CoChat
Sign Up
Cited by 56Gestational Diabetes Research and ManagementDiabetes, Cardiovascular Risks, and LipoproteinsDiabetes Management and Research

Progression to type 2 diabetes mellitus after gestational diabetes mellitus diagnosed by IADPSG criteria: Systematic review and meta-analysis

Open access
Juan, Juan, Sun, Yiying, Wei, Yumei, Wang, Shuang, Song, Geng, Yan, Jie, Zhou, Pengxiang, Yang, Huixia·2022·Frontiers in Endocrinology
DOI 10.3389/fendo.2022.1012244PMC PMC9582268
Open this paper in CoChat — free accountOpen PDF

Abstract

Background: To estimate the progression rates to type 2 diabetes mellitus (T2DM) in women with gestational diabetes mellitus (GDM) diagnosed by the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria. Methods: Systematic review and meta-analysis were conducted by searching Medline, Embase, and Cochrane between January 1, 2010 and December 31, 2021 for observational studies investigating progression to T2DM after GDM. Inclusion criteria were IADPSG-diagnosed GDM, studies with both GDM and controls, postpartum follow-up duration at least one year. Data were pooled by random effects meta-analysis models. Heterogeneity was assessed by I 2 statistic. The pooled relative risk for incidence of T2DM and pre-diabetes between GDM participants and controls were estimated. Reasons for heterogeneity among studies were investigated by prespecified subgroup and meta-regression analysis. Publication bias was assessed by the Begg’s and Egger’s tests. Results: This meta-analysis of six studies assessed a total of 61932 individuals (21978 women with GDM and 39954 controls). Women with IADPSG-diagnosed GDM were 6.43 times (RR=6.43, 95% CI:3.45-11.96) more likely to develop T2DM in the future compared with controls. For GDM women, the cumulative incidence of T2DM was 12.1% (95% CI: 6.9%-17.3%), while the pooled cumulative incidence of T2DM was estimated to be 8% (95% CI: 5-11%) in studies with 1 to 5 years of follow-up and increased to 19% (95% CI: 3-34%) for studies with more than 5 years of follow-up. Women with IADPSG-diagnosed GDM had 3.69 times (RR=3.69, 95% CI:2.70-5.06) higher risk of developing pre-diabetes (including impaired fasting glucose and/or impaired glucose tolerance) than controls. Meta-regression analysis showed that the study effect size was not significantly associated with study design, race, length of follow-up, and maternal age (P>0.05). Overall, the studies had a relatively low risk of bias. Conclusions: Women with IADPSG-diagnosed GDM have higher risk of developing T2DM and pre-diabetes. The risk of T2DM in GDM women are higher with longer follow-up duration. Our results highlight the importance of promoting postpartum screening and keeping health lifestyle as well as pharmacological interventions to delay/prevent the onset of T2DM/pre-diabetes in GDM women. Systematic review registration: https://www.crd.york.ac.uk/prospero , identifier (CRD42022314776)

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.3389/fendo.2022.1012244

Cites

5 of 5 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Risk factors for type 2 diabetes include overweight and obesity, physical inactivity, age, family history, race and ethnicity, history of gestational diabetes, and presence of other conditions (eg, hypertension, dyslipidemia, cardiovascular disease).

    “Risk factors for type 2 diabetes include overweight and obesity, physical inactivity, age, family history, race and ethnicity, history of gestational diabetes, and presence of other conditions (eg, hypertension, dyslipidemia, cardiovascular disease).9–14”

    From Diagnosis and Treatment of Type 2 Diabetes in Adults (2025) · cites this paper as [10]

    The Discussion identifies a history of gestational diabetes as a risk factor for later type 2 diabetes, and the Results quantify that increased risk. The paper does not substantiate the sentence’s full list of risk factors, including physical inactivity, overweight or obesity, and the listed other conditions; its race and age analyses did not find significant associations with the study effect size. Page numbers are not available in our copy. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 33

