Combined analysis of gestational diabetes and maternal weight status from pre-pregnancy through post-delivery in future development of type 2 diabetes

Abstract

We examined the associations of gestational diabetes mellitus (GDM) and women’s weight status from pre-pregnancy through post-delivery with the risk of developing dysglycaemia [impaired fasting glucose, impaired glucose tolerance, and type 2 diabetes (T2D)] 4–6 years post-delivery. Using Poisson regression with confounder adjustments, we assessed associations of standard categorisations of prospectively ascertained pre-pregnancy overweight and obesity (OWOB), gestational weight gain (GWG) and substantial post-delivery weight retention (PDWR) with post-delivery dysglycaemia (n = 692). Women with GDM had a higher risk of later T2D [relative risk (95% CI) 12.07 (4.55, 32.02)] and dysglycaemia [3.02 (2.19, 4.16)] compared with non-GDM women. Independent of GDM, women with pre-pregnancy OWOB also had a higher risk of post-delivery dysglycaemia. Women with GDM who were OWOB pre-pregnancy and had subsequent PDWR (≥ 5 kg) had 2.38 times (1.29, 4.41) the risk of post-delivery dysglycaemia compared with pre-pregnancy lean GDM women without PDWR. No consistent associations were observed between GWG and later dysglycaemia risk. In conclusion, women with GDM have a higher risk of T2D 4–6 years after the index pregnancy. Pre-pregnancy OWOB and PDWR exacerbate the risk of post-delivery dysglycaemia. Weight management during preconception and post-delivery represent early windows of opportunity for improving long-term health, especially in those with GDM.

Lipid Metabolism Is Dysregulated before, during and after Pregnancy in a Mouse Model of Gestational Diabetes

“…There is also accumulating evidence that maternal obesity-driven GDM leads to long-term (programmed) effects in the offspring [ 5 , 6 , 7 , 8 , 9 , 10 , 11 ], suggesting that GDM and its risk factors have inter-generational effects. There is an increased risk of both cardio-vascular disease and type 2 diabetes mellitus (T2DM) in the decade after delivery in individuals who developed GDM [ 12 , 13 , 14 , 15 , 16 ]. Research in this area includes a systematic review of over 5 million women across nine studies that found that women who developed GDM had a two-fold increased risk of cardiovascular events independent of developing T2DM [ 17 ].…”

“…There is an increased risk of both cardio-vascular disease and type 2 diabetes mellitus (T2DM) in the decade after delivery in individuals who developed GDM [12][13][14][15][16]. Research in this area includes a systematic review of over 5 million women across nine studies that Int.…”

Causation between Gestational Diabetes Mellitus(GDM) and Pregnancy Induced Hypertension(PIH): A Statistic Case Study in Harbin, China

“…It should be noted that both diabetes combined with pregnancy and GDM would cause blood glucose to increase in pregnancy 16 . The medical record provided by outpatient departments had discriminated against these two conditions.…”

The Impact of the One-Day Clinic Diabetes Mellitus Management Model on Perinatal Outcomes in Patients with Gestational Diabetes Mellitus

“…Therefore, the proper management of hyperglycemia during pregnancy is an important opportunity to reduce the risk of these conditions. 3 , 4 …”

“…Therefore, the proper management of hyperglycemia during pregnancy is an important opportunity to reduce the risk of these conditions. 3,4 Most patients with GDM can control their blood glucose within the normal range through standardized management, diet adjustment, reasonable exercise, and timely monitoring. Therefore, on the basis of individualized dietary interventions and exercise guidance, patients were advised to participate in the one-day clinic DM management model in our hospital.…”