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Screening Type 2 Diabetes Mellitus on the 2nd Day After Delivery in Women With Gestational Diabetes Mellitus

Not Applicable
Completed
Conditions
Diabetes, Gestational
Registration Number
NCT02290860
Lead Sponsor
Université de Sherbrooke
Brief Summary

Gestational diabetes mellitus (GDM) is defined as a hyperglycemia with onset or first recognition during pregnancy. GDM complicates 5 to 25% of pregnancies, depending on the diagnostic criteria used and the population being studied.

GDM is an important red flag: up to 70% women with GDM will develop type 2 diabetes mellitus (T2DM) during their lifetime. Accordingly, professional associations recommend T2DM postpartum screening (T2DM-pP-S), 6-to-24 weeks after delivery. A 75g oral glucose tolerance test (OGTT) should be performed for diagnosis (gold standard). Nevertheless, this T2DM-pP-S recommendation has failed worldwide for the same reasons: the presently impractical pattern of the testing. A solution is direly needed.

Our overall goal is to improve detection of pre-diabetes and diabetes and more specifically, to facilitate the recommended T2DM-pP-S in women diagnosed with GDM.

We hypothesize that, in GDM women, results of an OGTT performed after delivery, before hospital discharge (OGTT-1) predict results of the recommended OGTT at 6-to-12 weeks postpartum (OGTT-2). Our aims are:

1. To validate in Caucasian women the predictive threshold value of the 2hr-glucose of OGTT-1 established by our Stage-1 study.

2. To determine, in a multiethnic non-Caucasian cohort, the threshold value for the 2hr-glucose of OGTT-1 that is predictive of abnormal glucose tolerance at OGTT-2.

3. To define the OGTT time preference of women (before hospital discharge vs. 6-to-12 weeks postpartum).

If our results are in line with our Stage-1 data, most redundant 6-to-24 weeks postpartum OGTT will be avoided. Medical practice will change.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
228
Inclusion Criteria
  • Women aged between 18 and 45 years;
  • Having a positive diagnosis of gestational diabetes mellitus (GDM) (IADPSG or CDA criteria or patient followed for GDM);
  • Treated with diet, insulin or oral hypoglycemic agents;
  • Have given birth to a child at term (gestational age ≥ 37 weeks);
  • Have signed the consent form.
Exclusion Criteria
  • History of glucose intolerance or diabetes before the pregnancy;

  • Have presented another obstetrical pathology during the pregnancy;

    • Severe gestational high blood pressure with proteinuria;
    • Delayed intrauterine development syndrome;
    • Pregnancy with more than a foetus;
    • Drug addiction;
    • Had complications during the delivery such as:
  • Moderate to severe postpartum bleeding;

  • Surgery in postpartum (curettage, hysterectomy, etc.).

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Primary Outcome Measures
NameTimeMethod
abnormal glucose tolerance8 weeks after delivery
Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Centre de recherche clinique du CHUS

🇨🇦

Sherbrooke, Quebec, Canada

Centre de recherche clinique du CHUS
🇨🇦Sherbrooke, Quebec, Canada

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