Type 2 diabetes after a pregnancy with gestational diabetes among first nations women in Australia: The PANDORA study.

• Published in: Diabetes Research and Clinical Practice
• Main Authors: Wood, Anna J, Boyle, Jacqueline A, Barr, Elizabeth L M, Barzi, Federica, Hare, Matthew J L, Titmuss, Angela, Longmore, Danielle K, Death, Elizabeth, Kelaart, Joanna, Kirkwood, Marie, Graham, Sian, Connors, Christine, Moore, Elizabeth, O'Dea, Kerin, Oats, Jeremy J N, McIntyre, Harold D, Zimmet, Paul Z, Lu, Zhong X, Brown, Alex, Shaw, Jonathan E, Maple-Brown, Louise J
• Format: Article in Journal/Newspaper
• Language: English
• Published: Ireland 2021
• Subjects: Clayton; Menzies; First Nations
• Online Access: https://hdl.handle.net/10137/11939; https://doi.org/10.1016/j.diabres.2021.109092; https://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/34653565

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. Menzies School of Health Research, Charles Darwin University, John Mathews Building, Royal Darwin Hospital Campus, 58 Rocklands Drive, Tiwi, NT 0810, Australia; Department of Endocrinology, Royal Darwin Hospital, 58 Rocklands Drive, Tiwi, NT 0810, Australia. Electronic address: [e-mail]. Menzies School of Health Research, Charles Darwin University, John Mathews Building, Royal Darwin Hospital Campus, 58 Rocklands Drive, Tiwi, NT 0810, Australia; Monash Centre for Health Research and Implementation, Monash University, 43-51 Kanooka Grove, Clayton, Vic 3168, Australia. Menzies School of Health Research, ...