Risk factors for postpartum glucose intolerance in women with gestational diabetes mellitus

Kojima, Nobue; Tanimura, Kenji; Deguchi, Masashi; Morizane, Mayumi; Hirota, Yushi; Ogawa, Wataru; Yamada, Hideto

doi:10.1080/09513590.2016.1177009

Cited by 21 publications

(30 citation statements)

References 18 publications

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“…Previous studies have shown the prevalence rates of glucose intolerance (i.e. diabetes and impaired glucose tolerance/impaired fasting glucose) during the early postpartum period in Japanese women with GDM to be 16.7% , 27.1% and 34.3% . The prevalence of glucose intolerance in the present investigation was similar to or slightly higher than those of previous studies.…”

Section: Discussionsupporting

confidence: 84%

“…Previous studies suggest that insulinogenic index is a useful predictor of early postpartum glucose intolerance in Japanese women with GDM [16,17]. In the present study, the insulinogenic index in the glucose intolerance group was lower than that in the normal glucose tolerance group, but the difference was not statistically significant (P=0.056).…”

Section: Discussioncontrasting

confidence: 77%

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Factors predicting early postpartum glucose intolerance in Japanese women with gestational diabetes mellitus: decision‐curve analysis

et al. 2018

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Section: Discussionsupporting

confidence: 84%

Section: Discussioncontrasting

confidence: 77%

Factors predicting early postpartum glucose intolerance in Japanese women with gestational diabetes mellitus: decision‐curve analysis

et al. 2018

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“…Breastfeeding is a convenient and low‐cost method of improving postpartum health. However, many studies that analyzed the risk factors for progression of GDM to type 2 diabetes mellitus overlooked the mother's lactation status. Mothers with prior GDM were less likely to breast‐feed their children than mothers without diabetes.…”

Section: Discussionmentioning

confidence: 99%

Lactation and progression to type 2 diabetes in patients with gestational diabetes mellitus: A systematic review and meta‐analysis of cohort studies

Lin

et al. 2018

J of Diabetes Invest

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Aims/IntroductionTo explore the association between lactation and type 2 diabetes incidence in women with prior gestational diabetes.Materials and MethodsWe searched PubMed, Embase and the Cochrane Library for cohort studies published through 12 June 2017 that evaluated the effect of lactation on the development of type 2 diabetes in women with prior gestational diabetes. A random effects model was used to estimate relative risks (RRs) with 95% confidence intervals (CIs).ResultsA total of 13 cohort studies were included in the meta‐analysis. The pooled result suggested that compared with no lactation, lactation was significantly associated with a lower risk of type 2 diabetes (RR 0.66, 95% CI 0.48–0.90, I 2 = 72.8%, P < 0.001). This relationship was prominent in a study carried out in the USA (RR 0.66, 95% CI 0.43–0.99), regardless of study design (prospective design RR 0.56, 95% CI 0.41–0.76; retrospective design RR 0.63, 95% CI 0.40–0.99), smaller sample size (RR 0.52, 95% CI 0.30–0.92, P = 0.024) and follow‐up duration >1 years (RR 0.75, 95% CI 0.56–1.00), and the study used adjusted data (RR 0.69, 95% CI 0.50–0.94). Finally, by pooling data from three studies, we failed to show that compared with no lactation, long‐term lactation (>1 to 3 months postpartum) was associated with the type 2 diabetes risk (RR 0.69, 95% CI 0.41–1.17).ConclusionsThe present meta‐analysis showed that lactation was associated with a lower risk of type 2 diabetes in women with prior gestational diabetes. Furthermore, no significant relationship between long‐term lactation and type 2 diabetes risk was detected. The impact of long‐term lactation and the risk of type 2 diabetes should be verified in further large‐scale studies.

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“…Given that the susceptibility to glucose intolerance varies among different racial or ethnic groups, the clinical risk factors and genetic variants of pAGT might differ between Caucasian and Japanese women. However, few reports on the risk factors of pAGT are available with regard to Japanese women with GDM, and, to the best of our knowledge, there are no data on the genetic variants associated with pAGT in this population subgroup.…”

Section: Introductionmentioning

confidence: 99%

“…However, the rate of postpartum follow up for women with GDM is low; therefore, it is desirable to identify those at the greatest risk by determining the risk factors 3 . The clinical risk factors associated with postpartum abnormal glucose tolerance (pAGT) include a family history of diabetes, obesity, early GDM diagnosis, fasting hyperglycemia, insulin requirement during pregnancy and antepartum b-cell dysfunction [4][5][6][7][8][9][10][11][12][13] . Additionally, recent studies have shown that certain genetic variants are associated with the development of future type 2 diabetes mellitus in women with a history of GDM 9,14,15 .…”

Section: Introductionmentioning

confidence: 99%

Clinical and genetic characteristics of abnormal glucose tolerance in Japanese women in the first year after gestational diabetes mellitus

Kasuga

Miyakoshi

Tajima

et al. 2018

J of Diabetes Invest

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Aims/Introduction Risk factors of type 2 diabetes mellitus in Japanese women with recent gestational diabetes mellitus are unknown. The objective of the present study was to investigate the clinical and genetic characteristics associated with postpartum abnormal glucose tolerance in Japanese women with gestational diabetes mellitus. Materials and Methods A total of 213 Japanese women with recent gestational diabetes mellitus who underwent a postpartum 2‐h oral glucose tolerance test were investigated. The association between antepartum clinical characteristics and postpartum abnormal glucose tolerance (diabetes or prediabetes based on the Japan Diabetes Society criteria) was examined. Frequencies of 45 known type 2 diabetes mellitus‐associated genetic variants were also compared between women with and without postpartum abnormal glucose tolerance. Results A total of 59 women showed postpartum abnormal glucose tolerance (prediabetes, n = 51; diabetes, n = 8). Plasma glucose levels at 1 or 2 h, the insulinogenic index and the insulin secretion‐sensitivity index‐2 of the antepartum oral glucose tolerance test were independent of postpartum abnormal glucose tolerance risk factors ( P = 0.006, P = 0.00002, P = 0.01 and P = 0.006, respectively). Four genetic variants (rs266729 [ ADIPOQ ], rs6017317 [ HNF 4A ], rs5215 [ KCNJ 11 ] and rs7177055 [ HMG 20A ]) showed a nominally significant association with postpartum abnormal glucose tolerance ( P < 0.05, respectively). Among these, three were related to insulin secretion. Postpartum abnormal glucose tolerance risk significantly increased with increasing risk‐allele number ( P = 0.0005; odds ratio 1.91). Conclusions Clinical features and genetic variants related to impaired insulin secretion are risk factors of postpartum abnormal glucose tolerance in Japanese women with recent gestational diabetes mellitus.

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Risk factors for postpartum glucose intolerance in women with gestational diabetes mellitus

Abstract: II measured by OGTT during pregnancy might be a useful predictor of GI within the early postpartum period in women with GDM.

Cited by 21 publications

References 18 publications

Factors predicting early postpartum glucose intolerance in Japanese women with gestational diabetes mellitus: decision‐curve analysis

Factors predicting early postpartum glucose intolerance in Japanese women with gestational diabetes mellitus: decision‐curve analysis

Lactation and progression to type 2 diabetes in patients with gestational diabetes mellitus: A systematic review and meta‐analysis of cohort studies

Clinical and genetic characteristics of abnormal glucose tolerance in Japanese women in the first year after gestational diabetes mellitus

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