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Large 3-year trial: GDM ups type 2 risk long after index pregnancy; History of GDM conveys higher risk than impaired glucose tolerance without GDM.(News)
ORLANDO, FLA. -- Women with a history of gestational diabetes are far more likely to go on to develop type 2 diabetes than are women with equally impaired glucose tolerance who have never had gestational diabetes, Dr. Robert E. Ratner reported at the annual scientific sessions of the American Diabetes Association.
The new findings from a subanalysis of the Diabetes Prevention Program (DPP) also suggest that the risk of diabetes continues to rise long after the index pregnancy, said Dr. Ratner, professor of medicine at Georgetown University, Washington, and a principal investigator of the DPP.
"Physicians have been taught to follow women who have had gestational diabetes for 3-5 years after pregnancy. This study shows that the risk goes well beyond that time. These women must continue to be followed, particularly since we now have accumulating evidence of multiple ways to reduce the progression to diabetes," he told this newspaper.
The data come from an analysis of the 349 women with prior gestational diabetes mellitus (GDM) and 1,416 parous women without a history of GDM who participated in the DPP, the landmark 3-year trial in which both intensive lifestyle intervention and metformin were shown to significantly reduce the incidence of type 2 diabetes in subjects with impaired glucose tolerance (IGT) at baseline (N. Engl. J. Med. 346[6]:393-403, 2002).
At study entry, the two groups of women were similar in body mass index, waist circumference, and number of live births, but those with a history of GDM had a mean age of 43 years, compared with 51.5 for those without prior GDM, a significant difference. This is important because in the overall DPP population of 3,234 subjects, metformin (850 mg twice daily) was better at warding off diabetes in subjects below age 45 than in those aged 45 and older. All the subsequent analyses were therefore adjusted for age, Dr. Ratner said.
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Source: HighBeam Research, Large 3-year trial: GDM ups type 2 risk long after index pregnancy;...