Diabetes in Pregnancy Raises Risk of Future Diabetes

Oct. 21 2011 -- African-American women who develop pregnancy-related diabetes, called gestational diabetes, are more likely to develop diabetes in the future, a new study shows.

According to the American Diabetes Association, gestational diabetes affects 18% of pregnancies. Some women with gestational diabetes go on to develop type 2 diabetes years later.

African-American women are less likely than other women to develop gestational diabetes in the first place. When they do, they are 52% more likely to be diagnosed with diabetes in the future than white women who have gestational diabetes.

The new study is published in Diabetologia.

"Women who have gestational diabetes should be advised about diet and exercise and to watch out for other diabetes risk factors. And this is particularly important for African-American women," says study researcher Anny H. Xiang, MD. She is a senior research scientist at the Kaiser Permanente Department of Research and Evaluation in Pasadena, Calif.

The reasons that African-American women face a higher risk for developing diabetes in the future are not known. But the prevention message is clear. "These women need screening to see if their blood sugar or glucose is elevated, and they should engage in more exercise and watch their weight," Xiang says.

Exercise and weight loss can lower diabetes risk.

For the study, researchers reviewed information on 77,666 women who gave birth from 1995 to 2009. An African-American woman's risk of developing diabetes was almost 10 times greater if she had developed gestational diabetes during a past pregnancy than if she did not.

By contrast, non-Hispanic white women were 6.5 times more likely to develop diabetes if they had gestational diabetes. Hispanic women were 7.7 times more likely to develop diabetes if they had diabetes during pregnancy. Asian/Pacific Islander women were 6.3 times more likely to develop diabetes if they had a history of gestational diabetes.

The new findings suggest that a woman's race and ethnicity should be a factor during counseling about diabetes risk after pregnancy, Xiang says.  

Preventing Diabetes in African-American Women

John Buse, MD, PhD, chief of endocrinology at the University of North Carolina, Chapel Hill, says all women who develop diabetes during pregnancy should be screened for diabetes soon after delivery and at regular intervals thereafter.

Prevention is a must, he says.

Gianluca Iacobellis, MD, PhD, says African-American women are more prone to type 2 diabetes than some other racial/ethnic groups. Gestational diabetes is also a risk for type 2 diabetes, so this is two strikes right off the bat, he says. Iacobellis is an associate professor in the division of endocrinology, diabetes and metabolism at the University of Miami Miller School of Medicine.

If these women also have other risk factors for diabetes, such as a family history of diabetes or are overweight or obese, they should be counseled about their diabetes risk before they become pregnant, he says.

"They should be monitored more closely after pregnancy as well, but if they can change their lifestyle before or during pregnancy, we may be able to prevent gestational diabetes and type 2 diabetes," Iacobellis tells WebMD.