Progression to impaired glucose regulation, diabetes and metabolic syndrome in Chinese women with a past history of gestational diabetes

Abstract

Background: To examine the risk of developing impaired glucose regulation (IGR), diabetes mellitus (DM) and metabolic syndrome (MetS) in Chinese women with history of gestational diabetes.

Methods: 203 Chinese women enrolled in a previous study were followed up at a median of 8 (range 7-10) years of whom 136 had normal glucose tolerance (NGT) and 68 had gestational diabetes mellitus (GDM) and gestational impaired glucose tolerance (GIGT).

Results: In women with a history of gestational diabetes (n = 4), GIGT (n = 63) and NGT (n = 136), 2 (50%), 19 (30.2%) and 21 (15.4%) developed IGR while 2 (50%), 4 (6.3%), 3 (2.2%) developed DM respectively. Most women developed IGR (86%, n = 36) or DM (78%, n = 7) were undiagnosed. MetS occurred in 16 (7.9%) women with similar rates between those with and those without a history of gestational diabetes (7.5% vs 8.1%; p = 0.85). History of gestational diabetes [OR: 3.8 (95% CI 1.9-7.8)] and body mass index (BMI) >/= 23 kg/m(2) [OR: 3.4 (95% CI 1.7-6.8)] at first antenatal visit were predictors for IGR or DM. Family history of DM [OR: 5.0 (95% CI 1.5-16.4)] and BMI >/= 23 kg/m(2) [OR: 28.3 (95% CI 3.6-223)] at first antenatal visit were predictors for MetS.

Conclusions: Chinese women with a history of gestational diabetes have a high risk of IGR or DM. Overweight at the first antenatal visit is a common risk factor for IGR, DM and MetS. A prior history of gestational diabetes was predictive of IGR and DM while a positive family history of DM was predictive of MetS.