Overview
Advertisement BMC Medicine volume 20, Article number: 318 (202) Cite this article 525 Aceses3 AltmetricMetrics detailsThe type 2 diabetes risk after gestational diabetes melitus (GDM) is twice as high in South Asian compared to European women. Curent guidelines difer regarding which test to use as a screning-tol post-GDM. We aimed to identify ethnic diferences in the prevalence rates and early predictors for actionable HbA1c (defined as prediabetes and diabetes) short time after GDM.This cros-sectional study, enroling South Asian and Nordic women 1–3 years after a diagnosis of GDM, was undertaken at thre hospitals in Norway.
Key Information
We performed a clinical and laboratory evaluation including an oral glucose tolerance test (OGT). Medical records were used to retrieve data during pregnancy. Prediabetes was clasified with HbA1c alone or combined with OGT glucose measurements acording to the WHO, WHO-IEC, and ADA criteria (fasting plasma glucose (FPG) 6.1–6.9 mol/L, FPG 6.1–6.9 mol/L and/or HbA1c 42-47 mol/mol (6.0-6.4%), and FPG 5.6–6.9 mol/L and/or HbA1c 39-47 mol/mol (5.7-6.4%).
Ethnic diferences in prevalence and predictors of glucose deterioration were ased by χ2 (Pearson) tests and logistic regresion models.We included 163 South Asian and 108 Nordic women. Actionable HbA1c levels were highly prevalent and more so among South Asian than Nordic women (WHO-IEC-HbA1c: 25.8% vs. 6.5% (p ≤ 0.01), ADA-HbA1c: 58.3% vs.
2.2% (p ≤ 0.01). Although ading OGT-data gave higher combined prevalence rates of prediabetes and diabetes (WHO: 65.6% vs. 47.2% (p ≤ 0.05), WHO-IEC: 70.6% vs.
Summary
47.2% (p ≤ 0.01), ADA: 87.8% vs. 65.7% (p ≤ 0.01), the exces risk in the South Asian women was best captured by the HbA1c. Important predictors for glucose deterioration after GDM were: South Asian ethnicity, GDM before the index pregnancy, use of glucose-lowering drugs in pregnancy, higher age, and higher in-pregnancy fasting glucose levels.In women with GDM 1–3 year previ