Predictors of postpartum diabetes mellitus in patients with gestational diabetes

Introduction: Gestational diabetes (GD) is related to development of diabetes mellitus (DM) after delivery. The predictive factors in this association are not yet welt defined. Objetive: to study the predictive factors of dysglucosis in the postpartum period in a sample of patients with GD. Material and methods: A total of 1765 women with DG were studied. Variables analyzed: anthropometric data and maternal history. Glycemia in OGTT with 100 g (basal: 1, 2 and 3 h) and HbA(1c). Use of insulin in pregnancy. The OGTT with 75 g and HbA(1c) at 3 months after delivery. Results: Postpartum DM prevalence 2.1%. Among these patients, there was a higher percentage of patients with a history of GD (25.9 vs. 12.9%; P<.05), pre-pregnancy obesity (20.8 vs. 14.9%; P<.05) and insulin use during pregnancy (79.2 vs. 20%; P<.01). In the OGTT with 100 g, the number of pathological points was higher (3.18 +/- 0.69 in DM vs. 2.3 +/- 0.28 normal, 2.6 +/- 0.47 IFG, 2.5 +/- 0.32 IGT; P<.001). In the OGTT 100 g, the blood glucose level above which the diagnosis of postpartum DM is most likely is 189 mg/dl in the 2 h determination (S: 86.2%, E: 72%). A level of HbA(1c) >= 5.9% during pregnancy has a specificity of 95.9% for the diagnosis of postpartum DM in our sample. Conclusion: We show factors associated with the diagnosis of postpartum DM, among which are quantitative determinations such as glycemia at 2 h of the OGTT with 100 g and HbA(1c) during pregnancy in patients with DG. (C) 2018 Published by Elsevier Espana, S.L.U. on behalf of SEEN y SED.