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Diabetes Care Publish Ahead of Print published online ahead of print July 9, 2007
DOI: 10.2337/dc07-0329
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Original Research

Determinants of incident hyperglycemia 6 years after delivery in young rural Indian mothers: the Pune Maternal Nutrition Study (PMNS)

Smita R Kulkarni, MSc1, Caroline HD Fall, DM, FRCPCH2, Niranjan V Joshi, MD, DNB1, Himangi G Lubree, MSc1, Vaishali U Deshpande, MSc1, Rashmi V Pasarkar, MSc1, Dattatraya S Bhat, MSc1, Sadanand S Naik, Ph.D.1 and Chittaranjan S Yajnik, MD, FRCP1

1 Kamalnayan Bajaj Diabetology Research Centre, KEM Hospital and Research Centre, Pune.
2 MRC Epidemiology Resource Centre, University of Southampton, Southampton, UK.

diabetes{at}vsnl.com

ABSTRACT

Objective:To study determinants of incident hyperglycaemia in rural Indian mothers 6 years after delivery.

Research Design and Methods:The Pune Maternal Nutrition Study (PMNS) collected information in 6 villages near Pune on pre-pregnant characteristics, and nutrition, physical activity and glucose tolerance during pregnancy. An oral glucose tolerance test (OGTT) was repeated 6 years after delivery.

Results:Five hundred and ninety seven mothers had an OGTT at 28 weeks gestation; 3 had gestational diabetes (GDM, WHO 1999 criteria). Six years later, 42 of 509 originally normal glucose tolerant mothers were hyperglycemic (8 diabetic, 20 IGT and 14 IFG). The hyperglycemic women had shorter legs and thicker skinfolds before pregnancy (p<0.01, both) and were less active and more hyperglycemic (2-hour plasma glucose 4.8 vs. 4.4 mmol/L, p<0.001) during pregnancy. They had gained more weight during follow up (6.0 vs. 2.7 kg, p<0.001). Multivariate analysis revealed that total leucocyte count and blood pressure during pregnancy were additional independent predictors of 2h glucose concentration at follow up.

Conclusions:Our results suggest that compromised linear growth, adiposity, inflammation and less physical activity predispose to hyperglycemia in young rural Indian women. International cutpoints of diabetes risk factors are largely irrelevant in these women


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Copyright © 2007 by the American Diabetes Association.