β-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.