Rawal S, et al. - This Diabetes & Women’s Health (DWH) study analyzed if gestational diabetes mellitus (GDM), independent of subsequent diabetes, served as an early risk factor for renal impairment long term after the index pregnancy. It was determined that women who developed GDM in pregnancy exhibited a greater tendency of illustrating increased estimated glomerular filtration rate (eGFR) levels at 9–16 years’ postpartum. This could point towards early stages of glomerular hyperfiltration and renal damage. Nonetheless, overt renal damage as evidenced by elevated urinary albumin-to-creatinine ratio (UACR) was demonstrated by only those who subsequently developed diabetes.

Methods

• Experts contemplated the independent and joint correlations of GDM and subsequent diabetes with long-term renal function among 607 women with and 619 women without GDM in the Danish National Birth Cohort (DNBC) index pregnancy (1996-2002).
• An estimation was conducted of the serum creatinine (mg/dL) and urinary albumin (mg/L) and creatinine (mg/dL) at median follow-up of 13 years after the index pregnancy, from which estimated glomerular filtration rate (eGFR) (mL/min/1.73 m2) and urinary albumin-to-creatinine ratio (UACR) (mg/g) were derived.

Results

• In contrast with women without GDM or subsequent diabetes, women with a GDM history illustrated substantially higher eGFR even if they had not subsequently developed diabetes (adjusted β-coefficient [95% CI] = 3.3 [1.7, 5.0]).
• Findings reported that women who had a GDM history and later developed diabetes (n = 183) exhibited markedly higher UACR [exponent β = 1.3 [95% CI 1.1, 1.6]) as well as an increased risk of elevated UACR (≥20 mg/g) [adjusted relative risk [95% CI] = 2.3 [1.1, 5.9]) vs women with neither.
• No link was discovered between GDM without subsequent diabetes with UACR after adjusting for potential confounders including prepregnancy BMI and hypertension.