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Published on: November 13, 2016
Glucose Challenge Test Values Within the Normal Range and Long-Term Risk of Type 2 Diabetes by Pre-Pregnancy BMI: A
Yael Barer1,2, Tal Schiller2,3, Maya Nitecki1,4
1Department of Preventive Medicine, School of Public Health, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Aims:
Gestational diabetes (GDM) is the strongest known risk factor for maternal type 2 diabetes. However, little is known about type 2 diabetes risk in women with normal glucose challenge test (GCT) results during pregnancy. We investigated the association between GCT results in the normal range and type 2 diabetes risk, both overall and across pre-pregnancy BMI categories.
Materials And Methods:
This retrospective cohort study identified pregnant women aged 20-50 who had normal (< 140 mg/dL) GCT results between 2004 and 2022. Follow-up for type 2 diabetes extended from the date of the last documented GCT until 31 September 2024. Survival analyses examine GCT and combine BMI-GCT exposures.
Results:
Among 249 190 eligible women (mean age 32.7 years), 1354 developed type 2 diabetes during a median follow-up of 7 years. GCT results within the normal range were associated with the risk of type 2 diabetes, in a graded manner, without a clear threshold. Compared to women with normal pre-pregnancy BMI and GCT of 70-89 mg/dL, women with a GCT of 130-140 mg/dL had adjusted hazard ratios for type 2 diabetes ranging from 14.7 (95% CI: 6.2-33.3) among women with normal BMI to 145 (95% CI: 67.7-309) among women with obesity.
Conclusions:
Pre-pregnancy BMI and GCT values within the normal range can be used for further type 2 diabetes risk stratification, ranging from minimal risk among women with a GCT < 90 mg/dL and normal weight to substantially increased risk among women with pre-pregnancy overweight or obesity.
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