Gestational Diabetes and Diabetes and Prediabetes Risks Postpartum—A Large Observational Study

Abstract

The objective of this study was to compare risks of postpartum type 2 diabetes (T2D) and prediabetes in Chinese women with and without gestational diabetes (GDM) during pregnancy. Tianjin GDM observational study included 1263 women with a history of GDM and 7women without GDM who participated in the whole population’s GDM universal screening survey by using World Health Organization (WHO)’s criteria. Postpartum T2D and prediabetes were defined according to the American Diabetes Association (ADA) criteria after a standard oral glucose tolerance test. Cox proportional hazards regression was used to assess risks of postpartum T2D and prediabetes between women with and without GDM. During a mean follow-up of 3.53 years postpartum, 90 T2D and 599 prediabetes were identified. Multivariable-adjusted hazard ratios (HR) associated with GDM were 76.1 (95% CI 23.6-246) for T2D, and 25.4 (95% CI 18.2-35.3) for prediabetes. When a mean of follow-up extended to 4.40 years, 121 T2D and 616 prediabetes were identified. Women with prior GDM had a 13.0-fold increased risk (adjusted HR: 95% CI 5.54-30.6) for diabetes and 2.15-fold risk (95% CI 1.76-2.62) for prediabetes than women without GDM. The positive associations between GDM and the risks of postpartum T2D and prediabetes were significant and persistent across stratum by age at delivery (i.e., < 30 years vs. >= 30 years) and overall body adiposity status (i.e., normal vs. overweight). The present study among Chinese women indicated that women with prior GDM had a significantly increased risk for early postpartum T2D and prediabetes, with the risk being highest at the first 3 years postpartum, compared with those without GDM. Disclosure Y. Shen: None. P. Wang: None. L. Wang: None. S. Zhang: Employee; Self; American Diabetes Association. Advisory Panel; Self; Company/ABC. H. Liu: None. W. Li: None. N. Li: None. W. Li: None. J. Leng: None. J. Wang: None. H. Tian: None. C. Zhang: None. X. Yang: None. Z.M. Yu: None. G. Hu: None.