107 The association of postpartum glucose and persistent impaired glucose tolerance in women with gestational diabetes

Abstract

We evaluated the association of fasting glucose values on postpartum day 1 (PPD1) with impaired glucose tolerance (IGT) in patients with gestational diabetes (GDM). We aim to identify a population at risk for IGT who may benefit from improved postpartum follow-up. We conducted a retrospective cohort study of patients with GDM who delivered from 2009-2019 at 2 suburban hospitals. Eligible patients had a singleton pregnancy affected by GDM with complete data on PPD1 fasting glucose and an oral glucose tolerance test (GTT) at 4-12 weeks postpartum. GDM was diagnosed by 50g 1-hour GTT ≥200mg/dL or 3-hour GTT with ≥2 values exceeding defined thresholds. Postpartum IGT was defined as a fasting glucose ≥100mg/dL or 2-hour glucose ≥140mg/dL on postpartum GTT. PPD1 fasting glucose values were divided into three categories (<95, 95-109, and ≥110mg/dL) for analyses. Univariate analyses were performed using Chi-squared, ANOVA, and Wilcoxon rank-sum tests as appropriate to evaluate the association between postpartum IGT and demographic variables, clinical characteristics, and PPD1 glucose by glucose category. Logistic regression models were performed to adjust for variables that were determined a priori and those found to be significant (p<0.05) in univariate analyses. Our analysis included 337 women of which 66.8% had a PPD1 glucose of <95, 21.7% had a PPD1 glucose of 95-109, and 11.5% had a PPD1 glucose ≥110mg/dL. Non-Hispanic white women were more likely have PPD1 glucose values<95 (44.71%, p=0.03) but maternal, demographic, and obstetric characteristics were otherwise not statistically significant between categories (Table 1). 83 patients (24.6%) developed IGT postpartum. In multivariate analysis, as compared to PPD1 glucose 95–109mg/dL: aOR=1.10, 95% CI 0.58-2.07, p=0.77; PPD1 glucose≥110mg/dL: aOR 1.01, 95% CI 0.44-2.30, p=0.99, Table 2). A higher fasting glucose on PPD1 was not significantly associated with IGT at 4-12 weeks postpartum.View Large Image Figure ViewerDownload Hi-res image Download (PPT)