Health outcomes of women with gestational diabetes mellitus in North West London: a 10-year longitudinal study.

BMJ public health Pub Date : 2025-09-29 eCollection Date: 2025-01-01 DOI:10.1136/bmjph-2024-002279
Gabrielle Goldet, Rakesh Dattani, Benjamin Pierce, Zia Ul-Haq, Tahereh Kamalati, Moulesh Shah, Andrew Frankel, Frederick Wai Keung Tam
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Abstract

Background: Gestational diabetes mellitus (GDM) is known to be associated with the development of type 2 diabetes mellitus (T2DM). However, the health outcomes of women with GDM are poorly understood. The aim of this study is to better understand long-term outcomes for women having suffered GDM.

Methods: Among 2.3 million people in North West London in the Discover-NOW dataset, we identified a group of 400 subjects coded with GDM between 2010 and 2011 and followed them up through to the end of 2021. Affected individuals were assessed for a variety of complications (eg, hypertension, diabetic eye disease, cerebrovascular disease, ischaemic heart disease, fatty liver disease and diabetic foot disease) and time-to-event analyses were performed.

Results: The median age of first pregnancy among the study cohort was 31.57 years, with a diverse ethnic mix observed. Increased rates of T2DM, diabetic eye complications and fatty liver disease were observed. HRs (adjusted for age category, ethnicity and Index of Multiple Deprivation) were 11.32 for T2DM, 5.27 for diabetic eye complications, 7.86 for fatty liver disease and 5.69 for any comorbidity.

Conclusion: We have shown the burden of multimorbidity following GDM from real-world data over a 10-year period and demonstrated high rates of diabetic eye complications and fatty liver disease that have not been shown before.

伦敦西北部妊娠期糖尿病妇女的健康结局:一项为期10年的纵向研究
背景:妊娠期糖尿病(GDM)与2型糖尿病(T2DM)的发展有关。然而,对GDM妇女的健康结果了解甚少。这项研究的目的是为了更好地了解患有GDM的女性的长期结果。方法:在发现- now数据集中的伦敦西北部230万人中,我们确定了一组400名在2010年至2011年期间编码为GDM的受试者,并对他们进行了随访至2021年底。评估受影响个体的各种并发症(如高血压、糖尿病性眼病、脑血管病、缺血性心脏病、脂肪肝和糖尿病足病),并进行事件时间分析。结果:研究队列中首次怀孕的中位年龄为31.57岁,观察到不同种族的混合。观察到T2DM、糖尿病眼并发症和脂肪肝的发生率增加。2型糖尿病患者的hr(根据年龄、种族和多重剥夺指数进行调整)为11.32,糖尿病眼并发症为5.27,脂肪性肝病为7.86,任何合并症为5.69。结论:我们已经从10年的真实世界数据中显示了GDM后多重发病的负担,并证明了糖尿病眼并发症和脂肪肝的高发生率,这是以前从未显示过的。
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