Endocrine Abstracts

Introduction: The aim of the study was to assess antropometric and metabolic parametres in women with previous gestational diabetes mellitus (GDM) during a 30-month observation.

Design: Our prospective study cohort consisted of 367 women with GDM diagnosed according to WHO criteria. Oral glucose tolerance test (OGTT) was performed during 6-10 weeks and 12, 18, 24, 30 months after delivery. On every 6th month between 12th and 30th month after delivery we estimated: BMI, abdominal circumference, blood pressure and the lipid profile, fasting plasma glucose and insulin levels were assessed, from which the HOMA- IR was calculated. Yearly OGTT was performed.

Results: 139 (37.9%), 85 (23%) and 43 (12%) women underwent OGTT after 6–10 weeks, at 12 mo. and at 24 mo. after the delivery respectively. BMI 12 mo. after delivery was higher than pre-pregnancy BMI (23.47 and 24.12 kg/m² respectively), 18, 24, 30 months after delivery BMI was lower than before pregnancy. Abdominal obesity was found in 44.7% women at 24 months and in 27.3% at 30 months after delivery. Systolic and diastolic blood pressure were within normal population limits. Total cholesterol varied 201–172.5 mg/dl. HDL 67–63 mg/dl, LDL 112.6-96.2 mg/dl, triglycerides 78–85.5 mg/dl. HOMA IR was growing from 1.59–12 mo. to 2.09 mo. – 30 mo. after delivery. IFG was found in 12.96% women in 12 mo., 26.67% in 18 mo., 32.26% in 24 mo., 33.33% in 30 mo. IGT was found in 5% 12 mo., 24% in 24 mo., 28.57% in 30 mo. after delivery. We found no diabetes mellitus.

Conclusions: Insulin resistance is high and growing in women with previous GDM after delivery. The number of women with prediabetes status after delivery becomes an epidemiologic challenge. We also observed that women with GDM are very often lost to the follow up.