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Prevention of T2DM in women with a previous history of GDM

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Abstract

Women with a history of gestational diabetes mellitus (GDM) have a high risk of progression to type 2 diabetes mellitus (T2DM). Risk factors are similar for GDM and T2DM and include, among others, obesity, family history, and ethnic background. GDM is also associated with the metabolic syndrome. Women with impaired glucose tolerance or "prediabetes" postpartum have the highest risk of progression. In women with impaired glucose tolerance, lifestyle modification or pharmacologic therapy may prevent or delay the onset of T2DM.

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References and Recommended Reading

  1. Kim C, Newton KM, Knopp RH: Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care 2002, 25:1862–1868. Excellent review of studies of the link between GDM and T2DM.

    Article  PubMed  Google Scholar 

  2. Mestman JH, Anderson GV, Guadalupe V: Follow-up study of 360 subjects with abnormal carbohydrate metabolism during pregnancy. Obstet Gynecol 1972, 39:421–425.

    PubMed  CAS  Google Scholar 

  3. Aberg AEB, Jonsson EK, Eskilsson I, et al.: Predictive factors of developing diabetes mellitus in women with gestational diabetes. Acta Obstet Gynecol Scand 2002, 81:11–16.

    Article  PubMed  Google Scholar 

  4. Jang HC, Yim CH, Han KO, et al.: Gestational diabetes mellitus in Korea: prevalence and prediction of glucose intolerance at early postpartum. Diabetes Res Clin Pract 2003, 61:117–124.

    Article  PubMed  CAS  Google Scholar 

  5. Albareda M, Caballero A, Badell G, et al.: Diabetes and abnormal glucose tolerance in women with previous gestational diabetes. Diabetes Care 2003, 26:1199–1205.

    Article  PubMed  Google Scholar 

  6. Kjos SL, Peters RK, Xiang A, et al.: Predicting future diabetes in Latino women with gestational diabetes. Utility of early postpartum glucose testing. Diabetes 1995, 44:586–591.

    Article  PubMed  CAS  Google Scholar 

  7. Damm P, Kuhl C, Bertelsen A, Molsted-Pedersen L: Predictive factors for the development of diabetes in women with previous gestational diabetes mellitus. Am J Obstet Gynecol 1992, 167:607–616.

    PubMed  CAS  Google Scholar 

  8. Bell DS, Barger BO, Go RC, et al.: Risk factors for gestational diabetes in black population. Diabetes Care 1990, 13:1196–1201.

    Article  PubMed  CAS  Google Scholar 

  9. Branchtein L, Schmidt MI, Mengue SS, et al.: Waist circumference and waist-to-hip ratio are related to gestational glucose tolerance. Diabetes Care 1997, 20:509–511.

    Article  PubMed  CAS  Google Scholar 

  10. Solomon CG, Willett WC, Carey VJ, et al.: A prospective study of pregravid determinants of gestational diabetes mellitus. JAMA 1997, 27:1078–1083.

    Article  Google Scholar 

  11. Edelstein SL, Knowler WC, Bain RP, et al.: Predictors of progression from impaired glucose tolerance to NIDDM: an analysis of six prospective studies. Diabetes 1997, 46:701–710.

    Article  PubMed  CAS  Google Scholar 

  12. Diagnosis and classification of diabetes mellitus [no authors listed]. Diabetes Care 2005, 28(suppl 1):S37–S42.

    Google Scholar 

  13. Buchanan TA: Pancreatic beta-cell defects in gestational diabetes: implications for the pathogenesis and prevention of type 2 diabetes. J Clin Endocrinol Metab 2001, 86:989–993. Excellent commentary that provides a pathophysiology for the progression of GDM to T2DM.

    Article  PubMed  CAS  Google Scholar 

  14. MacNeill S, Dodds L, Hamilton DC, et al.: Rates and risk factors for recurrence of gestational diabetes. Diabetes Care 2001, 24:659–662.

    Article  PubMed  CAS  Google Scholar 

  15. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III): Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002, 106:3143–3421.

