European journal of obstetrics, gynecology, and reproductive biology · 2025
Progression to type 2 diabetes among women with gestational diabetes, a follow up cross sectional study from Southern India.
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Jayapal Pooja, Finney Aida Merin, Paul Catharine Priscilla, Jeyapaul Shalini, Kanagalakshmi V, Cherian Anne George, Prasad Jasmin Helan
Аннотация
TITLE: Postpartum Glycaemic Outcomes in Women with Prior Gestational Diabetes in Rural South India: A Community-Based Cross-Sectional Study.
OBJECTIVE: To estimate the prevalence of pre-diabetes and type 2 diabetes mellitus (T2DM) 2-4 years postpartum among women with prior gestational diabetes mellitus (GDM) and to identify pregnancy-related risk factors associated with dysglycaemia.
STUDY DESIGN: We conducted a community-based cross-sectional study between December 2021 and October 2022 in two rural blocks of Vellore District, Tamil Nadu, India. A total of 160 women diagnosed with GDM during pregnancies between 2018 and 2020 were randomly selected from hospital records and enrolled through household visits. Glycaemic status was assessed using HbA1c, with outcomes classified as normal (<5.7 %), pre-diabetes (5.7-6.4 %), or diabetes (≥6.5 %) per ADA criteria. Associations with demographic, obstetric, and pregnancy-related variables were analyzed using logistic regression.
RESULTS: At a median of 3 years postpartum, 25.6 % of participants had pre-diabetes and 16.9 % had diabetes. Only 5 of the 27 women with diabetes were diagnosed to have diabetes before this study was done, and despite the diagnosis, they had inadequate glycaemic control. Dysglycaemia was significantly associated with pharmacological treatment during pregnancy (OR 32.3; 95 % CI: 4.2-48.5) and higher glycaemic values during OGTT (fasting glucose >125 mg/dL or 1-hour ≥200 mg/dL; aOR 3.69; 95 % CI: 1.48-9.21). Obesity was associated with a stepwise increase in diabetes risk. Physical inactivity and age ≥30 showed trends but were not statistically significant.
CONCLUSION: One in six women with prior GDM developed T2DM within 2-4 years postpartum, with GDM severity and maternal obesity being key predictors. These findings underscore the urgent need for structured postpartum follow-up and preventive strategies targeting high-risk women in resource-limited settings.
OBJECTIVE: To estimate the prevalence of pre-diabetes and type 2 diabetes mellitus (T2DM) 2-4 years postpartum among women with prior gestational diabetes mellitus (GDM) and to identify pregnancy-related risk factors associated with dysglycaemia.
STUDY DESIGN: We conducted a community-based cross-sectional study between December 2021 and October 2022 in two rural blocks of Vellore District, Tamil Nadu, India. A total of 160 women diagnosed with GDM during pregnancies between 2018 and 2020 were randomly selected from hospital records and enrolled through household visits. Glycaemic status was assessed using HbA1c, with outcomes classified as normal (<5.7 %), pre-diabetes (5.7-6.4 %), or diabetes (≥6.5 %) per ADA criteria. Associations with demographic, obstetric, and pregnancy-related variables were analyzed using logistic regression.
RESULTS: At a median of 3 years postpartum, 25.6 % of participants had pre-diabetes and 16.9 % had diabetes. Only 5 of the 27 women with diabetes were diagnosed to have diabetes before this study was done, and despite the diagnosis, they had inadequate glycaemic control. Dysglycaemia was significantly associated with pharmacological treatment during pregnancy (OR 32.3; 95 % CI: 4.2-48.5) and higher glycaemic values during OGTT (fasting glucose >125 mg/dL or 1-hour ≥200 mg/dL; aOR 3.69; 95 % CI: 1.48-9.21). Obesity was associated with a stepwise increase in diabetes risk. Physical inactivity and age ≥30 showed trends but were not statistically significant.
CONCLUSION: One in six women with prior GDM developed T2DM within 2-4 years postpartum, with GDM severity and maternal obesity being key predictors. These findings underscore the urgent need for structured postpartum follow-up and preventive strategies targeting high-risk women in resource-limited settings.