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The impact of ethnicity on glucose regulation and the metabolic syndrome following gestational diabetes
Open accessAbstract
Aims/hypothesis We assessed the impact of ethnic origin on metabolism in women following gestational diabetes mellitus (GDM).Materials and methods Glucose regulation and other features of the metabolic syndrome were studied at 20.0 (18.2-22.1) months (geometric mean [95% CI]) post-partum in women with previous GDM (185 European, 103 Asian-Indian, 80 African-Caribbean). They were compared with the same features in 482 normal control subjects who had normal glucose regulation during and following pregnancy.Results Impaired glucose regulation or diabetes by WHO criteria were present in 37% of women with previous GDM (diabetes in 17%), especially in those of African-Caribbean and Asian-Indian origin (50 and 44%, respectively vs 28% in European, p=0.009). BMI, waist circumference, diastolic blood pressure, fasting triglyceride and insulin levels, and insulin resistance by homeostatic model assessment (HOMA), were increased following GDM (p<0.001 for all, vs control subjects). Where glucose regulation was normal following GDM, basal insulin secretion (by HOMA) was high (p<0.001 vs control subjects). Irrespective of glucose regulation in pregnancy, Asian-Indian origin was associated with high triglyceride and low HDL cholesterol levels, and African-Caribbean with increased waist circumference, blood pressure, and insulin levels, together with insulin resistance and low triglyceride concentrations. Nonetheless, the GDM-associated features were consistent within each ethnic group. The metabolic syndrome by International Diabetes Federation criteria was present in 37% of women with previous GDM, especially in non-Europeans (Asian-Indian 49%, African-Caribbean 43%, European 28%, p=0.001), and in 10% of controls.Conclusions/interpretation Following GDM, abnormal glucose regulation and the metabolic syndrome are common, especially in non-European women, indicating a need for diabetes and cardiovascular disease prevention strategies.
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Multiethnic studies reported a higher risk of developing diabetes or impaired glucose tolerance in Asians than in Caucasians (Ignell et al. 5-fold increased risk of diabetes at 1 to 2 years postpartum; Kousta et al. 44% vs. 28% with impaired glucose tolerance at 20 months postpartum).
“Multiethnic studies assessing postpartum diabetes reported a higher risk of developing diabetes or impaired glucose tolerance in Asians than in Caucasians (Ignell et al. [50] 5-fold increased risk of diabetes at 1 to 2 years postpartum; Kousta et al. [51] 44% vs. 28% with impaired glucose tolerance at 20 months postpartum).”
From Gestational Diabetes Mellitus: Diagnostic Approaches and Maternal-Offspring Complications (2022) · cites this paper as [51]
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References 12 · Cited by 74
Metadata
- Authors
- Kousta, E., Efstathiadou, Z., Lawrence, N. J., Jeffs, J. A. R., Godsland, I. F., Barrett, S. C., Doré, C. J., Penny, A., Anyaoku, V., Millauer, B. A., Cela, E., Robinson, S., McCarthy, M. I., & Johnston, D. G.
- Affiliations
- St Mary's Hospital (GB)
- Churchill Hospital (GB)
- Corresponding author
- Johnston, D. G.
- Venue
- Diabetologia
- Published
- 2005-12-09
- Volume
- 49
- Issue
- 1
- Pages
- 36-40
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W2015131076
- Semantic Scholar
- 8528eb3241bb153084dcbdfb2fd6cf43d44c9dd5
- Cited by
- 74
- References
- 12
- Citations by year
- 2026: 3 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 9 · 2019: 1 · 2018: 6 · 2017: 5 · 2016: 5 · 2015: 6 · 2014: 3 · 2013: 7 · 2012: 3
- FWCI
- 4.44
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Diabetes UK
- Medical Research Council
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Keywords
- gestational diabetes mellitus, ethnicity, metabolic syndrome, glucose regulation, insulin resistance, postpartum women, Asian Indian women, African-Caribbean women, type 2 diabetes, cardiovascular risk, triglycerides, HDL cholesterol, waist circumference, blood pressure
- MeSH terms
- Algorithms, Blood Glucose, Blood Pressure, England, Ethnicity, Fasting, Female, Humans, Insulin, Lipids, Pregnancy, Retrospective Studies, Body Mass Index, Diabetes, Gestational, Metabolic Syndrome
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