Herath Himali, Herath Rasika, Wickremasinghe Rajitha
Department of Nutrition, Medical Research Institute, Colombo, Sri Lanka.
Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
PLoS One. 2017 Jun 23;12(6):e0179647. doi: 10.1371/journal.pone.0179647. eCollection 2017.
Women with a history of gestational diabetes mellitus (GDM) have an increased risk of type 2 diabetes mellitus (T2DM) later in life compared to women with no GDM. This study was aimed to determine the risk of developing T2DM 10 years after GDM in Sri Lankan women.
A retrospective cohort study was conducted in the Colombo district, Sri Lanka. 7205 women who delivered a child in 2005 were identified through Public Health Midwives in the field. Women with antenatal records were interviewed and relevant data were extracted from medical records to identify potential participants. One hundred and nineteen women who had GDM and 240 women who did not have GDM were recruited. Current diagnosis of diabetes was based on history, relevant medical records and blood reports within the past 1 year.
The mean duration of follow up was 10.9 (SD = 0.35) years in the GDM group and 10.8 (SD = 0.31) years in the non-GDM group. The incidence density of diabetes in the GDM group was 56.3 per 1000 person years compared to 5.4 per 1000 person years in non GDM group giving a rate ratio of 10.42 (95% CI: 6.01-19.12). A woman having GDM in the index pregnancy was 10.6 times more likely to develop diabetes within 10 years compared to women with no GDM after controlling for other confounding variables. Delivering a child after 30 years, being treated with insulin during the pregnancy and delivering a baby weighing more than 3.5 Kg were significant predictors of development of T2DM after controlling for family history of diabetes mellitus (DM), GDM in previous pregnancies, parity and gestational age at delivery.
Women with GDM had a 10-fold higher risk of developing T2DM during a 10-year follow up period as compared to women with no GDM after controlling for other confounding variables.
与无妊娠糖尿病（GDM）的女性相比，有GDM病史的女性在晚年患2型糖尿病（T2DM）的风险增加。本研究旨在确定斯里兰卡女性在患GDM 10年后发生T2DM的风险。
在斯里兰卡科伦坡地区进行了一项回顾性队列研究。通过该地区的公共卫生助产士确定了2005年分娩的7205名女性。对有产前记录的女性进行访谈，并从医疗记录中提取相关数据以确定潜在参与者。招募了119名患有GDM的女性和240名未患有GDM的女性。目前糖尿病的诊断基于病史、过去1年内的相关医疗记录和血液报告。
GDM组的平均随访时间为10.9（标准差=0.35）年，非GDM组为10.8（标准差=0.31）年。GDM组糖尿病的发病密度为每1000人年56.3例，而非GDM组为每1000人年5.4例，率比为10.42（95%可信区间：6.01-19.12）。在控制其他混杂变量后，与无GDM的女性相比，在本次妊娠中患有GDM的女性在10年内患糖尿病的可能性高10.6倍。在控制糖尿病家族史、既往妊娠的GDM、产次和分娩时的孕周后，30岁后分娩、孕期接受胰岛素治疗以及分娩体重超过3.5千克的婴儿是T2DM发生的显著预测因素。
在控制其他混杂变量后，与无GDM的女性相比，患有GDM的女性在10年随访期内患T2DM的风险高10倍。
