title: The risk factors and incidence of type 2 diabetes mellitus and metabolic syndrome in women with previous gestational diabetes.
abstract: BACKGROUND
  Gestational diabetes mellitus (GDM) affects nearly 5% of pregnancies. Significant proportion of the women with previous GDM develops type 2 diabetes mellitus (T2DM) in the next years, which indicates a higher risk in them than in the general population.
  
  
  OBJECTIVE
  We conducted this study to determine the risk factors and incidence of abnormal glucose level and metabolic syndrome (MetS) in women with a history of GDM in a long period after delivery in our region.
  
  
  METHODS
  We extracted the demographic characteristics of 110 women with GDM who had delivered during 2004 - 2010 in three main hospitals of Zanjan City, Iran. The patients were recalled to perform oral glucose tolerance test (OGTT) and other necessary tests for MetS diagnosis. Anthropometric measurements were recorded of all the participants.
  
  
  RESULTS
  In this study, 110 women with a history of GDM were studied at one to six years since delivery. Among these women, 36 (32.7%) developed T2DM and 11 (10%) had impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). Moreover, 22 women (20%) had developed MetS. among those with abnormal results in glycemic test, 93.6% had fasting blood sugar (FBS) ≥ 95 mg/dL (≥ 5.27 mmol/L)at the time of GDM diagnosis in the index pregnancy that was significantly higher than the normal glycemic test (NGT) group with 42.9% being affected (OR, 19.55; P < 0.0001). There was a significant difference between those with abnormal results and NGT group in interval between delivery and performing laboratory tests (27 ± 18.8 and 18.5 ± 17.7 months, respectively; OR, 1.02; P = 0.02). No insulin use during pregnancy was discovered as a protective factor in women with a history of GDM (OR, 0.35; P = 0.01). Those with abnormal results were significantly different from NGT group in the number of parities (2.61 ± 1.4 vs. 2.05 ± 1.1, respectively; OR, 1.4; P = 0.03). The most common component of MetS among women with a history of GDM was FBS > 100 mg/dL (> 5.55 mmol/L).
  
  
  CONCLUSIONS
  Regarding the high incidence of the T2DM and MetS among women with a history of GDM, they should be screened at a regular interval for diabetes and other cardiovascular risk factors.
authors.affiliation: Metabolic Disease Research Center, Zanjan University of Medical Sciences, Zanjan, IR Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Valizadeh
authors.affiliation: Metabolic Disease Research Center, Zanjan University of Medical Sciences, Zanjan, IR Iran.
authors.forename: Nooshin
authors.initials: N
authors.lastname: Alavi
authors.affiliation: Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, IR Iran.
authors.forename: Saeideh
authors.initials: S
authors.lastname: Mazloomzadeh
authors.affiliation: Student Research Committee, Zanjan University of Medical Sciences, Zanjan, IR Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Piri
authors.affiliation: Medical Laboratory ,Vali-e-Asr Hospital, Zanjan University of Medical Sciences, Zanjan, IR Iran.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Amirmoghadami
keywords: Gestational Diabetes Mellitus; Metabolic Syndrome; Risk Factors; Type 2 Diabetes Mellitus