    Google Scholar 

  16. Lu GC, Luchesse A, Chapman V, et al.: Screening for gestational diabetes mellitus in the subsequent pregnancy: is it worthwhile? Am J Obstet Gynecol 2002, 187:918–921.

    Article  PubMed  Google Scholar 

  17. Schaefer-Graf UM, Buchanan TA, Xiang AH, et al.: Clinical predictors for a high risk for the development of diabetes mellitus in the early puerperium in women with recent gestational diabetes mellitus. Am J Obstet Gynecol 2002, 186:751–756.

    Article  PubMed  Google Scholar 

  18. Yang X, Hsu-Hage BH, Dong L, et al.: Postpartum glucose intolerance in Chinese women with gestational diabetes. Diabet Med 2003, 20:686–690.

    Article  Google Scholar 

  19. Branchtein L, Schmidt MI, Matos MC, et al.: Short stature and gestational diabetes in Brazil. Brazilian Gestational Diabetes Study Group. Diabetologia 2000, 43:848–851.

    Article  PubMed  CAS  Google Scholar 

  20. Bartha JL, Martinez-del-Fresno P, Comino-Delgado R:Postpartum metabolism and autoantibody markers in women with gestational diabetes mellitus diagnosed in early pregnancy. Am J Obstet Gynecol 2001, 184:965–970.

    Article  PubMed  CAS  Google Scholar 

  21. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 2003, 26:S5-S20.

    Article  Google Scholar 

  22. American College of Obstetricians and Gynecologists: Gestational diabetes. In ACOG Practice Bulletin 30. Washington, DC: American College of Obstetricians and Gynecologists; 2001.

    Google Scholar 

  23. Sattar N, Gaw A, Scherbakova O, et al.: Metabolic syndrome with and without C-reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study. Circulation 2003, 108:414–419.

    Article  PubMed  CAS  Google Scholar 

  24. Kousta E, Lawrence NJ, Godsland IF, et al.: Insulin resistance and beta-cell dysfunction in normoglycaemic European women with a history of gestational diabetes. Clin Endocrinol 2003, 59:289–297.

    Article  CAS  Google Scholar 

  25. Homko C, Sivan E, Chen X, et al.: Insulin secretion during and after pregnancy in patients with gestational diabetes mellitus. J Clin Endocrinol Metab 2001, 86:568–573.

    Article  PubMed  CAS  Google Scholar 

  26. Kousta E, Parker KH, Lawrence NJ, et al.: Delayed metabolic and thermogenic response to a mixed meal in normoglycemic European women with previous gestational diabetes. J Clin Endocrinol Metab 2002, 87:3407–3412.

    Article  PubMed  CAS  Google Scholar 

  27. Winzer C, Wagner O, Festa A, et al.: Plasma adiponectin, insulin sensitivity, and subclinical inflammation in women with prior gestational diabetes mellitus. Diabetes Care 2004, 27:1721–1727.

    Article  PubMed  CAS  Google Scholar 

  28. Kautzky-Willer A, Krssak M, Winzer C, et al.: Increased intramyocellular lipid concentration identifies impaired glucose metabolism in women with previous gestational diabetes. Diabetes 2003, 52:244–251.

    Article  PubMed  CAS  Google Scholar 

  29. World Health Organization: Definition, Diagnosis, and Classification of Diabetes Mellitus and Its Complications. Part 1. Diagnosis and Classification of Diabetes Mellitus. Report of a WHO consultation. Geneva: WHO; 1999.

    Google Scholar 

  30. Holt RIG, Goddard JR, Clarke P, Coleman MAG: A postnatal fasting plasma glucose is useful in determining which women with gestational diabetes should undergo a postnatal oral glucose tolerance test. Diabet Med 2003, 20:594–598.

    Article  PubMed  CAS  Google Scholar 

  31. McElduff A, Hitchman R: Fasting plasma glucose values alone miss most abnormalities of glucose tolerance in the postpartum. Diabet Med 2004, 21:646–651.

    Article  Google Scholar 

  32. Costa A, Carmona F, Martinez-Roman S, et al.: Post-partum reclassification of glucose tolerance in women previously diagnosed with gestational diabetes mellitus. Diabet Med 2000, 17:595–598.

