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Modestly Elevated Glucose Levels During Pregnancy Are Associated With a Higher Risk of Future Diabetes Among Women Without Gestational Diabetes Mellitus

¹ Department of Obstetrics & Gynecology, University of Washington, Seattle, Washington
² Group Health Center for Health Studies, Seattle, Washington
³ Department of Epidemiology, University of Washington, Seattle, Washington
⁴ Division of Metabolism, Endocrinology, and Nutrition, Veterans Affairs Puget Sound Health Care System and the University of Washington, Seattle, Washington
⁵ Cardiovascular Health Research Unit, Seattle, Washington

Address correspondence and reprint requests to Darcy B. Carr, MD, MS, Obstetrics & Gynecology, Box 356460, University of Washington, Seattle, WA 98195-6460. E-mail: darcarr{at}u.washington.edu

OBJECTIVE—To determine whether 1-h oral glucose challenge test (OGCT) or 3-h oral glucose tolerance test (OGTT) results below gestational diabetes mellitus (GDM) criteria are associated with developing diabetes.

RESEARCH DESIGN AND METHODS—A retrospective cohort study was performed among women without GDM who had a pregnancy OGCT (n = 24,780) or OGTT (n = 6,222). Subsequent diabetes was ascertained by ICD-9 codes or pharmacy or laboratory data over a median follow-up of 8.8 years.

RESULTS—Diabetes risk increased across OGCT quartiles: adjusted hazard ratio (HR) 1.67 (95% CI 1.07–2.61) for 5.4–6.2 mmol/l, 2.13 (1.39–3.25) for 6.3–7.3 mmol/l, and 3.60 (2.41–5.39) for 7.4 mmol/l compared with 5.3 mmol/l. Women with one abnormal OGTT result had a higher risk compared with those with normal values (HR 2.08 [95% CI 1.35–3.20]).

CONCLUSIONS—Women with modestly elevated glucose levels below the threshold for GDM had a higher risk for diabetes.

Abbreviations: GDM, gestational diabetes mellitus • OGCT, oral glucose challenge test • OGTT, oral glucose tolerance test

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