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The absolute and relative risk of type 2 diabetes after gestational diabetes: A systematic review and meta-analysis of 129 studies
Open accessAbstract
Aims To estimate development of type 2 diabetes (T2DM) in women with previous gestational diabetes (GDM) and investigate characteristics associated with higher diagnoses, building on previous meta-analyses and exploring heterogeneity. Methods Systematic literature review of studies published up to October 2019. We included studies reporting progression to T2DM ≥6 months after pregnancy, if diagnostic methods were reported and ≥50 women with GDM participated. We conducted random-effects meta-analyses and meta-regression of absolute and relative T2DM risk. PROSPERO ID: CRD42017080299. Results In 129 included studies, the percentage diagnosed with T2DM was 12% (95% confidence interval 8–16%) higher for each additional year after pregnancy, with a third developing diabetes within 15 years. Development was 18% (5–34%) higher per unit BMI at follow-up, and 57% (39–70%) lower in White European populations compared to others (adjusted for ethnicity and follow-up). Women with GDM had a relative risk of T2DM of 8.3 (6.5–10.6). 17.0% (15.1–19.0%) developed T2DM overall, although heterogeneity between studies was substantial (I 2 99.3%), and remained high after accounting for various study-level characteristics. Conclusions Percentage developing T2DM after GDM is highly variable. These findings highlight the need for sustained follow-up after GDM through screening, and interventions to reduce modifiable risk factors.
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“This risk is especially high for individuals with a high severity or postpartum continuation of glucose intolerance and high BMI199–201.”
From A global view of hypertensive disorders and diabetes mellitus during pregnancy (2022) · cites this paper as [200]
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“Women with GDM have a much higher risk of developing impaired glucose tolerance and T2DM in later life than women with uncomplicated pregnancies7,195–201”
From A global view of hypertensive disorders and diabetes mellitus during pregnancy (2022) · cites this paper as [200]
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“Development of type 2 diabetes is 18% higher per unit of BMI increase from prepregnancy BMI at follow-up, highlighting the importance of effective weight management after GDM (138).”
From 15. Management of Diabetes in Pregnancy: Standards of Care in Diabetes—2024 (2024) · cites this paper as [138]
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Metadata
- Authors
- Dennison, R. A., Chen, E. S., Green, M. E., Legard, C., Kotecha, D., Farmer, G., Sharp, S. J., Ward, R. J., Usher-Smith, J. A., & Griffin, S. J.
- Affiliations
- University of Cambridge (GB)
- Corresponding author
- Dennison, Rebecca A.
- Kotecha, Deeya
- Farmer, George
- Sharp, Stephen J.
- Ward, Rebecca J.
- Griffin, Simon J.
- ORCID
- Venue
- Diabetes Research and Clinical Practice
- Publisher
- Elsevier BV
- Published
- 2021-01
- Volume
- 171
- Pages
- 108625
- ISSN
- 0168-8227 (ISSN-L)
- PMC
- PMC7610694
- OpenAlex
- W3111270620
- Cited by
- 214
- References
- 46
- Citations by year
- 2026: 56 · 2025: 47 · 2024: 39 · 2023: 27 · 2022: 31 · 2021: 14
- FWCI
- 2.13
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Research and Clinical Practice (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Apollo (University of Cambridge) (submittedVersion, cc-by-nc-nd)
- Apollo
- Funders
- Cancer Research UK (A21464, 21464)
- Medical Research Council (MC_UU_12015/4)
- 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 › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- gestational diabetes mellitus, type 2 diabetes, postpartum diabetes risk, diabetes progression, body mass index, ethnicity, racial disparities, diabetes screening, risk factors
- MeSH terms
- Adolescent, Adult, Diabetes Mellitus, Type 2, Female, Humans, Mass Screening, Pregnancy, Risk, Risk Factors, Diabetes, Gestational, Young Adult
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