Early Gestational Diabetes Raises Postpartum Diabetes Risk, finds study
Researchers have discovered in a new study that women diagnosed with gestational diabetes mellitus (GDM) earlier than 24 weeks of pregnancy, termed early GDM, are almost twice as prone to developing diabetes mellitus (DM) post-delivery as those diagnosed with later pregnancy. The findings demonstrate that early GDM not only has a greater risk of postpartum diabetes but also is linked to more cases of impaired glucose tolerance following delivery. The study was published in the Journal of Diabetes and Its Complications by Sarah J. and fellow researchers.
GDM is usually screened for at or after 24 weeks' gestation, but increased early diagnosis has been more frequent as prenatal care remains more proactive. But whether early detection was linked to poorer outcomes postpartum has been subject to ongoing research until now.
The research was a systematic review and meta-analysis of the evidence. Researchers reviewed PubMed, EMBASE, WHO International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov, and the Cochrane Central Register of Controlled Trials from inception until March 2023. Researchers included observational studies and randomized controlled trials that contrasted the postpartum rate of DM among women diagnosed with early GDM (earlier than 24 weeks) compared to women with standard GDM (diagnosed at or later than 24 weeks).
The primary outcome was the diagnosis rate of postpartum diabetes. Secondary outcomes included postpartum visit attendance, completion and interpretation of oral glucose tolerance tests (OGTT), and glycated hemoglobin (HbA1c) levels. A total of 11 studies involving 1,573 women with early GDM and 3,340 with standard GDM were included in the final analysis.
Key Findings
Early GDM group (n = 1,573):
• Postpartum diabetes: 12.8%
• Impaired glucose tolerance: 24.7%
• Mean age: 30.2–37.0 years
• Mean BMI: 24.4–35.6 kg/m²
Standard GDM group (n = 3,340):
• Postpartum diabetes: 6.1%
• Impaired glucose tolerance: 13.0%
• Mean age: 28.9–32.8 years
• Mean BMI: 23.6–36.0 kg/m²
• Risk of postpartum diabetes: Almost twice (RR = 1.89) in early GDM
• Risk of impaired glucose tolerance: Almost twice (RR = 1.84) in early GDM
• Follow-up duration: Primarily 5–12 weeks after delivery, one study up to 6 years
This study affirmed that women with GDM diagnosed earlier than 24 weeks of pregnancy have a considerably increased risk of developing diabetes after delivery compared with those diagnosed after this time point. With approximately 13% of early GDM patients advancing to postpartum diabetes compared with slightly over 6% in usual GDM, the results underscore the necessity for increased vigilance, early intervention, and prolonged postpartum surveillance in this at-risk population.
Reference:
Weingarten, S. J., Levy, A. T., Al-Kouatly, H. B., & McLaren, R. A., Jr. (2025). Postpartum diabetes mellitus among patients with early gestational diabetes: A systematic review and meta-analysis. Journal of Diabetes and Its Complications, 109038, 109038. https://doi.org/10.1016/j.jdiacomp.2025.109038
