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

Wei Bao, Edwina Yeung, Deirdre K Tobias, Frank B Hu, Allan A Vaag, Jorge E Chavarro, James L Mills, Louise G Grunnet, Katherine Bowers, Sylvia H Ley, Michele Kiely, Sjurdur F. Olsen, Cuilin Zhang

Research output: Contribution to journalArticlepeer-review

100 Citations (Scopus)

Abstract

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/m(2) 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/m(2) 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
Original languageEnglish
Pages (from-to)1212-1219
Number of pages8
JournalDiabetologia
Volume58
Issue number6
DOIs
Publication statusPublished - Jun 2015

Keywords

  • Adiposity
  • Adult
  • Body Mass Index
  • Diabetes Mellitus, Type 2
  • Diabetes, Gestational
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Multivariate Analysis
  • Obesity
  • Pregnancy
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Surveys and Questionnaires
  • Weight Gain

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