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Type 2 diabetes after a pregnancy with gestational diabetes among first nations women in Australia: The PANDORA study

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Wood, Anna J., Boyle, Jacqueline A., Barr, Elizabeth L.M., Barzi, Federica, Hare, Matthew J.L., Titmuss, Angela, Longmore, Danielle K., Death, Elizabeth +13 more·2021·Diabetes Research and Clinical Practice
DOI 10.1016/j.diabres.2021.109092
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Abstract

AIMS: To determine among First Nations and Europid pregnant women the cumulative incidence and predictors of postpartum type 2 diabetes and prediabetes and describe postpartum cardiovascular disease (CVD) risk profiles. METHODS: PANDORA is a prospective longitudinal cohort of women recruited in pregnancy. Ethnic-specific rates of postpartum type 2 diabetes and prediabetes were reported for women with diabetes in pregnancy (DIP), gestational diabetes (GDM) or normoglycaemia in pregnancy over a short follow-up of 2.5 years (n = 325). Pregnancy characteristics and CVD risk profiles according to glycaemic status, and factors associated with postpartum diabetes/prediabetes were examined in First Nations women. RESULTS: The cumulative incidence of postpartum type 2 diabetes among women with DIP or GDM were higher for First Nations women (48%, 13/27, women with DIP, 13%, 11/82, GDM), compared to Europid women (nil DIP or GDM p < 0.001). Characteristics associated with type 2 diabetes/prediabetes among First Nations women with GDM/DIP included, older age, multiparity, family history of diabetes, higher glucose values, insulin use and body mass index (BMI). CONCLUSIONS: First Nations women experience a high incidence of postpartum type 2 diabetes after GDM/DIP, highlighting the need for culturally responsive policies at an individual and systems level, to prevent diabetes and its complications.

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Authors
Wood, A. J., Boyle, J. A., Barr, E. L. M., Barzi, F., Hare, M. J. L., Titmuss, A., Longmore, D. K., Death, E., Kelaart, J., Kirkwood, M., Graham, S., Connors, C., Moore, E., O'Dea, K., Oats, J. J. N., McIntyre, H. D., Zimmet, P. Z., Lu, Z. X., Brown, A., Shaw, J. E., & Maple-Brown, L. J.
Affiliations
  • Charles Darwin University (AU)
  • Baker Heart and Diabetes Institute (AU)
  • The University of Queensland (AU)
  • Government of the Northern Territory (AU)
  • The University of Melbourne (AU)
  • Monash University (AU)
  • Monash Medical Centre (AU)
  • South Australian Health and Medical Research Institute (AU)
Corresponding author
Wood, Anna J.
ORCID
Venue
Diabetes Research and Clinical Practice
Publisher
Elsevier BV
Published
2021-11
Volume
181
Pages
109092
ISSN
0168-8227 (ISSN-L)
DOI
10.1016/j.diabres.2021.109092
OpenAlex
W3205618074
Cited by
24
References
2
Citations by year
2026: 4 · 2025: 7 · 2024: 1 · 2023: 5 · 2022: 7
FWCI
2.96
Type
journal article
Language
en
Update notices
erratum (2024-07-01)
Open access
Licence
Locations
  • Diabetes Research and Clinical Practice (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by-nc-nd)
Funders
  • National Heart Foundation of Australia (101291, 1079438, 1137563)
  • National Health and 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 › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
type 2 diabetes, gestational diabetes mellitus, diabetes in pregnancy, postpartum diabetes, prediabetes, First Nations women, Indigenous health, cardiovascular risk, risk factors, body mass index, insulin use, multiparity, family history of diabetes
MeSH terms
Aged, Diabetes Mellitus, Type 2, Female, Humans, Prediabetic State, Pregnancy, Pregnancy in Diabetics, Prospective Studies, Risk Factors, Diabetes, Gestational, Postpartum Period

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