Blood sugar control in diabetes after pregnancy

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According to a recent study published in Diabetes Care, it is more difficult for individuals with diabetes to control their blood sugar if they developed diabetes after pregnancy.

Adult-onset diabetes, including gestational diabetes and type 2 diabetes, are significantly associated with increased risk of cardiovascular disease. Racial and ethnic disparities have been associated with adult-onset diabetes because of existing gaps in accessing health care and treatment.

There is little information on the association between gestational diabetes and future type 2 diabetes. To determine how diabetes risk and glycemic control are impacted by factors including race, ethnicity, and gestational diabetes, investigators from the Icahn School of Medicine at Mount Sinai conducted a population-based cohort study.

The study included over 330,000 postpartum women in New York City. Birth records from 2009 to 2017 were consulted for data on comorbidities associated with pregnancy, such as gestational hypertensive disorders and gestational diabetes. Race and ethnicity data was also collected, along with sociodemographic characteristics including age, insurance type, education, and nativity.

Data indicated the risk of developing diabetes within 9 years after delivery is 11 times greater in individuals who developed gestational diabetes during pregnancy than those who did not. This shows the importance of consistent screening for diabetes to potentially change future diabetes speed and progression.

Increased incidence for gestational diabetes was observed among South and Southeast Asian individuals, though the risk of diabetes after delivery was slightly lower in these populations compared to others. 

Issues with controlling glucose levels were associated with diabetes incidence after delivery. These issues were most significant in those with postpartum-onset diabetes after gestational diabetes, and the longest periods for controlling glucose levels were seen in Black and Hispanic individuals.

“In addition to care coordination between obstetric and primary care providers, provider education on the importance of obstetric history-taking is essential in facilitating diabetes awareness and early glycemic control,” said Katharine McCarthy, PhD, MPH, corresponding author of the study.

These results confirmed those of previous studies linking prior gestational diabetes to future diabetes risk. Investigators plan to investigate how environmental factors impact diabetes risk in the future.

Reference

People who develop diabetes after pregnancy are less likely to regain control of blood sugar if they had gestational diabetes. EurekAlert. June 21, 2023. Accessed June 21, 2023. https://www.eurekalert.org/news-releases/993172#:~:text=People%20who%20develop%20diabetes%20following,in%20the%20journal%20Diabetes%20Care