The Risk of a Persistent Glucose Metabolism Impairment After Gestational DiabetesMellitus Is Increased in PatientsWith Polycystic Ovary Syndrome

OBJECTIVEdTo test the hypothesis that the risk of persistent glucose impairment after ges-tational diabetes mellitus (GDM) is increased in patients with polycystic ovary syndrome (PCOS). RESEARCH DESIGN AND METHODSdThe prospective case-control study included 42 pregnant patients with PCOS and GDM and 84 pregnant control patients with GDM but without clinical and biochemical hyperandrogenism, polycystic ovaries, and oligo-anovulation. The case and control subjects were matched one to two for age and BMI. The glycemic profiles were studied in all subjects 6 weeks, 12 weeks, and 18 months after delivery. The incidence and the relative risk (RR) were calculated for overall persistence of an abnormal glycemic pattern and for each specific alteration, i.e., impaired glucose tolerance (IGT), impaired fasting glucose (IFG), and diabetes mellitus (DM). RESULTSdAt 18 months after delivery, the incidences of IFG, IGT, and IFG-IGT were sig-nificantly (P, 0.05) higher in the cases than in the controls. At the 18-month follow-up, the RR for the composite outcome of glucose metabolism impairment in PCOS women was 3.45 (95% CI 1.82–6.58). CONCLUSIONSdPatients with PCOS are at increased risk for a persistent impaired glucose metabolism after GDM. Diabetes Care 35:861–867, 2012 Polycystic ovary syndrome (PCOS) isa common multifaceted disease thatis characterized by ovulatory disor-ders, hyperandrogenism, and polycystic ovaries (PCOs) on ultrasonography (1). Several other features, such as obesity and insulin resistance, are related to PCOS and represent risk factors for alterations in glucose metabolism (2). In fact, patients with PCOS have an increased incidence of impaired glucose tolerance (IGT), im-paired fasting glucose (IFG), and diabetes mellitus (DM) (3). This PCOS-related metabolic impair-ment has an additive effect on the natural state of insulin resistance observed during pregnancy (4) by worsening the baseline insulin resistance and leading to an in-creased risk for several complications of pregnancy, particularly gestational D