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The risk of developing type 2 diabetes after gestational diabetes : a registry study from Finland |
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| Author: | Perämäki, Roosa1; Gissler, Mika2,3,4; Ollila, Meri-Maija5,6; |
| Organizations: |
1Department of Clinical Medicine, Faculty of Medicine, University of Turku, Kiinamyllynkatu 10, Turku 20520, Finland 2THL Finnish Institute for Health and Welfare, Department of Knowledge Brokers, Po Box 30, Helsinki 00271, Finland. 3Department of Molecular Medicine and Surgery, Karolinska Institute, Anna Steckséns gata 53, Stockholm 171 64, Sweden
4Region Stockholm, Academic Primary Health Care Centre, Po Box 45436, Stockholm 104 31, Sweden
5Research Unit of Internal Medicine, University of Oulu, Kajaanintie 50, Oulu 90220, Finland 6Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Aapistie 5a, Oulu 90220, Finland 7Biocenter Oulu, University of Oulu, Aapistie 5A, Oulu 90220, Finland 8Department of Obstetrics and Gynaecology, Oulu University Hospital, Kajaanintie 50, Oulu 90220, Finland 9PEDEGO Research Unit, Faculty of Medicine, University of Oulu, Aapistie 5a, Oulu 90220, Finland 10Department of Obstetrics and Gynaecology, Tampere University Hospital, Kuntokatu 2, Tampere 33520, Finland 11Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, Tampere 33520, Finland 12Department of Internal Medicine, Tampere University Hospital, Kuntokatu 2, 33520 Tampere, Finland 13Department of Obstetrics and Gynaecology, Kuopio University Hospital, Puijonlaaksontie 2, Kuopio 70210, Finland 14Department of Endocrinology and Clinical Nutrition, Kuopio University Hospital, Puijonlaaksontie 2, Kuopio 70210, Finland 15Department of Endocrinology, Turku University Hospital, Kiinamyllynkatu 4-8, Turku 20500, Finland |
| Format: | article |
| Version: | published version |
| Access: | open |
| Online Access: | PDF Full Text (PDF, 1.5 MB) |
| Persistent link: | http://urn.fi/urn:nbn:fi-fe2023052346394 |
| Language: | English |
| Published: |
Elsevier,
2022
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| Publish Date: | 2023-05-23 |
| Description: |
AbstractAims: Women with a history of gestational diabetes (GDM) have an increased risk of developing type 2 diabetes (T2DM). We studied the risk for T2DM in women with and without GDM in relation to body mass index (BMI) and examined whether insulin treatment for GDM associates with the risk of developing T2DM. In addition, we investigated whether the risk of developing T2DM after GDM had changed in 15 years. Methods: We used data by linking four registers; Medical Birth Register, Hospital Discharge Register and Primary Care Register run by THL Finnish Institute for Health and Welfare, and Medical Reimbursement Statistics run by the Social Insurance Institution of Finland (Kela). Registry data were collected from 2005 to 2020. The follow-up started from woman’s delivery in 2006–2020 and ended to the diagnosis of T2DM or December 2020. Cox proportional hazard modelling was used to estimate the effect of GDM exposure to T2DM. To assess whether the risk of developing T2DM after GDM had changed in 15 years, we compared the HR between years 2006–2008 and 2018–2020. Results: In total, 462 401 women were included in the study: 96 353 (21%) women had previous GDM. There were 5370 (1.2%) women who developed T2DM after childbirth during the follow-up. Among women with prior GDM, 3995 (4.1%) developed T2DM, while 1375 (0.4%) women without prior GDM developed T2DM during follow-up. The mean follow-up was 6.86 years (SD 4.21) for women with GDM and 9.07 years (SD 4.35) for women without GDM. The hazard ratio (HR) for developing T2DM after GDM was 18.49 (95% CI 17.39–19.67). The incidence of T2DM in women with a history of GDM began to rise almost steadily from the first year of follow-up. As BMI increased, T2DM incidence increased in both women with and without prior GDM but more in women with prior GDM. Insulin treatment had an independent association with increased risk of T2DM (HR 3.81, 95% CI 3.57–4.07). We did not observe any difference in HR between years 2006–2008 and 2018–2020. Conclusions: The relative risk for T2DM was 11-fold for women with previous GDM compared to women without previous GDM. A higher BMI and insulin treatment increased the risk of future diabetes. All measures to prevent the conversion of GDM to T2DM should be taken especially among women with overweight or obesity. see all
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| Series: |
Diabetes epidemiology and management |
| ISSN: | 2666-9706 |
| ISSN-E: | 2666-9706 |
| ISSN-L: | 2666-9706 |
| Volume: | 10 |
| Article number: | 100124 |
| DOI: | 10.1016/j.deman.2022.100124 |
| OADOI: | https://oadoi.org/10.1016/j.deman.2022.100124 |
| Type of Publication: |
A1 Journal article – refereed |
| Field of Science: |
3121 General medicine, internal medicine and other clinical medicine |
| Subjects: | |
| Funding: |
Meri-Maija Ollila: Research grant awarded by The Sakari Alhopuro Foundation |
| Copyright information: |
© 2022 The Authors. Published by Elsevier Masson SAS. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
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https://creativecommons.org/licenses/by-nc-nd/4.0/ |