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Diabetes Care Publish Ahead of Print published online ahead of print January 25, 2008
DOI: 10.2337/dc07-1957
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Original Research

Modestly Elevated Glucose Levels During Pregnancy Are Associated with A Higher Risk of Future Diabetes Among Women Without Gestational Diabetes

Darcy B Carr, MD, MS1, Katherine M Newton, PhD2,,3, Kristina M Utzschneider, MD4, Jenny Tong, MD, MPH4, Fernando Gerchman, MD4, Steven E Kahn, MB, ChB4 and Susan R Heckbert, MD, PhD2,,3,,5

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

darcarr{at}u.washington.edu

ABSTRACT

Objective: To determine whether 1-hour oral glucose challenge test (OGCT) or 3-hour oral glucose tolerance test (OGTT) results below gestational diabetes criteria are associated with developing future diabetes.

Research Design and Methods: A retrospective cohort study was performed among women without gestational diabetes who had a pregnancy OGCT (N=24,780) or OGTT (N=6,222). The risk of subsequent diabetes was ascertained by ICD-9 codes, pharmacy or laboratory data over a median follow-up of 8.8 years.

Results: Future 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 (95%CI 1.39–3.25) for 6.3–7.3 mmol/l; and 3.60 (95%CI 2.41–5.39) for ≥7.4 mmol/l compared to ≤5.3 mmol/l. Women with one abnormal OGTT result had a higher risk compared to those with normal values (adjusted HR, 2.08, 95%CI 1.35–3.20).

Conclusions: Women with modestly elevated glucose levels below the threshold for gestational diabetes had a higher risk of future diabetes.


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Copyright © 2008 by the American Diabetes Association.