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Subject    :    [2019 June;43(3)] Oral Glucose Tolerance Testing Allows Better Prediction of Diabetes in Women with a History of Gestational Diabetes Mellitus
Writer KDA
Date 2019-06-28 17:26:20 Hit 2,135
LINK URL https://e-dmj.org/DOIx.php?id=10.4093/dmj.2018.0086 (Click 54)
Diabetes Metab J. 2019 Jun;43(3):342-349. English.
Published online Dec 07, 2018.  https://doi.org/10.4093/dmj.2018.0086 
Copyright © 2019 Korean Diabetes Association
   
Oral Glucose Tolerance Testing Allows Better Prediction of Diabetes in Women with a History of Gestational Diabetes Mellitus
Tae Jung Oh,1,2,* Yeong Gi Kim,2,3,* Sunyoung Kang,2,3 Joon Ho Moon,2,3 Soo Heon Kwak,2,3Sung Hee Choi,1,2 Soo Lim,1,2 Kyong Soo Park,2,3 Hak C. Jang,1,2 Joon-Seok Hong,4 and Nam H. Cho5
1Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
2Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
3Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
4Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.
5Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Korea.

Corresponding author: Hak C. Jang. Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea. Email: janghak@snu.ac.kr

 

*Tae Jung Oh and Yeong Gi Kim contributed equally to this study as first authors.
 
Received May 24, 2018; Accepted August 09, 2018.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

 
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.

   
Keywords:
Diabetes, gestationalDiabetes mellitus, type 2Glucose tolerance testRisk factors

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