The Research On The Occurrence Of Postpartum Type 2 Diabetes Mellitus And Postpartum Behavior Intervention In Women With Gestational Diabetes Mellitus

Objective: To understand the postpartum glucose metabolism status and the risk factors in patients with gestational diabetes mellitus(GDM); To research the influence of postpartum behavior intervention to patients with GDM on the incidence of Type 2 Diabetes Mellitus(T2DM).Methods: 434 GDM patients were Collected from the First Affiliated Hospital of Dalian Medical University during January 2002 to January 2011, to count the incidence on follow-up of GDM postpartum women and abnormal glucose metabolism. 259 patients of GDM patients who take OGTT during 6-8 weeks after delivery, there were 127 cases occurred postpartum abnormal glucose metabolism in 9 years. According to postpartum glucose metabolism condition was divided into three groups: a group of 48 patients with T2DM, a group of 79 patients with IGT or IFG, and a group of 132 patients with NGT, according to the results of OGTT. Review the medical data of these three groups of women in their duration of pregnancy, and analyze the risk factors of abnormal blood glucose metabolism after their parturitions. According to the women who whether were with behavioral intervention or not , the women following up were divided into 2 groups: the intervention group of 109 cases and the control group of 150 cases , postpartum abnormal blood glucose metabolism between the two groups were compared.Results: In 434 GDM patients, there were 259 patients with follow-up during 6-8 weeks after delivery, the rate was 59.68%, the incidence rate of abnormal glucose metabolism was 29.73%, the incidence rate of postpartum abnormal glucose metabolism in 9 years was 49.03%. Between Postpartum abnormal glucose metabolism group and normal groups, Obesity, adverse pregnant production history, family history of diabetes and insulin treatment used in duration of pregnancy were compared respectively, there were statistical significance (P<0.05). GCT and Fasting plasma glucose level of Pregnancy In T2DM group were higher than that in the other two groups, there were statistical significance (P<0.05). one-hour and two-hour blood glucose of OGTT in NGT group was lower than that in T2DM group , there was statistical significance (P<0.05). In the Post-intervention group of 109 patients ,15.60% were of development to T2DM, 23.85% were of development to IGT or IFG, the incidence rate of abnormal glucose metabolism was 39.45%; while in the control group of 150 patients, 20.67% were of development to T2DM, 35.33% were of development to IGT or IFG, the incidence rate of abnormal glucose metabolism was 56.00%, it was lower than that in the control group, there was statistical significance (P<0.05).Conclusion:1. The incidence of postpartum glucose metabolism disorder in patients with GDM increased yearly, women with GDM were the high-risk groups of T2DM.2. We Should attach importance to the GIGT patients during pregnancy postpartum follow-up, the patients with GDM who are tested normal by OGTT should keep taking follow-up too.3. Obesity before pregnancy, adverse pregnant production history, with family medical history of diabetes mellitus, insulin treatment used in duration of pregnancy, early final diagnosis time of GDM,high level of GCT and high fasting blood glucose level are the risk factors that trigger postpartum abnormal blood glucose of GDM patients.4. Postpartum behavior intervention on patients with GDM can decrease the incidence of T2DM.