Effects of new criteria for type 2 diabetes on the rate of postpartum glucose intolerance in women with gestational diabetes

Deborah L. Conway, Oded Langer

Research output: Contribution to journalArticle

53 Scopus citations

Abstract

OBJECTIVE: Our purpose was to determine the impact of the 1997 American Diabetes Association diagnostic criteria for type 2 diabetes mellitus on the rate of postpartum glucose intolerance in women with gestational diabetes. STUDY DESIGN: Women identified as having gestational diabetes were instructed to undergo a 75-g, 2-hour glucose tolerance test 4 to 6 weeks after delivery. The results were retrospectively categorized with both the 1979 National Diabetes Data Group criteria and those recommended by the American Diabetes Association in 1997. RESULTS: Though the rate of overt diabetes mellitus did not increase when the 1997 American Diabetes Association criteria were used (7.8% vs 5.6%, P = not significant), the rate of impaired glucose metabolism was higher (20.1% vs 5%, P< .001). Most women (28/30, 93%) with a nondiagnostic glucose tolerance test result by the older criteria had abnormal results by the newer criteria. Fifty women had abnormalities of glucose metabolism under 1997 American Diabetes Association criteria; 34% of these women had fasting plasma glucose values in the normal range. Of the 25 women with impaired glucose tolerance, 16 (64%) had only an abnormal 2-hour value, with normal fasting glucose values. CONCLUSIONS: The rate of postpartum abnormalities in glucose metabolism more than doubles when the 1997 American Diabetes Association criteria are applied; more women are identified with lesser degrees of impairment. However, relying on fasting glucose levels alone, without glucose tolerance testing, may miss one third of women with such abnormalities.

Original languageEnglish (US)
Pages (from-to)610-614
Number of pages5
JournalAmerican Journal of Obstetrics and Gynecology
Volume181
Issue number3
DOIs
StatePublished - Jan 1 1999

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Keywords

  • Gestational diabetes mellitus
  • Glucose tolerance test
  • Type 2 diabetes mellitus

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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