    Article  PubMed  CAS  Google Scholar 

  33. Jacob Reichelt AA, Ferraz TM, Rocha Oppermann ML, et al.: Detecting glucose intolerance after gestational diabetes: inadequacy of fasting glucose alone and risk associated with gestational diabetes and second trimester waist-hip ratio. Diabetologia 2002, 45:455–457.

    Article  Google Scholar 

  34. Clark HD, van Walraven C, Code C, et al.: Did publication of a clinical practice guideline recommendation to screen for type 2 diabetes in women with gestational diabetes change practice? Diabetes Care 2003, 26:265–268.

    Article  PubMed  Google Scholar 

  35. Agarwal MM, Punnose J, Dhatt GS: Gestational diabetes: implications of variation in post-partum follow-up criteria. Eur J Obstet Gynecol Reprod Biol 2004, 113:149–153.

    Article  PubMed  Google Scholar 

  36. Buchanan TA, Xiang AH, Peters RK, et al.: Preservation of pancreatic B-cell function and prevention of type 2 diabetes by pharmacological treatment of insulin resistance in high-risk Hispanic women. Diabetes 2002, 51:2796–2803. Data from the TRIPOD study, the only study designed to specifically evaluate progression to T2DM in women with prior GDM.

    Article  PubMed  CAS  Google Scholar 

  37. Xiang AH, Peters RK, Kjos SL, et al.: Pharmacological treatment of insulin resistance at two different stages in the evolution of type 2 diabetes: impact on glucose tolerance and beta-cell function. J Clin Endocrinol Metab 2004, 89:2846–2851.

    Article  PubMed  CAS  Google Scholar 

  38. Pan XR, Li GW, Hu YH, et al.: Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care 1997, 20:537–544.

    Article  PubMed  CAS  Google Scholar 

  39. Tuomilehto J, Lindstrom J, Eriksson JG, et al.: Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001, 344:1343–1350.

    Article  PubMed  CAS  Google Scholar 

  40. Knowler WC, Barrett-Connor E, Fowler SE, et al.: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002, 346:393–403.

    Article  PubMed  CAS  Google Scholar 

  41. Herman WH, Hoerger TJ, Brandle M, et al.: The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with impaired glucose tolerance. Ann Intern Med 2005, 142:323–332.

    PubMed  Google Scholar 

  42. Chiasson JL, Josse RG, Gomis R, et al.: Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial. Lancet 2002, 359:2072–2077.

    Article  PubMed  CAS  Google Scholar 

  43. Chiasson JL, Josse RG, Gomis R, et al.: The STOP-NIDDM Trial. Acarbose treatment and the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance. JAMA 2003, 290:486–494.

    Article  PubMed  CAS  Google Scholar 

  44. Torgerson JS, Hauptman J, Boldren MN, Sjostrom L: XENical in the Prevention of Diabetes in Obese Subjects (XENDOS) Study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care 2004, 27:155–161.

    Article  PubMed  CAS  Google Scholar 

  45. Franz MJ, Bantle JP, Beebe CA, et al.: Nutrition principles and recommendations in diabetes. Diabetes Care 2004, 27:S36-S46.

    Article  PubMed  Google Scholar 

  46. Cruz ML, Weigensberg MJ, Huang TTK, et al.: The metabolic syndrome in overweight Hispanic youth and the role of insulin sensitivity. J Clin Endocrinol Metab 2004, 89:108–113. Interesting study that warns of the generational effect of diabetes mellitus.

    Article  PubMed  CAS  Google Scholar 

  47. Stage E, Ronneby H, Damm P: Lifestyle change after gestational diabetes. Diabetes Res Clin Pract 2004, 63:67–72.

    Article  PubMed  CAS  Google Scholar 

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Strehlow, S.L., Mestman, J.H. Prevention of T2DM in women with a previous history of GDM. Curr Diab Rep 5, 272–277 (2005). https://doi.org/10.1007/s11892-005-0022-3

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