One-year postpartum weight retention and glucose intolerance in women with prediabetes after gestational diabetes.
1 year
gestational diabetes mellitus
glucose intolerance
postpartum
prediabetes
weight retention
Journal
Diabetic medicine : a journal of the British Diabetic Association
ISSN: 1464-5491
Titre abrégé: Diabet Med
Pays: England
ID NLM: 8500858
Informations de publication
Date de publication:
03 Jul 2024
03 Jul 2024
Historique:
revised:
11
06
2024
received:
19
04
2024
accepted:
19
06
2024
medline:
3
7
2024
pubmed:
3
7
2024
entrez:
3
7
2024
Statut:
aheadofprint
Résumé
To determine risk factors for 1-year postpartum weight retention (PPWR) and glucose intolerance (prediabetes + diabetes) in women with a previous history of gestational diabetes (GDM) and prediabetes in early postpartum. In this exploratory analysis of the MELINDA randomized controlled trial, we report data of 167 women with prediabetes at the 6-16 weeks (early) postpartum oral glucose tolerance test after a recent history of GDM. Of all participants, 45% (75) had PPWR >0 kg at 1-year postpartum. Compared to women without PPWR, women with PPWR had higher gestational weight gain [10.5 ± 6.4 vs. 6.5 ± 4.5 kg, p < 0.001], higher BMI (p < 0.01) and a worse metabolic profile (higher waist circumference, worse lipid profile and more insulin resistance) (all p < 0.05) both in early and late postpartum. Of all women with PPWR, 40.0% developed metabolic syndrome, compared to 18.9% of women without late PPWR (p = 0.003). The only independent predictor for late PPWR was weight retention in early postpartum (p < 0.001). Of all participants, 55.1% (92) had glucose intolerance (84 prediabetes, 8 diabetes) 1-year postpartum. Independent predictors for late postpartum glucose intolerance were lower gestational age at start insulin therapy in pregnancy and delivery by caesarean section (resp. p = 0.044 and 0.014). In women with a previous history of GDM and prediabetes in early postpartum, PPWR in early postpartum was a strong independent predictor for late PPWR, while earlier start of insulin therapy during pregnancy and delivery by caesarean section were independent predictors of glucose intolerance in late postpartum.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e15400Informations de copyright
© 2024 Diabetes UK.
Références
American Diabetes Association Professional Practice Committee. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes‐2022. Diabetes Care. 2022;45(Suppl 1):S17‐S38.
Benhalima K, van Crombrugge P, Moyson C, et al. A modified two‐step screening strategy for gestational diabetes mellitus based on the 2013 WHO criteria by combining the glucose challenge test and clinical risk factors. J Clin Med. 2018;7(10):351.
Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med. 2005;352(24):2477‐2486.
Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta‐analysis. Lancet. 2009;373:1773‐1779.
Gerstein HC, Santaguida P, Raina P, et al. Annual incidence and relative risk of diabetes in people with various categories of dysglycemia: a systematic overview and meta‐analysis of prospective studies. Diabetes Res Clin Pract. 2007;78(3):305‐312.
Leuridan L, Wens J, Devlieger R, Verhaeghe J, Mathieu C, Benhalima K. Glucose intolerance in early postpartum in women with gestational diabetes: who is at increased risk? Prim Care Diabetes. 2015;9(4):244‐252.
Minschart C, Myngheer N, Maes T, et al. Weight retention and glucose intolerance in early postpartum after gestational diabetes. Eur J Endocrinol. 2023;18(8):438‐447.
Bogaerts A, de Baetselier E, Ameye L, Dilles T, van Rompaey B, Devlieger R. Postpartum weight trajectories in overweight and lean women. Midwifery. 2017;49:134‐141.
Goldstein RF, Abell SK, Ranasinha S, et al. Association of gestational weight gain with maternal and infant outcomes: a systematic review and meta‐analysis. JAMA. 2017;317(21):2207‐2225.
Quansah DY, Gross J, Gilbert L, Arhab A, Horsch A, Puder JJ. Predictors and consequences of weight retention in the early and late postpartum period in women with gestational diabetes. Diabetes Res Clin Pract. 2020;165:108238.
