Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel; Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel; Mehuedet HMO, Israel.
Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel.
Diabetes Res Clin Pract. 2024 Aug;214:111782. doi: 10.1016/j.diabres.2024.111782. Epub 2024 Jul 11.
To evaluate and compare the risk of progressing to type 2 diabetes (T2DM) based on the timing of gestational diabetes (GDM) diagnosis during pregnancy.
Retrospective analysis of pregnant individuals with gestational diabetes and post-pregnancy follow up. Data sourced from Meuhedet HMO's computerized laboratory system, cross-tabulated with the Israeli National Diabetes Registry. The cohort was divided into normoglycemic, early GDM (diagnosed by fasting plasma glucose 92-125 mg/dL (5.1-6.9 mM) at < 15 weeks), 2nd trimester GDM (diagnosed at 24-28 weeks), and late GDM (diagnosed after 29 weeks). Statistics included univariate analysis followed by survival analysis. Risk was further analyzed for individuals by obesity status.
75,459 entered the analysis: 90 % normoglycemic, 7.9 % early GDM, 1.4 % 2nd trimester GDM, and 0.7 % late GDM. Median post-pregnancy follow-up time was 4.3 (IQR 3.3-5.1). 2nd trimester GDM showed the highest T2DM risk annually after pregnancy. Cox regression analysis, adjusted for confounders, revealed a significantly higher T2DM risk for 2nd-trimester GDM compared to early and late GDM. Late GDM did not confer additional significant T2DM risk. Stratification by obesity status highlighted that early GDM increased the risk of T2DM only in individuals without obesity.
GDM diagnosis timing significantly impacts T2DM risk. 2nd trimester GDM carries the highest T2DM risk.
评估和比较妊娠期糖尿病（GDM）诊断时间对 2 型糖尿病（T2DM）进展风险的影响。
对患有妊娠糖尿病的孕妇进行回顾性分析，并进行产后随访。数据来源于 Meuhedet HMO 的计算机化实验室系统，并与以色列国家糖尿病登记处交叉核对。将队列分为血糖正常、早期 GDM（空腹血糖 92-125mg/dL（5.1-6.9mmol/L）<15 周时诊断）、中期 GDM（24-28 周时诊断）和晚期 GDM（29 周后诊断）。统计分析包括单因素分析和生存分析。进一步分析肥胖个体的风险。
75459 人进入分析：90%血糖正常，7.9%早期 GDM，1.4%中期 GDM，0.7%晚期 GDM。产后随访中位时间为 4.3（IQR 3.3-5.1）。中期 GDM 在产后每年显示出最高的 T2DM 风险。Cox 回归分析，调整混杂因素后，与早期和晚期 GDM 相比，中期 GDM 发生 T2DM 的风险显著更高。晚期 GDM 并未增加 T2DM 的额外显著风险。按肥胖状况分层表明，早期 GDM 仅在非肥胖个体中增加 T2DM 的风险。
GDM 诊断时间显著影响 T2DM 风险。中期 GDM 具有最高的 T2DM 风险。
