ATLANTIC-DIP: prevalence of metabolic syndrome and insulin resistance in women with previous gestational diabetes mellitus by International Association of Diabetes in Pregnancy Study Groups criteria

Abstract

Women with previous gestational diabetes (GDM) are a high-risk group for future development of diabetes, metabolic syndrome, and cardiovascular disease. The new International Association of Diabetes in Pregnancy Study Groups (IADPSG) criteria significantly increase the number of women diagnosed with GDM. The long-term metabolic outcome in these women is unknown. We set out to determine the prevalence of metabolic syndrome, using adult treatment panel-III criteria; and insulin resistance, using HOMA2-IR, in white European women with previous GDM. Using a cohort design, we invited women meeting IADPSG GDM criteria across four Irish antenatal centres between 2007 and 2010 to participate. Two hundred and sixty-five women with previous values meeting IADPSG criteria for GDM participated (44 % of the population eligible for participation). Mean age was 36.7 years (SD 5.0). These women were compared with a randomly selected control group of 378 women (mean age 37.6 years, SD 5.1) known to have normal glucose tolerance (NGT) in pregnancy during the same period. A total of 25.3 % of women with previous IADPSG-defined GDM met metabolic syndrome criteria, compared to 6.6 % of women with NGT [at 2.6 (SD 1.0) vs. 3.3 years (SD 0.7) post-partum]. The prevalence of HOMA2-IR >1.8 was higher in women with previous IADPSG-defined GDM (33.6 vs. 9.1 % with NGT, p < 0.001). Women with previous GDM by IADPSG criteria demonstrate a greater than threefold prevalence of metabolic syndrome compared to women with NGT in pregnancy. Efforts to prevent projected long-term consequences of this should focus on interventions both in the preconception and post-partum periods.

Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association

“…The prevalence of metabolic syndrome has been noted to be high among select special populations, including those with schizophrenia spectrum disorders, 36 those taking atypical antipsychotic drugs, 37 those receiving prior organ transplants, 38 HIV-infected individuals, 39 those previously treated for blood cancers, 40 those with systemic inflammatory disorders such as psoriasis, 41 individuals with well-treated type 1 DM, 42 those with hypopi-tuitarism, 43 those with prior gestational DM, 44 and individuals in select professions, including law enforcement 45 and firefighters. 46 …”

Abnormal glucose tolerance post-gestational diabetes mellitus as defined by the International Association of Diabetes and Pregnancy Study Groups criteria

“…Following an 8-to 12-h fast, and informed consent, participants underwent a 75 g OGTT, with plasma glucose values taken at 0 and 120 min. Samples for lipid profile, haemoglobin A1c (HbA1c) and Homeostatic Model Assessment 2-Insulin Resistance (HOMA2-IR) determination were also obtained, detailed results of which have been reported in separate papers (17,18).…”

Antioxidant Status and Risk of Gestational Diabetes Mellitus: a Case-Control Study

“…GDM has been reported to be associated with high risk of developing type 2 diabetes later in lifetime, metabolic syndrome, and cardiovascular disease. For example, the prevalence of metabolic syndrome in GDM women is 3 times higher than in women with normal glucose tolerance during pregnancy [5]. …”