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

• 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
• ISSN: 0918-8959; 1348-4540
• DOI: 10.1507/endocrj.EJ19-0367

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