PASADENA, Calif. — African-American women who develop gestational diabetes mellitus during pregnancy face a 52% increased risk of developing diabetes in the future, compared with white women who develop GDM during pregnancy, according to a Kaiser Permanente study published online Thursday in the journal Diabetologia.
African-American women are less likely to develop GDM during pregnancy, but for those who were diagnosed with having GDM, their future overt diabetes risk is the greatest among all race/ethnic groups. Although Asian/Pacific Islander women are much more likely to develop GDM than African-American or non-Hispanic white women, their future diabetes risk after GDM is similar to that for non-Hispanic white women, the study found.
"Race and ethnicity should be considered among the risk factors for Type 2 diabetes when physicians and nurses counsel women about their risk of developing diabetes after a pregnancy complicated by GDM," stated study lead author Anny Xiang, a senior research scientist at the Kaiser Permanente Department of Research and Evaluation.
This study, which consisted of 77,666 ethnically diverse women who gave birth from 1995 to 2009, found that African-American women who developed GDM had the highest risk of developing overt diabetes in the future in comparison with women from other racial and ethnic groups. For African-American women, their risk of developing diabetes was almost 10 times greater if they had developed GDM during a past pregnancy than if they did not develop GDM. In comparison, the relative risks were 6.5 times greater for non-Hispanic White women, 7.7 times greater for Hispanic women and 6.3 times greater in Asian/Pacific Islander women.
GDM is defined as glucose intolerance that typically occurs during the second or third trimester and most prevalent in Asian/Pacific Islanders (17% in the study population) and least prevalent in African-American women (7% in the study population). GDM can lead to such complications as early delivery and cesarean delivery and increases the baby's risk of developing diabetes, obesity and metabolic disease later in life. GDM typically goes away after pregnancy but risk of overt diabetes in the future is a concern.
"All women diagnosed with GDM should be screened for diabetes soon after their delivery and subsequently at regular intervals," Xiang said. "These women would benefit from lifestyle changes such as changes in diet and increases in physical activity that can reduce diabetes risk. … Our study shows that prevention messages, while important to all women who develop GDM, are particularly important for African-American women."