Introduction and Objective: Subtypes of gestational diabetes mellitus (GDM) have been described but their association with subsequent maternal cardiometabolic health remains uncertain. We examined whether GDM subtypes were differentially associated with cardiometabolic health 10-14 years after delivery.Methods: An exploratory secondary analysis from the prospective Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS). GDM was classified as insulin-deficient, insulin-resistant, mixed-defect and unclassified compared with no GDM (reference). The primary outcome was prediabetes or type 2 diabetes, and secondarily hypertension, dyslipidemia, metabolic syndrome, and predicted cardiovascular disease risk. Modified Poisson models adjusted for pregnancy covariates.Results: Of 4,156 assessed individuals, 3.0% had insulin-deficient GDM, 8.0% had insulin-resistant, 1.4% had mixed-defect and 0.7% were unclassified. The increased risk of prediabetes and diabetes (TABLE 1) was similar in magnitude regardless of GDM subtype. Individuals with insulin-deficient, insulin-resistant, and mixed-defect GDM were at increased risk of metabolic syndrome and high predicted risk of cardiovascular disease, but not dyslipidemia or hypertension.Conclusion: Individuals across GDM subtypes had a similar risk of prediabetes or diabetes, and adverse cardiometabolic outcomes, 10-14 years after delivery.
C.P. Field: None. W. Grobman: None. J. Wu: None. A. Kuang: Stock/Shareholder; Current; Dexcom, Inc. M.B. Landon: None. D. Scholtens: None. W. Lowe: None. N. Shah: None. J. Josefson: None. S. Khan: None. K. Venkatesh: None.
The Hyperglycemia and Adverse Pregnancy Outcome Follow-Up Study (HAPO FUS) was conducted by the HAPO FUS Investigators and supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The HAPO Study was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and American Diabetes Association. The data from the HAPO FUS reported here were supplied by the NIDDK Central Repository. This manuscript was prepared in collaboration with some of the investigators of the HAPO FUS and does not necessarily reflect the opinions or views of the HAPO FUS, the NIDDK Central Repository, or the NIDDK. Dr. Venkatesh was supported by the Care Innovation and Community Improvement Program at The Ohio State University. Dr Khan was supported by NHLBI grant #HL161514.
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