Women Who Develop Diabetes Later in Life Have Diabetes-Associated Complications during Preceding Pregnancies

DOI: 10.4236/jdm.2014.44047   PDF   HTML   XML   3,908 Downloads   4,507 Views   Citations


Aims: The aim of this study was to explore the outcome of previous pregnancies in women who later developed diabetes. Method: A Swedish population based cohort of 23,524 women from 1990 aged 45 - 85 yr in 2000 when they self reported health status in a questionnaire. To identify which women who delivered we matched it towards the Swedish Medical Birth Register (SMBR). We identified 14,856 women who appeared in both registers and a total of 30,559 new birth registrations. Among these women 216 had developed diabetes after their pregnancy (ies) and additional twelve women were reported to have gestational diabetes in SMBR. These 228 women and their 455 pregnancies were compared with women without diabetes. Results: Women who developed diabetes later in life were already heavier before the pregnancy (ies) (69.2 ± 13.9 vs. 63.2 ± 10.3 kg; p < 0.001) but had less weight gain during pregnancy (13.3 ± 5.4 vs. 14.1 ± 4.6 kg; p = 0.03) compared to women without diabetes. Newborns to women with diabetes diagnosed any time after pregnancy had higher birth weight (3602 vs. 3507 g; p < 0.001), were more often large for gestational age (10.5% vs. 3.1%; p < 0.001), were more often delivered by caesarean section (4.8% vs. 2.7%; p = 0.005) and had lower Apgar scores. Conclusion: Women who developed diabetes after pregnancy had hyperglycaemia-associated complications during their pregnancy (ies). We therefore postulated that women with Type 2 diabetes are mainly recruited from women with earlier GDM. A general screening for GDM should identify these women and enable life style intervention that may prevent or at least delay diabetes.

Share and Cite:

