The Research On The Influence Of Postpartum Behavior Intervention To Gestational Diabetes On The Incidence Of Type 2 Diabetes Mellitus

Objective: To research the risk factors which trigger postpartum abnormal blood glucose of Gestational Diabetes Mellitus (GDM) patients; to investigate the influence of postpartum behavior intervention to GDM on the incidence of Type 2 Diabetes Mellitus (T2DM).Methods: Divide 143 cases of GDM patients who take Oral Glucose Tolerance Test (OGTT) during the 6th to 8th week after their parturition into three groups according to the results of OGTT: a group of 12 patients with T2DM, a group of 42 patients with Impaired Glucose Tolerance (IGT) or Impaired Fasting Glucose (IFG), and a group of 89 patients with Normal Glucose Tolerance (NGT). Review the medical data of these three groups of females in their duration of pregnancy and analyze the risk factors that trigger abnormal blood glucose or even T2DM of GDM females. Divide the NGT and IGT or IFG females who take OGTT during the 6th to 8th week respectively into the intervention group and control group according to the situation of fellow-up. Take behavior intervention on the two intervention groups, and take another OGTT after one year to all the groups of intervention and control. Record their blood glucose data of intervention group and control group before and after intervention . Make comparisons between intervention groups and control groups, the recovering conditions of intervention groups before and after intervention and changes of blood glucose.Results: The incidence of abnormal blood glucose of 143 GDM patients during the 6th to 8th week after parturition is 37.76%. Comparing the data of final diagnosis time of GDM and fasting blood glucose level of T2DM group with NGT group, there is statistical significance (P<0.05); taking account of family history, comparing IGT or IFG group and T2DM group respectively with NGT group, there is statistical significance (P<0.05); taking account of insulin treatment used in the duration of pregnancy of the three groups of females, comparing group T2DM respectively with group IGT or IFG and group NGT, there is statistical significance (P<0.05) . After one year behavior intervention on IGT or IFG group, comparing the intervention group and the control group, there is significant difference in the incidence of T2DM (P<0.05); comparing fasting plasma glucose and two-hour plasma glucose of OGTT before and after intervention, there is significant difference (P<0.05), there is increased of two-hour blood glucose of OGTT in the control group, compared with that of a year ago, the difference has statistical significance (P<0.05). For postpartum NGT females, comparing two-hour plasma glucose of OGTT before and after intervention, there is significant difference (P<0.05); there is increased of two-hour blood glucose of OGTT in the control group, compared with that of a year ago, the difference has statistical significance (P<0.05).Conclusion: (1) Some who got GDM in their duration of pregnancy will still have abnormal blood glucose after their parturition. (2) Early final diagnosis time of GDM, high fasting blood glucose level, with family medical history of diabetes mellitus and insulin treatment used in duration of pregnancy are the risk factors that trigger postpartum abnormal blood glucose of GDM patients. (3) Postpartum behavior intervention on GDM can reduce the incidence of T2DM. (4) GDM patients who are tested normal by OGTT should keep taking follow-up.