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. 2020 Sep;8(1):e001060.
doi: 10.1136/bmjdrc-2019-001060.

β-Cell function or insulin resistance was associated with the risk of type 2 diabetes among women with or without obesity and a history of gestational diabetes

Yuxin Fan  1   2 , Leishen Wang  3 , Huikun Liu  3 , Shuang Zhang  3 , Huiguang Tian  3 , Yun Shen  2   4 , Jaakko Tuomilehto  5 , Zhijie Yu  6 , Xilin Yang  7 , Gang Hu  8 , Ming Liu  9
Affiliations

β-Cell function or insulin resistance was associated with the risk of type 2 diabetes among women with or without obesity and a history of gestational diabetes

Yuxin Fan et al. BMJ Open Diabetes Res Care. 2020 Sep.

Abstract

Introduction: To evaluate the single association of postpartum β-cell dysfunction and insulin resistance (IR), as well as different combinations of postpartum β-cell dysfunction, IR, obesity, and a history of gestational diabetes mellitus (GDM) with postpartum type 2 diabetes risk.

Research design and methods: The study included 1263 women with prior GDM and 705 women without GDM. Homeostatic model assessment was used to estimate homeostatic model assessment of β-cell secretory function (HOMA-%β) and homeostatic model assessment of insulin resistance (HOMA-IR).

Results: Multivariable-adjusted ORs of diabetes across quartiles of HOMA-%β and HOMA-IR were 1.00, 1.46, 2.15, and 6.25 (ptrend <0.001), and 1.00, 2.11, 5.59, and 9.36 (ptrend <0.001), respectively. Women with IR only had the same diabetes risk as women with β-cell dysfunction only. Obesity, together with IR or β-cell dysfunction, had a stronger effect on diabetes risk. This stronger effect was also found for a history of GDM with IR or β-cell dysfunction. Women with three risk factors, including obesity, a history of GDM and β-cell dysfunction/IR, showed the highest ORs of diabetes.

Conclusions: β-cell dysfunction or IR was significantly associated with postpartum diabetes. IR and β-cell dysfunction, together with obesity and a history of GDM, had the highest ORs of postpartum diabetes risk.

Keywords: insulin resistance; non-insulin-treated type 2 diabetes; obesity.

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Conflict of interest statement

Competing interests: None declared.

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