Body mass index trajectories and time in target range after delivery and long‐term type 2 diabetes risk in women with a history of gestational diabetes mellitus

• Published in: Diabetes, obesity & metabolism obesity & metabolism, 2025-01, Vol.27 (1), p.320-327
• Main Authors: Zhang, Lixia, Shen, Yun, Liu, Huikun, Li, Weiqin, Wang, Leishen, Zhang, Shuang, Leng, Junhong, Li, Wei, Liang, Zhaoxia, Yu, Zhijie, Yang, Xilin, Hu, Gang
• Format: Article
• Language: English
• Subjects: Adult; Body Mass Index; China - epidemiology; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; Diabetes, Gestational - epidemiology; Female; Follow-Up Studies; Gestational diabetes; gestational diabetes mellitus; Glucose tolerance; Glucose Tolerance Test; Humans; Postpartum; postpartum body mass index; Postpartum Period; Pregnancy; Risk Factors; time in target range; trajectory; type 2 diabetes
• ISSN: 1462-8902; 1463-1326; 1463-1326
• DOI: 10.1111/dom.16020

Aims This study aims to determine whether postpartum body mass index (BMI) trajectories and its time in target range (TTR) are associated with long‐term type 2 diabetes risk in women with a history of gestational diabetes mellitus (GDM). Materials and Methods The present study included 1057 women with a history of GDM who participated in the Tianjin Gestational Diabetes Mellitus Prevention Program (TGDMPP). Oral glucose tolerance tests or physician‐diagnosed information were used to diagnose type 2 diabetes after a median follow‐up period of 8.47 years. Latent class modelling was applied to identify trajectories of BMI after delivery. TTR was defined as the proportion of time that BMI was within the standard range (18.5 ≤ BMI 43.4%–0%–≤43.4% and 0% were 1.00, 1.84 (0.72–4.73), 2.75 (1.23–6.15) and 2.31 (1.05–5.08) (p for trend = 0.039), respectively. Conclusions Postpartum BMI trajectories of high‐stable and inverse U‐shape class as well as lower TTR were associated with an increased risk of type 2 diabetes among women with a history of GDM. Reducing BMI to a normal range in the early postpartum period and maintaining stable over time could attenuate the development of long‐term type 2 diabetes.