High blood sugar may persist after delivery in obese women with Gestational diabetes: Study

The study is published in the journal Revista Brasileira de Ginecologia e Obstetrícia. 

Gestational diabetes is diabetes diagnosed for the first time during pregnancy leading to high blood sugar that can affect pregnancy outcomes and baby's health.

According to the American Diabetes Association's "Standards of Medical Care in Diabetes--2010," , the presence of any one of the following criteria supports the diagnosis of diabetes mellitus:

Hemoglobin A1C (HbA1C) = 6.5%

Fasting blood sugar = >126 mg/dL (7.0 mmol/L)

A 2-hour blood sugar level = 200 mg/dL (11.1 mmol/L) during a 75-g OGTT

A random blood sugar level = 200 mg/dL (11.1 mmol/l) in a patient with classic symptoms of hyperglycemia or hyperglycemic crisis

Gestational diabetes appears to result from the same broad spectrum of physiological and genetic abnormalities that characterize diabetes outside of pregnancy. Indeed, women with GDM are at high risk for having or developing diabetes when they are not pregnant. Thus, gestational diabetes provides a unique opportunity to study the early pathogenesis of diabetes and to develop interventions to prevent the disease.

Therefore, Rehder PM and colleagues from the Obstetrics Departament, Universidade Estadual de Campinas, Campinas, SP, Brazil conducted the study to evaluate the obstetric and sociodemographic characteristics of gestational diabetic women who maintained hyperglycemia in the postpartum period (6-12 weeks postpartum).

A total of one hundred and twenty-two women were included in the longitudinal cohort study who have had gestational diabetes and/or macrosomic children.

Between 6 and 12 weeks after birth, women who had gestational diabetes collected fasting glycemia, glucose tolerance test, and glycated hemoglobin results. The data were collected from medical records and during an interview in the first postpartum consultation. A statistical analysis was performed using frequency, percentage, Chi-Squared test, Fisher exact test, Mann-Whitney test, and multivariate Poisson regression. The significance level adopted for the statistical tests was 5%.

The following results were noted-

a. Most of the women were younger than 35 years old (70.5%), white, multiparous, and with no history of gestational diabetes.

b. Thirteen percent of the participants developed persistent hyperglycemia or high blood sugar.

c. Univariate analysis showed that maternal age above 35 years, being overweight, having grade 1 obesity and weight gain under 5 kg was related to the persistence of high blood sugar or hyperglycemia in the postpartum period.

Therefore, it was concluded that "maternal age above 35 years, obesity and overweight, and the diagnosis of gestational diabetes in the first trimester of pregnancy is associated with hyperglycemia during the postpartum period."