title: Risk factors associated with abnormal glucose tolerance in the early postpartum period among Japanese women with gestational diabetes.
abstract: OBJECTIVE
  To identify the risk factors associated with abnormal glucose tolerance (AGT) on the first postpartum oral glucose tolerance test (OGTT) among Japanese women with gestational diabetes (GDM).
  
  
  METHODS
  In a retrospective study, data were analyzed from women with GDM who underwent their first postpartum OGTT 6-8weeks post partum at a center in Omura, Japan, between January 1, 2007, and December 31, 2011. Women with diabetes or impaired glucose tolerance were deemed to have postpartum AGT. The association between postpartum AGT and various risk factors was analyzed.
  
  
  RESULTS
  Among 169 women who underwent a postpartum OGTT, 58 (34.3%) had AGT. The significant risk factors associated with postpartum AGT in univariate analysis were pre-pregnancy body mass index (P=0.096), 1-hour plasma glucose (P=0.006), hemoglobin A1c (P<0.001), insulinogenic index (P=0.05), an insulinogenic index of less than 0.4 (P=0.006), and insulin therapy during pregnancy (P<0.001). Independent risk factors identified by multivariate logistic regression models were insulinogenic index (odds ratio [OR] 0.10, 95% confidence interval [CI] 0.01-0.74; P=0.002), an insulinogenic index of less than 0.4 (OR 5.70, 95% CI 1.69-21.66; P=0.005), and insulin therapy during pregnancy (OR 3.43, 95% CI 1.03-12.55; P=0.044).
  
  
  CONCLUSIONS
  Among Japanese women with GDM, a lower insulinogenic index and use of insulin therapy during pregnancy are associated with early postpartum AGT.
authors.affiliation: Department of Obstetrics and Gynecology, National Hospital Organization Nagasaki Medical Center, Omura, Japan.
authors.forename: Yukari
authors.initials: Y
authors.lastname: Kugishima
authors.affiliation: Department of Obstetrics and Gynecology, National Hospital Organization Nagasaki Medical Center, Omura, Japan. Electronic address: yasuhi@nagasaki-mc.com.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yasuhi
authors.affiliation: Department of Obstetrics and Gynecology, National Hospital Organization Nagasaki Medical Center, Omura, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamashita
authors.affiliation: Department of Obstetrics and Gynecology, National Hospital Organization Nagasaki Medical Center, Omura, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Fukuda
authors.affiliation: Department of Obstetrics and Gynecology, National Hospital Organization Nagasaki Medical Center, Omura, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Kuzume
authors.affiliation: Department of Obstetrics and Gynecology, National Hospital Organization Nagasaki Medical Center, Omura, Japan.
authors.forename: So
authors.initials: S
authors.lastname: Sugimi
authors.affiliation: Department of Obstetrics and Gynecology, National Hospital Organization Nagasaki Medical Center, Omura, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Umezaki
authors.affiliation: Department of Obstetrics and Gynecology, National Hospital Organization Nagasaki Medical Center, Omura, Japan.
authors.forename: Sachie
authors.initials: S
authors.lastname: Suga
authors.affiliation: Department of Obstetrics and Gynecology, National Hospital Organization Nagasaki Medical Center, Omura, Japan.
authors.forename: Nobuko
authors.initials: N
authors.lastname: Kusuda
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000097:blood* / Q000188:drug therapy; D005260:Female; D018149:Glucose Intolerance / Q000097:blood / Q000209:etiology*; D005951:Glucose Tolerance Test / Q000379:methods; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000097:blood / Q000627:therapeutic use; D007564:Japan; D049590:Postpartum Period / Q000097:blood* / Q000378:metabolism; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: Abnormal glucose tolerance; Gestational diabetes; Insulinogenic index; Japan; Postpartum period; Risk factors