Predicting the metabolic condition after gestational diabetes mellitus from oral glucose tolerance test curves shape

Ann Biomed Eng. 2014 May;42(5):1112-20. doi: 10.1007/s10439-014-0979-7. Epub 2014 Jan 29.

Abstract

The objective of this feasibility study is to predict the metabolic condition in women with a history of gestational diabetes mellitus (GDM) from the shape of oral glucose tolerance test (OGTT) data. The rationale for this approach is that the evolution to a metabolic condition could be traceable in the shape of OGTT curves. 3-h OGTT data of 136 women with follow up, for a total of 401 OGTTs were analyzed. Subjects were classified as having normal (NGT) or non-normal glucose tolerance (NON-NGT), according to the American Diabetes Association criteria. The measured glucose, insulin, C-peptide data and combination of them were used to build up NGT and NON-NGT reference curves. Similarity between reference and individual OGTT-based curves was calculated using the Kullback-Leibler divergence. Our findings suggest that the shape of OGTT curves (1) contains information on the evolution to disease and (2) could be a reliable indicator to predict with high sensitivity (75%) and high specificity (69%) the metabolic condition of women with a history of GDM. In the future, the proposed shape-based prediction could be easily translated to the clinical practice, because it does not require the intervention of an operator specifically trained, thus facilitating its application in a clinical setting and ultimately empowering risk estimation, by improving/complementing the information which is currently adopted for risk stratification after pregnancy with GDM.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose / analysis*
  • C-Peptide / blood*
  • Diabetes, Gestational / metabolism*
  • Feasibility Studies
  • Female
  • Glucose Tolerance Test
  • Humans
  • Insulin / blood*
  • Models, Biological*
  • Pregnancy

Substances

  • Blood Glucose
  • C-Peptide
  • Insulin