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CME Credit Offered
CME Credit Offered
Abstract Award
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Poster Session 4

(1219) Factors associated with subsequent diagnosis of T2DM following an initial pregnancy with GDM

Friday, January 31, 2025
4:00 PM – 6:00 PM  
Objective:

Gestational diabetes (GDM) affects more than 200,000 people annually in the US, with prevalence continuing to rise. GDM is associated with development of type 2 diabetes mellitus (T2DM) in the future, which can affect subsequent pregnancies. The purpose of this study was to identify factors that are associated with the development of T2DM in a subsequent pregnancy in patients who had GDM in their initial pregnancy.

Study Design:

This was a retrospective cohort study of pregnant persons in California between 2008-2020 with two births that were both singleton, non-anomalous, gestational ages 23-42 weeks. Included persons had GDM in their index pregnancy.  We assessed factors associated with development of T2DM in a subsequent pregnancy compared to those who did not develop T2DM. Statistical analyses were performed utilizing chi squared and multivariable logistic regression with a p-value of 0.05.

Results:

There were 65,160 (6.9%) of patients who had GDM in their initial pregnancy, of which 3,904 (6.0%) developed T2DM in their second pregnancy.  Factors associated with development of T2DM at second delivery included non-Hispanic black race (aOR 1.98, CI 95% 1.67-2.35), Hispanic ethnicity (aOR1.88, CI 95% 1.70-2.08), overweight or obese body mass index (BMI) (aOR 1.81, CI 95% 1.62-2.02; aOR 3.61, CI 95% 3.27-3.99), public insurance (aOR 1.26, CI 95% 1.17-1.36), and diagnosis of chronic hypertension (CHTN) (aOR 1.93, CI 95% 1.66-2.25). Patients that were less than 20 years of age were less likely to develop T2DM in their subsequent pregnancy (aOR 0.82, CI 95% 0.68-0.98).

Conclusion:

We found that a new diagnosis of T2DM in a subsequent pregnancy after an initial pregnancy with GDM is associated with several factors, including non-Hispanic black race, Hispanic ethnicity, overweight or obese BMI, public insurance and diagnosis of CHTN during initial pregnancy. These findings can be used when counseling patients with a history of GDM to discuss the risk of development of T2DM in subsequent pregnancies. Future studies should assess structural and sociocultural factors that may contribute to these findings.