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. 2025 Mar;16(3):535-542.
doi: 10.1111/jdi.14368. Epub 2024 Nov 28.

Gestational diabetes in early pregnancy is associated with postpartum glucose intolerance: A perspective from the diabetes and pregnancy outcome for mother and baby study in Japan

Maki Yokoyama  1 , Kei Miyakoshi  2 , Noriyuki Iwama  3 , Hiroshi Yamashita  4 , Ichiro Yasuhi  4 , Maki Kawasaki  5 , Naoko Arata  5 , Shiori Sato  5 , Yuko Imura  5 , Masako Waguri  6 , Haruna Kawaguchi  7 , Naoki Masaoka  8 , Yoshiyuki Nakajima  8 , Yuji Hiramatsu  9 , Takashi Sugiyama  1 ; DREAMBee Study Gestational Diabetes Mellitus Group
Affiliations

Gestational diabetes in early pregnancy is associated with postpartum glucose intolerance: A perspective from the diabetes and pregnancy outcome for mother and baby study in Japan

Maki Yokoyama et al. J Diabetes Investig. 2025 Mar.

Abstract

Aims: To compare perinatal outcomes and postpartum glucose tolerance between women diagnosed with gestational diabetes mellitus (GDM) before 20 weeks of gestation (EGDM) and those diagnosed at or after 24 weeks of gestation (LGDM) in a Japanese population.

Materials and methods: Data were obtained from a prospective GDM registry. Multivariate analysis was conducted to examine the association between the timing of GDM diagnosis (EGDM vs LGDM) and perinatal outcomes (preterm birth, small for gestational age, large for gestational age, pregnancy-induced hypertension, and neonatal hypoglycemia), as well as postpartum glucose intolerance.

Results: A total of 1,275 mother-infant pairs were analyzed for perinatal outcomes. Of these, 924 women underwent postpartum testing for glucose intolerance. No significant differences in perinatal outcomes were observed between the EGDM and LGDM groups, except that overweight/obese women with EGDM had 2.5-fold higher rate of preterm birth than those with LGDM. Postpartum glucose intolerance was 1.5 times more likely in the EGDM group than in the LGDM group.

Conclusions: Women with EGDM had a significantly higher risk of postpartum glucose intolerance than those with LGDM, despite similar perinatal outcomes between the two groups.

Keywords: Gestational diabetes mellitus in early pregnancy; Overweight/obesity; Postpartum glucose intolerance.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper.

Approval of the research protocol: This study received approval from the Institutional Review Board of Ehime University Hospital (approval number: 2310009; approval date: October 13, 2023) and the Ethics Committee of the Tohoku University School of Medicine (approval number: 35657; approval date: May 7, 2024). The protocol conforms to the provisions of the Declaration of Helsinki.

Informed consent: Written informed consent was obtained from all participants.

Registry and the registration no. of the study/trial: N/A.

Animal studies: N/A.

Figures

Figure 1
Figure 1
Flow diagram of study participants. BMI, body mass index; DREAMBee Study, the Diabetes and Pregnancy Outcome for Mother and Baby study‐GDM; GDM, gestational diabetes mellitus; EGDM, GDM diagnosed before 20 weeks’ pregnancy; LGDM, diagnosed after 24 weeks’ pregnancy; NGT, normal glucose tolerance; OGTT, oral glucose tolerance test.
See this image and copyright information in PMC

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