Type 2 diabetes after gestational diabetes, a cross-sectional study-DIVINE-NSW

Gestational diabetes mellitus (GDM) is a well-established independent risk factor for type 2 diabetes mellitus (T2DM) and cardiovascular disease. As risks emerge within the first decade following childbirth, early intervention is required. However, competing postpartum priorities and limited time inhibit many women from prioritising their post-GDM health. Therefore, the study aimed to: (1) Measure dysglycaemia prevalence and identify predictors among Australian women with recent GDM and (2) understand women's views regarding their risk of future T2DM and approach to potential preventive strategies, including post-GDM preventive pharmacotherapy.

Cross-sectional study of women with recent (within 5 years) GDM, including an online questionnaire and oral glucose tolerance test completion by participants.

Participants (n = 505) had a mean age of 37.3 ± 4.9 years, body mass index (BMI) of 27.5 ± 6.4 kg/m² and were 2.9 ± 1.4 years postpartum. Of the 248 (49.1%) participants completing an oral glucose tolerance test, 4% had T2DM and 11% had pre-diabetes. Each 1 kg/m² increase in BMI was associated with 10% greater odds of dysglycaemia (p = 0.03). On a 10-point scale (10 = highest), the median self-reported 5-year risk of developing T2DM was 5 [IQR: 3-7], and concern about developing T2DM was 7 [5-9]. Women strongly agreed (10 [8-10]) that preventing or delaying T2DM onset was important. Women reported being very likely to adopt lifestyle changes (4 [4-5] out of 5), and somewhat likely to take medication for T2DM prevention (3 [1-4] out of 5).

Women consider preventing or delaying the onset of diabetes very important. Hence, studies evaluating adjunct therapies, such as pharmacotherapy, are needed to reduce their long-term risk.