Subsequent Pregnancy After Gestational Diabetes Mellitus

Abstract

OBJECTIVE -The purpose of this study was to determine the frequency of recurrent gestational diabetes mellitus (GDM) and to find risk factors that can predict the recurrence of GDM in Korean women with previous GDM.RESEARCH DESIGN AND METHODS -We evaluated women who had GDM in an index pregnancy (1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)) and a subsequent pregnancy by 2003. An oral glucose tolerance test (OGTT) was performed during the index pregnancy and 2 months postpartum. The recurrence rate of GDM was assessed among 111 women who had a subsequent pregnancy. Multivariate logistic regression analysis was used to identify independent predictors of recurrent GDM.RESULTS -The frequency of recurrent GDM in subsequent pregnancies was 45.0% (95% CI 35.6 -54.4%). Women with impaired fasting glucose and/or impaired glucose tolerance 2 months postpartum were at increased risk for recurrent GDM (relative risk 2.31, 95% CI 1.24 -4.30). Higher BMI before the subsequent pregnancy (P ϭ 0.024), higher fasting glucose concentration (P ϭ 0.007) 2 months postpartum, and lower 1-h insulin concentration (P ϭ 0.004) of the diagnostic OGTT in the index pregnancy were independent risk factors for recurrence of GDM in subsequent pregnancies.CONCLUSIONS -GDM recurred in nearly half of subsequent pregnancies in Korean women. Fasting glucose 2 months postpartum might be a clinically valuable predictor of recurrent GDM risk.

Insulin secretion and insulin resistance in Korean women with gestational diabetes mellitus and impaired glucose tolerance

“…However, these studies were conducted after delivery, and few studies have analyzed insulin secretion, resistance, and sensitivity during pregnancy. Kwak et al [20] reported that GDM recurred in almost 50% of subsequent pregnancies in Korean women, and that fasting glucose at 2-month postpartum may be a clinically valuable predictor of risk for recurrent GDM. They also reported mean HOMA-IR values of 2.2 to 3.2 for Korean women who had a history of GDM; these values are not markedly different from those obtained in the present study (median HOMA-IR of 2.3 in GDM subjects).…”

Gestational Diabetes Mellitus in Korean Women: Similarities and Differences from Other Racial/Ethnic Groups

“…Korean women with histories of GDM are also at increased risk for recurrence of GDM [51]. Kwak et al [51] found that among women who had another pregnancy, 45% had recurrent GDM, a strikingly similar estimate to non-Koreans.…”

Finding Genetic Risk Factors of Gestational Diabetes

“…After parturition, about 15% of GDM women had persistent diabetes at an early postpartum period of 2 months [5]. GDM is also reported to recur at a frequency of 45% in subsequent pregnancies [6]. Women with a previous history of GDM are at increased risk of future development of type 2 diabetes mellitus (T2DM).…”