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  • Title: Nutritional risk factors of early development of postpartum prediabetes and diabetes in women with gestational diabetes mellitus.
    Author: Kim SH, Kim MY, Yang JH, Park SY, Yim CH, Han KO, Yoon HK, Park S.
    Journal: Nutrition; 2011; 27(7-8):782-8. PubMed ID: 21106349.
    Abstract:
    OBJECTIVE: Early detection of prediabetes and diabetes after delivery helps prevent and delay the development of overt type 2 diabetes in women with gestational diabetes mellitus (GDM). We sought to identify modifiable risk factors for the early development of postpartum type 2 diabetes in women with GDM that may help establish interventions for preventing or delaying the subsequent onset of type 2 diabetes. METHODS: Three hundred eighty-one women who developed GDM during pregnancy were tested for 1) antepartum anthropometric and biochemical measurements, 2) pregnancy outcome, 3) oral glucose tolerance test at 6 to 12 wk after delivery, and 4) postpartum anthropometric, biochemical, and nutritional measurements. The subjects were divided into three groups on the basis of the postpartum oral glucose tolerance test results: normal glucose tolerance group (n=193), prediabetes (n=161), and diabetes (n=27). RESULTS: The incidences of postpartum prediabetes and diabetes at 6 to 12 wk follow-up in Korean women with GDM were 44.8% and 5.2%, respectively. Antepartum modifiable risk factors for developing type 2 diabetes at early postpartum included higher body mass index, lower β-cell function, insulin dosage during late pregnancy, and the non-modifiable risk factor of family history of diabetes (R2=0.14). Postpartum risk factors included higher body mass index, serum triacylglycerols, hemoglobin A1c, and energy intake and lower insulin secretion capacity (R2=0.43). Animal fat intake was higher in the prediabetes and diabetes groups than in the normal glucose tolerance group, whereas breast-feeding did not alter the risk for the development of postpartum diabetes. CONCLUSION: This study strongly suggests that the development of postpartum type 2 diabetes in women with GDM can be prevented and/or delayed by lifestyle and nutritional intervention during antepartum and postpartum.
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