  1. [1]Vounzoulaki E Khunti K Abner SC Tan BK Davies MJ Gillies CL. Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysis. BMJ (2020) 369: m1361. doi: 10.1136/bmj.m1361 32404325 PMC7218708 · DOI · Paper page
  2. [2]Weinert LS. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy: comment to the international association of diabetes and pregnancy study groups consensus panel. Diabetes Care (2010) 33(7): e97. doi: 10.2337/dc10-0544 20190296 PMC2827530 · DOI
  3. [5]WHO guidelines approved by the Guidelines Review Committee. Diagnostic criteria and classification of hyperglycemia first detected in pregnancy. Geneva: World Health Organization (2013). 24199271
  4. [6]Hod M Kapur A Sacks DA Hadar E Agarwal M Di Renzo GC. The international federation of gynecology and obstetrics (FIGO) initiative on gestational diabetes mellitus: A pragmatic guide for diagnosis, management, and care. Int J Gynaecol Obstet. (2015) 131 Suppl 3: S173–211. doi: 10.1016/S0020-7292(15)30033-3 26433807 · DOI · Paper page
  5. [7]Sacks DA Hadden DR Maresh M Deerochanawong C Dyer AR Metzger BE. Frequency of gestational diabetes mellitus at collaborating centers based on IADPSG consensus panel-recommended criteria: the hyperglycemia and adverse pregnancy outcome (HAPO) study. Diabetes Care (2012) 35(3): 526–8. doi: 10.2337/dc11-1641 PMC3322716 22355019 · DOI · Paper page
  6. [8]O’Sullivan EP Avalos G O’Reilly M Dennedy MC Gaffney G Dunne F. Atlantic Diabetes in pregnancy (DIP): the prevalence and outcomes of gestational diabetes mellitus using new diagnostic criteria. Diabetologia. (2011) 54(7): 1670–5. doi: 10.1007/s00125-011-2150-4 21494772 · DOI · Paper page
  7. [9]Juan J Yang H. Prevalence, prevention, and lifestyle intervention of gestational diabetes mellitus in China. Int J Environ Res Public Health (2020) 17(24): 9517. doi: 10.3390/ijerph17249517 PMC7766930 33353136 · DOI
  8. [10]Juan J Yang H Su R Kapur A. Diagnosis of gestational diabetes mellitus in China: Perspective, progress and prospects. Maternal-Fetal Med (2019) 1(1): 31–7. doi: 10.1097/FM9.0000000000000008 · DOI
  9. [11]Minooee S Ramezani Tehrani F Rahmati M Mansournia MA Azizi F. Diabetes incidence and influencing factors in women with and without gestational diabetes mellitus: A 15year population-based follow-up cohort study. Diabetes Res Clin Pract (2017) 128: 24– 31. doi: 10.1016/j.diabres.2017.04.003 28432896 · DOI · Paper page
  10. [12]Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. (2010) 25(9): 603–5. doi: 10.1007/s10654-010-9491-z 20652370 · DOI · Paper page
  11. [14]Hiersch L Shah BR Berger H Geary M McDonald SD Murray-Davis B. Oral glucose tolerance test results in pregnancy can be used to individualize the risk of future maternal type 2 diabetes mellitus in women with gestational diabetes mellitus. Diabetes Care (2021) 44(8): 1860–7. doi: 10.2337/dc21-0659 34131049 · DOI
  12. [15]Wood AJ Boyle JA Barr ELM Barzi F Hare MJL Titmuss A. Type 2 diabetes after a pregnancy with gestational diabetes among first nations women in Australia: The PANDORA study. Diabetes Res Clin Pract (2021) 181: 109092. doi: 10.1016/j.diabres.2021.109092 34653565 · DOI · Paper page
  13. [16]Bayoumi RAL Khamis AH Tahlak MA Elgergawi TF Harb DK Hazari KS. Utility of oral glucose tolerance test in predicting type 2 diabetes following gestational diabetes: Towards personalized care. World J Diabetes. (2021) 12(10): 1778–88. doi: 10.4239/wjd.v12.i10.1778 PMC8554365 34754378 · DOI
  14. [17]Aziz S Munim TF Fatima SS. Post-partum follow-up of women with gestational diabetes mellitus: effectiveness, determinants, and barriers. J Matern Fetal Neonatal Med (2018) 31(12): 1607–12. doi: 10.1080/14767058.2017.1321630 28423981 · DOI
  15. [18]Kugishima Y Yasuhi I Yamashita H Sugimi S Umezaki Y Suga S. Risk factors associated with the development of postpartum diabetes in Japanese women with gestational diabetes. BMC Pregnancy Childbirth (2018) 18(1): 19. doi: 10.1186/s12884-017-1654-4 29310607 PMC5759797 · DOI
  16. [19]Bellamy L Casas JP Hingorani AD Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet (2009) 373(9677): 1773–9. doi: 10.1016/S0140-6736(09)60731-5 19465232 · DOI · Paper page
  17. [20]Kim C Newton KM Knopp RH. Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care (2002) 25(10): 1862–8. doi: 10.2337/diacare.25.10.1862 12351492 · DOI · Paper page
