Risk factors during the early postpartum period for type 2 diabetes mellitus in women with gestational diabetes

For women with gestational diabetes mellitus (GDM), the evaluation of glucose tolerance (GT) in the early postpartum period is universally recommended. Nevertheless, few studies have evaluated the risk factors for T2DM on the basis of GT data obtained during the early postpartum period. We aimed to...

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Bibliographic Details
Published in:Endocrine Journal 2020, Vol.67(4), pp.427-437
Main Authors: Kawasaki, Maki, Arata, Naoko, Sakamoto, Naoko, Osamura, Anna, Sato, Siori, Ogawa, Yoshihiro, Yasuhi, Ichiro, Waguri, Masako, Hiramatsu, Yuji
Format: Article
Language:English
Subjects:
Adult
Blood Glucose - analysis
Body Mass Index
Diabetes
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2 - diagnosis
Diabetes Mellitus, Type 2 - epidemiology
Diabetes, Gestational - physiopathology
Early postpartum period
Female
Gestational diabetes mellitus
Glucose
Glucose Intolerance - physiopathology
Glucose tolerance
Glucose Tolerance Test
Glycated Hemoglobin A - analysis
Hemoglobin
Humans
Japan
Obesity
Obesity - complications
Odds Ratio
Oral glucose tolerance test
Postpartum
Postpartum Period
Prediction
Pregnancy
Retrospective Studies
Risk Factors
Type 2 diabetes mellitus
Womens health
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Summary:For women with gestational diabetes mellitus (GDM), the evaluation of glucose tolerance (GT) in the early postpartum period is universally recommended. Nevertheless, few studies have evaluated the risk factors for T2DM on the basis of GT data obtained during the early postpartum period. We aimed to identify the risk factors for type 2 diabetes mellitus (T2DM) by evaluating GT in the first 12 weeks postpartum (12wPP) in women with GDM and to categorize the risk using a combination of the principal risk factors. This retrospective multicenter observational study included 399 East Asian women with GDM who underwent a 75-g oral glucose tolerance test (OGTT) within 12wPP, which was repeated annually or biennially and used to identify the postpartum development of T2DM. Forty-three women (10.8%) developed T2DM during a median follow-up period of 789 ± 477 days. The independent risk factors for T2DM were pre-pregnancy obesity (BMI ≥25 kg/m2), early postpartum impairment in glucose tolerance (IGT), and an early postpartum glycated hemoglobin (HbA1c) ≥5.7%. The odds ratios (95% confidence intervals) for T2DM were 3.2 (1.3–7.8) in women with either early postpartum IGT or pre-pregnancy obesity, 9.2 (3.0–28.3) in those with early postpartum IGT, pre-pregnancy obesity, and HbA1c
ISSN:0918-8959
1348-4540
DOI:10.1507/endocrj.EJ19-0367