In the Journals

Postpartum diabetes risk varies by gestational diabetes status, ethnicity

Women who had gestational diabetes — particularly women of Chinese ethnicity — are more likely to develop diabetes after pregnancy compared with women who did not have gestational diabetes, according to findings published in the Journal of Diabetes and its Complications.

Yu Shen

“A history of gestational diabetes dramatically increases the risk of postpartum diabetes; however, we found that Chinese women with a history of gestational diabetes showed the highest risk of incident type 2 diabetes compared with African American and white women with a history of gestational diabetes,” Yu Shen, MD, PhD, a post-doc at Pennington Biomedical Research Center and Gang Hu, MD, PhD, associate professor at Pennington Biomedical Research Center in Baton Rouge, Louisiana, told Endocrine Today. “No study has directly compared the risk of postpartum diabetes among African American, white and Chinese women with and without gestational diabetes.”

The researchers analyzed data from 1,263 women of Chinese ethnicity from the Tianjin GDM Observational Study (mean age, 29.4 years) and 1,786 African American and white women from the CARDIA study (mean age, 27.6 years). The researchers confirmed gestational diabetes via 2-hour oral glucose tolerance tests and diabetes after pregnancy via an OGTT every year in women from the Tianjin GDM Observational Study. Women in the CARDIA study self-reported gestational diabetes and diabetes after pregnancy, and researchers used medical records to confirm gestational diabetes.

Diabetes risks over time

When compared with African American women who did not have gestational diabetes, African American women with gestational diabetes had an HR of 9.29 (95% CI, 2.23-38.7) for developing diabetes in the 5 years after pregnancy, an HR of 9.98 (95% CI, 4.45-22.4) for developing diabetes in the 10 years after pregnancy and an HR of 5.95 (95% CI, 4.03-8.77) for developing diabetes 10 or more years after a pregnancy.

Gang Hu

Researchers were unable to establish an HR for white women in the 5 years after pregnancy due to a lack of cases, they wrote. However, when compared with white women without gestational diabetes, white women with gestational diabetes had an HR of 52.6 (95% CI, 5.73-462) for developing diabetes in the 10 years after pregnancy and an HR of 4.84 (95% CI, 2.69-8.69) after 10 or more years.

Women with gestational diabetes had an HR of 12.5 (95% CI, 3.42-45.4) for developing diabetes in the 5 years after pregnancy compared with women without gestational diabetes when including all women in the CARDIA study population. In addition, women who had gestational diabetes had an HR of 11.9 (95% CI, 5.96-23.8) for developing diabetes in the 10 years after pregnancy and an HR of 5.23 (95% CI, 3.82-7.17) after 10 or more years.

When compared with women of Chinese ethnicity who did not have gestational diabetes, women of Chinese ethnicity with gestational diabetes had an HR of 71.5 (95% CI, 9.76-525) for developing diabetes in the 5 years after pregnancy and an HR of 8.96 (95% CI, 4.39-18.3) for developing diabetes in the 10 years after pregnancy or longer.

Differences between populations

Researchers used African American women without gestational diabetes as the reference group for establishing HRs for developing diabetes among women who did have gestational diabetes.

In the 5 years after pregnancy, African American women with gestational diabetes had an HR of 7.56 (95% CI, 1.94-29.4) for developing diabetes, white women had an HR of 10.7 (95% CI, 1.91-60.3) and women of Chinese ethnicity had an HR of 103 (95% CI, 28.9-366).

In the 10 years after pregnancy, African American women with gestational diabetes had an HR of 8.25 (95% CI, 3.83-17.8) for developing diabetes, white women had an HR of 9.72 (95% CI, 3.82-24.7) and women of Chinese ethnicity had an HR of 54 (95% CI, 24-122). In addition, women of Chinese ethnicity without gestational diabetes had an HR of 5.06 (95% CI, 1.81-14.2) for developing diabetes compared with African American women who did not have gestational diabetes.

After 10 or more years following a pregnancy, African American women with gestational diabetes had an HR of 5.72 (95% CI, 3.93-8.32) for developing diabetes, white women had an HR of 3.62 (95% CI, 2.2-5.96) and women of Chinese ethnicity had an HR of 23.6 (95% CI, 13.9-40.2). During the same period, white women without gestational diabetes had a 30% lower risk for developing diabetes compared with African American women who did not have gestational diabetes (HR = 0.7; 95% CI, 0.49-0.99).

“Studies in terms of the racial and ethnic disparities in risks of diabetes among women with gestational diabetes may help strategy and guideline makers to pay more attention on the certain population with the highest risk,” the researchers wrote. “We also suggest that studies examining the effect of lifestyle interventions on gestational diabetes women by different races can help make individualizations for the best results.” – by Phil Neuffer

Disclosures: The authors report no relevant financial disclosures.

