Abstract：
OBJECTIVE: To evaluate and compare the risk of progressing to type 2 diabetes (T2DM) based on the timing of gestational diabetes (GDM) diagnosis during pregnancy.
METHODS: Retrospective analysis of pregnant individuals with gestational diabetes and post-pregnancy follow up. Data sourced from Meuhedet HMO\'s computerized laboratory system, cross-tabulated with the Israeli National Diabetes Registry. The cohort was divided into normoglycemic, early GDM (diagnosed by fasting plasma glucose 92-125 mg/dL (5.1-6.9 mM) at < 15 weeks), 2nd trimester GDM (diagnosed at 24-28 weeks), and late GDM (diagnosed after 29 weeks). Statistics included univariate analysis followed by survival analysis. Risk was further analyzed for individuals by obesity status.
RESULTS: 75,459 entered the analysis: 90 % normoglycemic, 7.9 % early GDM, 1.4 % 2nd trimester GDM, and 0.7 % late GDM. Median post-pregnancy follow-up time was 4.3 (IQR 3.3-5.1). 2nd trimester GDM showed the highest T2DM risk annually after pregnancy. Cox regression analysis, adjusted for confounders, revealed a significantly higher T2DM risk for 2nd-trimester GDM compared to early and late GDM. Late GDM did not confer additional significant T2DM risk. Stratification by obesity status highlighted that early GDM increased the risk of T2DM only in individuals without obesity.
CONCLUSIONS: GDM diagnosis timing significantly impacts T2DM risk. 2nd trimester GDM carries the highest T2DM risk.
METHODS: Retrospective analysis of pregnant individuals with gestational diabetes and post-pregnancy follow up. Data sourced from Meuhedet HMO\'s computerized laboratory system, cross-tabulated with the Israeli National Diabetes Registry. The cohort was divided into normoglycemic, early GDM (diagnosed by fasting plasma glucose 92-125 mg/dL (5.1-6.9 mM) at < 15 weeks), 2nd trimester GDM (diagnosed at 24-28 weeks), and late GDM (diagnosed after 29 weeks). Statistics included univariate analysis followed by survival analysis. Risk was further analyzed for individuals by obesity status.
RESULTS: 75,459 entered the analysis: 90 % normoglycemic, 7.9 % early GDM, 1.4 % 2nd trimester GDM, and 0.7 % late GDM. Median post-pregnancy follow-up time was 4.3 (IQR 3.3-5.1). 2nd trimester GDM showed the highest T2DM risk annually after pregnancy. Cox regression analysis, adjusted for confounders, revealed a significantly higher T2DM risk for 2nd-trimester GDM compared to early and late GDM. Late GDM did not confer additional significant T2DM risk. Stratification by obesity status highlighted that early GDM increased the risk of T2DM only in individuals without obesity.
CONCLUSIONS: GDM diagnosis timing significantly impacts T2DM risk. 2nd trimester GDM carries the highest T2DM risk.
摘要：
目的：根据妊娠期糖尿病（GDM）的诊断时机，评估和比较妊娠期2型糖尿病（T2DM）的进展风险。
方法：回顾性分析妊娠糖尿病患者的妊娠及妊娠后随访。数据来自MeuhedetHMO的计算机化实验室系统，与以色列国家糖尿病登记处交叉列表。该队列分为血糖正常，早期GDM（在<15周时通过空腹血糖92-125mg/dL（5.1-6.9mM）诊断），妊娠中期GDM（诊断为24-28周），和晚期GDM（29周后诊断）。统计学包括单变量分析和随后的生存分析。通过肥胖状态进一步分析个体的风险。
结果：75,459进入分析：90%血糖正常，7.9%早期GDM，1.4%孕中期GDM，和0.7%的晚期GDM。妊娠后随访时间中位数为4.3（IQR3.3-5.1）。妊娠中期GDM在妊娠后每年表现出最高的T2DM风险。Cox回归分析，针对混杂因素进行了调整，与早期和晚期GDM相比，妊娠中期GDM的T2DM风险明显更高。晚期GDM并不赋予额外的显著T2DM风险。肥胖状态的分层表明，早期GDM仅在没有肥胖的个体中增加T2DM的风险。
结论：GDM诊断时机显著影响T2DM风险。妊娠中期GDM具有最高的T2DM风险。
方法：回顾性分析妊娠糖尿病患者的妊娠及妊娠后随访。数据来自MeuhedetHMO的计算机化实验室系统，与以色列国家糖尿病登记处交叉列表。该队列分为血糖正常，早期GDM（在<15周时通过空腹血糖92-125mg/dL（5.1-6.9mM）诊断），妊娠中期GDM（诊断为24-28周），和晚期GDM（29周后诊断）。统计学包括单变量分析和随后的生存分析。通过肥胖状态进一步分析个体的风险。
结果：75,459进入分析：90%血糖正常，7.9%早期GDM，1.4%孕中期GDM，和0.7%的晚期GDM。妊娠后随访时间中位数为4.3（IQR3.3-5.1）。妊娠中期GDM在妊娠后每年表现出最高的T2DM风险。Cox回归分析，针对混杂因素进行了调整，与早期和晚期GDM相比，妊娠中期GDM的T2DM风险明显更高。晚期GDM并不赋予额外的显著T2DM风险。肥胖状态的分层表明，早期GDM仅在没有肥胖的个体中增加T2DM的风险。
结论：GDM诊断时机显著影响T2DM风险。妊娠中期GDM具有最高的T2DM风险。
