Metabolic record of patients with history of gestational diabetes. Follow-up of patients for six years (2013-2019)

Abstract

Introduction: there is no register of the number of women with gestational diabetes (GD) that have undergone metabolic post-partum control in the province of La Pampa, even though it is well-known the increased associated risk of becoming a diabetes type 2 patient (T2DM).

Objectives: to analyze at the Interzonal Public Hospital (Dr. Lucio Molas) the percentage of women with GD who returned to postpartum metabolic control and developed T2DM during six years of follow-up.

Materials and methods: descriptive ambispective study in 44 patients with GD diagnosed in 2013 with follow-up until 31 December 2019. Different characteristics were analyzed in all participants: previous history of GD and family members of diabetes (FHD), age, gestational week of the diagnosis with fasting glucose or oral glucose tolerance test (OGTT), body mass index (BMI), blood pressure, delivery route, newborn weight, glycated hemoglobin (HbA1C).

Results: in 2013, 1,238 deliveries were performed, 44 patients (3.7%) had diagnosed DG, 68% through OGTT. They presented 43% AFD, 38.6% overweight, 20.45% obesity, 68.2% cesarean sections and 11.4% newborns with high weight. In six years of follow-up, 54.5% of these patients underwent metabolic control; This group, unlike the group without control, presented a higher BMI at the beginning of the pregnancy (t:2.103; p<0.02), basal glycemia (t:10.59; p<0.001), systolic blood pressure (t:2.629 ; p<0.01), diastolic (t:1.965; p<0.05) and fetal macrosomia (4 vs 1). 33.3% manifested DM2 predominantly from three years postpartum.

Conclusions: 54.5% of the patients with DG attended late postpartum metabolic control, and 33.3% evolved to DM2; These patients even presented a greater number of obstetric and cardiometabolic risk factors than the group without control at the beginning of pregnancy.