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

  1. Darcy B. Carr, MD, MS1,
  2. Katherine M. Newton, PHD23,
  3. Kristina M. Utzschneider, MD4,
  4. Jenny Tong, MD, MPH4,
  5. Fernando Gerchman, MD4,
  6. Steven E. Kahn, MB, CHB4 and
  7. Susan R. Heckbert, MD, PHD235
  1. 1Department of Obstetrics & Gynecology, University of Washington, Seattle, Washington
  2. 2Group Health Center for Health Studies, Seattle, Washington
  3. 3Department of Epidemiology, University of Washington, Seattle, Washington
  4. 4Division of Metabolism, Endocrinology, and Nutrition, Veterans Affairs Puget Sound Health Care System and the University of Washington, Seattle, Washington
  5. 5Cardiovascular Health Research Unit, Seattle, Washington
  1. 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

Abstract

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.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 25 January 2008. DOI: 10.2337/dc07-1957.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted January 22, 2008.
    • Received October 9, 2007.
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  1. Diabetes Care vol. 31 no. 5 1037-1039
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