Risk Factors for Progression to Postpartum Diabetes Mellitus and Perinatal Complications in Women with Gestational Diabetes Mellitus

Abstract

Background: Gestational diabetes mellitus (GDM) is a hyperglycemic condition caused by increased insulin resistance and impaired insulin secretion during pregnancy. It is known to be temporary, but it can cause perinatal complications in the mother and baby. Additionally, it may progress to type 2 diabetes mellitus (T2DM). In the present study, we evaluated the risk factors for complications and progression to T2DM in patients with GDM. Methods: The study included 130 pregnant women who were diagnosed with GDM at gestational weeks 24-28 in 2011. Body mass index and the levels of glucose, total cholesterol, lipoproteins, and coagulation factors (von Willebrand factor and plasminogen activator inhibitor-1) were assessed in all patients. Results: The level of high-density lipoprotein (HDL) was significantly lower and the triglyceride/HDL ratio and coagulation factor levels were significantly higher in the group of patients with perinatal complications compared to those in the group of patients without complications. After delivery, the level of HDL was lower and the value of homeostasis model assessment of insulin resistance (HOMA-IR) was higher in women with impaired glucose metabolism compared to those in women with normal glucose metabolism. In logistic regression analysis, perinatal complications were independently associated with HDL and PAI-1 levels (OR = 0.929 and 1.101, respectively). Conclusion: The findings of our study show that the levels of HDL and coagulation factors are notable risk factors of perinatal complications. Additionally, we showed that lower HDL level may influence the progression to T2DM. Large-scale population studies are needed to verify our findings. (

Risk and Risk Factors for Postpartum Type 2 Diabetes Mellitus in Women with Gestational Diabetes: A Korean Nationwide Cohort Study

“…The risk and risk factors differ in the early and late (greater than 1 year follow-up) postpartum periods [15,22], and defects in beta-cell function, partly explained by genetic predisposition, are more remarkable in early converters [15]. Risk factors of postpartum T2DM across the perinatal period include pre-pregnancy obesity, gestational diabetes diagnostic test results during pregnancy, postpartum metabolism tests results, and obesity [22][23][24][25][26][27]. Given the potential for prevention strategy and usefulness of postpartum counseling for women with gestational diabetes, it is neces-sary to focus on late-onset postpartum T2DM and modifiable factors in the postpartum period.…”