Incidence and risk factors associated with abnormal postpartum glucose tolerance in women with gestational diabetes

Article Abstract:

Women with gestational diabetes (diabetes that is first diagnosed during pregnancy) are at risk for developing diabetes later in life. This study was performed to investigate the risk factors for diabetes in a postpartum population. The medical records from all patients with gestational diabetes during a two-year period were reviewed. Diagnoses were based on results from a three-hour oral glucose tolerance test (GTT). Patients with gestational diabetes received instructions on diet therapy and their blood glucose levels were carefully monitored. Insulin therapy was started only if glucose concentrations consistently exceeded standard levels. At their postpartum visit, all patients underwent a two-hour GTT. Of the 103 women who had both their own and their infant's records available, 23 (22 percent) had abnormal GTT results on the postpartum visit. Those with abnormal results differed from those with normal results; distinguishing factors included more pregnancies, more children borne, higher weight prior to pregnancy, higher body mass index, and higher weight at delivery. Gestational diabetes was diagnosed at an earlier stage of pregnancy for those with abnormal postpartum GTTs, and more of these infants weighed over 4,000 grams. The best predictors of abnormal glucose tolerance after delivery were the fasting glucose levels at the time of the oral GTT during pregnancy and the gestational age at the time of the abnormal test results. Seventy-eight percent of the patients with abnormal postpartum GTTs had required insulin during pregnancy, compared with 40 percent of the patients with normal results. These findings indicate that 20 percent of the women who develop gestational diabetes do not have normal glucose tolerance after delivery. This study included a predominantly white population, in contrast to previous reports which have often included mainly Hispanic and black women. Women with gestational diabetes should be tested with a GTT after their babies are born so that diabetes, if present, can be treated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Testing, Complications and side effects, Risk factors, Development and progression, Diabetes, Diabetes mellitus, Pregnant women

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Differential growth of fetal tissues during the second half of pregnancy

Article Abstract:

Ultrasonographic measurements of fat deposition in fetal limbs may be useful in identifying abnormal fetal growth. Researchers performed an average of four ultrasound scans on each of 36 normal pregnant women between 19 and 40 weeks of pregnancy. Fetal lean body mass and subcutaneous fat were measured and compared. The growth of lean body mass seemed to be linear, while the accumulation of fetal fat increased as birth weight and length of pregnancy advanced. Older mothers or those with pregnancy-related diabetes may have abnormally fat fetuses and need cesarean deliveries or have other complications.

Fetus, Growth, Pregnancy, Adipose tissues, Adipose tissue, Fetal development

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Longitudinal changes in glucose metabolism during pregnancy in obese women with normal glucose tolerance and gestational diabetes mellitus

Article Abstract:

Pregnant women with gestational diabetes have metabolic abnormalities similar to type 2 diabetes as their pregnancy progresses. This was the conclusion of a study of 8 pregnant women with normal glucose tolerance and 7 with gestational diabetes. An infusion of insulin at various times during pregnancy revealed that the women with gestational diabetes had a greater blood sugar increase in response but were more likely to be insulin-resistant compared to the other women. They also had less suppression of glucose production by the liver.

Glucose metabolism

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