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Diabetologia
Published in: Diabetologia 7/2016

Open Access 01-07-2016 | Meta-Analysis

Quantification of the type 2 diabetes risk in women with gestational diabetes: a systematic review and meta-analysis of 95,750 women

Authors: Girish Rayanagoudar, Amal A. Hashi, Javier Zamora, Khalid S. Khan, Graham A. Hitman, Shakila Thangaratinam

Published in: Diabetologia | Issue 7/2016

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Abstract

Aims/hypothesis

Women with gestational diabetes mellitus (GDM) are at risk of developing type 2 diabetes, but individualised risk estimates are unknown. We conducted a meta-analysis to quantify the risk of progression to type 2 diabetes for women with GDM.

Methods

We systematically searched the major electronic databases with no language restrictions. Two reviewers independently extracted 2 × 2 tables for dichotomous data and the means plus SEs for continuous data. Risk ratios were calculated and pooled using a random effects model.

Results

There were 39 relevant studies (including 95,750 women) BMI (RR 1.95 [95% CI 1.60, 2.31]), family history of diabetes (RR 1.70 [95% CI 1.47, 1.97]), non-white ethnicity (RR 1.49 [95% CI 1.14, 1.94]) and advanced maternal age (RR 1.20 [95% CI 1.09, 1.34]) were associated with future risk of type 2 diabetes. There was an increase in risk with early diagnosis of GDM (RR 2.13 [95% CI 1.52, 3.56]), raised fasting glucose (RR 3.57 [95% CI 2.98, 4.04]), increased HbA1c (RR 2.56 [95% CI 2.00, 3.17]) and use of insulin (RR 3.66 [95% CI 2.78, 4.82]). Multiparity (RR 1.23 [95% CI 1.01, 1.50]), hypertensive disorders in pregnancy (RR 1.38 [95% CI 1.32, 1.45]) and preterm delivery (RR 1.81 [95% CI 1.35, 2.43]) were associated with future diabetes. Gestational weight gain, macrosomia in the offspring or breastfeeding did not increase the risk.

Conclusions/interpretation

Personalised risk of progression to type 2 diabetes should be communicated to mothers with GDM.

Systematic review registration:

Appendix
Available only for authorised users
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Metadata
Title
Quantification of the type 2 diabetes risk in women with gestational diabetes: a systematic review and meta-analysis of 95,750 women
Authors
Girish Rayanagoudar
Amal A. Hashi
Javier Zamora
Khalid S. Khan
Graham A. Hitman
Shakila Thangaratinam
Publication date
01-07-2016
Publisher
Springer Berlin Heidelberg
Published in
Diabetologia / Issue 7/2016
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-016-3927-2

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