Weight gain and progression to type 2 diabetes in women with a history of gestational diabetes mellitus

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Abstract

Context: The effect of weight gain on the development of type 2 diabetes after gestational diabetes mellitus (GDM) is not fully understood in Asian women who have a relatively low body mass index (BMI). Objective:Weinvestigated the effect of postpartum longitudinal BMI change on the development of diabetes in Korean women with a history of GDM. Design and Setting: The study included a hospital-based, multicenter, prospective cohort with median follow-up of 4.0 years. Participants: A total of 418 women with previous GDM or gestational impaired glucose tolerance were recruited and underwent an oral glucose tolerance test at 6 weeks postpartum and annually thereafter. Main Outcome Measure: The risk of diabetes was analyzed according to the tertiles of BMI change. Changes in BMI were calculated between the initial postpartum visit and the last follow-up or at the onset of diabetes. Results: TheBMIchange in each tertile was -1.8±1.1,-0.2±0.3, and 1.6±1.2 kg/m2, respectively. We observed an increased risk of incident diabetes as the tertile of BMI change increased (8.6%, 12.6%, and 16.9%, P = .039). Postpartum BMI change was an independent predictor of diabetes in a multivariate Cox analysis (hazard ratio 1.27,95%confidence interval 1.04-1.56 r=.021), even after adjusting for BMI at the last follow-up. In the highest tertile group, there was a significant deterioration in cardiovascular risk factors including blood pressure, lipid profile, and insulin sensitivity. Conclusions: Postpartum increase in BMI is significantly associated with a risk of diabetes and deterioration of metabolic phenotypes in Korean GDM women.

Original languageEnglish
Pages (from-to)3548-3555
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Volume100
Issue number9
DOIs
StatePublished - 1 Sep 2015

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Gestational Diabetes
Medical problems
Type 2 Diabetes Mellitus
Weight Gain
Body Mass Index
Postpartum Period
Deterioration
Glucose Intolerance
Glucose Tolerance Test
Glucose
Insulin Resistance
Blood pressure
Multivariate Analysis
Outcome Assessment (Health Care)
Confidence Intervals
Blood Pressure
Phenotype
Lipids
Hazards
Insulin

Cite this

@article{28c19bdf6c5f42b7b7a5fdadc29b832f,
title = "Weight gain and progression to type 2 diabetes in women with a history of gestational diabetes mellitus",
abstract = "Context: The effect of weight gain on the development of type 2 diabetes after gestational diabetes mellitus (GDM) is not fully understood in Asian women who have a relatively low body mass index (BMI). Objective:Weinvestigated the effect of postpartum longitudinal BMI change on the development of diabetes in Korean women with a history of GDM. Design and Setting: The study included a hospital-based, multicenter, prospective cohort with median follow-up of 4.0 years. Participants: A total of 418 women with previous GDM or gestational impaired glucose tolerance were recruited and underwent an oral glucose tolerance test at 6 weeks postpartum and annually thereafter. Main Outcome Measure: The risk of diabetes was analyzed according to the tertiles of BMI change. Changes in BMI were calculated between the initial postpartum visit and the last follow-up or at the onset of diabetes. Results: TheBMIchange in each tertile was -1.8±1.1,-0.2±0.3, and 1.6±1.2 kg/m2, respectively. We observed an increased risk of incident diabetes as the tertile of BMI change increased (8.6{\%}, 12.6{\%}, and 16.9{\%}, P = .039). Postpartum BMI change was an independent predictor of diabetes in a multivariate Cox analysis (hazard ratio 1.27,95{\%}confidence interval 1.04-1.56 r=.021), even after adjusting for BMI at the last follow-up. In the highest tertile group, there was a significant deterioration in cardiovascular risk factors including blood pressure, lipid profile, and insulin sensitivity. Conclusions: Postpartum increase in BMI is significantly associated with a risk of diabetes and deterioration of metabolic phenotypes in Korean GDM women.",
author = "Moon, {Joon Ho} and Kwak, {Soo Heon} and Jung, {Hye Seung} and Choi, {Sung Hee} and Soo Lim and Cho, {Young Min} and Park, {Kyong Soo} and Jang, {Hak C.} and Cho, {Nam H.}",
year = "2015",
month = "9",
day = "1",
doi = "10.1210/JC.2015-1113",
language = "English",
volume = "100",
pages = "3548--3555",
journal = "Journal of Clinical Endocrinology and Metabolism",
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TY - JOUR

