Increasing incidence of diabetes after gestational diabetes: a long-term follow-up in a Danish population.
OBJECTIVE
To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes.


METHODS
Women with diet-treated GDM during 1978-1985 (old cohort, n = 241, also followed up around 1990) or 1987-1996 (new cohort, n = 512) were examined in 2000-2002. Women were classified by a 2-h, 75-g oral glucose tolerance test according to the World Health Organization criteria or an intravenous glucagon test supplemented by measurement of GAD antibodies. Historical data from index-pregnancy and anthropometrical measurements were collected.


RESULTS
A total of 481 (63.9%) women were examined (median 9.8 years [interquartile range 6.4-17.2]) after index pregnancy. Diabetes and impaired glucose tolerance (IGT)/impaired fasting glucose were present in 40.0 and 27.0% of women, respectively. In the new cohort, 40.9% had diabetes compared with 18.3% in the old cohort at the 1990 follow-up (P < 0.0005). Prepregnancy BMI was significantly higher in the new compared with the old cohort (26.0 [22.5-30.8] vs. 22.9 kg/m2 [20.2-28.0], P < 0.0005). Among others, new-cohort membership, prepregnancy overweight (BMI > or = 25 kg/m2), and IGT postpartum were identified as independent predictors of diabetes by multiple logistic regression analyses.


CONCLUSIONS
The incidence of diabetes among Danish women with previous diet-treated GDM was very high and had more than doubled over a 10-year period. This seems to be due to a substantial increase in BMI in women with GDM.
Lauenborg
Jeannet
J
Department of Obstetrics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. jeannet@lauenb.org
Hansen
Torben
T
Jensen
Dorte Møller
DM
Vestergaard
Henrik
H
Mølsted-Pedersen
Lars
L
Hornnes
Peter
P
Locht
Henning
H
Pedersen
Oluf
O
Damm
Peter
P
D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology*; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D005934:Glucagon; D005951:Glucose Tolerance Test; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008875:Middle Aged; D011247:Pregnancy; D013997:Time Factors
D005934:Glucagon