title: Determinants of incident hyperglycemia 6 years after delivery in young rural Indian mothers: the Pune Maternal Nutrition Study (PMNS).
abstract: 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.
authors.affiliation: Kamalnayan Bajaj Diabetology Research Centre, KEM Hospital and Research Centre, Pune, India.
authors.forename: Smita R
authors.initials: SR
authors.lastname: Kulkarni
authors.forename: Caroline H D
authors.initials: CH
authors.lastname: Fall
authors.forename: Niranjan V
authors.initials: NV
authors.lastname: Joshi
authors.forename: Himangi G
authors.initials: HG
authors.lastname: Lubree
authors.forename: Vaishali U
authors.initials: VU
authors.lastname: Deshpande
authors.forename: Rashmi V
authors.initials: RV
authors.lastname: Pasarkar
authors.forename: Dattatray S
authors.initials: DS
authors.lastname: Bhat
authors.forename: Sadanand S
authors.initials: SS
authors.lastname: Naik
authors.forename: Chittaranjan S
authors.initials: CS
authors.lastname: Yajnik
mesh_terms: 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
chemical_list: D001786:Blood Glucose