Women who had gestational diabetes — particularly women of Chinese ethnicity — are more likely to develop diabetes after pregnancy compared with women who did not have gestational diabetes, according to findings published in the Journal of Diabetes and its Complications.

Yu Shen

“A history of gestational diabetes dramatically increases the risk of postpartum diabetes; however, we found that Chinese women with a history of gestational diabetes showed the highest risk of incident type 2 diabetes compared with African American and white women with a history of gestational diabetes,” Yu Shen, MD, PhD, a post-doc at Pennington Biomedical Research Center and Gang Hu, MD, PhD, associate professor at Pennington Biomedical Research Center in Baton Rouge, Louisiana, told Endocrine Today. “No study has directly compared the risk of postpartum diabetes among African American, white and Chinese women with and without gestational diabetes.”

The researchers analyzed data from 1,263 women of Chinese ethnicity from the Tianjin GDM Observational Study (mean age, 29.4 years) and 1,786 African American and white women from the CARDIA study (mean age, 27.6 years). The researchers confirmed gestational diabetes via 2-hour oral glucose tolerance tests and diabetes after pregnancy via an OGTT every year in women from the Tianjin GDM Observational Study. Women in the CARDIA study self-reported gestational diabetes and diabetes after pregnancy, and researchers used medical records to confirm gestational diabetes.

Diabetes risks over time

When compared with African American women who did not have gestational diabetes, African American women with gestational diabetes had an HR of 9.29 (95% CI, 2.23-38.7) for developing diabetes in the 5 years after pregnancy, an HR of 9.98 (95% CI, 4.45-22.4) for developing diabetes in the 10 years after pregnancy and an HR of 5.95 (95% CI, 4.03-8.77) for developing diabetes 10 or more years after a pregnancy.

Gang Hu

Researchers were unable to establish an HR for white women in the 5 years after pregnancy due to a lack of cases, they wrote. However, when compared with white women without gestational diabetes, white women with gestational diabetes had an HR of 52.6 (95% CI, 5.73-462) for developing diabetes in the 10 years after pregnancy and an HR of 4.84 (95% CI, 2.69-8.69) after 10 or more years.

Women with gestational diabetes had an HR of 12.5 (95% CI, 3.42-45.4) for developing diabetes in the 5 years after pregnancy compared with women without gestational diabetes when including all women in the CARDIA study population. In addition, women who had gestational diabetes had an HR of 11.9 (95% CI, 5.96-23.8) for developing diabetes in the 10 years after pregnancy and an HR of 5.23 (95% CI, 3.82-7.17) after 10 or more years.

PAGE BREAK

When compared with women of Chinese ethnicity who did not have gestational diabetes, women of Chinese ethnicity with gestational diabetes had an HR of 71.5 (95% CI, 9.76-525) for developing diabetes in the 5 years after pregnancy and an HR of 8.96 (95% CI, 4.39-18.3) for developing diabetes in the 10 years after pregnancy or longer.

Differences between populations

Researchers used African American women without gestational diabetes as the reference group for establishing HRs for developing diabetes among women who did have gestational diabetes.

In the 5 years after pregnancy, African American women with gestational diabetes had an HR of 7.56 (95% CI, 1.94-29.4) for developing diabetes, white women had an HR of 10.7 (95% CI, 1.91-60.3) and women of Chinese ethnicity had an HR of 103 (95% CI, 28.9-366).

In the 10 years after pregnancy, African American women with gestational diabetes had an HR of 8.25 (95% CI, 3.83-17.8) for developing diabetes, white women had an HR of 9.72 (95% CI, 3.82-24.7) and women of Chinese ethnicity had an HR of 54 (95% CI, 24-122). In addition, women of Chinese ethnicity without gestational diabetes had an HR of 5.06 (95% CI, 1.81-14.2) for developing diabetes compared with African American women who did not have gestational diabetes.

After 10 or more years following a pregnancy, African American women with gestational diabetes had an HR of 5.72 (95% CI, 3.93-8.32) for developing diabetes, white women had an HR of 3.62 (95% CI, 2.2-5.96) and women of Chinese ethnicity had an HR of 23.6 (95% CI, 13.9-40.2). During the same period, white women without gestational diabetes had a 30% lower risk for developing diabetes compared with African American women who did not have gestational diabetes (HR = 0.7; 95% CI, 0.49-0.99).

“Studies in terms of the racial and ethnic disparities in risks of diabetes among women with gestational diabetes may help strategy and guideline makers to pay more attention on the certain population with the highest risk,” the researchers wrote. “We also suggest that studies examining the effect of lifestyle interventions on gestational diabetes women by different races can help make individualizations for the best results.” – by Phil Neuffer

Disclosures: The authors report no relevant financial disclosures.