Predicting the metabolic condition after gestational diabetes mellitus from oral glucose tolerance test curves shape.
The objective of this feasibility study is to predict the metabolic condition in women with a history of gestational diabetes mellitus (GDM) from the shape of oral glucose tolerance test (OGTT) data. The rationale for this approach is that the evolution to a metabolic condition could be traceable in the shape of OGTT curves. 3-h OGTT data of 136 women with follow up, for a total of 401 OGTTs were analyzed. Subjects were classified as having normal (NGT) or non-normal glucose tolerance (NON-NGT), according to the American Diabetes Association criteria. The measured glucose, insulin, C-peptide data and combination of them were used to build up NGT and NON-NGT reference curves. Similarity between reference and individual OGTT-based curves was calculated using the Kullback-Leibler divergence. Our findings suggest that the shape of OGTT curves (1) contains information on the evolution to disease and (2) could be a reliable indicator to predict with high sensitivity (75%) and high specificity (69%) the metabolic condition of women with a history of GDM. In the future, the proposed shape-based prediction could be easily translated to the clinical practice, because it does not require the intervention of an operator specifically trained, thus facilitating its application in a clinical setting and ultimately empowering risk estimation, by improving/complementing the information which is currently adopted for risk stratification after pregnancy with GDM.
Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Corso Duca degli Abruzzi, 24, 10129, Turin, Italy, umberto.morbiducci@polito.it.
Umberto
U
Morbiducci
Giacomo
G
Di Benedetto
Laura
L
Gaetano
Alexandra
A
Kautzky-Willer
Giovanni
G
Pacini
Andrea
A
Tura
D001786:Blood Glucose / Q000032:analysis*; D002096:C-Peptide / Q000097:blood*; D016640:Diabetes, Gestational / Q000378:metabolism*; D005240:Feasibility Studies; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood*; D008954:Models, Biological; D011247:Pregnancy
D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin