The impact of ethnicity on glucose regulation and the metabolic syndrome following gestational diabetes

Diabetologia. 2006 Jan;49(1):36-40. doi: 10.1007/s00125-005-0058-6. Epub 2005 Dec 9.

Abstract

Aims/hypothesis: We assessed the impact of ethnic origin on metabolism in women following gestational diabetes mellitus (GDM).

Materials and methods: Glucose regulation and other features of the metabolic syndrome were studied at 20.0 (18.2-22.1) months (geometric mean [95% CI]) post-partum in women with previous GDM (185 European, 103 Asian-Indian, 80 African-Caribbean). They were compared with the same features in 482 normal control subjects who had normal glucose regulation during and following pregnancy.

Results: Impaired glucose regulation or diabetes by WHO criteria were present in 37% of women with previous GDM (diabetes in 17%), especially in those of African-Caribbean and Asian-Indian origin (50 and 44%, respectively vs 28% in European, p=0.009). BMI, waist circumference, diastolic blood pressure, fasting triglyceride and insulin levels, and insulin resistance by homeostatic model assessment (HOMA), were increased following GDM (p<0.001 for all, vs control subjects). Where glucose regulation was normal following GDM, basal insulin secretion (by HOMA) was high (p<0.001 vs control subjects). Irrespective of glucose regulation in pregnancy, Asian-Indian origin was associated with high triglyceride and low HDL cholesterol levels, and African-Caribbean with increased waist circumference, blood pressure, and insulin levels, together with insulin resistance and low triglyceride concentrations. Nonetheless, the GDM-associated features were consistent within each ethnic group. The metabolic syndrome by International Diabetes Federation criteria was present in 37% of women with previous GDM, especially in non-Europeans (Asian-Indian 49%, African-Caribbean 43%, European 28%, p=0.001), and in 10% of controls.

Conclusions/interpretation: Following GDM, abnormal glucose regulation and the metabolic syndrome are common, especially in non-European women, indicating a need for diabetes and cardiovascular disease prevention strategies.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Algorithms
  • Blood Glucose / metabolism*
  • Blood Pressure
  • Body Mass Index
  • Diabetes, Gestational / epidemiology*
  • Diabetes, Gestational / physiopathology
  • England / epidemiology
  • Ethnic Groups / classification*
  • Fasting
  • Female
  • Humans
  • Insulin / blood
  • Lipids / blood
  • Metabolic Syndrome / epidemiology*
  • Metabolic Syndrome / etiology
  • Metabolic Syndrome / physiopathology
  • Pregnancy
  • Retrospective Studies

Substances

  • Blood Glucose
  • Insulin
  • Lipids