Dr Vivian Lee1,2, Dr Amanda Beech3, Prof Angela Makris2,4, A/Prof Clare Arnott1,2,5, Dr Janani Shanthosh1, Ms. Katherine Donges6, Prof Anushka Patel1,2, Prof Amanda Henry1,7,8
1The George Institute for Global Health, Sydney, Australia, 2Faculty of Medicine, University of New South Wales, Kensington 2052, Australia, 3Royal Hospital for Women and Prince of Wales Hospital, Randwick 2031, Australia, 4School of Medicine, Western Sydney University, Campbelltown 2560, Australia, 5Department of Cardiology, Royal Prince Alfred Hospital, Newtown 2042, Australia, 6Charles Sturt University, Wagga Wagga 2678, Australia, 7Department of Women’s and Children’s Health, St George Hospital, Kogarah 2217, Australia, 8Discipline of Women’s Health, School of Clinical Medicine, UNSW Medicine and Health, Kensington 2052, Australia
Biography:
A Research Fellow at TGI and a Conjoint-lecturer at UNSW. Her research interests include the prevention of NCDs with a particular emphasis on leveraging physical activity. Currently working to identify effective strategies to reduce the long-term risk of diabetes in postpartum-women, using a comprehensive approach of pharmacotherapy and physical activity.
Abstract:
Background: Gestational Diabetes Mellitus (GDM) is a well-established independent risk factor for Type 2 Diabetes Mellitus (T2DM). This study aimed to 1) measure the prevalence and identify predictors of persisting dysglycaemia among Australian women with recent GDM 2) understand women's views regarding their risk of future T2DM and preventive strategies 3) examine the feasibility of post-GDM preventive pharmacotherapy.
Methods: A retrospective cohort study of women who experienced a GDM affected pregnancy and gave birth in three Sydney Hospitals (2018-2021). Participants completed an online questionnaire and an oral glucose tolerance test (OGTT) to assess their current glycaemic status. Relevant information was extracted from their medical records.
Results: The 505 consenting women had a mean age of 37.3±4.9 years, mean BMI of 27.5±6.4 kg/m2 and were 2.9±1.4 years postpartum. Three (0.7%) and 92 women (21%) reported being diagnosed with T2DM or dysglycaemia respectively since the index pregnancy.
Of the 248 (49.1%) women who completed an OGTT, 4% (n=9) had T2DM, 11% (n=27) were dysglycaemic and 85% (n=212) were normoglycaemic. Maternal age (OR:1.08/ 1 year increase; 95% CI 1.00-1.17, p=0.04) and time postpartum (OR:1.36/1 year; 95% CI 1.07-1.97, p=0.012) were associated with increased rates of dysglycaemia.
On a 10-point scale (10=highest), self-reported risk of developing T2DM in the next 5 years was 5.1±2.5 and concern about developing T2DM was 6.5±2.8. Women strongly agreed (8.8±1.7) that preventing or delaying T2DM onset was very important.
Women reported being very likely to take on lifestyle changes (4.2±0.9/5), and less likely to take medication for T2DM prevention (2.9±1.7/5). However, 68-77% were willing to take medications to prevent T2DM, for as long as necessary (49%) through tablets or capsules (52%).
Discussion: Age and time post-partum were associated with increased dysglycaemia risk in women with recent GDM. While lifestyle changes are preferred, women are open to T2DM-preventing pharmacotherapy.
Keywords
Prevention, post-partum, glycaemic status