Risk factors for postpartum prediabetes and type 2 diabetes in women with gestational diabetes: insights from the edugest study in Argentina.

Abstract

Aim: To describe postpartum glycemic status in a cohort of women with Gestational diabetes (GD) from the EDUGEST (Education in women with GD) study, and to determine factors associated with a diagnosis of prediabetes or T2D.

Methods: This observational, analytical study analyzed records of pregnant women with GD recruited in the framework of the EDUGEST study. Data from QUALIDAB-GEST were analyzed for patients who completed postpartum glycemic assessment at six weeks. Information included concurrent cardiovascular risk factors, obstetric history in previous pregnancies, clinical and metabolic indicators, treatments, and postpartum screening results. Descriptive analyses were performed using means ± standard deviation (SD), medians with interquartile ranges [IQR], or proportions, as appropriate. Differences were tested using parametric and non-parametric tests. Regression models assessed factors associated with prediabetes or T2D development postpartum.

Results: The analysis included 573 patients (median age: 31 [26-36] years; median gestational age at the first specialty visit after GD diagnosis: 28 [26-32] weeks; BMI: 31.2 [26.7-34.9]). Postpartum screening showed 76.3% normal results, 19.5% prediabetes, and 4.2% T2D. T2D was significantly associated with insulin use during pregnancy (OR: 4.20) and family history of diabetes (OR: 3.21), while prediabetes was associated with hypertension (OR: 2.39), insulin use during pregnancy (OR: 1.62), BMI al the first specialty visit (OR: 1.05), and fructosamine levels (OR: 1.01).

Conclusion: This study identified locally relevant parameters associated with postpartum prediabetes and T2D in women with GD, highlighting the importance of early identification of high-risk patients and the role of postpartum glycemic assessment for timely diagnosis.