Gestational diabetes and subsequent development of NIDDM in aboriginal women of northwestern Ontario.
OBJECTIVE
To determine (1) the risk of development of non-insulin-dependent diabetes mellitus (NIDDM) in women with a previous history of gestational diabetes mellitus (GDM), (2) the average duration between diagnoses of GDM and NIDDM, (3) various modes of presentation, and (4) adequacy of follow-up post diagnosis of GDM.


METHODS
A retrospective chart review of women diagnosed with GDM in the Sioux Lookout Zone between 1985-1995. There were 4,211 pregnancies and 332 women with a diagnosis of GDM. Sixty-one charts were randomly selected. Both GDM and NIDDM were defined according to World Health Organization standards.


RESULTS
Seventy percent of the women with GDM went on to develop NIDDM. The average duration between diagnosis of GDM and diagnosis of NIDDM was three years. Greater than 70% of the women developed NIDDM within four years post diagnosis of GDM. The majority presented with asymptomatic hyperglycemia (88%); 3% presented with acidosis; 6% presented with symptoms of polydipsia and polyuria; and 3% presented with abnormal weight gain. Specific physician-requested follow-up after six weeks postpartum occurred in only 38% of the cases. However six-week follow-up occurred in 41%, a yearly follow-up occurred in 61% of the women, and 81% of the women had some sort of follow-up post diagnosis of GDM.


CONCLUSIONS
The risk of developing NIDDM after GDM is very high in Aboriginal women of the Sioux Lookout Zone. There is an urgent need for a structured follow-up program for this group of high-risk women. Furthermore, the offspring of these pregnancies should be a focus for follow-up and preventive programs.
Mohamed
N
N
Sioux Lookout Zone Hospital, University of Toronto Program, Ontario, Canada.
Dooley
J
J
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D044467:American Indian or Alaska Native / Q000706:statistics & numerical data*; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology*; D016640:Diabetes, Gestational / Q000208:ethnology*; D005260:Female; D006801:Humans; D015994:Incidence; D015873:Northwest Territories / Q000453:epidemiology; D009864:Ontario / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors