Smoking affects the oral glucose tolerance test profile and the relationship between glucose and HbA(1c) in gestational diabetes mellitus
Por:
Aulinas, A, Colom, C, Patterson, AG, Ubeda, J, Maria, MA, Orellana, I, Adelantado, JM, de Leiva, A, Corcoy, R
Publicada:
1 sep 2016
Resumen:
AimsCurrent smokers in the general population have a lower 2 h plasma glucose after an oral glucose tolerance test (OGTT) and a higher HbA(1c) than non-smokers, but the relationships between OGTT/HbA(1c) and smoking status have not been addressed in pregnancy. We analysed glycaemic measurements in women with gestational diabetes mellitus in relation to smoking status.
MethodsWe performed a review of the prospectively collected database of the diabetes and pregnancy clinic. We included women with gestational diabetes mellitus and a singleton pregnancy who delivered between 1986 and 2006. Bivariate and multivariate analyses were used to evaluate patient characteristics in relation to smoking status.
ResultsA total of 2361 women met the inclusion criteria: 556 (23.5%) were active smokers, 266 (11.3%) quit during pregnancy and 1539 (65.2%) were non-smokers. Most baseline characteristics were similar across groups. Diagnostic OGTT was performed at a gestational age of [median (25th, 75(th) centiles)] 29 weeks (26, 33). Women who smoked at the beginning of pregnancy had a higher 1-h plasma glucose than non-smokers [11.8 (11, 12.7), 11.6 (11, 12.6) and 11.5 (10.8, 12.5) mmol/l, for active smokers, those who quit during pregnancy and non-smokers, respectively, P < 0.001] and a lower 3-h plasma glucose [7.3 (5.9, 8.4), 7.6 (6.4, 8.7) and 8.0 (6.8, 9.0) mmol/l, respectively, P < 0.001]. HbA(1c) was higher in women who smoked at the beginning of pregnancy. Multiple regression analysis confirmed the independent association of smoking status with HbA(1c) and OGTT plasma glucose.
ConclusionsIn women with gestational diabetes mellitus who smoke at the beginning of pregnancy, the shape of the OGTT is consistent with accelerated glucose absorption, and HbA(1c) is higher than expected for glycaemic values.
Filiaciones:
Aulinas, A:
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Colom, C:
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Patterson, AG:
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Ubeda, J:
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Maria, MA:
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Orellana, I:
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Adelantado, JM:
Hosp Santa Creu & Sant Pau, Dept Obstet & Gynecol, Barcelona, Spain
Univ Autonoma Barcelona, Dept Pediat Obstet & Gynecol, Prevent Med & Publ Hlth, Barcelona, Spain
de Leiva, A:
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Inst Salud Carlos III, Ctr Biomed Network Res Bioengn Biomat & Nanotechn, Madrid, Spain
Corcoy, R:
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Inst Salud Carlos III, Ctr Biomed Network Res Bioengn Biomat & Nanotechn, Madrid, Spain
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