Development Of Type Ii Diabetes Mellitus In Women With Gestational Diabetes

To identify characteristics that contribute to the development of type II diabetes mellitus (T2DM) in patients with gestational diabetes mellitus (GDM) Case-control study of patients with GDM who delivered at a single site from 2011 to 2019. Cases were defined as patients with recent pregnancy with GDM who developed T2DM within 5 years of delivery. Diagnosis of T2DM was per the American Diabetes Association criteria. Controls included patients with pregnancy complicated by GDM who underwent negative testing for T2DM within five years of delivery. Univariate and multivariable analyses were performed, followed by logistic regression analyses to evaluate for factors that independently contributed to the development of T2DM. Out of 715 patients who met inclusion criteria, 75 (10.5%) were diagnosed with T2DM within five years of delivery. Patients who developed T2DM were more likely to have a higher body mass index (BMI) both early in pregnancy and at the time of delivery, have public insurance, self-identify as non-white, identify as single, have a higher blood glucose on the one hour oral glucose challenge test (OGCT), have a higher fasting blood glucose on the three hour OGTT, be diagnosed earlier in gestation, require pharmacotherapy earlier in gestation, and deliver at an earlier gestational age (Table 1). After controlling for confounders, early pregnancy BMI (aOR 1.32, 95% CI 1.06 – 1.63) and having no insurance (aOR 4.07, 95% CI 1.04-15.93) were persistently independently associated with the development of T2DM within five years of delivery (Table 2) Women with GDM who develop T2DM within five years of delivery were more likely to have a higher early pregnancy BMI and have no insurance. These women may benefit from dietary and exercise lifestyle modifications as well as access to diabetes screening after delivery.View Large Image Figure ViewerDownload Hi-res image Download (PPT)