Beta-Cell Function Or Insulin Resistance Was Associated With The Risk Of Type 2 Diabetes Among Women With Or Without Obesity And A History Of Gestational Diabetes

Introduction To evaluate the single association of postpartum beta-cell dysfunction and insulin resistance (IR), as well as different combinations of postpartum beta-cell dysfunction, IR, obesity, and a history of gestational diabetes mellitus (GDM) with postpartum type 2 diabetes risk.Research design and methods The study included 1263 women with prior GDM and 705 women without GDM. Homeostatic model assessment was used to estimate homeostatic model assessment of beta-cell secretory function (HOMA-%beta) and homeostatic model assessment of insulin resistance (HOMA-IR).Results Multivariable-adjusted ORs of diabetes across quartiles of HOMA-%beta and HOMA-IR were 1.00, 1.46, 2.15, and 6.25 (p(trend)<0.001), and 1.00, 2.11, 5.59, and 9.36 (p(trend)<0.001), respectively. Women with IR only had the same diabetes risk as women with beta-cell dysfunction only. Obesity, together with IR or beta-cell dysfunction, had a stronger effect on diabetes risk. This stronger effect was also found for a history of GDM with IR or beta-cell dysfunction. Women with three risk factors, including obesity, a history of GDM and beta-cell dysfunction/IR, showed the highest ORs of diabetes.Conclusions beta-cell dysfunction or IR was significantly associated with postpartum diabetes. IR and beta-cell dysfunction, together with obesity and a history of GDM, had the highest ORs of postpartum diabetes risk.