title: Prevalence and predictors of postpartum glucose intolerance in Italian women with gestational diabetes mellitus.
abstract: OBJECTIVE
  To determine the prevalence of both prediabetes and type 2 diabetes mellitus (T2DM) by postpartum oral glucose tolerance test (ppOGTT) in Italian women diagnosed with gestational diabetes mellitus (GDM), and identify antepartum predictors of glucose intolerance.
  
  
  METHODS
  Retrospective study of 454 Caucasian women that underwent a 75g OGTT between 6 and 12 weeks postpartum in Calabria (Southern Italy) between 2004 and 2012. Prediabetes and T2DM were diagnosed according to the American Diabetes Association (ADA) criteria. Data were examined by univariate analysis and multiple regression analysis.
  
  
  RESULTS
  290 women (63.9%) were normal, 146 (32.1%) had prediabetes (85 impaired fasting glycemia; 61 impaired glucose tolerance), and 18 (4.0%) had T2DM. Of the continuous variables, pre-pregnancy body mass index (BMI), age at pregnancy, fasting plasma glucose (FPG) at gravid OGTT, and week at diagnosis of GDM were associated with prediabetes and T2DM, whereas the parity was associated with T2DM only. For categorical traits, pre-pregnancy BMI ≥ 25 and previous diagnosis of polycystic ovary syndrome (PCOS) emerged as the strongest predictors of prediabetes whereas the strongest predictors of T2DM were FPG ≥ 100 mg/dl (5.6 mmol/l) at GDM diagnosis and pre-pregnancy BMI ≥ 25. Moreover, FPG at GDM screening was a good predictor of T2DM after receiver-operating-characteristic analysis.
  
  
  CONCLUSIONS
  Our findings confirm the high prevalence of glucose intolerance in the early postpartum period in women with previous GDM. PCOS emerges as a new strong antepartum predictor of prediabetes.
authors.affiliation: Complex Operative Structure of Endocrinology-Diabetology, Pugliese-Ciaccio Hospital, 88100 Catanzaro, Italy.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Capula
authors.affiliation: Department of Health Sciences, University "Magna Græcia" of Catanzaro, 88100 Catanzaro, Italy.
authors.forename: Eusebio
authors.initials: E
authors.lastname: Chiefari
authors.affiliation: Complex Operative Structure of Endocrinology-Diabetology, Pugliese-Ciaccio Hospital, 88100 Catanzaro, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Vero
authors.affiliation: Department of Health Sciences, University "Magna Græcia" of Catanzaro, 88100 Catanzaro, Italy.
authors.forename: Daniela P
authors.initials: DP
authors.lastname: Foti
authors.affiliation: Department of Health Sciences, University "Magna Græcia" of Catanzaro, 88100 Catanzaro, Italy. Electronic address: brunetti@unicz.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Brunetti
authors.affiliation: Complex Operative Structure of Endocrinology-Diabetology, Pugliese-Ciaccio Hospital, 88100 Catanzaro, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Vero
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000473:pathology; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology* / Q000209:etiology; D005951:Glucose Tolerance Test; D006801:Humans; D007558:Italy / Q000453:epidemiology; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000473:pathology; D049590:Postpartum Period; D011236:Prediabetic State / Q000453:epidemiology* / Q000473:pathology; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose
keywords: Gestational diabetes mellitus; Polycystic ovary syndrome; Prediabetes; Type 2 diabetes mellitus