Weight Change and Cardiometabolic Outcomes in Postpartum Women with History of Gestational Diabetes.

Siew Lim,Vincent L Versace,Sharleen O’Reilly,Edward Janus,James Dunbar

doi:10.3390/nu11040922

Siew Lim, Vincent L Versace + Show 3 more

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https://doi.org/10.3390/nu11040922

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Abstract

Weight gain after childbirth is a significant risk factor for type 2 diabetes (T2DM) development after gestational diabetes mellitus (GDM). The level of weight loss achieved in diabetes prevention programs for women after GDM is often low but its effects on the cardiometabolic risk are not known. In a secondary analysis of a diabetes prevention program in postpartum women with history of gestational diabetes, we evaluated the effect of weight change on the cardiometabolic outcomes at 1-year follow-up. Of the 284 women randomized to the intervention arm, 206 with the final outcome measurements were included in the analyses. Participants were categorized into weight loss (>2 kg, n = 74), weight stable (±2 kg, n = 74) or weight gain (>2 kg, n = 58) groups. The weight loss group had significantly greater decrease in glycated hemoglobin (HbA1c) than the weight gain group (−0.1 + 0.4% vs. 0 + 0.4%, p = 0.049). The weight loss group had significantly greater decrease in total cholesterol and low-density lipoprotein cholesterol cholesterol than the other two groups (p < 0.05). The weight gain group had significantly greater increase in triglyceride and triglyceride:high-density lipoprotein cholesterol ratio compare with the other groups (p < 0.01). Overall, a small amount of weight loss and prevention of further weight gain was beneficial to the cardiometabolic outcomes of postpartum women after GDM.

Highlights

Gestational diabetes mellitus (GDM) affects one in five pregnancies according to the InternationalAssociation of the Diabetes and Pregnancy Study Groups (IADPSG) criteria [1]
We explored the effect of weight change on anthropometric and cardiometabolic outcomes in postpartum women with a history of gestational diabetes at 1 year following a diabetes prevention program
When we stratified the group according to weight loss achieved, we found that weight loss as little as over 2 kg is associated with improvements in HbA1c, fasting plasma glucose, triglyceride:HDL, LDL cholesterol, total cholesterol and triglyceride compared with those who gained weight

Summary

Introduction

Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria [1]. This could rise to above 40% in certain ethnic groups such as Middle Eastern populations [2]. GDM are seven times more likely to develop type 2 diabetes (T2DM) compared with women with normoglycemic pregnancies [3]. Due to the risks associated with obesity in the development of T2DM, weight loss is one of the intervention goals in diabetes prevention programs for the general population and for women after GDM [6,7,8]. Numerous real-world diabetes prevention programs in the general population have demonstrated a significant reduction in the incidence of diabetes through diet and physical activity

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