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Insulin Resistance Syndrome in Women with Prior History of Gestational Diabetes Mellitus

Department of Community Health (A.V.), Brown Medical School, Providence, Rhode Island 02912; Department of Pediatrics (C.M.B.), Division of Endocrinology and Metabolism, Rhode Island Hospital, Brown Medical School, Providence, Rhode Island 02903; and Department of Pediatrics (R.T., B.R.V.), Women and Infants’ Hospital, Brown Medical School, Providence, Rhode Island 02905

Address all correspondence and requests for reprints to: Betty R. Vohr, M.D., Women and Infants’ Hospital, 101 Dudley Street, Providence, Rhode Island 02905. E-mail: . bvohr{at}wihri.org

Abstract

The purpose of this study was to determine the prevalence of insulin resistance syndrome (IRS) and the risk factors for developing IRS among women with a history of gestational diabetes mellitus (GDM), compared with controls over 11 postdelivery years. Assessments of 106 women with a prior history of GDM and 101 controls were done on six occasions from 4–11 yr after delivery. Tests included glucose, insulin, lipids, blood pressure, and body measurements. The risk of IRS was analyzed by Cox regression. The results were that 27.2% of GDM and 8.2% of controls developed IRS by 11 yr after delivery. The hazard of developing IRS was 5.6 times (95% confidence interval = 2.6–12.3) among women with prepregnant obesity (body mass index >27.3 kg/m²), compared with women without prepregnant obesity and 4.4 times (95% confidence interval = 1.7–11.1) in women with a history of GDM, compared with controls. At 11 yr after delivery, the cumulative hazard for developing IRS in the next 2 yr was 26 times higher among GDM with prepregnant obesity, compared with controls without prepregnant obesity. We concluded that obesity and GDM in a prior pregnancy are significant risk factors for developing IRS over time. Early detection of markers of IRS is vital for possible prevention of type 2 diabetes and cardiovascular adverse events in women.

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