Gestational diabetes mellitus in a multiethnic population in Spain: Incidence and factors associated to impaired glucose tolerance one year after delivery

Endocrinol Diabetes Nutr (Engl Ed). 2019 Apr;66(4):240-246. doi: 10.1016/j.endinu.2018.07.007. Epub 2018 Oct 9.
[Article in English, Spanish]

Abstract

Background and aim: Women with history of gestational diabetes mellitus (GDM) are at increased risk for diabetes. Ethnicity may modify such risk, but no studies have been conducted in our environment. The aim of this study was to assess the incidence of type 2 diabetes mellitus and prediabetes one year after delivery in women with GDM and in a multiethnic background and to identify the associated factors.

Patients and methods: A retrospective analysis of a prospective, observational cohort of women with GDM who attended annual postpartum follow-up visits at Hospital del Mar from January 2004 to March 2016.

Results: Three hundred and five women attended postpartum follow-up visits. Of these, 47.2% were Caucasian, 22% from South-Central Asia, 12% from Latin America, and 10% from Morocco and East Asia. Incidence rates of type 2 diabetes mellitus and prediabetes in these patients were 5.2 and 36.6%, respectively. In a multivariate analysis, non-Caucasian origin (OR=3.15, 95% CI [1.85-5.39]), recurrent gestational diabetes (OR=2.26, 95% CI [1.11-4.59]), and pre-pregnancy body mass index (OR=1.09, 95% CI [1.04-1.15]) were independent predictors of impaired glucose tolerance.

Conclusions: In a multiethnic Spanish population of women with GDM, incidence of impaired glucose tolerance in the first year after delivery was 41.8%, with a three-fold increased risk for women of non-Caucasian ethnicity.

Keywords: Diabetes mellitus gestacional; Diabetes mellitus tipo 2; Gestational diabetes mellitus; Glucose intolerance; Intolerancia a la glucosa; Prediabetes; Type 2 diabetes mellitus.

MeSH terms

  • Adult
  • Asia / ethnology
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetes, Gestational / ethnology*
  • Ethnicity / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Glucose Intolerance / ethnology*
  • Humans
  • Incidence
  • Morocco / ethnology
  • Observational Studies as Topic / statistics & numerical data
  • Pregnancy
  • Retrospective Studies
  • Spain / epidemiology