Abstract
Background and Aims: to determine the incidence of postpartum diabetes mellitus (DM) in the years following a diagnosis of gestational diabetes (GDM) and to determine whether severity of GDM is associated with developing diabetes.
Methods: a retrospective cohort study was performed among 185,340 pregnant women who had glucose challenge test (OGCT) or 3-h oral glucose tolerance test (OGTT) in a large HMO in Israel. Subsequent diagnosis of diabetes was ascertained by using an automated DM registry.
Results: a total of 11,259 subjects were diagnosed as suffering from GDM comprising 6.07% of the cohort. During a total follow-up period of 946,978 Person-Years there were 1065 (1.74 per 100 Person-Years) and 1118 (0.12 per 100 Person-Years) diagnoses of postpartum DM among GDM and non-GDM women, respectively. After 10 years of follow-up, 16% of the GDM population developed diabetes mellitus, compared with 1% among the non-GDM population. GDM was associated with an 8-fold higher risk of postpartum DM after adjusting for important confounder such as socioeconomic status and BMI. Among women with GDM history, diabetes risk increased with number of abnormal OGCT values and among women with Type A2 GDM.
Conclusions: GDM, and particularly severe GDM, are important predictors of future development of DM.
- Received May 27, 2010.
- Accepted May 27, 2010.
