The Risk Factors and Incidence of Type 2 Diabetes Mellitus and Metabolic Syndrome in Women With Previous Gestational Diabetes

Abstract

Background:Gestational diabetes mellitus (GDM) affects nearly 5% of pregnancies. Significant proportion of the women with previous GDM develops type 2 diabetes mellitus (T2DM) in the next years, which indicates a higher risk in them than in the general population.Objectives:We conducted this study to determine the risk factors and incidence of abnormal glucose level and metabolic syndrome (MetS) in women with a history of GDM in a long period after delivery in our region.Patients and Methods:We extracted the demographic characteristics of 110 women with GDM who had delivered during 2004 - 2010 in three main hospitals of Zanjan City, Iran. The patients were recalled to perform oral glucose tolerance test (OGTT) and other necessary tests for MetS diagnosis. Anthropometric measurements were recorded of all the participants.Results:In this study, 110 women with a history of GDM were studied at one to six years since delivery. Among these women, 36 (32.7%) developed T2DM and 11 (10%) had impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). Moreover, 22 women (20%) had developed MetS. among those with abnormal results in glycemic test, 93.6% had fasting blood sugar (FBS) ≥ 95 mg/dL (≥ 5.27 mmol/L)at the time of GDM diagnosis in the index pregnancy that was significantly higher than the normal glycemic test (NGT) group with 42.9% being affected (OR, 19.55; P < 0.0001). There was a significant difference between those with abnormal results and NGT group in interval between delivery and performing laboratory tests (27 ± 18.8 and 18.5 ± 17.7 months, respectively; OR, 1.02; P = 0.02). No insulin use during pregnancy was discovered as a protective factor in women with a history of GDM (OR, 0.35; P = 0.01). Those with abnormal results were significantly different from NGT group in the number of parities (2.61 ± 1.4 vs. 2.05 ± 1.1, respectively; OR, 1.4; P = 0.03). The most common component of MetS among women with a history of GDM was FBS > 100 mg/dL (> 5.55 mmol/L).Conclusions:Regarding the high incidence of the T2DM and MetS among women with a history of GDM, they should be screened at a regular interval for diabetes and other cardiovascular risk factors.

Ethnic Differences in the Risk of Developing Metabolic Syndrome or its Components in Women with a History of Gestational Diabetes Mellitus

“…Non-Caucasian ethnicity was a predictor for postpartum metabolic syndrome [38]. This result agrees with the findings in an Iranian population at 23 months postpartum of 20% prevalence of metabolic syndrome in 110 women with previous GDM [39]. Kousta et al presented data showing that women with GDM had 37% global incidence of metabolic syndrome at 20 months postpartum, with a higher incidence in Indo-Asians (49%) and African-Caribbeans (43%), compared to Europeans (37%) [40].…”

A randomized clinical trial of exercise during pregnancy to prevent gestational diabetes mellitus and improve pregnancy outcome in overweight and obese pregnant women

“…9 Importantly, these poor outcomes also potentially impact the long-term health of both the mothers and their offspring. [10][11][12] Thus, focusing on women who are overweight or obese before pregnancy and seeking ways to decrease their risk of GDM and other adverse pregnancy outcomes are of great importance.…”

Long-Term Effects of Pregnancy Complications on Maternal Health: A Review

“…Valizadeh et al also studied risk factors and incidences of abnormal glucose levels and metabolic syndrome in 110 women with history of GDM one to six years after their pregnancy. Thirty-six women (32.7%) developed type 2 diabetes, 11 (10%) had impaired fasting glucose or impaired glucose tolerance and 22 women (20%) developed metabolic syndrome [ 13 ]. The authors suggested that women with a history of GDM should be screened at regular intervals for diabetes and other cardiovascular risk factors.…”