EVALUATION OF PREDICTIVE FACTORS OF DEVELOPMENT OF TYPE 2 DIABETES MELLITUS (T2DM) IN PATIENTS WITH GESTATIONAL DIABETES MELLITUS (GDM)

Abstract

Abstract

Introduction: Several groups have been considered as the population at risk for diabetes, one of which is women with a history of gestational diabetes. Women with gestational diabetes are likely to develop type 2 diabetes mellitus (T2DM) and cardiovascular disease. Given the great importance of controlling risk factors for T2DM following gestational diabetes, it was decided to conduct a study to investigate predictive factors of the development of T2DM in patients with gestational diabetes mellitus (GDM).

Methods: This cross-sectional study had been conducted on pregnant women with gestational diabetes in 2015. All pregnant women underwent screening for gestational diabetes at the first visit. At six to 12 weeks after parturition, they were put under oral glucose tolerance test (OGTT) again. Follow-up was done in all cases where there was an abnormality in diagnostic test or symptoms of hyperglycemia, glycosuria, and abnormal weight gain. All blood samples were centrifuged, and plasma samples obtained were transferred to measure glucose. Chi-square test was used for data analysis with IBM SPSS 21.0 statistical software. P-value less than 0.05 was considered as the significance level.

Results: A total of approximately 185 patients were included in this study with a mean age of 27.7 ± 4.8 years. Among 185 patients who were followed-up for six to 12 weeks after parturition, 10% of patients were with type 2 diabetes after pregnancy. In addition, 10% of postpartum patients have had impaired glucose tolerance test (IGT), but diabetes was not found. Also, 30.27% (n = 56) of the patients have had impaired fasting glucose (IFG). Finally, about 44.32% (n = 82) of the patients had abnormal blood glucose test (AGT). After analyzing the data, it was found that, of 185 patients, two patients had a BMI less than 20, three people with a BMI between 20–24.9, seven patients with a BMI between 25–29.9, and three patients with BMI between 30–40 had diabetes, according to GTT test. Risk factors such as cholesterol, history of hyperthyroidism, history of hypothyroidism, polycystic ovarian syndrome, obesity, acanthosis nigricans, and family history of diabetes had no significant relationship with development of diabetes after pregnancy (p>0.05).

Conclusion: About 10% of patients after parturition clearly had diabetes, according to the tests carried out. Our study showed that BMI and FBS play a significant role in predicting the development of diabetes, but factors such as history of miscarriage, stillbirth, macrosomia, death without cause and medical records such as hypertension, obesity, hyperthyroidism, and hypothyroidism have not played a significant role in this prediction.