PMID- 36277725
OWN - NLM
STAT- MEDLINE
DCOM- 20221025
LR  - 20221026
IS  - 1664-2392 (Print)
IS  - 1664-2392 (Electronic)
IS  - 1664-2392 (Linking)
VI  - 13
DP  - 2022
TI  - Progression to type 2 diabetes mellitus after gestational diabetes mellitus 
      diagnosed by IADPSG criteria: Systematic review and meta-analysis.
PG  - 1012244
LID - 10.3389/fendo.2022.1012244 [doi]
LID - 1012244
AB  - BACKGROUND: To estimate the progression rates to type 2 diabetes mellitus (T2DM) 
      in women with gestational diabetes mellitus (GDM) diagnosed by the International 
      Association of Diabetes and Pregnancy Study Group (IADPSG) criteria. METHODS: 
      Systematic review and meta-analysis were conducted by searching Medline, Embase, 
      and Cochrane between January 1, 2010 and December 31, 2021 for observational 
      studies investigating progression to T2DM after GDM. Inclusion criteria were 
      IADPSG-diagnosed GDM, studies with both GDM and controls, postpartum follow-up 
      duration at least one year. Data were pooled by random effects meta-analysis 
      models. Heterogeneity was assessed by I(2) statistic. The pooled relative risk 
      for incidence of T2DM and pre-diabetes between GDM participants and controls were 
      estimated. Reasons for heterogeneity among studies were investigated by 
      prespecified subgroup and meta-regression analysis. Publication bias was assessed 
      by the Begg's and Egger's tests. RESULTS: This meta-analysis of six studies 
      assessed a total of 61932 individuals (21978 women with GDM and 39954 controls). 
      Women with IADPSG-diagnosed GDM were 6.43 times (RR=6.43, 95% CI:3.45-11.96) more 
      likely to develop T2DM in the future compared with controls. For GDM women, the 
      cumulative incidence of T2DM was 12.1% (95% CI: 6.9%-17.3%), while the pooled 
      cumulative incidence of T2DM was estimated to be 8% (95% CI: 5-11%) in studies 
      with 1 to 5 years of follow-up and increased to 19% (95% CI: 3-34%) for studies 
      with more than 5 years of follow-up. Women with IADPSG-diagnosed GDM had 3.69 
      times (RR=3.69, 95% CI:2.70-5.06) higher risk of developing pre-diabetes 
      (including impaired fasting glucose and/or impaired glucose tolerance) than 
      controls. Meta-regression analysis showed that the study effect size was not 
      significantly associated with study design, race, length of follow-up, and 
      maternal age (P>0.05). Overall, the studies had a relatively low risk of bias. 
      CONCLUSIONS: Women with IADPSG-diagnosed GDM have higher risk of developing T2DM 
      and pre-diabetes. The risk of T2DM in GDM women are higher with longer follow-up 
      duration. Our results highlight the importance of promoting postpartum screening 
      and keeping health lifestyle as well as pharmacological interventions to 
      delay/prevent the onset of T2DM/pre-diabetes in GDM women. SYSTEMATIC REVIEW 
      REGISTRATION: https://www.crd.york.ac.uk/prospero, identifier (CRD42022314776).
CI  - Copyright (c) 2022 Juan, Sun, Wei, Wang, Song, Yan, Zhou and Yang.
FAU - Juan, Juan
AU  - Juan J
AD  - Department of Obstetrics and Gynecology, Peking University First Hospital, 
      Beijing, China.
FAU - Sun, Yiying
AU  - Sun Y
AD  - Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, 
      Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 
      China.
FAU - Wei, Yumei
AU  - Wei Y
AD  - Department of Obstetrics and Gynecology, Peking University First Hospital, 
      Beijing, China.
FAU - Wang, Shuang
AU  - Wang S
AD  - Department of Obstetrics and Gynecology, Peking University First Hospital, 
      Beijing, China.
FAU - Song, Geng
AU  - Song G
AD  - Department of Obstetrics and Gynecology, Peking University First Hospital, 
      Beijing, China.
FAU - Yan, Jie
AU  - Yan J
AD  - Department of Obstetrics and Gynecology, Peking University First Hospital, 
      Beijing, China.
FAU - Zhou, Pengxiang
AU  - Zhou P
AD  - Department of Pharmacy, Peking University Third Hospital, Beijing, China.
AD  - Institute for drug evaluation, Peking University Health Science Center, Beijing, 
      China.
FAU - Yang, Huixia
AU  - Yang H
AD  - Department of Obstetrics and Gynecology, Peking University First Hospital, 
      Beijing, China.
LA  - eng
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20221006
PL  - Switzerland
TA  - Front Endocrinol (Lausanne)
JT  - Frontiers in endocrinology
JID - 101555782
RN  - IY9XDZ35W2 (Glucose)
SB  - IM
MH  - Pregnancy
MH  - Female
MH  - Humans
MH  - *Diabetes, Gestational/diagnosis/epidemiology/etiology
MH  - Glucose Tolerance Test
MH  - *Diabetes Mellitus, Type 2/diagnosis/epidemiology/etiology
MH  - *Prediabetic State
MH  - *Pregnancy in Diabetics
MH  - Glucose
PMC - PMC9582268
OTO - NOTNLM
OT  - IADPSG criteria
OT  - gestational diabetes mellitus
OT  - meta-analysis
OT  - systematic review
OT  - type 2 diabetes mellitus
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/10/25 06:00
MHDA- 2022/10/26 06:00
PMCR- 2022/01/01
CRDT- 2022/10/24 04:37
PHST- 2022/08/05 00:00 [received]
PHST- 2022/09/21 00:00 [accepted]
PHST- 2022/10/24 04:37 [entrez]
PHST- 2022/10/25 06:00 [pubmed]
PHST- 2022/10/26 06:00 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fendo.2022.1012244 [doi]
PST - epublish
SO  - Front Endocrinol (Lausanne). 2022 Oct 6;13:1012244. doi: 
      10.3389/fendo.2022.1012244. eCollection 2022.