Gestational diabetes mellitus as a risk factor for future Type-2 diabetes mellitus: An experience from a tertiary care diabetes hospital, Karachi - Pakistan

Objective : To evaluate the history of gestational diabetes mellitus and other risk factors in women presenting with Type -2 diabetes mellitus at a tertiary care hospital. Methods : This cross-sectional study was carried out at Baqai Institute of Diabetology & Endocrinology (BIDE), Baqai Medical University (BMU), Karachi -Pakistan from July 2019 to May 2022. Women with Type -2 diabetes mellitus (T2DM) visiting outpatient department of BIDE with a previous history of GDM were recruited. Details were obtained on predesigned questionnaire after taking informed written consent. Results : A total of 378 women who had a prior history of GDM were included. Mean age (years) was 43.53 +/- 10.17. Mostly women were obese (BMI = 30.53 +/- 6.08) and have sedentary lifestyle. Mean HbA1c (%) was 9.08 +/- 2.24. This study found family history of T2DM and hypertension were common risk factors in women with GDM history. Mostly, women were diagnosed as GDM during 2 nd trimester 153(42%) and was mainly seen in multiparous women (occur in 4 th and above pregnancy). We found hypertension as common complication during pregnancy. Around 46% women developed T2DM within one year of GDM diagnosis, and 29.6% between one to five years. Conclusion : Majority of women with GDM developed T2DM within five years of diagnosis. The potential associated risk factors were age, family history of diabetes, insulin use during pregnancy, trimester of GDM diagnosis, and hypertension during pregnancy. Awareness and life style modifications along with regular post-partum follow up with screening for T2DM should be part of GDM management to prevent or delay the occurrence of this serious complication.