Evidence map›Paper›PMID 33731202›Full record

ArticleDiabetology & metabolic syndrome2021

The utility of diagnostic tests in the detection and prediction of glucose intolerance in the early and late postpartum period in women after gestational diabetes: a longitudinal cohort study.

Dan Yedu Quansah, Justine Gross, Richard Mbundu-Ilunga, Jardena J Puder

Open access · goldAbstract read
In one paragraph

Article in Diabetology & metabolic syndrome, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Guideline
  2. Article
  3. Article
  4. Postpartum uptake of diabetes screening tests in women with gestational diabetes: The PANDORA study.Diabetic medicine : a journal of the British Diabetic Association · 2023
    Article
  5. Hyperglycemia in Pregnancy and Women's Health in the 21st Century.International journal of environmental research and public health · 2022
    Review
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Dan Yedu QuansahObstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne Switzerland Avenue de la Sallaz, CH-1011, Lausanne, Switzerland. dan.quansah@chuv.ch.ORCID http://orcid.org/0000-0002-3091-9400
Justine GrossObstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne Switzerland Avenue de la Sallaz, CH-1011, Lausanne, Switzerland.
Richard Mbundu-IlungaService of Endocrinology, Diabetes and Metabolism, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland.
Jardena J PuderObstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne Switzerland Avenue de la Sallaz, CH-1011, Lausanne, Switzerland.
University of Lausanne · CH

Funding

Swiss National Science Foundation SNF 32003B_176119
6 · The paper itself

Abstract

backgroundDue to diverging international recommendations, the unclear role of HbA1c and the lack of longitudinal data, we investigated the accuracy of diagnostic tests in the early and late postpartum in women with gestational diabetes (GDM) especially to predict future glucose-intolerance.

methodsThis longitudinal cohort included 967 women with GDM from 2011 to 2020. A 75-g oGTT and HbA1c were performed at 4-12 weeks (early) postpartum. FPG and HbA1c were measured at 1 and 3-year (late) postpartum. ADA criteria were used as gold standards. At all time-points (4-12 weeks, 1-year and 3-year postpartum) women with diabetes and prediabetes were grouped together and referred to as glucose-intolerant, because at most 3% of the entire cohort population had diabetes at any time-point.

resultsThe prevalence of glucose-intolerance in the early postpartum was higher using FPG and HbA1c (27.5%) than oGTT criteria (18.2%). Only 48-80% of women diagnosed with glucose-intolerance in the early postpartum actually remained intolerant. This was especially low when FPG or oGTT were combined with HbA1c (1-year: ≤ 62% and 3-years: ≤ 50%). Regardless of the test used, 1/3 of women with initially normal glucose-tolerance became glucose-intolerant in the late postpartum. HbA1c was unrelated to iron status/intake, remained stable throughout, but poorly predicted future glucose-intolerance. In the longitudinal analyses, all diagnostic tests in the early postpartum showed acceptable specificities (74-96%) but poor sensitivities (all < 38%) to predict glucose-intolerance after only 10-months. At 1-year postpartum however, the combination of FPG and HbA1c could best predict glucose-intolerance 2-years later.

conclusionsCombining FPG with HbA1c at 1-year postpartum represents a reliable choice to predict future glucose-intolerance. Given the poor prediction of tests including oGTT in the early postpartum, focus should rather be on continuous long-term screening.

Indexed as

DiagnosisGestational diabetesGlucose-intolerancePositive predictive valuePostpartumSensitivity

Identifiers

PMID33731202
PMCPMC7966915
OpenAlexW3138179195

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.