Model for individual prediction of diabetes up to 5 years after gestational diabetes mellitus

作者：Ignell Claes^*; Ekelund Magnus; Anderberg Eva; Berntorp Kerstin

来源：SpringerPlus, 2016, 5(1): 318.

DOI：10.1186/s40064-016-1953-7

• Diabetes mellitus
• Follow-up
• Gestational diabetes mellitus
• Glucose tolerance
• Prediction

Aims: To identify predictors of diabetes development up to 5 years after gestational diabetes mellitus (GDM) and to develop a prediction model for individual use.
Methods: Five years after GDM, a 75-g oral glucose tolerance test (OGTT) was performed in 362 women, excluding women already diagnosed with diabetes at 1-to 2-year follow-up or later (n = 45). All but 21 women had results from follow-up at 1-2 years, while 84 women were lost from that point. Predictive variables were identified by logistic regression analysis.
Results: Five years after GDM, 28/362 women (8 %) were diagnosed with diabetes whereas 187/362 (52 %) had normal glucose tolerance (NGT). Of the latter, 139/187 (74 %) also had NGT at 1-to 2-year follow-up. In simple regression analysis, using NGT at 1-2 years and at 5 years as the reference, diabetes at 1-to 2-year follow-up or later was clearly associated with easily assessable clinical variables, such as BMI at 1-to 2-year follow-up, 2-h OGTT glucose concentration during pregnancy, and non-European origin (P < 0.0001). A prediction model based on these variables resulting in 86 % correct classifications, with an area under the receiver-operating characteristic curve of 0.91 (95 % CI 0.86-0.95), was applied in a function-sheet line diagram illustrating the individual effect of weight on diabetes risk.
Conclusions: The results highlight the importance of BMI as a potentially modifiable risk factor for diabetes after GDM. Our proposed prediction model performed well, and should encourage validation in other populations in future studies.

• 出版日期2016-3-11