title: Weight Gain and Progression to Type 2 Diabetes in Women With a History of Gestational Diabetes Mellitus.
abstract: BACKGROUND
  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
  We investigated the effect of postpartum longitudinal BMI change on the development of diabetes in Korean women with a history of GDM.
  
  
  METHODS
  The study included a hospital-based, multicenter, prospective cohort with median follow-up of 4.0 years.
  
  
  METHODS
  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.
  
  
  METHODS
  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
  The BMI change in each tertile was -1.8 ± 1.1, -0.2 ± 0.3, and 1.6 ± 1.2 kg/m(2), 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, P = .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.
authors.affiliation: Department of Internal Medicine (J.H.M., S.H.K., H.S.J., S.H.C., S.L., Y.M.C., K.S.P., H.C.J.), Seoul National University College of Medicine, Seoul 110-744, Korea; Department of Internal Medicine (J.H.M., S.H.K., H.S.J., Y.M.C., K.S.P.), Seoul National University Hospital, Seoul 110-799, Korea; and Department of Internal Medicine (S.H.C., S.L., H.C.J.), Seoul National University Bundang Hospital, Seongnam 463-707, Korea; and Department of Preventive Medicine (N.H.C.), Ajou University School of Medicine, Suwon 443-721, Korea.
authors.forename: Joon Ho
authors.initials: JH
authors.lastname: Moon
authors.affiliation: Department of Internal Medicine (J.H.M., S.H.K., H.S.J., S.H.C., S.L., Y.M.C., K.S.P., H.C.J.), Seoul National University College of Medicine, Seoul 110-744, Korea; Department of Internal Medicine (J.H.M., S.H.K., H.S.J., Y.M.C., K.S.P.), Seoul National University Hospital, Seoul 110-799, Korea; and Department of Internal Medicine (S.H.C., S.L., H.C.J.), Seoul National University Bundang Hospital, Seongnam 463-707, Korea; and Department of Preventive Medicine (N.H.C.), Ajou University School of Medicine, Suwon 443-721, Korea.
authors.forename: Soo Heon
authors.initials: SH
authors.lastname: Kwak
authors.affiliation: Department of Internal Medicine (J.H.M., S.H.K., H.S.J., S.H.C., S.L., Y.M.C., K.S.P., H.C.J.), Seoul National University College of Medicine, Seoul 110-744, Korea; Department of Internal Medicine (J.H.M., S.H.K., H.S.J., Y.M.C., K.S.P.), Seoul National University Hospital, Seoul 110-799, Korea; and Department of Internal Medicine (S.H.C., S.L., H.C.J.), Seoul National University Bundang Hospital, Seongnam 463-707, Korea; and Department of Preventive Medicine (N.H.C.), Ajou University School of Medicine, Suwon 443-721, Korea.
authors.forename: Hye Seung
authors.initials: HS
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine (J.H.M., S.H.K., H.S.J., S.H.C., S.L., Y.M.C., K.S.P., H.C.J.), Seoul National University College of Medicine, Seoul 110-744, Korea; Department of Internal Medicine (J.H.M., S.H.K., H.S.J., Y.M.C., K.S.P.), Seoul National University Hospital, Seoul 110-799, Korea; and Department of Internal Medicine (S.H.C., S.L., H.C.J.), Seoul National University Bundang Hospital, Seongnam 463-707, Korea; and Department of Preventive Medicine (N.H.C.), Ajou University School of Medicine, Suwon 443-721, Korea.
authors.forename: Sung Hee
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine (J.H.M., S.H.K., H.S.J., S.H.C., S.L., Y.M.C., K.S.P., H.C.J.), Seoul National University College of Medicine, Seoul 110-744, Korea; Department of Internal Medicine (J.H.M., S.H.K., H.S.J., Y.M.C., K.S.P.), Seoul National University Hospital, Seoul 110-799, Korea; and Department of Internal Medicine (S.H.C., S.L., H.C.J.), Seoul National University Bundang Hospital, Seongnam 463-707, Korea; and Department of Preventive Medicine (N.H.C.), Ajou University School of Medicine, Suwon 443-721, Korea.
authors.forename: Soo
authors.initials: S
authors.lastname: Lim
authors.affiliation: Department of Internal Medicine (J.H.M., S.H.K., H.S.J., S.H.C., S.L., Y.M.C., K.S.P., H.C.J.), Seoul National University College of Medicine, Seoul 110-744, Korea; Department of Internal Medicine (J.H.M., S.H.K., H.S.J., Y.M.C., K.S.P.), Seoul National University Hospital, Seoul 110-799, Korea; and Department of Internal Medicine (S.H.C., S.L., H.C.J.), Seoul National University Bundang Hospital, Seongnam 463-707, Korea; and Department of Preventive Medicine (N.H.C.), Ajou University School of Medicine, Suwon 443-721, Korea.
authors.forename: Young Min
authors.initials: YM
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine (J.H.M., S.H.K., H.S.J., S.H.C., S.L., Y.M.C., K.S.P., H.C.J.), Seoul National University College of Medicine, Seoul 110-744, Korea; Department of Internal Medicine (J.H.M., S.H.K., H.S.J., Y.M.C., K.S.P.), Seoul National University Hospital, Seoul 110-799, Korea; and Department of Internal Medicine (S.H.C., S.L., H.C.J.), Seoul National University Bundang Hospital, Seongnam 463-707, Korea; and Department of Preventive Medicine (N.H.C.), Ajou University School of Medicine, Suwon 443-721, Korea.
authors.forename: Kyong Soo
authors.initials: KS
authors.lastname: Park
authors.affiliation: Department of Internal Medicine (J.H.M., S.H.K., H.S.J., S.H.C., S.L., Y.M.C., K.S.P., H.C.J.), Seoul National University College of Medicine, Seoul 110-744, Korea; Department of Internal Medicine (J.H.M., S.H.K., H.S.J., Y.M.C., K.S.P.), Seoul National University Hospital, Seoul 110-799, Korea; and Department of Internal Medicine (S.H.C., S.L., H.C.J.), Seoul National University Bundang Hospital, Seongnam 463-707, Korea; and Department of Preventive Medicine (N.H.C.), Ajou University School of Medicine, Suwon 443-721, Korea.
authors.forename: Hak C
authors.initials: HC
authors.lastname: Jang
authors.affiliation: Department of Internal Medicine (J.H.M., S.H.K., H.S.J., S.H.C., S.L., Y.M.C., K.S.P., H.C.J.), Seoul National University College of Medicine, Seoul 110-744, Korea; Department of Internal Medicine (J.H.M., S.H.K., H.S.J., Y.M.C., K.S.P.), Seoul National University Hospital, Seoul 110-799, Korea; and Department of Internal Medicine (S.H.C., S.L., H.C.J.), Seoul National University Bundang Hospital, Seongnam 463-707, Korea; and Department of Preventive Medicine (N.H.C.), Ajou University School of Medicine, Suwon 443-721, Korea.
authors.forename: Nam H
authors.initials: NH
authors.lastname: Cho
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D015994:Incidence; D049590:Postpartum Period / Q000502:physiology*; D011247:Pregnancy; D012307:Risk Factors; D015430:Weight Gain / Q000502:physiology*