Subtypes of gestational diabetes and future risk of pre-diabetes or diabetes
Ravi Retnakaran, Ye Rim Chang, Anthony J. Hanley, Philip W. Connelly, Mathew Sermer, Bernard Zinman
Abstract
BACKGROUND: Recent studies have suggested that gestational diabetes (GDM) is a heterogeneous condition with distinct subtypes determined by whether the predominant metabolic abnormality is impaired insulin sensitivity or deficient insulin secretion. However, it is not known if the elevated future risk of pre-diabetes/diabetes associated with GDM varies according to these subtypes. Thus, we sought to evaluate maternal metabolic function in the 1st year postpartum in relation to GDM subtypes. METHODS: In this prospective cohort study conducted in Toronto, Canada, 613 women underwent GDM screening by oral glucose tolerance test (OGTT) in pregnancy, followed by repeat OGTT at both 3-months and 12-months postpartum between 09/2003 and 03/2016. The antepartum OGTT identified 3 groups of women: GDM with predominant sensitivity defect (GDM-sensitivity), GDM with predominant secretion defect (GDM-secretion), and non-GDM. FINDINGS: = 0.75). INTERPRETATION: Beta-cell dysfunction, glycemia and incident pre-diabetes/diabetes do not vary between GDM subtypes in the 1st year postpartum. FUNDING: Canadian Institutes of Health Research; Diabetes Canada.