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Gestational diabetes tied to long-term risk of type 2 diabetes

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Gestational diabetes markedly and persistently increases the risk of future type 2 diabetes, according to a report in the May 23rd issue of The Lancet.

The findings, which stem from a review and meta-analysis of published studies, suggest that women with gestational diabetes are roughly seven times more likely to develop type 2 diabetes during their lifetime than are women without this pregnancy complication.

“Increased awareness of the magnitude and timing of the risk of type 2 diabetes after gestational diabetes among patients and clinicians could provide an opportunity to test and use dietary, lifestyle, and pharmacological interventions that might prevent or delay the onset of type 2 diabetes in affected women,” Dr. David Williams and co-authors note.

In searching Embase and Medline with terms such as “gestational diabetes” and “diabetic pregnancy,” Dr. Williams, from University College London, and colleagues identified 20 relevant cohort studies that included 675,455 women and 10,859 type 2 diabetic events.

In each of the studies, the presence of gestational diabetes increased the risk of type 2 diabetes, and on the combined analysis, the relative risk was 7.43. The relative risks, however, varied widely from one study to the next with a low of 1.32 to a high of 47.25. In the largest study, which featured nearly 660,000 women, the relative risk was 12.66.

There is enough evidence to conclude that gestational diabetes is an important predictor of future type 2 diabetes, Dr. Rhonda Bentley-Lewis, from Brigham and Women’s Hospital, Boston, comments in a related editorial. The key now is to make sure that this information reaches clinicians so that preventive measures can be applied to women with gestational diabetes.

“In view of the compelling data that link gestational diabetes to the development of type 2 diabetes, we as clinicians are afforded the rare opportunity to alter the natural course of disease and change the future of women today,” she adds.

Lancet 2009;373:1738-1740,1773-1779.