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Gestational diabetes for obese women raises risk of lasting problem

43 times higher risk of developing type 2 diabetes, study shows

Adrian O'Dowd

Thursday, 19 March 2015

Women who were overweight before becoming pregnant, developed gestational diabetes and then put on 5kg after pregnancy are more than 40 times more likely to develop full-blown type 2 diabetes, according to a study* published today in Diabetologia (the journal of the European Association for the Study of Diabetes).

US researchers found a much higher risk of type 2 diabetes developing in women in these circumstances.

The research, which the authors said underlined the importance of maintaining a healthy body weight before and after pregnancy, was led by a team from the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the US National Institutes of Health, Rockville, US.

Both type 2 diabetes and gestational diabetes are growing trends, as risk factors for both conditions (unhealthy diet, obesity, lack of physical activity) increase in almost all countries of the world.

Previous studies have shown that as many as a third of women with type 2 diabetes have a history of gestational diabetes during pregnancy, and as a result, women with a history of diabetes during pregnancy are usually advised to control their weight after giving birth.

For the study, the authors used data from women with a history of gestational diabetes in the Nurses’ Health Study II (NHS II), as part of the ongoing Diabetes & Women’s Health study.

The latter aims to identify what determines progression from gestational diabetes to type 2 diabetes among participants in NHS II and the Danish National Birth Cohort.

Women were eligible for the new study if they reported incident gestational diabetes from 1991 to 2001, and 1,695 women were included in the study. They were followed up until the return of the 2009 follow-up questionnaire.

The data showed 259 incident cases of type 2 diabetes during up to 18 years of follow-up.

Analysis showed that there was an increased risk of developing type 2 diabetes of 16% for each increase of one unit (1 kg/m2) in either baseline BMI (body mass index) or most recent BMI.

In addition, each 5 kg increment of weight gain after gestational diabetes development was associated with a 27% higher risk of type 2 diabetes.

Jointly, women who had a BMI of 30 or higher, and gained 5 kg or more after gestational diabetes, had a 43-times increased risk of developing type 2 diabetes compared with women who had a BMI of 25 or less at baseline and gained 5 kg or less after gestational diabetes.

The associations of BMI and weight change with risk of type diabetes were the same across different categories of age, family history of diabetes, diet quality, physical activity, breastfeeding duration and time since gestational diabetes pregnancy.

The authors concluded: “Baseline BMI, most recent BMI and weight gain after gestational diabetes were significantly and positively associated with risk of progression from gestational diabetes to type 2 diabetes.

“Our findings provide evidence to support the importance of achieving and maintaining a healthy weight in these high-risk women to prevent future development of type 2 diabetes.”


* Wei Bao, et al. 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. Diabetologia, March 2015. DOI 10.1007/s00125-015-3537-4

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