[Carbohydrate disturbances among women after gestational diabetes mellitus]. / Wystepowanie zaburzen gospodarki weglowodanowej u kobiet po przebytej cukrzycy ciazowej.

UNLABELLED: Gestational diabetes (GDM) is regarded as a predilecting factor for a subsequent development of diabetes or other disturbances in carbohydrate metabolism. The aim of the study was to evaluate the risk of occurrence of failures in carbohydrate metabolism in females who sufferred from GDM, as well as to determine the prognostic values of selected markers that were regarded as factors favouring the development of diabetes mellitus (DM). MATERIAL AND METHODS: Patients who in the past suffered from GDM were subjected to this study. Out of 153 patients who responded positively to the written invitation to participate in this study, 74 had already been treated for DM. In 5 of them, abnormal glucose tolerance was found, and 74 of this group had been subjected to a 75g OGTT. The control group consisted of 153 subjects, who had given birth at least twice and in whom the metabolic diagnostics performed during the first pregnancy excluded GDM. Results of our study have revealed that patients who in the past had sufferred from GDM constituted a group with high risk for developing disturbances in carbohydrate metabolism or symptoms of metabolic syndrome after pregnancy. The main factors pro the development of the disturbances in carbohydrante metabolism were: overweight, increased fasting glycemia at the time of GDM diagnosis and insulin requirement during pregnancy. CONCLUSION: High percentage of diagnosis of an impaired carbohydrate metabolism and DM, calls for a special attention toward a group of patients with previous GDM, for a properly directed treatment that would enable a considerable delay in the development of an overt diabetes, as well as would apply a rational therapy, that would result in an optimal control of existing diabetes.

Components of metabolic syndrome in women after gestational diabetes.

OBJECTIVES: The aim of the study was to evaluate the risk of occurrence of metabolic syndrome (MS) in females who suffered from gestational diabetes mellitus (GDM). PATIENTS AND METHODS: 495 letters were sent to patients with a history of GDM treated in the Department between 1993-2002. One hundred and fifty-three (30.9%) patients who responded positively formed the study group. Out of them 74 had already been treated for diabetes mellitus, and glucose intolerance was found in 5 subjects. Seventy-four patients had been subjected to a 75 g Oral Glucose Tolerance Test, as well as the control group that consisted of 155 subjects, in whom GDM during pregnancy was excluded. In all patients lipid parameters, blood pressure, height, weight and waist circumference were measured and body mass index (BMI) was calculated. Metabolic syndrome was diagnosed according to the modified NCEP-ATP III criteria from 2005 (3 of 5 had to be fulfilled). RESULTS: Patients from the study group were older than from the control group (p <0.05), higher was their BMI at the time of the index pregnancy, as well as after the observation time (p <0.0001). Metabolic syndrome was developed in 47 (30.7%) patients of the study group and 8 (5.2%) patients from the control group (p <0.001). The study group presented all components of MS significantly more often than the control group--in both groups, we found respectively: abnormal waist circumference--57% vs. 37.6% (p <0.005), hypertension--18.9% vs. 1.9% (p <0.001), elevated fasting glycemia--79.1% vs. 1.9%, hypertriglyceridemia--21.6% vs. 2.6% (p <0.0001), and decreased concentrations of high-density lipoprotein cholesterol--11.1% vs. 2.6% (p <0.005). CONCLUSIONS: Patients who suffered from GDM are at high risk for carbohydrate disturbances and metabolic syndrome in the following year. Therefore, they should be under continuous medical surveillance that would enable early detection and treatment of the metabolic disturbances.