The prognostic value of the oral glucose tolerance test for future type-2 diabetes in nulliparous pregnant women testing negative for gestational diabetes - 14/09/22
, Baiju R. Shah c, Howard Berger d, Michael Geary d, Sarah D. McDonald e, Beth Murray-Davis e, Ilana Halperin f, Longdi Fu g, Ravi Retnakaran h, i, az, Jon Barrett a, Nir Melamed a, for-DOH-NET-(Diabetes-Obesity-and-Hypertension-in-Pregnancy-Research-Network)-and-SOON-(Southern-Ontario-Obstetrical-Network)-Investigators TM a
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Abstract |
Aim |
To determine the prognostic value of the antepartum 75g-oral glucose tolerance test (OGTT) for future type 2 diabetes mellitus (T2DM) in nulliparous pregnant women who tested negative for GDM.
Methods |
A population-based retrospective cohort study of nulliparous pregnant women who underwent testing for GDM using a 75g-OGTT in Ontario, Canada (2007-2017). The overwhelming majority of women in Ontario undergo screening using the preferred 2-step approach where the 75g-OGTT is performed following an abnormal non-fasting 1 h 50g-glucose challenge test. The relationship between the 75g-OGTT results in women who tested negative for GDM (defined as normal glucose at fasting, 1 and 2 h post 75g-glucose load) and future T2DM (as recorded in the Ontario Diabetes Database by the end date of follow up period) was explored.
Findings |
Of the 162,622 women who underwent 75g-OGTT during the study period, there were 41,507 (75.0%) who met the study criteria. In women without GDM, the adjusted hazard ratios (aHR) for T2DM were–At fasting 2.82 (95%-CI 2.18-3.64), at 1 h 1.26 (1.15-1.37), at 2 h 1.14 (1.04-1.25) for a 1 mmol/L increase in glucose. A model that combined all 3 OGTT values and clinical characteristics could detect 43% (42.6%-43.4%) of those who developed T2DM at 5-years post the index pregnancy for a false-positive rate of 20%.
Interpretation |
The results of the antepartum OGTT can be used to refine the future risk of T2DM even in nulliparous pregnant women who tested negative for GDM.
Le texte complet de cet article est disponible en PDF.Keywords : Diabetes, Oral tolerance test, Pregnancy, Prognosis, Type 2
Plan
Vol 48 - N° 5
Article 101364- septembre 2022 Retour au numéro
Article précédent
- Prevalence and predictors of non-alcoholic steatohepatitis in subjects with morbid obesity and with or without type 2 diabetes
- Erminia Lembo, Maria Francesca Russo, Ornella Verrastro, Danila Anello, Giulia Angelini, Amerigo Iaconelli, Caterina Guidone, Gianluigi Stefanizzi, Luigi Ciccoritti, Francesco Greco, Luca Sessa, Laura Riccardi, Maurizio Pompili, Marco Raffaelli, Fabio Maria Vecchio, Stefan R. Bornstein, Geltrude Mingrone, Amalia Gastaldelli, Esmeralda Capristo
- Metformin use is associated with a lower risk of rotator cuff disease in patients with Type 2 diabetes mellitus
- Renin Chang, Ting-Yu Tu, Yao-Min Hung, Jing-Yang Huang, Mei-Chia Chou, James Cheng-Chung Wei
Bienvenue sur EM-consulte, la référence des professionnels de santé.