Prevalence of Postpartum-abnormal Glucose Tolerance (P-AGT) and its Associated Factors among Women with Gestational Diabetes mellitus (GDM) in Klang, Selangor

Abstract

Introduction: Women with gestational diabetes mellitus (GDM) have a sevenfold risk of developing diabetes. The study aimed to determine the prevalence of postpartum-abnormal glucose tolerance (P-AGT), the level of knowledge on GDM and its associated factors for P-AGT among postpartum women with GDM attending public health clinics in Klang. Methods: This cross-sectional study used convenience sampling and was conducted among GDM women attending the oral glucose tolerance test (OGTT) at six to 12 weeks postpartum. Sociodemographic factors, clinical characteristics, knowledge about GDM (using a validated questionnaire, GDMKQ) and postpartum OGTT results were collected. Results: A total of 439 participants, with the majority aged < 35-year-old (71.8%), Malay ethnicity (82.7%), and demonstrated adequate knowledge of GDM (92.9%) with mean GDMKQ score of 12.21 ± 2.22 over 15. P-AGT prevalence was 28.9% (95% CI:24.7, 33.4). Multiple logistic regression showed having a first-degree family history of diabetes carried 1.5 higher odds of developing P-AGT [aOR:1.55,95%CI:1.01,2.39;(p = 0.047)], gestational age at GDM diagnosis <24 weeks had 1.8 higher odds of developing P-AGT [aOR:1.85,95%CI:1.17,2.92;(p=0.009)] and women with 2HPP level of  ≥7.8mmol/L upon GDM diagnosis had a threefold higher risk of developing P-AGT [aOR:2.95,95%CI:1.74,5.01;(p<0.001)]. Conclusion: This study revealed a doubled prevalence of P-AGT compared to previous local studies. Targeted monitoring and management strategies are crucial, especially for women diagnosed with GDM before 24 weeks of gestation, those who had an abnormal 2HPP level upon GDM diagnosis and those with a first-degree family history of diabetes to prevent the occurrence of P-AGT.