Evaluation of metabolic parameters of gestational diabetics in postpartum period

Fatih Turker; Suleyman Ahbab; Esra Ataoglu; Turker Betul Cavusoglu; Evrim Cakir

doi:10.1530/endoabs.41.EP478

Background: Gestational diabetes mellitus (GDM) is the high blood glucose levels in pregnant women. GDM have high risk for type 2 diabetes mellitus after pregnancy. Therefore, we evaluated postpartum DM frequency and metabolic parameters of the patients who had GDM in this study.

Methods: It was enrolled 40 patients, who had high glucose level during fasting or/and after meal and abnormal glucose level during OGTT in 24–28 weeks, in endocrinology outpatient between 2011–2014. We evaluated metabolic parameters of GDM in the sixth month of postpartum period.

Weight, height, BMI were evaluated. Blood tests were performed (fasting and after meal glucose level, insulin, lipid profile, hbA1c, urea, creatinine, spot urea protein/creatinine).

Results: Postpartum diabetes mellitus was developed in seven patients in follow up period (17.5%). The median age of the postnatal diabetics is 33.14±6.4, the postnatal nondiabetics median age is 34.48±5.7. Mean fasting glucose level and hbA1c values were statistically higher in postpartum diabetic patients, 125.14±49.421, 6.243±1.41, P:0.001, P:0.005, respectively. The mean BMI, waist circumference, triglyseride levels of the postpartum diabetic patients are 31.47±8.91, 99±16.381, 165.271±127.499, of nondiabetics are 29.13±4.4, 96.45±13.44, 102.706±68.525. There is no significant difference between BMI, waist circumference, triglyseride level of two groups. (P:0.521, P:0.607, P:0.240).

Conclusion: There was not a precise finding to forsee permanent diabetes mellitus after pregnancy in GDM patients according to our study. Moreover, GDM enhances risk of postpartum ongoing diabetes mellitus.

Table 1 Comparison of metabolic and laboratory parameters of study groups
	Group A - GDM with initial vitamin D ≤20 ng/ml (n: 17)	Group B - GDM with initial vitamin D >20 ng/ml (n: 21)	P value
Age	33.50±3.90	31.82±5.01	0.244
Weight in first trimester (kg)	70.61±7.91	66.47±13.22	0.241
Weight in peripartum (kg)	80.57±7.67	76.06±12.56	0.294
BMI (kg/m²)	28.37±4.06	25.62±5.60	0.033
Fasting blood glucose (mg/dl)	96.17±13.51	89.93±10.63	0.341
HbA1c in peripartum (%)	5.51±0.54	5.04±0.48	0.006
Insulin (U/l)	9.21±3.12	12.44±4.95	0.027
HOMA-IR	1.92±0.93	2.82±1.34	0.297
50 gr OGTT – 1. hour (mg/dl)	165.19±20.32	176.15±16.02	0.856
100 gr OGTT – fasting glucose (mg/dl)	102.06±16.56	93.21±12.55	0.438
100 gr OGTT – 1. hour (mg/dl)	221.18±45.22	218.10±26.31	0.296
100 gr OGTT – 2. hour (mg/dl)	175.04±49.51	165.89±45.57	0.707
100 gr OGTT – 3. hour (mg/dl)	102.33±51.89	128.08±46.11	0.165
Free T4 hormone	0.72±0.25	0.75±0.24	0.641
Thyroid stimulant hormone	1.27±0.82	3.06±3.41	0.042
Anti thyroid peroxidase anticore	43.36±140.67	35.50±71.49	0.957
Anti thyroglobulin anticore	32.96±33.60	100.55±279.46	0.789
Parathormone	27.08±15.44	27.29±12.83	0.056
Calcium (mg/dl)	9.22±0.36	9.15±0.54	0.977
Phosphate (mg/dl)	3.90±0.63	3.68±0.92	0.486
Albumin (mg/dl)	3.74±0.21	3.61±0.42	0.241

Table 2 Spearman’s correlation results between vitamin D and metabolic parameters
	BMI	HbA1c in Peripartum	Fasting Blood Glucose	HOMA-IR
Vitamin D
R	−0.377	−0.424	−0.202	0.147
P	0.030	0.014	0.232	0.386
N	33	33	37	37

Endocrine Abstracts

EP478