The American Journal of Medicine
Volume 122, Issue 3 , Pages 207-214.e4, March 2009

Risk Factors for Type 2 Diabetes Among Women with Gestational Diabetes: A Systematic Review

  • Kesha Baptiste-Roberts, PhD, MPH

      Affiliations

    • Department of Epidemiology, Johns Hopkins Medical Institutions, Baltimore, Md
    • ,
  • Bethany B. Barone, ScM

      Affiliations

    • Department of Epidemiology, Johns Hopkins Medical Institutions, Baltimore, Md
    • ,
  • Tiffany L. Gary, PhD, MHS

      Affiliations

    • Department of Epidemiology, Johns Hopkins Medical Institutions, Baltimore, Md
    • Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Md
    • ,
  • Sherita H. Golden, MD, MHS

      Affiliations

    • Department of Epidemiology, Johns Hopkins Medical Institutions, Baltimore, Md
    • Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Md
    • ,
  • Lisa M. Wilson, ScM

      Affiliations

    • Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Md
    • ,
  • Eric B. Bass, MD, MPH

      Affiliations

    • Department of Epidemiology, Johns Hopkins Medical Institutions, Baltimore, Md
    • Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Md
    • ,
  • Wanda K. Nicholson, MD, MPH

      Affiliations

    • Department of Obstetrics & Gynecology, Johns Hopkins Medical Institutions, Baltimore, Md
    • Department of Population and Family and Reproductive Health, Johns Hopkins Medical Institutions, Baltimore, Md
    • Corresponding Author InformationRequests for reprints should be addressed to Wanda K. Nicholson, MD, MPH, Department of Obstetrics and Gynecology, Phipps 247, 600 N. Wolfe Street, Baltimore, MD 21205

Abstract 

We conducted a systematic review of studies examining risk factors for the development of type 2 diabetes among women with previous gestational diabetes. Our search strategy yielded 14 articles that evaluated 9 categories of risk factors of type 2 diabetes in women with gestational diabetes: anthropometry, pregnancy-related factors, postpartum factors, parity, family history of type 2 diabetes, maternal lifestyle factors, sociodemographics, oral contraceptive use, and physiologic factors. The studies provided evidence that the risk of type 2 diabetes was significantly higher in women having increased anthropometric characteristics with relative measures of association ranging from 0.8 to 8.7 and women who used insulin during pregnancy with relative measures of association ranging between 2.8 and 4.7. A later gestational age at diagnosis of gestational diabetes, >24 weeks gestation on average, was associated with a reduction in risk of development of type 2 diabetes with relative measures of association ranging between 0.35 and 0.99. We concluded that there is substantial evidence for 3 risk factors associated with the risk of type 2 diabetes in women having gestational diabetes.

Keywords: Gestational diabetes, Type 2 diabetes

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 Funding: This research was supported by the Agency for Healthcare Research and Quality.

 Conflict of Interest: Each author represents and warrants that they have no financial affiliation or involvement with any commercial organization with potential financial interest in the subject or materials discussed in this manuscript except Sherita H. Golden, MD, MHS, who provides consulting services for Merck, Inc. and serves as a member of the US Clinical Diabetes Advisory Board.

 Authorship: Each author participated in the conception and design of this work or the analysis and interpretation of the data, as well as the writing of the manuscript.

 Prior Presentation: American Diabetes Association Scientific Sessions, June 2008.

 Disclaimer: The authors of this article are responsible for its contents, including any clinical or treatment recommendations. No statement in this article should be construed as an official position of the Agency for Healthcare Research and Quality or of the U.S. Department of Health and Human Services.

PII: S0002-9343(08)00981-9

doi:10.1016/j.amjmed.2008.09.034

The American Journal of Medicine
Volume 122, Issue 3 , Pages 207-214.e4, March 2009

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