Gestational diabetes mellitus and the risk of metabolic syndrome: a population-based study in Lausanne, Switzerland

Abstract

Aims: Ta investigate the relationships between gestational diabetes mellitus (GDM) and the metabolic syndrome (MS), as it was suggested that insulin resistance was the hallmark of bath conditions. Ta analyse post-partum screening in order ta identify risk factors for the subsequent development of type 2 diabetes mellitus (DM). Methods: A retrospective analysis of all singleton pregnancies diagnosed with GDM at the Lausanne University Hospital for 3 consecutive years. Pre-pregnancy obesity, hypertension and dyslipidaemia were recorded as constituents of the MS. Results: For 5788 deliveries, 159 women (2.7%) with GDM were identified. Constituents of the MS were present before GDM pregnancy in 26% (n = 37/144): 84% (n = 31/37) were obese, 38% (n = 14/37) had hypertension and 22% (n = 8/37) had dyslipidaemia. Gestational hypertension was associated with obesity (OR = 3.2, P = 0.02) and dyslipidaemia (OR= 5.4, P = 0.002). Seventy-four women (47%) returned for post-partum OGTT, which was abnormal in 20 women (27%): 11 % (n = 8) had type 2 diabetes and 16% (n = 12) had impaired glucose tolerance. lndependent predictors of abnormal glucose tolerance in the post-partum were: having > 2 abnormal values on the diagnostic OGTT during pregnancy and presenting MS constituents (OR = 5.2, Cl 1.8-23.2 and OR = 5.3, Cl 1.3-22.2). Conclusions: ln one fourth of GDM pregnancies, metabolic abnormalities precede the appearance of glucose intolerance. These women have a high risk of developing the MS and type 2 diabetes in later years. Where GDM screening is not universal, practitioners should be aware of those metabolic risks in every pregnant woman presenting with obesity, hypertension or dyslipidaemia, in order ta achieve better diagnosis and especially better post-partum follow-up and treatment.

Gestational diabetes and pre-eclampsia: common antecedents?

“…Thus, the increased risk of pre-eclampsia in women with gestational diabetes may be reflecting an underlying common pathophysiology related to the metabolic syndrome outside of pregnancy. Although gestational diabetes and pre-eclampsia have each been postulated to be an early expression of metabolic syndrome (51)(52)(53)(54), our report provides epidemiological evidence for common risk factors in pregnancy for both diseases.…”

Serum concentrations of retinol-binding protein 4 in women with and without gestational diabetes

“…Gestational diabetes mellitus is defined as glucose intolerance with onset or first recognition during pregnancy [1]. Women with gestational diabetes show various features of the metabolic syndrome [2] like obesity, low-grade inflammation [3] or hypertriacylglycerolaemia [4,5], and have an increased risk of developing type 2 diabetes mellitus [6]. Insulin resistance plays a major role in the adverse cardiovascular risk profile found in women with gestational diabetes.…”

Türkiye florasında diyabet tedavisinde kullanılan tıbbi bitkiler

“…Gebelikte başlayan ya da ilk kez bu süreçte tanımlanan, gebelerin %3-5'inde görülen karbonhidrat intoleransıdır (1,(11)(12)(13). Bu durum anne ve fetüs sağlığıyla yakından ilişkilidir (12).…”