Prevalence of glucose intolerance and metabolic syndrome within one year following delivery of a pregnancy complicated by gestational diabetes

Abstract

BackgroundWomen with a history of gestational diabetes (GDM) are at risk for development of both overt Type 2 diabetes (T2DM) and cardiovascular disease (CVD) at higher rates and at earlier ages than control women. Current guidelines recommend longitudinal testing of glucose tolerance for women with prior GDM, but no formal assessments of cardiovascular disease are suggested. This study estimated the prevalence of metabolic syndrome in women with GDM in recent pregnancy who were followed for at least 1 year postpartum to quantify their cardiovascular risks.MethodsThis is a retrospective study of women who were diagnosed with GDM in a public hospital and followed for at least 1 year after delivery and who had tests performed at a minimum 4–12 weeks postpartum and 6 and 12 months postpartum. Primary outcomes were prevalence of glucose tolerance abnormalities and metabolic syndrome (MetS) defined by two prevailing sets of diagnostic criteria.ResultsOne hundred fifty-one indigent, primarily Latina women who had been diagnosed in their last pregnancy with GDM comprised the study population. At the first visit postpartum, 4.7% were found to have overt diabetes and between 24 and 31% met the criteria for MetS. By the end of 12 months, another 14.5% were diagnosed with overt diabetes, and 38.5% had prediabetes. An additional 12–25% of the woman who had not had MetS at baseline developed MetS by the end of the 1-year follow-up.ConclusionsGiven the high prevalence of MetS among women with recent history of GDM immediately postpartum and its rapid development in the following year, further research is needed to enable the development of practice guidelines that will define appropriate short and long-term evaluations needed to assess risk for cardiovascular disease in these women.

Gender Differences and Their Influences on T2DM Self-Management Among Spanish-Speaking Latinx Immigrants

“…However, the females in this study with a GDM history reported their T2DM diagnosis was made only after seeking care for symptoms, often up to 2-year postpartum. These accounts, and those in the literature, support current standards for ongoing glucose monitoring for women with a GDM history, illustrate the importance of taking the aforementioned risk factors into account in patient care, and provide a basis for extending regular glucose monitoring beyond 1-year postpartum (ADA, 2020b;Rayanagoudar et al, 2016;Sodhi & Nelson, 2018). It may also be well advised that providers and educators present GDM as a risk factor for developing T2DM to avoid any misinterpretation about the importance of making the recommended lifestyle changes.…”

“…Although Rayanagoudar and colleagues' (2016) were unable to provide progression rates for specific ethnic subgroups, they concluded that a history of GDM, family history of diabetes, non-White ethnicity, and excess weight contributed to increased risk of T2DM results that are also supported by others (Sodhi & Nelson, 2018). In Sodhi and Nelson's (2018) retrospective chart review of primarily Latinx women, over 25.5% of those with recent GDM experienced worsening glucose tolerance within 1-year postpartum. However, the females in this study with a GDM history reported their T2DM diagnosis was made only after seeking care for symptoms, often up to 2-year postpartum.…”

“…While males are more likely than females to exhibit a significant delay in accepting the diagnosis and translating this diagnosis into action, almost half the women recounted a history of GDM. Based on information from their health care providers, the women thought that their diabetes would resolve postpartum, which was a concerning finding given the amount of evidence in the literature that contradicts this assumption for many Latinx women (Bao et al, 2015, Sodhi & Nelson, 2018). Although Rayanagoudar and colleagues’ (2016) were unable to provide progression rates for specific ethnic subgroups, they concluded that a history of GDM, family history of diabetes, non-White ethnicity, and excess weight contributed to increased risk of T2DM results that are also supported by others (Sodhi & Nelson, 2018).…”

“…Based on information from their health care providers, the women thought that their diabetes would resolve postpartum, which was a concerning finding given the amount of evidence in the literature that contradicts this assumption for many Latinx women (Bao et al, 2015, Sodhi & Nelson, 2018). Although Rayanagoudar and colleagues’ (2016) were unable to provide progression rates for specific ethnic subgroups, they concluded that a history of GDM, family history of diabetes, non-White ethnicity, and excess weight contributed to increased risk of T2DM results that are also supported by others (Sodhi & Nelson, 2018). In Sodhi and Nelson’s (2018) retrospective chart review of primarily Latinx women, over 25.5% of those with recent GDM experienced worsening glucose tolerance within 1-year postpartum.…”

Risk of developing Type 2 diabetes mellitus in South Asian women with history of gestational diabetes mellitus: A systematic review and meta-analysis

“…[ 3 ] In the long term, GDM increases the risk of T2DM and metabolic syndrome in later years. [ 23 24 ] Shriraam et al 2013[ 25 ] found low awareness of GDM among antenatal women from rural area in South India. Knowledge on risk factors of GDM and subsequent risk of developing T2DM was also low among the antenatal women.…”