Estimating the risk after gestational diabetes mellitus: can we improve the information from the postpartum OGTT?

Risk stratification after pregnancy with gestational diabetes mellitus (GDM) is based on screening with the 2-h oral glucose tolerance test (OGTT). Actually, prediabetes and diabetes are diagnosed by impaired fasting [fasting plasma glucose (FPG)] and 120 min-postload glucose levels (120'-PLG). We hypothesized that the clinical information could be improved by including measurements at different time points from the OGTT in the medical decision-making process. One hundred ten women with previous gestational diabetes (pGDM) and 41 controls were included 3–6 mo after delivery and underwent specific metabolic assessments: 3-h OGTT, frequently sampled intravenous glucose tolerance test (FSIGT) with markers of inflammation and endothelial function. pGDMs were annually invited for reexaminations for a maximum of 10 yr. Multiple linear regression suggested that postload glucose levels at 60 min (60'-PLG) were a better predictor for insulin sensitivity [β: −0.10, 95% confidence interval (CI) −0.14 to −0.05, P < 0...