بررسي رابطه فاكتورهاي خطر ديابت بارداري با بروز ديابت پس از بارداري

Relationship between Risk Factors in Gestational Diabetes Mellitus with Turn up of Diabetes Mellitus

Introduction: Diabetes mellitus is a group of metabolism disease that is often asymptomatic in its early stages and the chronic hyperglycemia is associated with long-term dysfunction, damage and failure of various organs. Early diagnosis of diabetes not only prevents progressing of disease and complications but also is cost-effective. This study was conducted to Survey the risk factors turn up of diabetes mellitus in women with previous gestational diabetes mellitus (GDM). Material & Methods: In a prospective study, after offering the prenatal cares and recording the complications during pregnancy delivery and postpartum at least 6-8 wks after delivery, for all women with GDM screening was done with 75gr oral glucose and based on the American diabetes association (ADA) criteria three groups (normal, Impaired and overt diabetes) were diagnosed. Statistical analysis was performed with SPSS version 9.0 and t-test, chi-square and Fisher exact test, One-way analysis of variance, Q-Q plot for normality and Logistic regression were used. Results: From 63 pregnant women with previous GDM, 7 women (11%) had IGT or impaired tasting glucose (lFG) and 8 women (13%) had overt diabetes. In women with overt diabetes the rate of glycosuria (Odds ratio=8.6, CI=1.6-45.5, p<0.05) and age. 30 (Odds ratio=14, C1=1.6-123.8, p<0.01) as risk factors of gestational diabetes mellitus, elevated FBS in GTT (Odds ratio=14, CI=1.6-123.8, p<0.01), diagnosis of GDM in early pregnancy (Odds ratio=1.3, C1=0.99-2, p<0.05), insulin therapy (Odds ratio=0.04, CI=0.01-0.2, p<0.001) also the rate of still-birth (Odds ratio=2.3, C1=0 99-5.5, P<0.001), Gestational hypertension (Odds ratio=11.3, C1=1.7-75.2, p<0.05), hydramnios (Odds ratio=188, C1=1.43-245.9, p<0.01), respiratory distress syndrome (RDS) (Odds ratio=70.5, C1=4.9-1017.2, p<0.01), neonatal hypoglycemia (Odds ratio=10, CI=1.4-72.7, p<0.05), had statistical difference with normal group. Conclusion: The finding indicated that the rate of odds in turn up of overt diabetes in GDM women age. 30, glycosuria, the high rate of complications, elevated FBS in GTT, Diagnosis of GDM in early pregnancy and need to insulin therapy during pregnancy was high, also Logistic model showed that insulin therapy during pregnancy is the most important factor in turn up of overt diabetes after delivery.