Determinants of incident hyperglycemia 6 years after delivery in young rural Indian mothers: the Pune Maternal Nutrition Study (PMNS).
OBJECTIVE
To study determinants of incident hyperglycemia in rural Indian mothers 6 years after delivery.


METHODS
The Pune Maternal Nutrition Study collected information in six villages near Pune on prepregnant characteristics and nutrition, physical activity, and glucose tolerance during pregnancy. An oral glucose tolerance test (OGTT) was repeated 6 years after delivery.


RESULTS
A total of 597 mothers had an OGTT at 28 weeks' gestation; 3 had gestational diabetes (by World Health Organization 1999 criteria). Six years later, 42 of 509 originally normal glucose-tolerant mothers were hyperglycemic (8 diabetic, 20 with impaired glucose tolerance, and 14 with impaired fasting glucose). The hyperglycemic women had shorter legs and thicker skinfolds before pregnancy (P < 0.01, both), were less active and more hyperglycemic (2-h plasma glucose 4.8 vs. 4.4 mmol/l, P < 0.001) during pregnancy, and gained more weight during follow-up (6.0 vs. 2.7 kg, P < 0.001). Multivariate analysis revealed that total leukocyte count and blood pressure during pregnancy were additional independent predictors of 2-h glucose concentration at follow-up.


CONCLUSIONS
Our results suggest that compromised linear growth, adiposity, inflammation, and less physical activity predispose to hyperglycemia in young rural Indian women. International cut points of diabetes risk factors are largely irrelevant in these women.
Kulkarni
Smita R
SR
Kamalnayan Bajaj Diabetology Research Centre, KEM Hospital and Research Centre, Pune, India.
Fall
Caroline H D
CH
Joshi
Niranjan V
NV
Lubree
Himangi G
HG
Deshpande
Vaishali U
VU
Pasarkar
Rashmi V
RV
Bhat
Dattatray S
DS
Naik
Sadanand S
SS
Yajnik
Chittaranjan S
CS
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D016640:Diabetes, Gestational / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000453:epidemiology; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology*; D015994:Incidence; D007194:India / Q000453:epidemiology; D011247:Pregnancy / Q000502:physiology*; D012424:Rural Population; D012959:Socioeconomic Factors; D013997:Time Factors
D001786:Blood Glucose