DIVINE NSW: Preventing Type 2 Diabetes among women who experience gestational diabetes

Background

• Gestational Diabetes Mellitus (GDM), once thought to be fully reversed after pregnancy, is now a firmly established independent risk factor for Type 2 Diabetes Mellitus (T2DM), cardiovascular disease and other chronic conditions.
• Given the high levels of risk, low-cost and scalable pharmacological preventive approaches may prove an effective tool for prevention of GDM.
• While there is strong rationale for preventive strategies focused on behavioural modification in women with prior GDM, the early years after pregnancy present unique challenges to mothers.

Aims

This study will:

• Measure prevalence and identify predictors of persisting abnormal blood sugar levels (dysglycaemia) among women with recent GDM.
• Identify women’s views and the views of their healthcare providers on the long-term risks of T2DM.
• Examine the feasibility of a randomised controlled trial of preventive drug therapies, in addition to lifestyle interventions, among this population.

Method

• One thousand women diagnosed with GDM from three Sydney Hospitals in the past four years will be identified and invited to participate.

Potential Impact

• Given the uncertainty of engagement with lifestyle interventions at this time of a mother’s life, DIVINE will add to understanding the viability of pharmacological approaches to prevent T2DM among this unique population.

Fast Facts

• In 2020–21, around 1 in every 6 women (49,000 women) who gave birth in hospital were diagnosed with GDM.¹
• The incidence rate for GDM increases with age, peaking at 31% for females aged 45-49.²
• The risk of T2DM in women with previous GDM is as high as 10-fold when compared to those without GDM.³

Reference

1, 2 Diabetes: Australian facts, Gestational diabetes - Australian Institute of Health and Welfare (aihw.gov.au), accessed February 2023.

3. Vounzoulaki et al. Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysis (bmj.com)BMJ 2020;369:m1361