Gestational diabetes and subsequent development of NIDDM in aboriginal women of northwestern Ontario

Int J Circumpolar Health. 1998;57 Suppl 1:355-8.

Abstract

Objectives: To determine (1) the risk of development of non-insulin-dependent diabetes mellitus (NIDDM) in women with a previous history of gestational diabetes mellitus (GDM), (2) the average duration between diagnoses of GDM and NIDDM, (3) various modes of presentation, and (4) adequacy of follow-up post diagnosis of GDM.

Methods: A retrospective chart review of women diagnosed with GDM in the Sioux Lookout Zone between 1985-1995. There were 4,211 pregnancies and 332 women with a diagnosis of GDM. Sixty-one charts were randomly selected. Both GDM and NIDDM were defined according to World Health Organization standards.

Results: Seventy percent of the women with GDM went on to develop NIDDM. The average duration between diagnosis of GDM and diagnosis of NIDDM was three years. Greater than 70% of the women developed NIDDM within four years post diagnosis of GDM. The majority presented with asymptomatic hyperglycemia (88%); 3% presented with acidosis; 6% presented with symptoms of polydipsia and polyuria; and 3% presented with abnormal weight gain. Specific physician-requested follow-up after six weeks postpartum occurred in only 38% of the cases. However six-week follow-up occurred in 41%, a yearly follow-up occurred in 61% of the women, and 81% of the women had some sort of follow-up post diagnosis of GDM.

Conclusions: The risk of developing NIDDM after GDM is very high in Aboriginal women of the Sioux Lookout Zone. There is an urgent need for a structured follow-up program for this group of high-risk women. Furthermore, the offspring of these pregnancies should be a focus for follow-up and preventive programs.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • American Native Continental Ancestry Group / statistics & numerical data*
  • Comorbidity
  • Diabetes Mellitus, Type 2 / ethnology*
  • Diabetes, Gestational / ethnology*
  • Female
  • Humans
  • Incidence
  • Northwest Territories / epidemiology
  • Ontario / epidemiology
  • Pregnancy
  • Pregnancy Outcome
  • Retrospective Studies
  • Risk Factors