Long-term maternal cardiometabolic outcomes 22 years after gestational diabetes mellitus.

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  • Additional Information
    • Source:
      Publisher: Asian Association for the Study of Diabetes and Blackwell Pub. Asia Country of Publication: Japan NLM ID: 101520702 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2040-1124 (Electronic) Linking ISSN: 20401116 NLM ISO Abbreviation: J Diabetes Investig Subsets: MEDLINE
    • Publication Information:
      Original Publication: Tokyo : Asian Association for the Study of Diabetes and Blackwell Pub. Asia
    • Subject Terms:
      Time Factors*; Diabetes Mellitus, Type 2/*epidemiology ; Diabetes, Gestational/*blood ; Glucose Intolerance/*epidemiology ; Metabolic Syndrome/*epidemiology; Adult ; Blood Glucose/analysis ; Body Mass Index ; Cardiometabolic Risk Factors ; Case-Control Studies ; China ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/etiology ; Fasting/blood ; Female ; Follow-Up Studies ; Glucose Intolerance/blood ; Glucose Intolerance/etiology ; Glucose Tolerance Test ; Humans ; Logistic Models ; Metabolic Syndrome/blood ; Metabolic Syndrome/etiology ; Middle Aged ; Odds Ratio ; Pregnancy ; Pregnancy Trimesters/blood ; Prevalence ; Prospective Studies
    • Abstract:
      Aims/introduction: Women with gestational diabetes mellitus are at increased risk for type 2 diabetes. We characterized the association between maternal glycemia during pregnancy with long-term outcomes.
      Methods and Methods: In this prospective nested case-cohort study, participants were recalled for follow up with detailed evaluation including oral glucose tolerance test at 8, 15 and 22 years. Logistic regression was used to estimate the risk of developing impaired glucose tolerance/type 2 diabetes and metabolic syndrome at follow up. The association between maternal glycemia at pregnancy and follow up was evaluated by linear regression. We also charted trajectory of β-cell function during follow up.
      Results: The analysis included 121 women with a mean follow-up period of 22.5 years, and a mean age of 50.3 years. Gestational diabetes was associated with an adjusted odds ratio of 2.48 (95% confidence interval 1.03-5.99) for combined diabetes/impaired glucose tolerance at follow up (P = 0.04). Women with a pre-pregnancy body mass index ≥23 had an odds ratio of 5.43 (95% confidence interval 1.87-15.72) for metabolic syndrome at follow up, compared with those with body mass index <23 (P = 0.002). Both fasting and 2-h glucose during pregnancy were strongly associated with glycemic indices at follow up (P-value <0.001-0.016). Gestational diabetes was associated with impaired β-cell function that remained relatively stable after the index pregnancy.
      Conclusions: Chinese women with a history of gestational diabetes have a high prevalence of impaired glucose tolerance/type 2 diabetes at 22-year follow up. Glucose levels during mid-pregnancy are strongly associated with those of middle age.
      (© 2020 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.)
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    • Grant Information:
      Hong Kong Research Grants Council; Hong Kong Foundation for Research and Development in Diabetes; T12-402/13N Research Grants Council Theme-based Research Scheme; 14110415 RGC General Research Fund
    • Contributed Indexing:
      Keywords: Gestational diabetes mellitus; Obesity; Type 2 diabetes
    • Accession Number:
      0 (Blood Glucose)
    • Publication Date:
      Date Created: 20200109 Date Completed: 20210706 Latest Revision: 20240329
    • Publication Date:
      20240329
    • Accession Number:
      PMC7378443
    • Accession Number:
      10.1111/jdi.13209
    • Accession Number:
      31912653