title: A Korean multicenter study of prenatal risk factors for overt diabetes during the postpartum period after gestational diabetes mellitus.
abstract: OBJECTIVE
  To identify prenatal risk factors for postpartum diabetes among pregnant women with gestational diabetes mellitus (GDM).
  
  
  METHODS
  In a retrospective study, baseline characteristics and data from a postpartum 75-g glucose tolerance test (GTT) were reviewed for patients with GDM who had delivered in four Korean tertiary institutions from 2006 to 2012. Clinical characteristics were compared between women with and those without postpartum diabetes. Cutoffs to predict postpartum diabetes and diagnostic values were calculated from receiver operating characteristic (ROC) curves.
  
  
  RESULTS
  Of 1637 patients with GDM, 498 (30.4%) underwent a postpartum 75-g GTT. Postpartum diabetes was diagnosed in 40 (8.0%) patients and impaired glucose intolerance in 157 (31.5%). Women with postpartum diabetes had higher glycated hemoglobin (HbA1c) levels at GDM diagnosis (P=0.008) and higher 100-g GTT values (P<0.05 for all). In ROC curve analysis, optimal cutoffs for predicting postpartum diabetes were 0.058 for HbA1c level and 5.3 mmol/L (fasting), 10.9 mmol/L (1h), 10.2 mmol/L (2h), and 8.6 mmol/L (3h) for 100-g GTT. The highest sensitivity was observed for 3-h 100-g GTT (76.9%) and the highest positive predictive value was for HbA1c at diagnosis (15.2%).
  
  
  CONCLUSIONS
  HbA1c level at GDM diagnosis and 100-g GTT values could be used to identify patients at high risk of postpartum diabetes who should undergo postpartum screening.
authors.affiliation: Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Na-Ri
authors.initials: NR
authors.lastname: Shin
authors.affiliation: Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: So-Yeon
authors.initials: SY
authors.lastname: Yoon
authors.affiliation: Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, South Korea.
authors.forename: Geum Joon
authors.initials: GJ
authors.lastname: Cho
authors.affiliation: Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Suk-Joo
authors.initials: SJ
authors.lastname: Choi
authors.affiliation: Department of Obstetrics and Gynecology, Konkuk University School of Medicine, Seoul, South Korea.
authors.forename: Han-Sung
authors.initials: HS
authors.lastname: Kwon
authors.affiliation: Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, South Korea.
authors.forename: Soon Cheol
authors.initials: SC
authors.lastname: Hong
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.
authors.forename: Ja-Young
authors.initials: JY
authors.lastname: Kwon
authors.affiliation: Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. Electronic address: ohsymd@skku.edu.
authors.forename: Soo-Young
authors.initials: SY
authors.lastname: Oh
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D016640:Diabetes, Gestational / Q000175:diagnosis*; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D049590:Postpartum Period / Q000097:blood*; D011247:Pregnancy; D012372:ROC Curve; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: 100-g glucose tolerance test; 75-g glucose tolerance test; Gestational diabetes mellitus; Glycated hemoglobin; Overt diabetes mellitus; Postpartum period