Two-year follow-up of Patients with GestationalDiabetes Mellitus in Örebro County : – a retrospective cohort study

University essay from Örebro universitet/Institutionen för medicinska vetenskaper

Abstract: Introduction: Gestational diabetes mellitus (GDM) is a risk factor for developing type 2diabetes mellitus (T2DM). However, compliance to postpartum follow-up remains low.The new outcome-based International Association of Diabetes and Pregnancy StudyGroups (IADPSG)-criteria have led to a worldwide increase of GDM prevalence. Thepotential impact of the new IADPSG-critera on the frequency of T2DM/prediabetesdiagnosis, during follow-up of prior GDM-women in Örebro County, has not yet beenstudied. Aim: To investigate whether there is a difference in prevalence of prediabetes/T2DM inGDM-women two years postpartum, based on older GDM-criteria vs. the new lower IADPSG2010/WHO 2013-criteria, and to describe compliance to follow-up in primary health care(PHC). Methods: A retrospective cohort study of 108 GDM-women in Örebro County. Data obtainedfrom medical records: cardiometabolic risk factors, compliance data, outcomes withnormoglycemia used as comparison at follow-up. Results: T2DM and prediabetes were non-statistically significant higher in the old criteriagroup[11 (28.9%) vs. 6 (18.2%), p=0.289] and [12 (30.8%) vs. 5 (15.6%), p=0.137],respectively. Compliance to both 1st and 2nd follow-up was seen in 81 (75%) women. 96(88.9%) to first and 88 (81.5%) to second follow-up. An increase in mean BMI was seen frombaseline to PHC (31 vs. 31.7, p=0.014) as well as an increase in alcohol consumption [4(6.6%) vs. 23 (37.7%), p<0.001]. Conclusions: GDM-diagnosis based on IADPSG-criteria did not show any statisticallysignificant difference in the prevalence of T2DM/prediabetes two years postpartum, whencompared to GDM-diagnosis based on old criteria. Moderate compliance to postpartumfollow-up was observed, with an increased number of dropouts. More research is needed inthis area, following implication of IADPSG-criteria.

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