Postpartum diabetes mellitus among patients with early gestational diabetes: A systematic review and meta-analysis

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications Pub Date : 2025-04-08 DOI:10.1016/j.jdiacomp.2025.109038

Sarah J. Weingarten , Ariel T. Levy , Huda B. Al-Kouatly , Rodney A. McLaren Jr.

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引用次数: 0

Abstract

Aims

It is unclear whether patients diagnosed with early gestational diabetes mellitus (GDM) (<24 weeks) are at higher risk of diabetes mellitus (DM) in the postpartum period compared to those with standard GDM (diagnosed ≥24 weeks). This study assessed if rate of DM diagnosed postpartum differs among patients with early versus standard GDM.

Methods

PubMed, EMBASE, WHO ICTRP, Clinicaltrials.gov and Cochrane Central Register of Controlled Trials were searched from inception to March 2023. Randomized controlled trials or observational studies that assessed rate of postpartum DM among patients with early GDM were included. Primary outcome was rate of DM diagnosed postpartum. Secondary outcomes were postpartum visit attendance, completion and results of postpartum oral glucose tolerance testing, and glycated hemoglobin (HbA1c) levels.

Results

Of 5682 studies screened, 11 met inclusion criteria (N = 1573 early GDM vs. N = 3340 standard GDM). Patients with early GDM had mean age of 30.2–37.0 years and mean body mass index (BMI) of 24.4–35.6 kg/m², while the standard group had a mean age of 28.9–32.8 years and mean BMI of 23.6–36.0 kg/m². Most studies evaluated postpartum glucose tolerance at 5–12 weeks, though one followed patients up to six years postpartum. Overall, patients with early GDM were more likely to be diagnosed with DM postpartum than those with standard GDM (12.8 % vs. 6.1 %, RR 1.89, 95 % CI 1.10–3.24). Impaired glucose tolerance was also higher in patients with early GDM (24.7 % vs. 13.0 %, RR 1.84, 95 % CI 1.32–2.57).

Conclusions

Rate of DM diagnosed postpartum was higher in patients with early GDM compared to standard GDM.

查看原文本刊更多论文

妊娠早期糖尿病患者的产后糖尿病：一项系统回顾和荟萃分析

目的尚不清楚妊娠早期糖尿病（GDM）患者（≤24周）是否比标准GDM（≥24周）患者在产后发生糖尿病（DM）的风险更高。本研究评估早期与标准GDM患者产后糖尿病诊断率的差异。方法检索spubmed、EMBASE、WHO ICTRP、Clinicaltrials.gov和Cochrane Central Register of Controlled Trials，检索时间为建库至2023年3月。纳入评估早期GDM患者产后糖尿病发生率的随机对照试验或观察性研究。主要观察指标为产后糖尿病确诊率。次要结局为产后访诊出勤率、产后口服糖耐量试验的完成情况和结果以及糖化血红蛋白（HbA1c）水平。结果在筛选的5682项研究中，11项符合纳入标准（N = 1573例早期GDM vs. N = 3340例标准GDM）。早期GDM患者平均年龄为30.2 ~ 37.0岁，平均体重指数（BMI）为24.4 ~ 35.6 kg/m2，而标准组平均年龄为28.9 ~ 32.8岁，平均BMI为23.6 ~ 36.0 kg/m2。大多数研究评估的是产后5-12周的葡萄糖耐量，尽管有一项研究跟踪了产后6年。总体而言，早期GDM患者比标准GDM患者更有可能被诊断为产后DM（12.8%比6.1%,RR 1.89, 95% CI 1.10-3.24）。早期GDM患者糖耐量受损也更高（24.7% vs 13.0%, RR 1.84, 95% CI 1.32-2.57）。结论早期GDM患者产后诊断DM的比例高于标准GDM患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of diabetes and its complications 医学-内分泌学与代谢

CiteScore

5.90

自引率

3.30%

发文量

153

审稿时长

16 days

期刊介绍： Journal of Diabetes and Its Complications (JDC) is a journal for health care practitioners and researchers, that publishes original research about the pathogenesis, diagnosis and management of diabetes mellitus and its complications. JDC also publishes articles on physiological and molecular aspects of glucose homeostasis. The primary purpose of JDC is to act as a source of information usable by diabetes practitioners and researchers to increase their knowledge about mechanisms of diabetes and complications development, and promote better management of people with diabetes who are at risk for those complications. Manuscripts submitted to JDC can report any aspect of basic, translational or clinical research as well as epidemiology. Topics can range broadly from early prediabetes to late-stage complicated diabetes. Topics relevant to basic/translational reports include pancreatic islet dysfunction and insulin resistance, altered adipose tissue function in diabetes, altered neuronal control of glucose homeostasis and mechanisms of drug action. Topics relevant to diabetic complications include diabetic retinopathy, neuropathy and nephropathy; peripheral vascular disease and coronary heart disease; gastrointestinal disorders, renal failure and impotence; and hypertension and hyperlipidemia.