History of Gestational Diabetes Mellitus Leading to Type 2 Diabetes Mellitus in Hyderabad Population

Background: Women having gestational diabetes mellitus are at greater risk of effecting type 2 diabetes mellitus. Particularly because of the scarcity of data in India, there is requirement for understanding the distribution and possibility factors of dysglycaemia (types 2 diabetes mellitus and prediabetes) in women having affected earlier with gestational diabetes mellitus. Methods: All women (n = 751) with past history of GDM attending two obstetric units in Hyderabad were invited to participate in the study. Among them 279(37.15%) accepted to take part in the present study. Socio-demographic, medical and anthropometric information were collected; and 75gm OGTT performed. Results: 213 (76.34%) women were found dysglycaemic within 5 year (median 14 months) of the pregnancy. Age was found to be 1.27 fold increase risk of having dysglycaemia (OR 1.27, 95% CI 1.03 - 1.35 p = 0.03). Presence of acanthosis nigricans (OR 2.09, 95% CI 1.89 - 6.56 p = 0.002), postpartum screening interval (OR 1.41, 95% CI 1.15 - 1.92 p = 0.02) were found to be risk factors to have dysglycaemia. The ADA suggested threshold HbA1c value of >39 mmol/mol (5.6%) have a sensitivity and specificity of 72.3% and 67.3% respectively for detecting the occurrence of T2DM postpartum. Conclusion: In conclusion, this study found a high possibility of development of t2dm among with a history of gdm and there is an immediate need to improve postpartum screening rates.