Reply to Retnakaran R, Shah BR. Abnormal screening glucose challenge test in pregnancy and future risk of diabetes in young women. Diabet Med 2009; 26: 474-477.

摘要

I am not convinced from the study by Renakaran and Shah [1] claiming that an abnormal gestational diabetes mellitus (GDM) test during pregnancy followed by a normal oral glucose tolerance test (OGTT) provides prognostic information that could not be obtained rather more simply. The authors created a matched cohort based upon age, region, socio-economic status and year of delivery. However, they did not match for body mass index (BMI), nor for non-pregnant abdominal circumference. I wonder if Renakaren and Shah could explore their database to determine if the women who developed Type 2 diabetes mellitus (T2DM) during the study were more overweight and had a greater abdominal circumference, and whether these risk factors were similar in the cohort and the matched population? As the 'number needed to test' is 303 to identify one patient who will go on to develop diabetes; one wonders if information such as abdominal circumference and BMI would be practical indicators of risk.