Insulin Use for Gestational Diabetes Associated With Postpartum Diabetes

This article is part of Endocrinology Advisor‘s coverage of the 26th American Association of Clinical Endocrinologists (AACE) Annual Scientific Sessions & Clinical Congress, taking place in Austin, Texas. Our staff will report on medical research and technological advances in diabetes, obesity, and thyroid conditions, conducted by experts in the field. Check back regularly for more news from AACE 2017.

In a retrospective study presented at the 26th American Association of Clinical Endocrinologists (AACE) Annual Scientific Sessions & Clinical Congress, May 3-7, in Austin, Texas, women who required insulin for gestational diabetes mellitus (GDM) had an elevated risk for postpartum diabetes vs those with GDM who did not require insulin.¹

According to the Centers for Disease Control and Prevention (CDC), up to 9.2% of pregnant women develop GDM.² These patients have an increased risk for subsequent type 2 diabetes, underscoring the need for follow-up glucose testing in this population.

In the current study, researchers from Federal Medical Centre and Lagos University Teaching Hospital in Nigeria investigated factors linked to postpartum screening in 85 women with GDM at a tertiary healthcare facility.

Using data collected within 6 to 12 weeks of delivery, the researchers analyzed associations among patient age, body mass index (BMI), parity, treatment approach, and postpartum screening results. GDM patients had a mean age of 36 years, and 58.8% of the sample had given birth 2 to 3 times previously. Approximately 66% of patients had a BMI ≥25 kg/m².

Only 40% of the sample had postpartum glucose testing at 6 to 12 weeks. Of these patients, 7.05% were diagnosed with diabetes mellitus, and an additional 15.3% had impaired glucose tolerance. A higher risk for postpartum diabetes was found in patients with GDM who had required insulin during pregnancy.

In line with earlier findings, the present results showed that the “majority of women with GDM did not have postpartum screening as recommended,” despite the high risk for type 2 diabetes in these patients, the investigators wrote. “Women with GDM should have a long term management plan from pregnancy period to prevent being lost during follow up.”

Communication may be improved with the use of text messages and telephone calls, and thereby increase the likelihood of postpartum glucose screening with such patients after discharge.

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Reference

1. Chukwunyere C, Ukandu I. Postpartum glucose testing after gestational diabetes mellitus and patterns of abnormal glucose results. Abstract 234. Presented at: 26th American Association of Clinical Endocrinologists (AACE) Annual Scientific Sessions & Clinical Congress. May 3-7, 2017; Austin, TX.
2. DeSisto CL, Kim SY, Sharma AJ. Prevalence estimates of gestational diabetes mellitus in the United States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2007-2010. Prev Chronic Dis. 2014;11:130415. doi:10.5888/pcd11.130415