后续妊娠
后续妊娠中,30% 至 84% 会复发妊娠糖尿病。[17]Kim C, Berger DK, Chamany S. Recurrence of gestational diabetes mellitus: a systematic review. Diabetes Care. 2007 May;30(5):1314-9.http://care.diabetesjournals.org/content/30/5/1314.full 妊娠期糖尿病 (GDM) 复发的危险因素包括高龄、体重指数 (BMI) 增加以及两次妊娠之间体重增加较多。[93]Schwartz N, Nachum Z, Green MS. Risk factors of gestational diabetes mellitus recurrence: a meta-analysis. Endocrine. 2016 Sep;53(3):662-71.
2 型糖尿病的发生
最终大多数妊娠糖尿病女性会发生 2 型糖尿病。[94]Kim C, Newton KM, Knopp RH. Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care. 2002 Oct;25(10):1862-8.http://care.diabetesjournals.org/content/25/10/1862.full 对糖尿病预防项目 (Diabetes Prevention Program) 的因果分析表明,主要为自我报告妊娠糖尿病史的中年女性接受强化生活方式干预或使用二甲双胍后,糖尿病发病率大约降低 50%。[95]Ratner RE, Christophi CA, Metzger BE, et al; Diabetes Prevention Program Research Group. Prevention of diabetes in women with a history of gestational diabetes: effects of metformin and lifestyle interventions. J Clin Endocrinol Metab. 2008 Dec;93(12):4774-9.http://press.endocrine.org/doi/10.1210/jc.2008-0772 十年风险大约为 50%。[94]Kim C, Newton KM, Knopp RH. Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care. 2002 Oct;25(10):1862-8.http://care.diabetesjournals.org/content/25/10/1862.full 根据不同研究之间的方法差异加以调整后,结果提示不同族裔之间,妊娠糖尿病后发生 2 型糖尿病的风险大致相等。