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Development of diabetes in women with gestational diabetes during pregnancy - a national study in Croatia

Background: Women burdened with gestational diabetes (GD) during pregnancy are at risk of developing diabetes later in life and the occurrence rate is highest in the first 5 years after pregnancy. The aim of this study was to determine the prevalence of diabetes in women 5 years after having gestational diabetes diagnosed in pregnancy. Material and methods: This longitudinal study was performed using data from medical birth certificates and CroDiab diabetes registry. Women burdened with GD in 2011 were identified and followed up until year 2016. Those registered in CroDiab registry were recognised as new diabetics. Age at the end of follow-up, body mass index (BMI) before pregnancy, level of education and marital status was analysed. Women with GD who were not followed up after childbirth due to lack of identification (ID) number were compared to followed up. Statistical analyses was performed using SAS Enterprise Guide ver. 7.1. Results: Among 40641 deliveries in 2011, 1181 (2.9%) women had reported GD. Among them 853 (72.23%) were identified and followed up in CroDiab diabetes registry. None of them died during the follow up period and 32 (3.75%) were identified as new diabetics. Mean time from childbirth to onset of diabetes was 26.85±2.45 months. The groups did not significantly differ according to age (p=0.587), level of education (p=0.549) or marital status (p=0.849) while the diabetes group was significantly more obese than non diabetic group before pregnancy (p=0.002). Furthermore, 328 women who were not followed up in CroDiab diabetes registry did not differ significantly compared to followed up GD women concerning age (p=0.185) and BMI (p=0.914). Conclusions: Based on CroDiab diabetes registry data prevalence of diabetes 5 years after pregnancy complicated with GD is 3.75% in Croatia which seems to be less than in previously published studies. However, underreporting should be kept in mind possibly affecting the results. Women who develop diabetes after GD in pregnancy have higher BMI so preventive measures and education should be especially oriented toward obese women who have GD during pregnancy. Furthermore, additional efforts should be made to raise public awareness of long-term squeals of GD during pregnancy.

gestational diabetes, diabetes, prevalence

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