Gestational Diabetes Increases Risk for Subsequent Diabetes Development

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The relative increase in risk of developing subsequent diabetes was highest at 3 to 6 years after gestational diabetes onset.
The relative increase in risk of developing subsequent diabetes was highest at 3 to 6 years after gestational diabetes onset.

Women with a history of gestational diabetes (GD) are at highest risk for subsequent diabetes development 3 to 6 years following GD diagnosis, according to a meta-analysis published in Obesity Reviews.

Investigators systematically reviewed 30 cohort studies that reported the incidence of GD and diabetes in pregnant women (N=2,626,905). Included studies assessed the risk and time to post-pregnancy diabetes onset in women with GD and without GD. The investigators performed a subgroup analysis of patients in whom diabetes developed <3 years, ≥3 to <6 years, ≥6 to <10 years, ≥10 to <15 years, and ≥15 years after GD.

Based on the pooled data analysis, prior GD was associated with a 7.76-fold unadjusted risk for diabetes compared with risk in women without prior GD (95% CI, 5.10-11.81). The adjusted risk for diabetes in women with vs without prior GD was 17.92-fold (95% CI, 16.96-18.94).

The risk for diabetes was highest in the subgroup of women who had GD 3 to 6 years prior to follow-up (risk ratio [RR] 16.16; 95% CI, 9.96-26.24) after the index pregnancy.

Women with GD age ≥35 to <40 years also had a higher risk for postpartum diabetes (RR 14.71; 95% CI, 8.87-24.40) vs women with GD age <35 years (RR 6.81; 95% CI, 3.30-14.05) and those age ≥40 years (RR 5.46; 95% CI, 1.44-20.73).

The studies included in this meta-analysis were reported in either English or Chinese, limiting the potential extent of the analysis across the population. In some studies, the investigators were unable to adjust for missing age or body mass index at the individual level, which may have introduced residual confounding.

Findings from this analysis emphasize “the importance to educate women with GD to adopt active lifestyles within 3 years of delivery.”

Reference

Song C, Lyu Y, Li C, et al. Long-term risk of diabetes in women at varying durations after gestational diabetes: a systematic review and meta-analysis with more than 2 million women. Obes Rev. 2018;19:421-429.

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