Prevalence and Predictors of Glucose Intolerance after Gestational Diabetes Mellitus by 2013 WHO Criteria (IADPSG)

Introduction and Objective: To evaluate the prevalence and predictors associated with glucose intolerance in women with a recent history of gestational diabetes mellitus (GDM) by 2013 WHO criteria (IADPSG). Methods: This is a retrospective cohort analysis of 575 patients diagnosed with GDM by 2013 WHO criteria at Rajavithi Hospital (Thailand) between 2016 and 2020. All participants underwent a 75-g OGTT at six weeks postpartum. Participants were classified into two groups: normal glucose tolerance (NGT) and abnormal glucose tolerance (AGT) based on OGTT results. Multivariate analyses were conducted to compare pregestational and gestational factors between two groups. Results: Of all 575 GDM patients, 29.4% (169) had glucose intolerance at six weeks postpartum (1.7% impaired fasting glucose, 22.4% impaired glucose tolerance, 2.4% combined IFG&IGT and 2.8% type 2 diabetes). Compared to women with normal glucose tolerance, women with glucose intolerance were older (34.2±4.68 vs 32.96±5.16 years, p=0.005), early diagnosed of GDM at gestational age (20.12±5.94 vs 22.14±5.57 week, p<0.001), had history of previous GDM (7.7% vs 3.4%, p=0.028), insulin use during pregnancy (26% vs 15.8%, p=0.004), cesarian delivery (64.5% vs 49.5%, p=0.001), two or three abnormal values on 75-g OGTT at diagnosis of GDM (13% vs 4.4%, p<0.001). In the multivariate logistic regression, three abnormal values on 75-g OGTT at diagnosis of GDM [OR 3.92 (1.96-7.84), p<0.001)], diagnosed GDM before 24 weeks [OR 1.79 (1.23-2.6), p=0.002)] and cesarian delivery [OR 1.7 (1.16-2.5), p=0.006)] remained significant predictors for glucose intolerance in early postpartum. Conclusion: Based on 2013 WHO criteria, the prevalence of postpartum glucose intolerance is 29.4%. Three significant predictors for glucose intolerance include having all three abnormal glucose values on the OGTT during pregnancy, an early diagnosis of GDM before 24 weeks of gestation and delivery by cesarean section. Disclosure: K. Kandet: None. C. Deerochanawong: None. T. Treesaranuwattana: None.