title: Nutritional risk factors of early development of postpartum prediabetes and diabetes in women with gestational diabetes mellitus.
abstract: OBJECTIVE
  Early detection of prediabetes and diabetes after delivery helps prevent and delay the development of overt type 2 diabetes in women with gestational diabetes mellitus (GDM). We sought to identify modifiable risk factors for the early development of postpartum type 2 diabetes in women with GDM that may help establish interventions for preventing or delaying the subsequent onset of type 2 diabetes.
  
  
  METHODS
  Three hundred eighty-one women who developed GDM during pregnancy were tested for 1) antepartum anthropometric and biochemical measurements, 2) pregnancy outcome, 3) oral glucose tolerance test at 6 to 12 wk after delivery, and 4) postpartum anthropometric, biochemical, and nutritional measurements. The subjects were divided into three groups on the basis of the postpartum oral glucose tolerance test results: normal glucose tolerance group (n=193), prediabetes (n=161), and diabetes (n=27).
  
  
  RESULTS
  The incidences of postpartum prediabetes and diabetes at 6 to 12 wk follow-up in Korean women with GDM were 44.8% and 5.2%, respectively. Antepartum modifiable risk factors for developing type 2 diabetes at early postpartum included higher body mass index, lower β-cell function, insulin dosage during late pregnancy, and the non-modifiable risk factor of family history of diabetes (R2=0.14). Postpartum risk factors included higher body mass index, serum triacylglycerols, hemoglobin A1c, and energy intake and lower insulin secretion capacity (R2=0.43). Animal fat intake was higher in the prediabetes and diabetes groups than in the normal glucose tolerance group, whereas breast-feeding did not alter the risk for the development of postpartum diabetes.
  
  
  CONCLUSIONS
  This study strongly suggests that the development of postpartum type 2 diabetes in women with GDM can be prevented and/or delayed by lifestyle and nutritional intervention during antepartum and postpartum.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.
authors.forename: Sung-Hoon
authors.initials: SH
authors.lastname: Kim
authors.forename: Moon-Young
authors.initials: MY
authors.lastname: Kim
authors.forename: Jae-Hyug
authors.initials: JH
authors.lastname: Yang
authors.forename: So-Young
authors.initials: SY
authors.lastname: Park
authors.forename: Chang Hoon
authors.initials: CH
authors.lastname: Yim
authors.forename: Ki Ok
authors.initials: KO
authors.lastname: Han
authors.forename: Hyun Koo
authors.initials: HK
authors.lastname: Yoon
authors.forename: Sunmin
authors.initials: S
authors.lastname: Park
mesh_terms: D000328:Adult; D000818:Animals; D044466:Asian People; D015992:Body Mass Index; D001942:Breast Feeding; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D016640:Diabetes, Gestational / Q000097:blood / Q000503:physiopathology*; D004041:Dietary Fats / Q000008:administration & dosage; D042241:Early Diagnosis; D002149:Energy Intake; D005260:Female; D020022:Genetic Predisposition to Disease; D018149:Glucose Intolerance / Q000150:complications*; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000008:administration & dosage / Q000378:metabolism; D000078790:Insulin Secretion; D050417:Insulin-Secreting Cells / Q000502:physiology; D008460:Meat; D049590:Postpartum Period; D011236:Prediabetic State / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D004041:Dietary Fats; D006442:Glycated Hemoglobin; D007328:Insulin; D014280:Triglycerides