ArticleDiabetologia2023
Deteriorating beta cell function is the dominant determinant of progression from normal glucose tolerance to prediabetes/diabetes in young women following pregnancy.
Article in Diabetologia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 20 citations in OpenAlex.
- Empagliflozin for the preservation of beta-cell function in women with recent gestational diabetes: A randomized placebo-controlled trial.Diabetes, obesity & metabolism · 2025Trial
- How the First 9 Months Shape the Rest of Your Life: The Impact of Gestational Diabetes on the Metabolic Future.Diabetes, obesity & metabolism · 2026Review
- Social determinants of health and recommended A1C monitoring among women with postpartum-onset diabetes: results from a retrospective cohort.BMJ open diabetes research & care · 2026Article
- Risks of cardiometabolic diseases in women with history of adverse pregnancy outcomes.Journal of human hypertension · 2026Review
- Delayed insulin secretion in the early postpartum period is associated with future abnormal glucose metabolism among women with a history of gestational diabetes mellitus: a prospective cohort study.BMC pregnancy and childbirth · 2026Article
- Age at type 2 diabetes onset, HOMA-derived indices and risks of diabetic retinopathy: a real-world cross-sectional study.Frontiers in endocrinology · 2026Article
- Regression from prediabetes to normoglycaemia and the role of cardiometabolic risk factors on the subsequent risk of developing type 2 diabetes.Diabetologia · 2026Article
- Postpartum weight retention and the early evolution of cardiovascular risk over the first 5 years after pregnancy.Cardiovascular diabetology · 2024Observational
- Article
- Implementing care for women with gestational diabetes after delivery-the challenges ahead.Frontiers in global women's health · 2024Review
- Future cardiometabolic implications of insulin hypersecretion in response to oral glucose: a prospective cohort study.EClinicalMedicine · 2024Article
- Therapeutic potential of adiponectin in prediabetes: strategies, challenges, and future directions.Therapeutic advances in endocrinology and metabolism · 2024Review
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
aims/hypothesisExcess adiposity, insulin resistance and beta cell dysfunction each contribute to the development of prediabetes (impaired glucose tolerance and/or impaired fasting glucose)/diabetes but their comparative impact in relation to one another remains uncertain. We thus ranked their contributions to incident dysglycaemia over the first 5 years postpartum in women reflecting the full spectrum of gestational glucose tolerance (spanning normoglycaemia to gestational diabetes) and hence a range of future diabetic risk.
methodsIn this study, 302 women with normal glucose tolerance (NGT) on OGTT at 3 months postpartum underwent repeat OGTT at 1 year, 3 years and 5 years, enabling serial assessment of glucose tolerance, insulin sensitivity/resistance (Matsuda index, HOMA-IR) and beta cell function (insulin secretion-sensitivity index-2 [ISSI-2], insulinogenic index [IGI]/HOMA-IR). Determinants of prediabetes/diabetes were ranked by change in concordance index (CCI) of Cox proportional hazard regression models.
resultsOver 5 years of follow-up, 89 women progressed from NGT to prediabetes/diabetes (progressors). At 3 months postpartum, though all women were normoglycaemic, future progressors had higher fasting glucose (p=0.03) and 2 h glucose (p<0.0001) than non-progressors, coupled with higher BMI (p=0.001), greater insulin resistance (both Matsuda index and HOMA-IR, p≤0.02) and poorer beta cell function (both ISSI-2 and IGI/HOMA-IR, p≤0.006). Unlike their peers, progressors exhibited deteriorating beta cell function from 1 year to 5 years (both p<0.0001). On regression analyses, the dominant determinants of progression to prediabetes/diabetes were time-varying ISSI-2 (change in CCI 25.2%) and IGI/HOMA-IR (13.0%), in contrast to time-varying Matsuda index (2.9%) and HOMA-IR (0.5%). Neither time-varying BMI nor waist were significant predictors after adjustment for beta cell function and insulin sensitivity/resistance. CONCLUSION/
interpretationDeclining beta cell function is the dominant determinant of incident prediabetes/diabetes in young women following pregnancy.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.