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<p>While both individual- and neighborhood-level factors play a role in the progression from gestational diabetes mellitus (GDM) to type 2 diabetes mellitus (T2DM), few studies have simultaneously examined these two sets of factors. In this retrospective cohort study of 3567 women with a history of GDM, we used multilevel survival analysis to quantify T2DM risk associated with patient-level and neighborhood-level factors. During a mean follow-up of 2.2&#xa0;years, 195 women (5.5%) developed T2DM. Statistically significant risk factors of T2DM progression included Black or Asian race, preeclampsia, family history of diabetes, and overweight or obesity. Importantly, residing in neighborhoods with a top tertile social deprivation index was also associated with increased risk (HR = 1.78, 95% CI: 1.01–3.14). In addition, after accounting for other factors, the residual clustering associated with neighborhoods conferred a 19% higher risk. Interventions addressing both individual- and neighborhood-level factors, including socioeconomic disparities, are critical to reducing the risk of T2DM in women with GDM.</p>

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Factors Associated with Progression to Type 2 Diabetes among Women with Gestational Diabetes

  • 期刊论文

  • 发表日期：

    2025年8月1日

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  • Junxiu Liu,
  • Chen Yang,
  • Bian Liu,
  • Ryung Kim,
  • Athena Philis-Tsimikas,
  • Carmen Isasi,
  • Diana Wolfe,
  • Carol Levy,
  • Jee-Young Moon,
  • Lihua Li

摘要

While both individual- and neighborhood-level factors play a role in the progression from gestational diabetes mellitus (GDM) to type 2 diabetes mellitus (T2DM), few studies have simultaneously examined these two sets of factors. In this retrospective cohort study of 3567 women with a history of GDM, we used multilevel survival analysis to quantify T2DM risk associated with patient-level and neighborhood-level factors. During a mean follow-up of 2.2 years, 195 women (5.5%) developed T2DM. Statistically significant risk factors of T2DM progression included Black or Asian race, preeclampsia, family history of diabetes, and overweight or obesity. Importantly, residing in neighborhoods with a top tertile social deprivation index was also associated with increased risk (HR = 1.78, 95% CI: 1.01–3.14). In addition, after accounting for other factors, the residual clustering associated with neighborhoods conferred a 19% higher risk. Interventions addressing both individual- and neighborhood-level factors, including socioeconomic disparities, are critical to reducing the risk of T2DM in women with GDM.