Diabetes Metab J.  2019 Jun;43(3):342-349. 10.4093/dmj.2018.0086.

Oral Glucose Tolerance Testing Allows Better Prediction of Diabetes in Women with a History of Gestational Diabetes Mellitus

• Oh TJ
• Kim YG
• Kang S
• Moon JH
• Kwak SH
• Choi SH
• Lim S
• Park KS
• Jang HC
• Hong JS
• Cho NH

• KMID: 2454061
• DOI: http://doi.org/10.4093/dmj.2018.0086

Abstract

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.

Keyword

Diabetes, gestational; Diabetes mellitus, type 2; Glucose tolerance test; Risk factors

MeSH Terms

Diabetes Mellitus, Type 2
Diabetes, Gestational*
Female
Follow-Up Studies
Glucose
Glucose Tolerance Test*
Humans
Insulin
Insulin Resistance
Logistic Models
Postpartum Period
Pregnancy
Prospective Studies
Risk Factors
Glucose
Insulin

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