Long-term risk of type 2 diabetes mellitus in relation to BMI and weight change among women with a history of gestational diabetes mellitus: a prospective cohort study

TY - JOUR

T1 - Long-term risk of type 2 diabetes mellitus in relation to BMI and weight change among women with a history of gestational diabetes mellitus

T2 - a prospective cohort study

AU - Bao, Wei

AU - Yeung, Edwina

AU - Tobias, Deirdre K

AU - Hu, Frank B

AU - Vaag, Allan A

AU - Chavarro, Jorge E

AU - Mills, James L

AU - Grunnet, Louise G

AU - Bowers, Katherine

AU - Ley, Sylvia H

AU - Kiely, Michele

AU - Olsen, Sjurdur F.

AU - Zhang, Cuilin

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Aims/hypothesis: Women with a history of gestational diabetes mellitus (GDM) are advised to control their weight after pregnancy. We aimed to examine how adiposity and weight change influence the long-term risk of developing type 2 diabetes after GDM. Methods: We included 1,695 women who had incident GDM between 1991 and 2001, as part of the Diabetes & Women’s Health study, and followed them until the return of the 2009 questionnaire. Body weight and incident type 2 diabetic cases were reported biennially. We defined baseline as the questionnaire period when women reported an incident GDM pregnancy. We estimated HRs and 95% CIs using Cox proportional hazards models. Results: We documented 259 incident cases of type 2 diabetes during up to 18 years of follow-up. The adjusted HRs of type 2 diabetes associated with each 1 kg/m2 increase in BMI were 1.16 (95% CI 1.12, 1.19) for baseline BMI and 1.16 (95% CI 1.13, 1.20) for most recent BMI. Moreover, each 5 kg increment of weight gain after GDM development was associated with a 27% higher risk of type 2 diabetes (adjusted HR 1.27; 95% CI 1.04, 1.54). Jointly, women who had a BMI ≥30.0 kg/m2 at baseline and gained ≥5 kg after GDM had an adjusted HR of 43.19 (95% CI 13.60, 137.11), compared with women who had a BMI <25.0 kg/m2 at baseline and gained <5 kg after GDM. Conclusions/interpretation: Baseline BMI, most recent BMI and weight gain after GDM were significantly and positively associated with risk of progression from GDM to type 2 diabetes.

AB - Aims/hypothesis: Women with a history of gestational diabetes mellitus (GDM) are advised to control their weight after pregnancy. We aimed to examine how adiposity and weight change influence the long-term risk of developing type 2 diabetes after GDM. Methods: We included 1,695 women who had incident GDM between 1991 and 2001, as part of the Diabetes & Women’s Health study, and followed them until the return of the 2009 questionnaire. Body weight and incident type 2 diabetic cases were reported biennially. We defined baseline as the questionnaire period when women reported an incident GDM pregnancy. We estimated HRs and 95% CIs using Cox proportional hazards models. Results: We documented 259 incident cases of type 2 diabetes during up to 18 years of follow-up. The adjusted HRs of type 2 diabetes associated with each 1 kg/m2 increase in BMI were 1.16 (95% CI 1.12, 1.19) for baseline BMI and 1.16 (95% CI 1.13, 1.20) for most recent BMI. Moreover, each 5 kg increment of weight gain after GDM development was associated with a 27% higher risk of type 2 diabetes (adjusted HR 1.27; 95% CI 1.04, 1.54). Jointly, women who had a BMI ≥30.0 kg/m2 at baseline and gained ≥5 kg after GDM had an adjusted HR of 43.19 (95% CI 13.60, 137.11), compared with women who had a BMI <25.0 kg/m2 at baseline and gained <5 kg after GDM. Conclusions/interpretation: Baseline BMI, most recent BMI and weight gain after GDM were significantly and positively associated with risk of progression from GDM to type 2 diabetes.

KW - Adiposity

KW - Adult

KW - Body Mass Index

KW - Diabetes Mellitus, Type 2

KW - Diabetes, Gestational

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Middle Aged

KW - Multivariate Analysis

KW - Obesity

KW - Pregnancy

KW - Proportional Hazards Models

KW - Prospective Studies

KW - Risk Factors

KW - Surveys and Questionnaires

KW - Weight Gain

U2 - 10.1007/s00125-015-3537-4

DO - 10.1007/s00125-015-3537-4

M3 - Journal article

C2 - 25796371

SN - 0012-186X

VL - 58

SP - 1212

EP - 1219

JO - Diabetologia

JF - Diabetologia

IS - 6

ER -