Journal article
Conversion of gestational diabetes mellitus to future Type 2 diabetes mellitus and the predictive value of HbA1c in an Indian cohort
Diabetic Medicine, Vol.34(1), pp.37-43
2017
Abstract
Aim: To investigate the distribution of and risk factors for dysglycaemia (Type 2 diabetes and prediabetes) in women with previous gestational diabetes mellitus in India. Methods: All women (n = 989) from two obstetric units in New Delhi and Hyderabad with a history of gestational diabetes were invited to participate, of whom 366 (37%) agreed. Sociodemographic, medical and anthropometric data were collected and 75-g oral glucose tolerance test were carried out. Results: Within 5 years (median 14 months) of the pregnancy in which they were diagnosed with gestational diabetes, 263 (72%) women were dysglycaemic, including 119 (32%) and 144 (40%) with Type 2 diabetes and prediabetes, respectively. A higher BMI [odds ratio 1.16 per 1-kg/m2 greater BMI (95% CI 1.10, 1.28)], presence of acanthosis nigricans [odds ratio 3.10, 95% CI (1.64, 5.87)], postpartum screening interval [odds ratio 1.02 per 1 month greater screening interval 95% CI (1.01, 1.04)] and age [odds ratio 1.10 per 1-year older age 95% CI (1.04, 1.16)] had a higher likelihood of having dysglycaemia. The American Diabetes Association-recommended threshold HbA1c value of ≥48 mmol/mol (6.5%) had a sensitivity and specificity of 81.4 and 90.7%, respectively, for determining the presence of Type 2 diabetes postpartum. Conclusion: The high post-pregnancy conversion rates of gestational diabetes to diabetes reported in the present study reinforce the need for mandatory postpartum screening and identification of strategies for preventing progression to Type 2 diabetes. Use of the American Diabetes Association-recommended HbA1c threshold for diabetes may lead to significant under-diagnosis.
Details
- Title
- Conversion of gestational diabetes mellitus to future Type 2 diabetes mellitus and the predictive value of HbA1c in an Indian cohort
- Authors
- Y Gupta (Author) - All India Institute of Medical Sciences, IndiaD Kapoor (Author) - Centre for Chronic Disease Control, IndiaA Desai (Author) - Goa Medical College, IndiaD Praveen (Author) - George Institute for Global Health, IndiaR Joshi (Author) - George Institute for Global Health, IndiaR Rozati (Author) - Centre for Fertility Management - MHRT, IndiaN Bhatla (Author) - All India Institute of Medical Sciences, IndiaD Prabhakaran (Author) - Centre for Chronic Disease Control, IndiaPrasuna Reddy (Author) - University of NewcastleA Patel (Author) - George Institute for Global Health, IndiaN Tandon (Author) - All India Institute of Medical Sciences, India
- Publication details
- Diabetic Medicine, Vol.34(1), pp.37-43
- Publisher
- Wiley-Blackwell Publishing Ltd.
- Date published
- 2017
- DOI
- 10.1111/dme.13102
- ISSN
- 0742-3071
- Organisation Unit
- University of the Sunshine Coast, Queensland
- Language
- English
- Record Identifier
- 99451260302621
- Output Type
- Journal article
Metrics
4 File views/ downloads
1170 Record Views
InCites Highlights
These are selected metrics from InCites Benchmarking & Analytics tool, related to this output
- Collaboration types
- Domestic collaboration
- International collaboration
- Web Of Science research areas
- Endocrinology & Metabolism
UN Sustainable Development Goals (SDGs)
This output has contributed to the advancement of the following goals:
Source: InCites