Pensee Wu p.wu@keele.ac.uk
Pre-eclampsia is associated with a twofold increase in diabetes: a systematic review and meta-analysis
Wu, Pensee; Shing Kwok, Chun; Haththotuwa, Randula; Kotronias, Rafail A.; Babu, Aswin; Fryer, Anthony A.; Myint, Phyo K.; Chew-Graham, Carolyn A.; Mamas, Mamas A.
Authors
Chun Shing Kwok
Randula Haththotuwa
Rafail A. Kotronias
Aswin Babu
Professor Anthony Fryer a.a.fryer@keele.ac.uk
Phyo K. Myint
Carolyn Chew-Graham c.a.chew-graham@keele.ac.uk
Mamas Mamas m.mamas@keele.ac.uk
Abstract
Aims/hypothesis: Pre-eclampsia is a pregnancy-specific multi-system disorder and a state of physiological insulin resistance. Our aim is to systematically evaluate and quantify the evidence on the relationship between pre-eclampsia and the future risk of diabetes. Methods: We conducted a systematic review and meta-analysis of studies that evaluated diabetes in women with and without pre-eclampsia. We performed a systematic search of MEDLINE and EMBASE to identify relevant studies. Independent double data extractions were conducted by four reviewers. Random effects meta-analysis was used to estimate the risk of future diabetes following pre-eclampsia. Results: Twenty-one studies were identified with over 2.8 million women including >72,000 women with pre-eclampsia. Meta-analysis of studies that adjusted for potential confounders demonstrated that pre-eclampsia was independently associated with an increased risk of future diabetes (risk ratio (RR) 2.37, 95% CI 1.89, 2.97). This risk appeared in studies that followed up women from <1 year (RR 1.97, 95% CI 1.35, 2.87) and persisted to over 10 years post-partum (RR 1.95, 95% CI 1.28, 2.97). After adjusting for BMI or gestational diabetes, pre-eclampsia was linked with an increased risk of future diabetes (RR 2.38, 95% CI 1.74, 3.24) or (RR 2.36, 95% CI 1.94, 2.88), respectively. Conclusions/interpretation: Pre-eclampsia is independently associated with a two-fold increase in future diabetes. Our study highlights the importance of clinical risk assessment for the future development of diabetes in women with pre-eclampsia. We recommend detailed evaluation of a screening programme for diabetes in this high-risk population.
Citation
Wu, P., Shing Kwok, C., Haththotuwa, R., Kotronias, R. A., Babu, A., Fryer, A. A., Myint, P. K., Chew-Graham, C. A., & Mamas, M. A. (2016). Pre-eclampsia is associated with a twofold increase in diabetes: a systematic review and meta-analysis. Diabetologia, 59, 2518-2526. https://doi.org/10.1007/s00125-016-4098-x
Journal Article Type | Article |
---|---|
Acceptance Date | Aug 4, 2016 |
Online Publication Date | Sep 19, 2016 |
Publication Date | 2016-12 |
Publicly Available Date | May 26, 2023 |
Journal | Diabetologia |
Print ISSN | 0012-186X |
Electronic ISSN | 1432-0428 |
Publisher | Springer Verlag |
Peer Reviewed | Peer Reviewed |
Volume | 59 |
Pages | 2518-2526 |
DOI | https://doi.org/10.1007/s00125-016-4098-x |
Keywords | Diabetes mellitus, Meta-analysis, Pre-eclampsia, Risk predictors, Screening, Systematic review |
Public URL | https://keele-repository.worktribe.com/output/406664 |
Publisher URL | http://dx.doi.org/10.1007/s00125-016-4098-x |
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