Division of Populations, Evidence, and Technologies of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, ICMR Center for Advanced Research on Diabetes, Chennai, Tamil Nadu, India.
PLoS One. 2022 Dec 12;17(12):e0278919. doi: 10.1371/journal.pone.0278919. eCollection 2022.
The burden of Gestational Diabetes Mellitus (GDM) is very high in south Asia (SA) and southeast Asia (SEA). Thus, there is a need to understand the prevalence and risk factors for developing prediabetes and type 2 diabetes mellitus (T2DM) postpartum, in this high-risk population.
To conduct a systematic review and meta-analysis to estimate the prevalence of prediabetes and T2DM among the women with history of GDM in SA and SEA.
A comprehensive literature search was performed in the following databases: Medline, EMBASE, Web of Knowledge and CINHAL till December 2021. Studies that had reported greater than six weeks of postpartum follow-up were included. The pooled prevalence of diabetes and prediabetes were estimated by random effects meta-analysis model and I2 statistic was used to assess heterogeneity.
Meta-analysis of 13 studies revealed that the prevalence of prediabetes and T2DM in post-GDM women were 25.9% (95%CI 18.94 to 33.51) and 29.9% (95%CI 17.02 to 44.57) respectively. Women with history of GDM from SA and SEA seem to have higher risk of developing T2DM than women without GDM (RR 13.2, 95%CI 9.52 to 18.29, p<0.001). The subgroup analysis showed a rise in the prevalence of T2DM with increasing duration of follow-up.
The conversion to T2DM and prediabetes is very high among women with history of GDM in SA and SEA. This highlights the need for follow-up of GDM women for early identification of dysglycemia and to plan interventions to prevent/delay the progression to T2DM.
南亚（SA）和东南亚（SEA）的妊娠糖尿病（GDM）负担非常高。因此，需要了解该高风险人群产后发生糖尿病前期和 2 型糖尿病（T2DM）的患病率和危险因素。
进行系统评价和荟萃分析，以估计 SA 和 SEA 有 GDM 史的女性中糖尿病前期和 T2DM 的患病率。
在以下数据库中进行了全面的文献检索：Medline、EMBASE、Web of Knowledge 和 CINHAL，检索时间截至 2021 年 12 月。纳入报道了超过 6 周产后随访的研究。采用随机效应荟萃分析模型估计糖尿病和糖尿病前期的合并患病率，并使用 I2 统计量评估异质性。
对 13 项研究的荟萃分析显示，产后 GDM 女性的糖尿病前期和 T2DM 患病率分别为 25.9%（95%CI 18.94 至 33.51）和 29.9%（95%CI 17.02 至 44.57）。与无 GDM 的女性相比，SA 和 SEA 有 GDM 史的女性发生 T2DM 的风险似乎更高（RR 13.2，95%CI 9.52 至 18.29，p<0.001）。亚组分析显示，随着随访时间的延长，T2DM 的患病率上升。
SA 和 SEA 有 GDM 史的女性中，T2DM 和糖尿病前期向 T2DM 的转化率非常高。这突出表明需要对 GDM 女性进行随访，以早期发现糖代谢异常，并计划干预措施以预防/延迟向 T2DM 的进展。
