Progression from gestational diabetes to type 2 diabetes in one region of Scotland: an observational follow-up study

Abstract

BackgroundThe aim of this study was to investigate long-term risk of type 2 diabetes (T2D) following a diagnosis of gestational diabetes and to identify factors that were associated with increased risk of T2D.MethodsAn observational cohort design was used, following up all women diagnosed with gestational diabetes mellitus (GDM) attending a Diabetes Antenatal Clinic in the Dundee and Angus region of Scotland between 1994 and 2004 for a subsequent diagnosis of T2D, as recorded on SCI-DC (a comprehensive diabetes clinical information system).ResultsThere were 164 women in the study who were followed up until 2012. One quarter developed T2D after a pregnancy with GDM in a mean time period of around eight years. Factors associated with a higher risk of developing T2D after GDM were increased weight during pregnancy, use of insulin during pregnancy, higher glycated haemoglobin (HbA1c) levels at diagnosis of GDM, and fasting blood glucose.ConclusionsThese findings suggest there is a viable time window to prevent progression from GDM to T2D and highlights those women who are at the greatest risk and should therefore be prioritised for preventative intervention.

Quantification of the type 2 diabetes risk in women with gestational diabetes: a systematic review and meta-analysis of 95,750 women

“…In all, there were 22 prospective cohort studies (56%) [ 13 , 14 , 17 , 19 – 21 , 29 , 32 , 35 – 37 , 39 – 41 , 43 , 44 , 46 – 48 , 50 , 52 , 55 ] and 17 retrospective cohort studies (44%) [ 15 , 27 , 28 , 30 , 31 , 33 , 34 , 38 , 42 , 45 , 49 , 51 , 53 , 54 , 56 – 58 ]. The studies evaluated the association of maternal characteristics, pregnancy-specific factors and postpartum characteristics with progression to type 2 diabetes in women with GDM.…”

Gestational diabetes mellitus and risk of type 2 diabetes 10 years after the index pregnancy in Sri Lankan women—A community based retrospective cohort study

“…Feig et al reported maternal age as an independent predictor of developing diabetes in a large population based study in Canada [18]. In contrast, two studies conducted in South India and Scotland did not show a statistically significant association between maternal age and development of T2DM [21, 32]…”

Gestational diabetes using diverse diagnostic criteria, risk factors including dietary intakes, pregnancy outcomes and postpartum glycemic status: a nested case-control study in Ghana

“…GDM is known to increase short-and long-term cardio-metabolic risk especially for type 2 diabetes [6,7,10]. A third of the GDM cases in our study was persistently hyperglycemic at 12 weeks postpartum.…”

“…Adverse outcomes linked to GDM include preeclampsia, postpartum hemorrhage, obstructed labor, cesarean delivery, macrosomia, birth trauma, asphyxia, neonatal hypoglycemia and perinatal mortality [5,8,9]. GDM affects breastfeeding [7] and long-term cardio-metabolism of mother-offspring pairs [6,7,10]. Despite recommendation by the International Association of Diabetes and Pregnancy Study Group (IADPSG) on 'one-step' testing of all pregnant women using fasting glucose and the 'gold standard' 2-hour oral glucose tolerance test (OGTT) [11], disagreements exist on diagnostic thresholds [12].…”