  18. [21]National Diabetes Data Group. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes (1979) 28(12): 1039–57. doi: 10.2337/diab.28.12.1039 510803 · DOI · Paper page
  19. [23]Huvinen E Lahti J Klemetti MM Bergman PH Räikkönen K Orho-Melander M. Genetic risk of type 2 diabetes modifies the effects of a lifestyle intervention aimed at the prevention of gestational and postpartum diabetes. Diabetologia (2022) 65(8): 1291–301. doi: 10.1007/s00125-022-05712-7 PMC9283155 35501401 · DOI
  20. [24]Rhee SY Kim JY Woo JT Kim YS Kim SH. Familial clustering of type 2 diabetes in Korean women with gestational diabetes mellitus. Korean J Intern Med (2010) 25(3): 269–72. doi: 10.3904/kjim.2010.25.3.269 PMC2932939 20830223 · DOI
  21. [25]Mao H Li Q Gao S. Meta-analysis of the relationship between common type 2 diabetes risk gene variants with gestational diabetes mellitus. PLoS One (2012) 7(9): e45882. doi: 10.1371/journal.pone.0045882 23029294 PMC3454322 · DOI · Paper page
  22. [26]Pu J Zhao B Wang EJ Nimbal V Osmundson S Kunz L. Racial/Ethnic differences in gestational diabetes prevalence and contribution of common risk factors. Paediatr Perinat Epidemiol (2015) 29(5): 436–43. doi: 10.1111/ppe.12209 PMC6519933 26201385 · DOI
  23. [27]Krishnan M Murphy R Okesene-Gafa KAM Ji M Thompson JMD RS T. The pacific-specific CREBRF rs373863828 allele protects against gestational diabetes mellitus in māori and pacific women with obesity. Diabetologia (2020) 63(10): 2169–76. doi: 10.1007/s00125-020-05202-8 32654027 · DOI
  24. [28]Shen Y Jia Y Li Y Gu X Wan G Zhang P. Genetic determinants of gestational diabetes mellitus: a case-control study in two independent populations. Acta Diabetol (2020) 57(7): 843–52. doi: 10.1007/s00592-020-01485-w 32114639 · DOI
  25. [30]Minsart AF Vander Maelen A Fontaine V Kirkpatrick C. Social, medical and self-perceived factors influencing postpartum screening of diabetes after gestational diabetes. J Obstet Gynaecol (2014) 34(1): 8– 12. doi: 10.3109/01443615.2013.826639 24359040 · DOI
  26. [31]Eggleston EM LeCates RF Zhang F Wharam JF Ross-Degnan D Oken E. Variation in postpartum glycemic screening in women with a history of gestational diabetes mellitus. Obstet Gynecol. (2016) 128(1): 159–67. doi: 10.1097/AOG.0000000000001467 PMC5049505 27275787 · DOI
  27. [32]Almario CV Ecker T Moroz LA Bucovetsky L Berghella V Baxter JK. Obstetricians seldom provide postpartum diabetes screening for women with gestational diabetes. Am J Obstet Gynecol (2008) 198(5): 528.e1–5. doi: 10.1016/j.ajog.2007.11.001 18191799 · DOI
  28. [33]Chang Y Chen X Cui H Zhang Z Cheng L. Follow-up of postpartum women with gestational diabetes mellitus (GDM). Diabetes Res Clin Pract (2014) 106(2): 236–40. doi: 10.1016/j.diabres.2014.08.020 25271112 · DOI
  29. [34]Sunny SH Malhotra R Ang SB Lim CSD Tan YSA Soh YMB. Facilitators and barriers to post-partum diabetes screening among mothers with a history of gestational diabetes mellitus-a qualitative study from Singapore. Front Endocrinol (Lausanne). (2020) 11: 602. doi: 10.3389/fendo.2020.00602 32982985 PMC7484739 · DOI
  30. [35]Daly B Toulis KA Thomas N Gokhale K Martin J Webber J. Increased risk of ischemic heart disease, hypertension, and type 2 diabetes in women with previous gestational diabetes mellitus, a target group in general practice for preventive interventions: A population-based cohort study. PLoS Med (2018) 15(1): e1002488. doi: 10.1371/journal.pmed.1002488 29337985 PMC5770032 · DOI · Paper page
  31. [36]Tobias DK Hu FB Chavarro J Rosner B Mozaffarian D Zhang C. Healthful dietary patterns and type 2 diabetes mellitus risk among women with a history of gestational diabetes mellitus. Arch Intern Med (2012) 172(20): 1566–72. doi: 10.1001/archinternmed.2012.3747 PMC3774782 22987062 · DOI · Paper page
  32. [37]Aroda VR Christophi CA Edelstein SL Zhang P Herman WH Barrett-Connor E. The effect of lifestyle intervention and metformin on preventing or delaying diabetes among women with and without gestational diabetes: the diabetes prevention program outcomes study 10-year follow-up. J Clin Endocrinol Metab (2015) 100(4): 1646–53. doi: 10.1210/jc.2014-3761 PMC4399293 25706240 · DOI · Paper page
  33. [38]Ratner RE Christophi CA Metzger BE Dabelea D Bennett PH Pi-Sunyer X. Prevention of diabetes in women with a history of gestational diabetes: effects of metformin and lifestyle interventions. J Clin Endocrinol Metab (2008) 93(12): 4774–9. doi: 10.1210/jc.2008-0772 PMC2626441 18826999 · DOI · Paper page

