Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysis Article Swipe
Elpida Vounzoulaki
,
Kamlesh Khunti
,
Sophia Abner
,
Bee K. Tan
,
Melanie J. Davies
,
Clare Gillies
·
YOU?
·
· 2020
· Open Access
·
· DOI: https://doi.org/10.1136/bmj.m1361
YOU?
·
· 2020
· Open Access
·
· DOI: https://doi.org/10.1136/bmj.m1361
Objective To estimate and compare progression rates to type 2 diabetes mellitus (T2DM) in women with gestational diabetes mellitus (GDM) and healthy controls. Design Systematic review and meta-analysis. Data sources Medline and Embase between January 2000 and December 2019, studies published in English and conducted on humans. Eligibility criteria for selecting studies Observational studies investigating progression to T2DM. Inclusion criteria were postpartum follow-up for at least 12 months, incident physician based diagnosis of diabetes, T2DM reported as a separate outcome rather than combined with impaired fasting glucose or impaired glucose tolerance, and studies with both a group of patients with GDM and a control group. Results This meta-analysis of 20 studies assessed a total of 1 332 373 individuals (67 956 women with GDM and 1 264 417 controls). Data were pooled by random effects meta-analysis models, and heterogeneity was assessed by use of the I 2 statistic. The pooled relative risk for the incidence of T2DM between participants with GDM and controls was estimated. Reasons for heterogeneity between studies were investigated by prespecified subgroup and meta-regression analyses. Publication bias was assessed by funnel plots and, overall, studies were deemed to have a low risk of bias (P=0.58 and P=0.90). The overall relative risk for T2DM was almost 10 times higher in women with previous GDM than in healthy controls (9.51, 95% confidence interval 7.14 to 12.67, P<0.001). In populations of women with previous GDM, the cumulative incidence of T2DM was 16.46% (95% confidence interval 16.16% to 16.77%) in women of mixed ethnicity, 15.58% (13.30% to 17.86%) in a predominantly non-white population, and 9.91% (9.39% to 10.42%) in a white population. These differences were not statistically significant between subgroups (white v mixed populations, P=0.26; white v non-white populations, P=0.54). Meta-regression analyses showed that the study effect size was not significantly associated with mean study age, body mass index, publication year, and length of follow-up. Conclusions Women with a history of GDM appear to have a nearly 10-fold higher risk of developing T2DM than those with a normoglycaemic pregnancy. The magnitude of this risk highlights the importance of intervening to prevent the onset of T2DM, particularly in the early years after pregnancy. Systematic review registration PROSPERO CRD42019123079.
Related Topics
Concepts
Gestational diabetes
Medicine
Meta-analysis
Confidence interval
Relative risk
Subgroup analysis
Funnel plot
Publication bias
Internal medicine
Type 2 diabetes
Diabetes mellitus
Impaired glucose tolerance
Observational study
Incidence (geometry)
Type 2 Diabetes Mellitus
Obstetrics
Pregnancy
Endocrinology
Gestation
Genetics
Optics
Physics
Biology
Metadata
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.1136/bmj.m1361
- https://www.bmj.com/content/bmj/369/bmj.m1361.full.pdf
- OA Status
- hybrid
- Cited By
- 969
- References
- 60
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W3016572394
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W3016572394Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1136/bmj.m1361Digital Object Identifier
- Title
-
Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysisWork title
- Type
-
reviewOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2020Year of publication
- Publication date
-
2020-05-13Full publication date if available
- Authors
-
Elpida Vounzoulaki, Kamlesh Khunti, Sophia Abner, Bee K. Tan, Melanie J. Davies, Clare GilliesList of authors in order
- Landing page
-
https://doi.org/10.1136/bmj.m1361Publisher landing page
- PDF URL
-
https://www.bmj.com/content/bmj/369/bmj.m1361.full.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
hybridOpen access status per OpenAlex
- OA URL
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https://www.bmj.com/content/bmj/369/bmj.m1361.full.pdfDirect OA link when available
- Concepts
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Gestational diabetes, Medicine, Meta-analysis, Confidence interval, Relative risk, Subgroup analysis, Funnel plot, Publication bias, Internal medicine, Type 2 diabetes, Diabetes mellitus, Impaired glucose tolerance, Observational study, Incidence (geometry), Type 2 Diabetes Mellitus, Obstetrics, Pregnancy, Endocrinology, Gestation, Genetics, Optics, Physics, BiologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
969Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 203, 2024: 237, 2023: 221, 2022: 173, 2021: 108Per-year citation counts (last 5 years)
- References (count)
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60Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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| referenced_works | https://openalex.org/W4251966062, https://openalex.org/W2789732774, https://openalex.org/W2605340160, https://openalex.org/W2164563864, https://openalex.org/W2145739964, https://openalex.org/W2003913413, https://openalex.org/W2146039664, https://openalex.org/W2034523588, https://openalex.org/W2169121457, https://openalex.org/W1997103090, https://openalex.org/W2027829606, https://openalex.org/W2021441410, https://openalex.org/W2155326729, https://openalex.org/W2619129282, https://openalex.org/W2049624032, https://openalex.org/W2943433905, https://openalex.org/W2576440140, https://openalex.org/W1979423827, https://openalex.org/W2116475791, https://openalex.org/W2107328434, https://openalex.org/W2169033223, https://openalex.org/W1562569437, https://openalex.org/W2606784636, https://openalex.org/W2063430126, https://openalex.org/W2901594847, https://openalex.org/W2100574091, https://openalex.org/W2080670873, https://openalex.org/W2015131076, https://openalex.org/W1989014932, https://openalex.org/W1593944395, https://openalex.org/W2138596165, https://openalex.org/W2099450086, https://openalex.org/W2607448764, https://openalex.org/W2782684935, https://openalex.org/W2654905359, https://openalex.org/W2107892956, https://openalex.org/W2165047940, https://openalex.org/W2118703698, https://openalex.org/W4244773019, https://openalex.org/W2141762558, https://openalex.org/W1994529958, https://openalex.org/W2117147552, https://openalex.org/W1958058634, https://openalex.org/W1974600972, https://openalex.org/W2948416806, https://openalex.org/W2614593778, https://openalex.org/W2591578423, https://openalex.org/W2017442836, https://openalex.org/W2531269403, https://openalex.org/W2093639829, https://openalex.org/W2141904558, https://openalex.org/W2905916237, https://openalex.org/W2324898875, https://openalex.org/W3022903699, https://openalex.org/W2071551339, https://openalex.org/W1598602811, https://openalex.org/W2118202495, https://openalex.org/W2134293572, https://openalex.org/W1966376723, https://openalex.org/W2588681363 |
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| abstract_inverted_index.I | 146 |
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