Cardiometabolic risk in Chinese women with prior gestational diabetes: a 15-year follow-up study

Gynecol Obstet Invest. 2012;73(2):168-76. doi: 10.1159/000329339. Epub 2011 Dec 16.

Abstract

Aims: The progression to type 2 diabetes mellitus (DM) and other long-term cardiometabolic risks in Chinese women with prior history of gestational diabetes (GD) was studied at 15 years postpartum.

Methods: 139 Chinese women (45 with GD and 94 with normal glucose tolerance (NGT) at the index pregnancy) who had their insulin sensitivity and β-cell functions examined at 8 years postpartum were again followed up at 15 years for the investigation of the rate of type 2 DM, hypertension and metabolic syndrome.

Results: Women with prior history of GD had a significantly higher rate of hypertension (35.6% vs. 16.0%, p = 0.01), type 2 DM (24.4% vs. 5.3%, p < 0.001) and impaired glucose regulation (26.6% vs. 14.9%, p < 0.001) than women with NGT during the index pregnancy. The Matsuda insulin sensitivity index and the quantitative insulin sensitivity check index at 8 years postpartum were independent predictors of both DM and metabolic syndrome at 15 years postpartum.

Conclusions: The conversion rate of type 2 DM increased at an average rate of 1.6% per year after a pregnancy affected by GD. Insulin resistance at 8 years postpartum could refine a future diabetic risk in women with prior history of GD.

MeSH terms

  • Adult
  • Case-Control Studies
  • China / epidemiology
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes, Gestational / epidemiology*
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension / epidemiology*
  • Insulin Resistance
  • Insulin-Secreting Cells / physiology
  • Metabolic Syndrome / epidemiology*
  • Middle Aged
  • Predictive Value of Tests
  • Pregnancy
  • Prevalence
  • Risk Factors