title: Model for individual prediction of diabetes up to 5 years after gestational diabetes mellitus.
abstract: OBJECTIVE
  To identify predictors of diabetes development up to 5 years after gestational diabetes mellitus (GDM) and to develop a prediction model for individual use.
  
  
  METHODS
  Five years after GDM, a 75-g oral glucose tolerance test (OGTT) was performed in 362 women, excluding women already diagnosed with diabetes at 1- to 2-year follow-up or later (n = 45). All but 21 women had results from follow-up at 1-2 years, while 84 women were lost from that point. Predictive variables were identified by logistic regression analysis.
  
  
  RESULTS
  Five years after GDM, 28/362 women (8 %) were diagnosed with diabetes whereas 187/362 (52 %) had normal glucose tolerance (NGT). Of the latter, 139/187 (74 %) also had NGT at 1- to 2-year follow-up. In simple regression analysis, using NGT at 1-2 years and at 5 years as the reference, diabetes at 1- to 2-year follow-up or later was clearly associated with easily assessable clinical variables, such as BMI at 1- to 2-year follow-up, 2-h OGTT glucose concentration during pregnancy, and non-European origin (P < 0.0001). A prediction model based on these variables resulting in 86 % correct classifications, with an area under the receiver-operating characteristic curve of 0.91 (95 % CI 0.86-0.95), was applied in a function-sheet line diagram illustrating the individual effect of weight on diabetes risk.
  
  
  CONCLUSIONS
  The results highlight the importance of BMI as a potentially modifiable risk factor for diabetes after GDM. Our proposed prediction model performed well, and should encourage validation in other populations in future studies.
authors.affiliation: Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden ; Department of Obstetrics and Gynecology, Helsingborg Hospital, SE-251 87 Helsingborg, Sweden.
authors.forename: Claes
authors.initials: C
authors.lastname: Ignell
authors.affiliation: Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden ; Department of Internal Medicine, Helsingborg Hospital, Helsingborg, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Ekelund
authors.affiliation: Department of Clinical Sciences, Lund, Lund University, Lund, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Anderberg
authors.affiliation: Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden ; Department of Endocrinology, Skåne University Hospital, Malmö, Sweden.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Berntorp
keywords: Diabetes mellitus; Follow-up; Gestational diabetes mellitus; Glucose tolerance; Prediction