Moll, U. , Olsson, H. and Landin-Olsson, M. (2014) Women Who Develop Diabetes Later in Life Have Diabetes-Associated Complications during Preceding Pregnancies. Journal of Diabetes Mellitus, 4, 341-349. doi: 10.4236/jdm.2014.44047.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Aberg, A.E.B., Jonsson, E.K., Eskilsson, I., Landin-Olsson, M. and Frid, A.H. (2002) Predictive Factors of Developing Diabetes Mellitus in Women with Gestational Diabetes. Acta Obstetricia et Gynecologica Scandinavica, 81, 11-16. http://dx.doi.org/10.1046/j.0001-6349.2001.00000.x
[2] Feig, D.S., Zinman, B., Wang, X. and Hux, J.E. (2008) Risk of Development of Diabetes Mellitus after Diagnosis of Gestational Diabetes. CMAJ, 179, 229-234. http://dx.doi.org/10.1503/cmaj.080012
[3] Damm, P. (2009) Future Risk of Diabetes in Mother and Child after Gestational Diabetes Mellitus. International Journal of Gynecology Obstetrics, 104, S25-S26.
[4] Pedersen, J. (1952) Course of Diabetes during Pregnancy. Acta Endocrinology, 9, 342-364.
[5] Wood, S.L., Jick, H. and Sauve, R. (2003) The Risk of Stillbirth in Pregnancies before and after the Onset of Diabetes. Diabetic Medicine, 20, 703-707.
[6] Aberg, A., Rydhstrom, H. and Frid, A. (2001) Impaired Glucose Tolerance Associated with Adverse Pregnancy Outcome: A Population-Based Study in Southern Sweden. American Journal of Obstetrics Gynecology, 184, 77-83. http://dx.doi.org/10.1067/mob.2001.108085
[7] Anderberg, E., K?llén, K., Berntorp, K., Frid, A. and Aberg, A. (2007) A Simplified Oral Glucose Tolerance Test in Pregnancy: Compliance and Results. Acta Obstetricia et Gynecologica Scandinavica, 86, 1432-1436. http://dx.doi.org/10.1080/00016340701532444
[8] Anderberg, E., Kollén, K. and Berntorp, K. (2010) The Impact of Gestational Diabetes Mellitus on Pregnancy Outcome Comparing Different Cut-Off Criteria for Abnormal Glucose Tolerance. Acta Obstetricia et Gynecologica Scandinavica, 89, 1532-1537.
[9] Weinert, L.S. (2010) International Association of Diabetes and Pregnancy Study Groups Recommendations on the Diagnosis and Classification of Hyperglycemia in Pregnancy: Comment to the International Association of Diabetes and Pregnancy Study Groups Consensus Panel. Diabetes Care, 33, e97-e98. http://dx.doi.org/10.2337/dc10-0544
[10] Jensen, D.M., Korsholm, L., Ovesen, P., Beck-Nielsen, H., Molsted-Pedersen, L. and Damm, P. (2008) Adverse Pregnancy Outcome in Women with Mild Glucose Intolerance: Is There a Clinically Meaningful Threshold Value for Glucose? Acta Obstetricia et Gynecologica Scandinavica, 87, 59-62.
[11] Metzger, B.E., Lowe, L.P., Dyer, A.R., Trimble, E.R., Chaovarindr, U., et al., HAPO Study Cooperative Research Group (2008) Hyperglycemia and Adverse Pregnancy Outcomes. The New England Journal of Medicine, 358, 1991-2002. http://dx.doi.org/10.1056/NEJMoa0707943
[12] HAPO Study Cooperative Research Group (2009) Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: Associations with Neonatal Anthropometrics. Diabetes, 58, 453-459.
[13] Crowther, C.A., Hiller, J.E., Moss, J.R., McPhee, A.J., Jeffries, W.S., Robinson, J.S., et al. (2005) Effect of Treatment of Gestational Diabetes Mellitus on Pregnancy Outcomes. The New England Journal of Medicine, 352, 2477-2486. http://dx.doi.org/10.1056/NEJMoa042973
[14] Landon, M.B., Spong, C.Y., Thom, E., Carpenter, M.W., Ramin, S.M., Casey, B., et al. (2009) A Multicenter, Randomized Trial of Treatment for Mild Gestational Diabetes. The New England Journal of Medicine, 361, 1339-1348. http://dx.doi.org/10.1056/NEJMoa0902430
[15] Horvath, K., Koch, K., Jeitler, K., Matyas, E., Bender, R., Bastian, H., et al. (2010) Effects of Treatment in Women with Gestational Diabetes Mellitus: Systematic Review and Meta-Analysis. BMJ, 340, c1395. http://dx.doi.org/10.1136/bmj.c1395
[16] Buckley, B.S., Harreiter, J., Damm, P., Corcoy, R., Chico, A., Simmons, D., et al. (2012) Gestational Diabetes Mellitus in Europe: Prevalence, Current Screening Practice and Barriers to Screening. A Review. Diabetic Medicine, 29, 844-854. http://dx.doi.org/10.1111/j.1464-5491.2011.03541.x
[17] Hartling, L., Dryden, D.M., Guthrie, A., Muise, M., Vandermeer, B. and Donovan, L. (2014) Diagnostic Thresholds for Gestational Diabetes and Their Impact on Pregnancy Outcomes: A Systematic Review. Diabetic Medicine, 31, 319-331. http://dx.doi.org/10.1111/dme.12357
[18] Lindqvist, P.G., Olsson, H. and Landin-Olsson, M. (2010) Are Active Sun Exposure Habits Related to Lowering Risk of Type 2 Diabetes Mellitus in Women, a Prospective Cohort Study? Diabetes Research and Clinical Practice, 90, 109-114. http://dx.doi.org/10.1016/j.diabres.2010.06.007
[19] HAPO Study Cooperative Research Group (2010) Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) Study: Associations with Maternal Body Mass Index. BJOG, 117, 575-584.
[20] Wikstrom, I., Axelsson, O. and Bergstrom, R. (1991) Maternal Factors Associated with High Birth Weight. Acta Obstetricia et Gynecologica Scandinavica, 70, 55-61.
[21] Cedergren, M. (2006) Effects of Gestational Weight Gain and Body Mass Index on Obstetric Outcome in Sweden. International Journal of Gynecology Obstetrics, 93, 269-274.
[22] Ostlund, I., Hanson, U., Bj?rklund, A., Hjertberg, R., Eva, N., Nordlander, E., et al. (2003) Maternal and Fetal Outcomes If Gestational Impaired Glucose Tolerance Is Not Treated. Diabetes Care, 26, 2107-2111. http://dx.doi.org/10.2337/diacare.26.7.2107
[23] Fadl, H.E., Ostlund, I.K.M., Magnuson, A.F.K. and Hanson, U.S.B. (2010) Maternal and Neonatal Outcomes and Time Trends of Gestational Diabetes Mellitus in Sweden from 1991 to 2003. Diabetic Medicine, 27, 436-441. http://dx.doi.org/10.1111/j.1464-5491.2010.02978.x
[24] Tovar, A., Chasan-Taber, L., Eggleston, E. and Oken, E. (2011) Postpartum Screening for Diabetes among Women with a History of Gestational Diabetes Mellitus. Preventing Chronic Disease, 8, A124.
[25] Bihan, H., Cosson, E., Khiter, C., Vittaz, L., Faghfouri, F., Leboeuf, D., et al. (2014) Factors Associated with Screening for Glucose Abnormalities after Gestational Diabetes Mellitus: Baseline Cohort of the Interventional IMPACT Study. Diabetes Metabolism, 40, 151-157.
[26] Nilsson, C., Carlsson, A. and Landin-Olsson, M. (2014) Increased Risk for Overweight among Swedish Children Born to Mothers with Gestational Diabetes Mellitus. Pediatric Diabetes, 15, 57-66. http://dx.doi.org/10.1111/pedi.12059
[27] Morgan, K., Rahman, M., Atkinson, M., Zhou, S.-M., Hill, R., Khanom, A., et al. (2013) Association of Diabetes in Pregnancy with Child Weight at Birth, Age 12 Months and 5 Years—A Population-Based Electronic Cohort Study. PLoS ONE, 8, e79803. http://dx.doi.org/10.1371/journal.pone.0079803
[28] Hiersch, L. and Yogev, Y. (2014) Impact of Gestational Hyperglycemia on Maternal and Child Health. Current Opinion in Clinical Nutrition and Metabolic Care, 17, 255-260.
[29] Ferrara, A. and Ehrlich, S.F. (2011) Strategies for Diabetes Prevention before and after Pregnancy in Women with GDM. Current Diabetes Reviews, 7, 75-83.
[30] Rautio, N., Jokelainen, J., Korpi-Hyovalti, E., Oksa, H., Saaristo, T., Peltonen, M., et al. (2014) Lifestyle Intervention in Prevention of Type 2 Diabetes in Women with and without a History of Gestational Diabetes Mellitus: One-Year Results of the FIN-D2D Project. Journal of Women’s Health (Larchmt), 23, 506-512. http://dx.doi.org/10.1089/jwh.2013.4520

comments powered by Disqus

Copyright © 2020 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.