Diabetes among Maori women with self-reported past gestational diabetes mellitus in a New Zealand Maori community

BackgroundGestational diabetes mellitus (GDM) is a risk factor for subsequent development of type 2 diabetes mellitus (T2DM). We have investigated the extent of this risk among Maori women without known diabetes. Materials and methodsWe recruited 2786Maori women aged 28-86years between 2004 and 2006, without diagnosed diabetes from the Waikato and Southern Lakes regions, via media, community and general practitioner channels, and invited them for an oral glucose tolerance test (OGTT). ResultsFifty (1.8%) women reported previous GDM (pGDM). The prevalence decreased significantly with age (P=0.009). Women aged <50years with pGDM had higher body mass index (35.66.7 vs 32.4 +/- 7.7kg/m(2), P<0.01), waist circumference (105.3 +/- 18.8 vs 96.9 +/- 16.6cm, P<0.01), fasting blood glucose (5.5 +/- 1.0 vs 5.1 +/- 0.8mmol/L, P0.01), two-hour post-prandial blood glucose (6.6 +/- 3.0 vs 5.6 +/- 2.1mmol/L, P<0.01) and HbA1c (6.0 +/- 0.8 vs 5.8 +/- 0.6%, P<0.05) than women without pGDM. PGDM was a significant risk factor for undiagnosed diabetes (odds ratio 4.0; (5% confidence interval 1.67-9.71). Undiagnosed diabetes was significantly more prevalent among women with than without pGDM aged <40years (20.0% vs 1.5%). ConclusionSelf-reported past GDM was a significant risk factor for undiagnosed diabetes in this Maori population, particularly among women aged <40years, highlighting the importance of targeting this group for more intensive screening.