro-Martinez, Juana-Antonia Flores-Le Roux, Gemma Llauradó, Lucia Gortazar, Antonio Payà, Laura Mañé, Juan Pedro-Botet, David Benaiges
    Gynecological Endocrinology.2023;[Epub]     CrossRef
  • Analysis of the gut microflora in women with gestational diabetes mellitus
    Xuping Wang, Bingfeng Bian, Fuman Du, Chaofeng Xiang, Yu Liu, Na Li, Binhong Duan
    International Journal of Diabetes in Developing Countries.2023;[Epub]     CrossRef
  • The association between gestational impaired glucose tolerance and hyperglycemic markers: A prospective study
    Ohad Gluck, Hadas Ganer Herman, Nataly Fainstein, Neri Katz, Jacob Bar, Michal Kovo
    International Journal of Gynecology & Obstetrics.2022; 156(1): 82.     CrossRef
  • Association of abnormal-glucose tolerance during pregnancy with exposure to PM2.5 components and sources
    Dejian Mai, Chengfang Xu, Weiwei Lin, Dingli Yue, Shaojie Fu, Jianqing Lin, Luan Yuan, Yan Zhao, Yuhong Zhai, Huiying Mai, Xiaoling Zeng, Tingwu Jiang, Xuejiao Li, Jiajia Dai, Boning You, Qin Xiao, Qing Wei, Qiansheng Hu
    Environmental Pollution.2022; 292: 118468.     CrossRef
  • Postprandial Free Fatty Acids at Mid-Pregnancy Increase the Risk of Large-for-Gestational-Age Newborns in Women with Gestational Diabetes Mellitus
    So-Yeon Kim, Young Shin Song, Soo-Kyung Kim, Yong-Wook Cho, Kyung-Soo Kim
    Diabetes & Metabolism Journal.2022; 46(1): 140.     CrossRef
  • The Clinical Characteristics of Gestational Diabetes Mellitus in Korea: A National Health Information Database Study
    Kyung-Soo Kim, Sangmo Hong, Kyungdo Han, Cheol-Young Park
    Endocrinology and Metabolism.2021; 36(3): 628.     CrossRef
  • Gestational Diabetes Mellitus: Diagnosis and Glycemic Control
    Tae Jung Oh, Hak Chul Jang
    The Journal of Korean Diabetes.2020; 21(2): 69.     CrossRef
  • Health literacy and diabetes control in pregnant women
    Azar Pirdehghan, Mohammad Eslahchi, Farzaneh Esna-Ashari, Shiva Borzouei
    Journal of Family Medicine and Primary Care.2020; 9(2): 1048.     CrossRef
Epidemiology
Oral Glucose Tolerance Testing Allows Better Prediction of Diabetes in Women with a History of Gestational Diabetes Mellitus
Tae Jung Oh, Yeong Gi Kim, Sunyoung Kang, Joon Ho Moon, Soo Heon Kwak, Sung Hee Choi, Soo Lim, Kyong Soo Park, Hak C. Jang, Joon-Seok Hong, Nam H. Cho
Diabetes Metab J. 2019;43(3):342-349.   Published online December 7, 2018
DOI: https://doi.org/10.4093/dmj.2018.0086
  • 4,698 View
  • 59 Download
  • 10 Web of Science
  • 10 Crossref
AbstractAbstract PDFPubReader   
Background

We aimed to identify the postpartum metabolic factors that were associated with the development of diabetes in women with a history of gestational diabetes mellitus (GDM). In addition, we examined the role of the oral glucose tolerance test (OGTT) in the prediction of future diabetes.

Methods

We conducted a prospective study of 179 subjects who previously had GDM but did not have diabetes at 2 months postpartum. The initial postpartum examination including a 75-g OGTT and the frequently sampled intravenous glucose tolerance test (FSIVGTT) was performed 12 months after delivery, and annual follow-up visits were made thereafter.

Results

The insulinogenic index (IGI30) obtained from the OGTT was significantly correlated with the acute insulin response to glucose (AIRg) obtained from the FSIVGTT. The disposition indices obtained from the OGTT and FSIVGTT were also significantly correlated. Women who progressed to diabetes had a lower insulin secretory capacity including IGI30, AIRg, and disposition indices obtained from the FSIVGTT and OGTT compared with those who did not. However, the insulin sensitivity indices obtained from the OGTT and FSIVGTT did not differ between the two groups. Multivariate logistic regression analysis showed that the 2-hour glucose and disposition index obtained from the FSIVGTT were significant postpartum metabolic risk factors for the development of diabetes.

