title: Quantification of the type 2 diabetes risk in women with gestational diabetes: a systematic review and meta-analysis of 95,750 women.
abstract: Women with gestational diabetes mellitus (GDM) are at risk of developing type 2 diabetes, but individualised risk estimates are unknown. We conducted a meta-analysis to quantify the risk of progression to type 2 diabetes for women with GDM.
  
  
  
  We systematically searched the major electronic databases with no language restrictions. Two reviewers independently extracted 2 × 2 tables for dichotomous data and the means plus SEs for continuous data. Risk ratios were calculated and pooled using a random effects model.
  
  
  
  There were 39 relevant studies (including 95,750 women) BMI (RR 1.95 [95% CI 1.60, 2.31]), family history of diabetes (RR 1.70 [95% CI 1.47, 1.97]), non-white ethnicity (RR 1.49 [95% CI 1.14, 1.94]) and advanced maternal age (RR 1.20 [95% CI 1.09, 1.34]) were associated with future risk of type 2 diabetes. There was an increase in risk with early diagnosis of GDM (RR 2.13 [95% CI 1.52, 3.56]), raised fasting glucose (RR 3.57 [95% CI 2.98, 4.04]), increased HbA1c (RR 2.56 [95% CI 2.00, 3.17]) and use of insulin (RR 3.66 [95% CI 2.78, 4.82]). Multiparity (RR 1.23 [95% CI 1.01, 1.50]), hypertensive disorders in pregnancy (RR 1.38 [95% CI 1.32, 1.45]) and preterm delivery (RR 1.81 [95% CI 1.35, 2.43]) were associated with future diabetes. Gestational weight gain, macrosomia in the offspring or breastfeeding did not increase the risk.
  
  
  
  Personalised risk of progression to type 2 diabetes should be communicated to mothers with GDM.
  
  
  
  www.crd.york.ac.uk/PROSPERO CRD42014013597.
authors.affiliation: Women's Health Research Unit, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street, London, E1 2AB, UK.
authors.forename: Girish
authors.initials: G
authors.lastname: Rayanagoudar
authors.affiliation: Women's Health Research Unit, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street, London, E1 2AB, UK.
authors.forename: Amal A
authors.initials: AA
authors.lastname: Hashi
authors.affiliation: Women's Health Research Unit, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street, London, E1 2AB, UK.|Clinical Biostatistics Unit, Hospital Ramon y Cajal (IRYCIS), Madrid, Spain.|CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Zamora
authors.affiliation: Women's Health Research Unit, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street, London, E1 2AB, UK.|Multidisciplinary Evidence Synthesis Hub (mEsh), Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Khalid S
authors.initials: KS
authors.lastname: Khan
authors.affiliation: Women's Health Research Unit, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street, London, E1 2AB, UK.
authors.forename: Graham A
authors.initials: GA
authors.lastname: Hitman
authors.affiliation: Women's Health Research Unit, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street, London, E1 2AB, UK. s.thangaratinam@qmul.ac.uk.|Multidisciplinary Evidence Synthesis Hub (mEsh), Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK. s.thangaratinam@qmul.ac.uk.
authors.forename: Shakila
authors.initials: S
authors.lastname: Thangaratinam
mesh_terms: D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology*; D016640:Diabetes, Gestational / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000503:physiopathology; D012307:Risk Factors
keywords: Gestational diabetes; Meta-analysis; Postpartum; Predictors; Pregnancy; Risk factors; Systematic review; Type 2 diabetes