Minschart C, Myngheer N, Maes T, et al. Effectiveness of a blended mobile‐based lifestyle intervention in women with glucose intolerance after a recent history of gestational diabetes (MELINDA): a 1‐year, prospective, multicentre, randomised controlled trial. EClinicalMedicine. 2024;70:102523.
World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191‐2194.
Minschart C, Maes T, de Block C, et al. Mobile‐based lifestyle intervention in women with glucose intolerance after gestational diabetes mellitus (MELINDA), a multicenter randomized controlled trial: methodology and design. J Clin Med. 2020;9(8):2635.
International Association of Diabetes and Pregnancy Study Groups Consensus Panel. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33:676‐682.
Benhalima K, Minschart C, van Crombrugge P, et al. The 2019 Flemish consensus on screening for overt diabetes in early pregnancy and screening for gestational diabetes mellitus. Acta Clin Belg. 2020;75(5):340‐347.
Alberti KG, Zimmet P, Shaw J. Metabolic syndrome—a new world‐wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med. 2006;23(5):469‐480.
Matsuda M, DeFronzo RA. Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Diabetes Care. 1999;22(9):1462‐1470.
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and β‐cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412‐419.
Kahn SE. The relative contributions of insulin resistance and beta‐cell dysfunction to the pathophysiology of type 2 diabetes. Diabetologia. 2003;46(1):3‐19.
Kirwan JP, Huston‐Presley L, Kalhan SC, Catalano PM. Clinically useful estimates of insulin sensitivity during pregnancy—validation studies in women with normal glucose tolerance and gestational diabetes mellitus. Diabetes Care. 2001;24(9):1602‐1607.
Retnakaran R, Qi Y, Goran MI, Hamilton JK. Evaluation of proposed oral disposition index measures in relation to the actual disposition index. Diabet Med. 2009;26(12):1198‐1200.
Benhalima K, van Crombrugge P, Verhaeghe J, et al. The Belgian Diabetes in Pregnancy Study (BEDIP‐N), a multi‐centric prospective cohort study on screening for diabetes in pregnancy and gestational diabetes: methodology and design. BMC Pregnancy Childbirth. 2014;14(226):1‐13.
Gallagher K, Ralph J, Petros T, Qualls C, Leeman L, Rogers RG. Postpartum weight retention in primiparous women and weight outcomes in their offspring. J Midwifery Womens Health. 2019;64(4):427‐434.
Wright C, Mogul M, Acevedo G, et al. Preparing for a trial to test a postpartum weight retention intervention among low‐income women: feasibility of a protocol in a community‐based organization. BMC Womens Health. 2018;18(1):27.
Kapinos KA, Yakusheva O, Weiss M. Cesarean deliveries and maternal weight retention. BMC Pregnancy Childbirth. 2017;17(1):343.
Sandall J, Tribe RM, Avery L, et al. Short‐term and long‐term effects of caesarean section on the health of women and children. Lancet. 2018;392(10155):1349‐1357.
Ehrlich SF, Hedderson MM, Quesenberry CP Jr, et al. Post‐partum weight loss and glucose metabolism in women with gestational diabetes: the DEBI study. Diabet Med. 2014;31(7):862‐867.
Makama M, Skouteris H, Moran LJ, Lim S. Reducing postpartum weight retention: a review of the implementation challenges of postpartum lifestyle interventions. J Clin Med. 2021;10(9):1891.
O’Dea A, Tierney M, McGuire BE, et al. Can the onset of type 2 diabetes be delayed by a group‐based lifestyle intervention in women with prediabetes following gestational diabetes mellitus (GDM)? Findings from a randomized control mixed methods trial. J Diabetes Res. 2015;2015:798460.
Minschart C, Lammertyn A, Van Crombrugge P, et al. Low gestational weight gain in women with gestational diabetes is safe with better metabolic profile postpartum. J Clin Endocrinol Metab. 2023;108(3):665‐679.
Rayanagoudar G, Hashi AA, Zamora J, Khan KS, Hitman GA, Thangaratinam S. Quantification of the type 2 diabetes risk in women with gestational diabetes: a systematic review and meta‐analysis of 95,750 women. Diabetologia. 2016;59(7):1403‐1411.
Catalano PM, Shankar K. Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child. BMJ. 2017;356:j1.