Conclusion

We identified a crucial role of β-cell dysfunction in the development of diabetes in Korean women with previous GDM. The 2-hour glucose result from the OGTT is an independent predictor of future diabetes. Therefore, the OGTT is crucial for better prediction of future diabetes in Korean women with previous GDM.

Citations

Citations to this article as recorded by  
  • Diagnosis and management of gestational diabetes mellitus
    Tae Jung Oh
    Journal of the Korean Medical Association.2023; 66(7): 414.     CrossRef
  • Risk factors for women with gestational diabetes mellitus developing type 2 diabetes and the impact on children's health
    Yi‐Ling Chiou, Chich‐Hsiu Hung, Ching‐Yun Yu, Te‐Fu Chan, Ming‐Gwo Liu
    Journal of Clinical Nursing.2022; 31(7-8): 1005.     CrossRef
  • Postprandial Free Fatty Acids at Mid-Pregnancy Increase the Risk of Large-for-Gestational-Age Newborns in Women with Gestational Diabetes Mellitus
    So-Yeon Kim, Young Shin Song, Soo-Kyung Kim, Yong-Wook Cho, Kyung-Soo Kim
    Diabetes & Metabolism Journal.2022; 46(1): 140.     CrossRef
  • Gestational Diabetes Mellitus: Diagnostic Approaches and Maternal-Offspring Complications
    Joon Ho Moon, Hak Chul Jang
    Diabetes & Metabolism Journal.2022; 46(1): 3.     CrossRef
  • Higher Muscle Mass Protects Women with Gestational Diabetes Mellitus from Progression to Type 2 Diabetes Mellitus
    Yujin Shin, Joon Ho Moon, Tae Jung Oh, Chang Ho Ahn, Jae Hoon Moon, Sung Hee Choi, Hak Chul Jang
    Diabetes & Metabolism Journal.2022; 46(6): 890.     CrossRef
  • Pancreatic fat accumulation is associated with decreased β‐cell function and deterioration in glucose tolerance in Korean adults
    Sang Ouk Chin, You‐Cheol Hwang, In‐Jin Cho, In‐Kyung Jeong, Kyu Jeung Ahn, Ho Yeon Chung
    Diabetes/Metabolism Research and Reviews.2021;[Epub]     CrossRef
  • The Clinical Characteristics of Gestational Diabetes Mellitus in Korea: A National Health Information Database Study
    Kyung-Soo Kim, Sangmo Hong, Kyungdo Han, Cheol-Young Park
    Endocrinology and Metabolism.2021; 36(3): 628.     CrossRef
  • Bihormonal dysregulation of insulin and glucagon contributes to glucose intolerance development at one year post-delivery in women with gestational diabetes: a prospective cohort study using an early postpartum 75-g glucose tolerance test
    Riyoko Shigeno, Ichiro Horie, Masaki Miwa, Ayako Ito, Ai Haraguchi, Shoko Natsuda, Satoru Akazawa, Ai Nagata, Yuri Hasegawa, Shoko Miura, Kiyonori Miura, Atsushi Kawakami, Norio Abiru
    Endocrine Journal.2021; 68(8): 919.     CrossRef
  • Risk factors during the early postpartum period for type 2 diabetes mellitus in women with gestational diabetes
    Maki Kawasaki, Naoko Arata, Naoko Sakamoto, Anna Osamura, Siori Sato, Yoshihiro Ogawa, Ichiro Yasuhi, Masako Waguri, Yuji Hiramatsu
    Endocrine Journal.2020; 67(4): 427.     CrossRef
  • Cod-Liver Oil Improves Metabolic Indices and hs-CRP Levels in Gestational Diabetes Mellitus Patients: A Double-Blind Randomized Controlled Trial
    Shuli Yang, Ruixin Lin, Lihui Si, Zhuo Li, Wenwen Jian, Qing Yu, Yan Jia
    Journal of Diabetes Research.2019; 2019: 1.     CrossRef

Diabetes Metab J : Diabetes & Metabolism Journal