Long-term risk of type 2 diabetes mellitus in relation to BMI and weight change among women with a history of gestational diabetes mellitus: a prospective cohort study.
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Aims/hypothesis Women with a history of gestational diabetes mellitus (GDM) are advised to control their weight after pregnancy. We aimed to examine how adiposity and weight change influence the long-term risk of developing type 2 diabetes after GDM.Methods We included 1,695 women who had incident GDM between 1991 and 2001, as part of the Diabetes & Women's Health study, and followed them until the return of the 2009 questionnaire. Body weight and incident type 2 diabetic cases were reported biennially. We defined baseline as the questionnaire period when women reported an incident GDM pregnancy. We estimated HRs and 95% CIs using Cox proportional hazards models.Results We documented 259 incident cases of type 2 diabetes during up to 18 years of follow-up. The adjusted HRs of type 2 diabetes associated with each 1 kg/m(2) increase in BMI were 1.16 (95% CI 1.12, 1.19) for baseline BMI and 1.16 (95% CI 1.13, 1.20) for most recent BMI. Moreover, each 5 kg increment of weight gain after GDM development was associated with a 27% higher risk of type 2 diabetes (adjusted HR 1.27; 95% CI 1.04, 1.54). Jointly, women who had a BMI ≥30.0 kg/m(2) at baseline and gained ≥5 kg after GDM had an adjusted HR of 43.19 (95% CI 13.60, 137.11), compared with women who had a BMI <25.0 kg/m(2) at baseline and gained <5 kg after GDM.Conclusions/interpretation Baseline BMI, most recent BMI and weight gain after GDM were significantly and positively associated with risk of progression from GDM to type 2 diabetes.
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A meta-analysis of 20 studies performed prior to the development of the IADPSG criteria and using varied criteria to diagnose gestational diabetes demonstrated that women with a history of gestational diabetes had a higher risk of developing type 2 diabetes compared with women with a normoglycemic pregnancy (relative risk, 7.43).
“A meta-analysis of 20 studies that were performed prior to the development of the IADPSG criteria and that used varied criteria to diagnose gestational diabetes demonstrated that women with a history of gestational diabetes had a higher risk of developing type 2 diabetes compared with women with a normoglycemic pregnancy (relative risk, 7.43).23”
From Association of Gestational Diabetes With Maternal Disorders of Glucose Metabolism and Childhood Adiposity (2018) · cites this paper as [23]
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- Authors
- Bao, W., Yeung, E., Tobias, D. K., Hu, F. B., Vaag, A. A., Chavarro, J. E., Mills, J. L., Grunnet, L. G., Bowers, K., Ley, S. H., Kiely, M., Olsen, S. F., & Zhang, C.
- Affiliations
- National Institutes of Health (US)
- Brigham and Women's Hospital (US)
- Rigshospitalet (DK)
- Cincinnati Children's Hospital Medical Center (US)
- Harvard University (US)
- Statens Serum Institut (DK)
- Corresponding author
- Zhang, Cuilin
- ORCID
- Venue
- Diabetologia
- Published
- 2015-03-22
- Volume
- 58
- Issue
- 6
- Pages
- 1212-1219
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- PMC
- PMC4629783
- OpenAlex
- W2024686179
- Cited by
- 137
- References
- 48
- Citations by year
- 2026: 9 · 2025: 13 · 2024: 9 · 2023: 9 · 2022: 19 · 2021: 11 · 2020: 8 · 2019: 17 · 2018: 13 · 2017: 13 · 2016: 15 · 2015: 1
- FWCI
- 15.93
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- CUNY Academic Works (City University of New York) (submittedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- National Institutes of Health
- U.S. Public Health Service (HHSN275201000020C)
- National Cancer Institute (CA50385, UM1CA176726, R01CA050385)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK058845, P30DK046200, P30 DK-46200, DK58845)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (# HHSN275201000020C)
- 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, type 2 diabetes, body mass index, postpartum weight gain, obesity, diabetes risk, women
- MeSH terms
- Adult, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Humans, Middle Aged, Obesity, Pregnancy, Prospective Studies, Surveys and Questionnaires, Risk Factors, Weight Gain, Body Mass Index, Multivariate Analysis, Proportional Hazards Models, Diabetes, Gestational, Adiposity
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