Type 2 diabetes after a pregnancy with gestational diabetes among First Nations women in Australia: The PANDORA study

Anna J. Wood, Jacqueline A. Boyle, Elizabeth L.M. Barr, Federica Barzi, Matthew J.L. Hare, Angela Titmuss, Danielle K. Longmore, Elizabeth Death, Joanna Kelaart, Marie Kirkwood, Sian Graham, Christine Connors, Elizabeth Moore, Kerin O'Dea, Jeremy J.N. Oats, Harold D. McIntyre, Paul Z. Zimmet, Zhong X. Lu, Alex Brown, Jonathan E. ShawLouise J. Maple-Brown

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Abstract

Aims: To determine among First Nations and Europid pregnant women the cumulative incidence and predictors of postpartum type 2 diabetes and prediabetes and describe postpartum cardiovascular disease (CVD) risk profiles. 

Methods: PANDORA is a prospective longitudinal cohort of women recruited in pregnancy. Ethnic-specific rates of postpartum type 2 diabetes and prediabetes were reported for women with diabetes in pregnancy (DIP), gestational diabetes (GDM) or normoglycaemia in pregnancy over a short follow-up of 2.5 years (n = 325). Pregnancy characteristics and CVD risk profiles according to glycaemic status, and factors associated with postpartum diabetes/prediabetes were examined in First Nations women. 

Results: The cumulative incidence of postpartum type 2 diabetes among women with DIP or GDM were higher for First Nations women (48%, 13/27, women with DIP, 13%, 11/82, GDM), compared to Europid women (nil DIP or GDM p < 0.001). Characteristics associated with type 2 diabetes/prediabetes among First Nations women with GDM/DIP included, older age, multiparity, family history of diabetes, higher glucose values, insulin use and body mass index (BMI). 

Conclusions: First Nations women experience a high incidence of postpartum type 2 diabetes after GDM/DIP, highlighting the need for culturally responsive policies at an individual and systems level, to prevent diabetes and its complications.

Original languageEnglish
Article number109092
Pages (from-to)1-10
Number of pages10
JournalDiabetes Research and Clinical Practice
Volume181
DOIs
Publication statusPublished - Nov 2021

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