Cited by

Sorted by citations

Authors
Juan, J., Sun, Y., Wei, Y., Wang, S., Song, G., Yan, J., Zhou, P., & Yang, H.
Affiliations
  • Peking University First Hospital (CN)
  • Chinese Academy of Medical Sciences & Peking Union Medical College (CN)
  • Peking University (CN)
Corresponding author
Yang, Huixia
ORCID
Venue
Frontiers in Endocrinology
Publisher
Frontiers Media SA
Published
2022-10-06
Volume
13
Pages
1012244-1012244
ISSN
1664-2392 (ISSN-L)
DOI
10.3389/fendo.2022.1012244
PMC
PMC9582268
OpenAlex
W4303188397
Cited by
56
References
5
Citations by year
2026: 20 · 2025: 18 · 2024: 12 · 2023: 6
FWCI
1.81
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Endocrinology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Peking University First Hospital
  • National Natural Science Foundation of China (82003528, 2021YFC2700700)
  • Peking University
  • National Key Research and Development Program of China (22cz020301-4803014, 2021YFC2700700, 82003528)
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, IADPSG criteria, prediabetes, impaired fasting glucose, impaired glucose tolerance, postpartum follow-up, cumulative incidence, women's health, publication bias, risk of bias assessment, meta-regression
MeSH terms
Diabetes Mellitus, Type 2, Female, Glucose, Glucose Tolerance Test, Humans, Prediabetic State, Pregnancy, Pregnancy in Diabetics, Diabetes, Gestational

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review