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Objectives <p>This study examined whether early postpartum insulin response patterns (&lt; 6 months) following a glucose load predict the emergence of abnormal glucose metabolism (AGM) in women who were previously diagnosed with gestational diabetes mellitus (GDM).</p> Methods <p>We conducted a prospective cohort study involving 308 women who had prior GDM. A 75-gram oral glucose tolerance test was administered to each participant within six months after delivery, and the participant’s insulin levels were measured at baseline, 30&#xa0;min, and 2&#xa0;h following glucose administration. Participants were categorized as having delayed insulin secretion (In2h ≥ In30min; <i>n</i> = 196) or a normal insulin response (In2h &lt; In30min; <i>n</i> = 112). Over an average follow-up period of 32.7 months, Cox proportional hazards models were employed to assess adjusted hazard ratios for AGM development.</p> Results <p>Among the 308 women, 153 (49.7%) developed AGM. The delayed insulin secretion group faced a significantly elevated risk (adjusted HR 1.739 [95% CI 1.141–2.649], <i>P</i> = 0.010). Other significant risk factors included elevated fasting glucose levels during pregnancy (adjusted HR 1.565 [95% CI 1.152–2.125], <i>P</i> = 0.004) and early postpartum hypertriglyceridemia (adjusted HR 1.448 [95% CI 1.029–2.039], <i>P</i> = 0.034).</p> Conclusions <p>A sluggish insulin response during the early postpartum phase is a robust predictor of future AGM in women with prior GDM.</p>

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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

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  • 发表日期：

    2026年1月27日

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  • Shuhui Liang,
  • Chenxue Wang,
  • Fenghua Lai,
  • Changliu Xu,
  • Xuejie Wang,
  • Nan Chen,
  • Yanbing Li,
  • Haipeng Xiao,
  • Xiaopei Cao

摘要

Objectives

This study examined whether early postpartum insulin response patterns (< 6 months) following a glucose load predict the emergence of abnormal glucose metabolism (AGM) in women who were previously diagnosed with gestational diabetes mellitus (GDM).

Methods

We conducted a prospective cohort study involving 308 women who had prior GDM. A 75-gram oral glucose tolerance test was administered to each participant within six months after delivery, and the participant’s insulin levels were measured at baseline, 30 min, and 2 h following glucose administration. Participants were categorized as having delayed insulin secretion (In2h ≥ In30min; n = 196) or a normal insulin response (In2h < In30min; n = 112). Over an average follow-up period of 32.7 months, Cox proportional hazards models were employed to assess adjusted hazard ratios for AGM development.

Results

Among the 308 women, 153 (49.7%) developed AGM. The delayed insulin secretion group faced a significantly elevated risk (adjusted HR 1.739 [95% CI 1.141–2.649], P = 0.010). Other significant risk factors included elevated fasting glucose levels during pregnancy (adjusted HR 1.565 [95% CI 1.152–2.125], P = 0.004) and early postpartum hypertriglyceridemia (adjusted HR 1.448 [95% CI 1.029–2.039], P = 0.034).

Conclusions

A sluggish insulin response during the early postpartum phase is a robust predictor of future AGM in women with prior GDM.