Endocrine Abstracts (2016) 41 EP560 | DOI: 10.1530/endoabs.41.EP560

Predictive factors in the management and the prognosis of Korean women with gestational diabetes mellitus

Min Jeong Kwon1,2, Seoyoung Hong2, Younju Kwon2, Yonghee Kwon2, Seonhung Kim2, Hyunjun Kim2, Yunje Lee2, Taekyoon Kim1,2, Soonhee Lee1,2 & Jeon Hyun Park1,2

1Busanpaik Hospital, College of Medicine, Inje University, Busan, Republic of Korea; 2College of Medicine, Inje University, Busan, Republic of Korea.

Introduction: Gestational diabetes mellitus (GDM) of increasing prevalence, lacks factors known to predict the prognosis of GDM. The correlations between levels of Oral Glucose Tolerance Test (OGTT) and BMI before pregnancy and the clinical progress of GDM were evaluated.

Methods: Data of pregnant women diagnosed as GDM in Busanpaik hospital from January 1, 2010 to February 28, 2015 were studied. Correlations between patients’ OGTT in gestational age 24–28 weeks, BMI before pregnancy, and the prognosis of GDM (insulin usage and dose, postpartum 75-g OGTT, neonatal APGAR) were analyzed.

Results: Among 97 patients, 35% required insulin treatment. Initial OGTT had profound effect on prognosis of GDM and complications of the pregnant woman and the fetus. One-hour 50-g OGTT (value: >165.5 mg/dl, sensitivity: 0.840, specificity: 0.420) and 2-h 100-g OGTT (value: >171.5 mg/dl, sensitivity: 0.800, specificity: 0.380) showed affinitive correlations with insulin usage. 75-g OGTT result after delivery in the group that used insulin therapy was significantly higher compared to the group that controlled by just diet modification, all in fasting, after 1-h, and 2-h test. Especially, fasting glucose levels showed affinitive correlation with the usage of insulin (P=0.043). For neonatal health, one and two hour 100-g OGTT showed meaningful correlation with 1 min APGAR score (P=0.042, P=0.010), especially 2-h OGTT showing affinitive correlation with 5 minute APGAR score (P=0.010). Unlike OGTT, BMI showed no consequential correlation.

Conclusion: Initial 50- and 100-g OGTT are factors legitimate for prediction of prognosis of GDM such as need of insulin treatment and mother and fetal complications.