Gestational Glucose Intolerance Puts Young Women at High Risk for Type 2 Diabetes: The Lancet

Israel: A new study has revealed that women who experience glucose intolerance during pregnancy, even if it does not meet the criteria for gestational diabetes, are at a significantly higher risk of developing type 2 diabetes in young adulthood pointed out research published in The Lancet Diabetes & Endocrinology.

The aim of the study was to investigate the connections between different levels of gestational glucose intolerance and the likelihood of developing type 2 diabetes in early adulthood. It highlights the need for greater recognition of these conditions as risk factors for type 2 diabetes.

The study, which was conducted by researchers from the National Israeli Conscription Database and Maccabi Healthcare Services, looked at data from over 177,241 women who had undergone a pre-recruitment evaluation during adolescence (16-21 years) and later underwent two-step gestational diabetes screening. The women were followed up for a median of 10.8 years, during which time 1,262 were diagnosed with type 2 diabetes.

The researchers adjusted the results for sociodemographic characteristics, adolescent BMI, and age at gestational screening.

The results of the study revealed the following key clinical takeaways:

1. 1.The risk of type 2 diabetes was higher in women with an abnormal glucose challenge test (GCT) and normal oral glucose tolerance test (OGTT) and in women with one abnormal OGTT value.
2. 2.The risk was even higher in women with gestational diabetes. The risk of type 2 diabetes was also increased in women with isolated elevated fasting glucose, and in women with gestational diabetes and abnormal fasting glucose.

The findings of this study have significant implications for the management of glucose intolerance during pregnancy. Currently, women who do not meet the criteria for gestational diabetes are not routinely monitored for type 2 diabetes, but this research suggests that they should be.

The authors of the study added that “Gestational glucose intolerance, including conditions not meeting gestational diabetes criteria, should be recognized as a risk factor for type 2 diabetes, especially among women with abnormal fasting glucose concentrations during pregnancy. The findings underscore the need for greater awareness of the risks associated with glucose intolerance during pregnancy and for improved monitoring and management of these conditions.

Reference:

Bardugo A., Bendor C., Shmuel Rotem R., Tsur A., Derazne E., Gerstein H., et al; Glucose intolerance in pregnancy and risk of early-onset type 2 diabetes: a population-based cohort study; The Lancet Diabetes & Endocrinology; 2023.03.31 doi: https://doi.org/10.1016/S2213-8587(23)00062-1