T1 - Weight gain and progression to type 2 diabetes in women with a history of gestational diabetes mellitus

AU - Moon, Joon Ho

AU - Kwak, Soo Heon

AU - Jung, Hye Seung

AU - Choi, Sung Hee

AU - Lim, Soo

AU - Cho, Young Min

AU - Park, Kyong Soo

AU - Jang, Hak C.

AU - Cho, Nam H.

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Context: The effect of weight gain on the development of type 2 diabetes after gestational diabetes mellitus (GDM) is not fully understood in Asian women who have a relatively low body mass index (BMI). Objective:Weinvestigated the effect of postpartum longitudinal BMI change on the development of diabetes in Korean women with a history of GDM. Design and Setting: The study included a hospital-based, multicenter, prospective cohort with median follow-up of 4.0 years. Participants: A total of 418 women with previous GDM or gestational impaired glucose tolerance were recruited and underwent an oral glucose tolerance test at 6 weeks postpartum and annually thereafter. Main Outcome Measure: The risk of diabetes was analyzed according to the tertiles of BMI change. Changes in BMI were calculated between the initial postpartum visit and the last follow-up or at the onset of diabetes. Results: TheBMIchange in each tertile was -1.8±1.1,-0.2±0.3, and 1.6±1.2 kg/m2, respectively. We observed an increased risk of incident diabetes as the tertile of BMI change increased (8.6%, 12.6%, and 16.9%, P = .039). Postpartum BMI change was an independent predictor of diabetes in a multivariate Cox analysis (hazard ratio 1.27,95%confidence interval 1.04-1.56 r=.021), even after adjusting for BMI at the last follow-up. In the highest tertile group, there was a significant deterioration in cardiovascular risk factors including blood pressure, lipid profile, and insulin sensitivity. Conclusions: Postpartum increase in BMI is significantly associated with a risk of diabetes and deterioration of metabolic phenotypes in Korean GDM women.

AB - Context: The effect of weight gain on the development of type 2 diabetes after gestational diabetes mellitus (GDM) is not fully understood in Asian women who have a relatively low body mass index (BMI). Objective:Weinvestigated the effect of postpartum longitudinal BMI change on the development of diabetes in Korean women with a history of GDM. Design and Setting: The study included a hospital-based, multicenter, prospective cohort with median follow-up of 4.0 years. Participants: A total of 418 women with previous GDM or gestational impaired glucose tolerance were recruited and underwent an oral glucose tolerance test at 6 weeks postpartum and annually thereafter. Main Outcome Measure: The risk of diabetes was analyzed according to the tertiles of BMI change. Changes in BMI were calculated between the initial postpartum visit and the last follow-up or at the onset of diabetes. Results: TheBMIchange in each tertile was -1.8±1.1,-0.2±0.3, and 1.6±1.2 kg/m2, respectively. We observed an increased risk of incident diabetes as the tertile of BMI change increased (8.6%, 12.6%, and 16.9%, P = .039). Postpartum BMI change was an independent predictor of diabetes in a multivariate Cox analysis (hazard ratio 1.27,95%confidence interval 1.04-1.56 r=.021), even after adjusting for BMI at the last follow-up. In the highest tertile group, there was a significant deterioration in cardiovascular risk factors including blood pressure, lipid profile, and insulin sensitivity. Conclusions: Postpartum increase in BMI is significantly associated with a risk of diabetes and deterioration of metabolic phenotypes in Korean GDM women.

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U2 - 10.1210/JC.2015-1113

DO - 10.1210/JC.2015-1113

M3 - Article

C2 - 26171796

AN - SCOPUS:84941703076

VL - 100

SP - 3548

EP - 3555

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

SN - 0021-972X

IS - 9

ER -